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Biomedical subjects

J Bellamy

Publications and source records attributed to J Bellamy.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Caustic stenosis of the esophagus in Libreville. Results of the surgical treatment].

41 cases of caustic stenosis of the oesophagus were treated surgically by the thoracic and visceral surgical teams of La Fodation Jeanne Ebori and L'Hopital Pédiatrique d'Owendo in Libreville. The lesions were due to bleach ingestion in 38 cases, caustic soda in 2 cases and sulfuric acid in 1 case. Ingestion was an accident in 29 cases and voluntary in 12. There were 32 men and 9 women. Among them, there were 32 infants and 9 adults. The mean age was 4.5 years for the infants and 25 years for the adults. The surgical procedures were gastrostomy, followed by dilatations of the stenosis in 19 cases, