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Biomedical subjects

G Etienne

Publications and source records attributed to G Etienne.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Role of surgery in the treatment of diffuse hyperthyroidisms].

A prospective study was set up to help in the choice of treatment for diffuse hyperthyroidism: antithyroid drugs, radioactive iodine or surgery? Over a 20-year period 477 patients with diffuse hyperthyroidism were operated upon and followed up every year. Early complications were uncommon; permanent functional sequelae, usually not troublesome, were observed in only 1.8 percent of the cases. The endocrine status obtained remained stable beyond 2 years in 98 percent of the patients. Ten years after surgery, failure or relapse were recorded in 3 percent of the cases, hypothyroidism in 27 percent and euthyroidism in 78 percent. These results appear to be better than those of the other methods reported in the literature. Antithyroid drugs expose to relapse in 50 percent of the cases. With radioactive iodine, the cumulative incidence of hypothyroidism is 3.6 percent per year and 100 percent in 30 years. The recent preference for non-surgical therapeutic methods does not seem to be soundly founded. Except when diffuse hyperthyroidism occurs in adolescents or in elderly or high surgical risk adults, surgery performed by a well-trained multidisciplinary team deserves to be considered.

Adolescent↗
PubMed1990

A screening method for antifungal substances using Saccharomyces cerevisiae strains resistant to polyene macrolides.

Strains of Saccharomyces cerevisiae FL200 capable of growing on a solid medium containing a mixture of polyene macrolide antibiotics (nystatin, 40 micrograms/ml, amphotericin B, 40 micrograms/ml, pimaricin, 150 micrograms/ml and RP9971 antibiotic, 10 micrograms/ml) have been isolated after successive selection steps. The mutant strains, PR13 and PRC24, are 10 to 100 times more resistant than the polyene macrolide antibiotics. When 4% Tween 80 is added to the medium, resistance to these antifungal drugs is further increased. In addition, strain PRC24, derived from strain PR13, is resistant to a non-polyene macrolide antifungal antibiotic, cycloheximide. In contrast, PR13 and PRC24 are both highly susceptible to a large range of compounds, including non-polyenic antifungal, antitumor and antibacterial agents. These particular characteristics make these strains useful for the rapid detection of antifungal compounds of the polyene macrolide and cycloheximide types, as well as for the recognition of antimitotic substances.

Anti-Bacterial Agents↗
PubMed1990

[Postoperative vascular infections. A pathognomonic x-ray computed tomographic sign].

The potential gravity of post-operative vascular infection makes early diagnosis essential. We report a case where this diagnosis was made on CT findings alone, in the absence of any other signs of infection. Rapid intervention led to complete cure. Beyond the immediate post-operative period, the presence of gas on the CT scan is rare but pathognomonic in the absence of a cutaneous fistula. The presence of this sign is therefore sufficient to indicate that reintervention is mandatory.

Aged↗
PubMed1990

[Surgical treatment of associated bronchial, upper respiratory and digestive tract cancers].

Between 1980 and 1987, 63 lung cancers associated with upper aero-digestive tract carcinomas were operated on 50% of the primary malignancies of the upper aero-digestive system were laryngeal. These tumors developed synchronously in 13% and metachronously in 87%. The operative mortality rate was 3%. The five years survival rate was 30%. Our results were found identical to those observed in a single lung cancer series. Coin lesion of the lung should be therefore considered as a second primary cancer. Thus, the best treatment is surgical resection. When the option exist, the lung cancer should be treated before the upper airway cancer to avoid the impact of previous irradiation and/or surgical treatment of the upper airway cancer upon the post-thoracotomy management.

Adult↗
PubMed1990

[Esophago-bronchial fistula in adults].

The authors report five cases of benign oesophago-bronchial fistula in adults. These chronic bronchitic patients presented with recurrent episodes of secondary lung infections (or even haemoptysis). Questioning of the patients revealed a history of coughing when swallowing liquids in three cases. Two women concealed this symptom, which was only revealed retrospectively. The fistula was detected by upper GI series in three cases and by oesophageal fibroscopy in one case. In the remaining case, it was discovered at operating for severe haemoptysis. In four of the five cases, the fistula was situated on the right and was of post-tuberculous origin. In one case of post-traumatic fistula, it involved the left main bronchus. All of the patients were operated: a resection-suture of the fistula was performed via the oesophageal approach and, via the bronchial approach, simple suture of the fistula was possible in two cases, while resection of the destroyed pulmonary parenchyma was necessary in three cases (one right lower lobectomy, two bilobectomies). Demonstration of the oesophago-bronchial fistula, definition of its site and assessment of the condition of the pulmonary parenchyma are essential steps to be performed prior to surgery.

Adult↗
PubMed1990

[Natural and corrected history of obliterative radiation arteritis. Apropos of 14 case reports].

Analysis of a series of 14 cases of obliterative radiation arteriopathy was carried out in order to study the clinical features, symptomatology and the results of appropriate therapy. This demonstrated that the diagnosis is often missed due to the time interval since radiation and that on the contrary the diagnosis should only be considered in precise circumstances in terms of the delay and localisation superimposed on the irradiated zone with respect of other non-irradiated zones. Diagnosis requires double investigation both in terms of the arterial disease and associated post-radiation lesions and also in terms of the malignant disease, its progression and treatment. Arterial surgery is fraught with difficulty due to sclerosis and other specific problems: skin closure problems, and in the case of a prosthesis, anastomotic breakdown and superinfection. These dangers should not be underestimated even if in the series presented there were no serious postoperative complications. The indication for surgery should therefore be carefully considered: best avoided in asymptomatic forms, dilatation for short lesions and revascularisation for widespread and symptomatic lesions, while choosing the most appropriate revascularisation procedure. Radiation arteritis should be better understood by radiotherapists who should pay attention to preventive measures and advise systematic screening after three years.

Adult↗
PubMed1989

[Treatment of hydrothorax in patients with cirrhosis using a peritoneo-jugular shunt].

Two cirrhotic patients with massive hydrothorax associated with ascites resistant to medical management were treated by insertion of peritoneovenous shunt. In each case the hydrothorax resolved within 2 to 4 months after shunt insertion. This treatment was still successful 10 to 26 months after surgery. The peritoneovenous shunt is an alternative to medical therapy for large effusions. Its effectiveness in resolving them supports the idea that diaphragmatic defects are involved in their formation.

Adult↗
PubMed1989

[Bronchial cancer associated with upper respiratory and digestive tract cancers].

The authors report a series of 63 cases, all operated, of bronchial cancer associated with upper airway cancer. The laryngeal portion of the upper airways was the site of cancer in 50% of cases. The two cancers occurred synchronously in 13% and at different times in 87% of cases. Operative mortality was 3%. Post-operative complications were dominated by bronchopulmonary congestion. Long-term survival was similar to that in series of operated bronchial cancer alone and was 70% at one year and 30% at five years. These results should lead to all isolated pulmonary lesions being considered as second primary cancers with early surgical resection being proposed.

Adult↗
PubMed1988

Crystal structure determination and refinement of pike 4.10 parvalbumin (minor component from Esox lucius).

The crystal and molecular structure of the minor component of pike parvalbumins has been determined at 1.93 A resolution by molecular replacement (1 A = 0.1 nm). The crystals are orthorhombic, space group P2(1)2(1)2 with a = 59.62 A, b = 59.83 A and c = 26.35 A. A location of the secondary cation binding site is proposed for this parvalbumin of the beta phylogenetic series.

Amino Acid Sequence↗
PubMed1988

Operation for hyperthyroidism. Methods and rationale.

Five hundred patients with hyperthyroidism underwent operation between 1970 and 1984. Sixty-nine percent had Graves' disease, 19 percent had toxic thyroid adenoma, and 12 percent had multinodular toxic goiter. Good results were achieved in the 275 patients most recently treated. These results may be attributed to the following: good personal contact between the surgeon and the patient at the first meeting, 1 month of preoperative management with carbimazole and propranolol without interruption of work, operation adapted to the type of goiter, and treatment of postoperative tachycardia by propranolol. The mean duration of hospital stay was 5 days. Sequelae were rare. In the patients with Graves' disease, results at 2 years were as follows: 74 percent of operated patients were euthyroid, 23 percent required substitutive treatment, and surgical treatment failed or early relapse occurred in 3 percent. There were no recurrences after operation in patients with solitary or multinodular toxic goiter, but 30 percent of the former and 98 percent of the latter had to be treated with L-thyroxine. Seventy-two percent of the patients who presented with atrial fibrillation had return of normal cardiac rhythm after operation.

Adenoma↗
PubMed1988

A simple screening method for insecticidal substances from actinomycetes.

A simple and selective assay system was developed in the search for new insecticidal substances from Actinomycetales strains propagated on solid culture media. The strains were first tested for their ability to produce antimicrobial compounds. Only strains displaying weak or no activity were retained and screened in the insecticidal bioassay. Microbial solid cultures were given as food to larvae and to adults of Musca domestica to detect insecticide producers. A second phase, after extraction of the active compounds, consisted of an evaluation of the insecticidal potency and a primarily biological identification of the products synthesized by the selected strain. Of 6,280 actinomycete strains which were screened, 47 were active but only 30 of these were finally chosen in the second phase of screening. All these strains, except one, produced known metabolites such as piericidins, avermectins or valinomycin. The one strain, CL307-24, and its insecticide products appeared novel and will be the topic of further study.

Actinomycetales↗
PubMed1988

[Surgery of primary hyperparathyroidism in 1988. Strategies during primary operations, in case of failure and in case of cancer].

In primary hyperparathyroidism, an operation is indicated when the calcemia exceeds 115 mg/l and phosphoremia is low in several successive instances, regardless of the symptoms, even if PTH levels and cervical ultrasonography are normal. In case of calcemia under 110 mg/l, the diagnosis must be confirmed by titration of the nephrogenic cyclic AMP and symptomatic patients must be operated upon as well as asymptomatic patients with a life expectancy exceeding 10 years. In case of acute hypercalcemia, the procedure must be performed as a semi-emergency without waiting for a definite diagnosis, since the course may rapidly be fatal in spite of all medical treatments. Ultrasonography mostly presents the advantage of detecting intrathyroid parathyroids glands. The experience of the surgeon is essential for the mandatory locating of 4 glands, and the choice of the surgical strategy. In front of a secondary indication for failure or recurrence, one must take into consideration what was seen and done during the first procedure, the calcemia levels and clinical, radiological or biological consequences. Finally, in case of cancer (2 p. cent), the best prognosis rests in wide excision of the thyroid compartment and nodes areas, since medical treatments and radiation therapy are ineffective.

Female↗
PubMed1988

[Ultrasonography and x-ray computed tomography in the diagnosis of intra-abdominal textiloma. Apropos of 12 cases].

Feared by every surgeon, retained surgical sponges (or gossypiboma) are rare iatrogenic entities. Ultrasonography and computed tomography are very valuable, providing an immediate answer in the majority of cases. We report 12 cases of intra-abdominal retained surgical swabs. The ultrasonic pattern was made whether of a large poorly echogenic mass with a hyper-echogenic center and sharply delineated posterior acoustic shadow (7 cases) or of a large acoustic shadow posterior to a solitary highly echogenic area (4 cases). Computed tomography demonstrated whether large peripherally enhanced cystic mass associated with serpiginous or spongiform central area (5 cases) or heterogeneous abscess-like fluid mass.

Abdomen↗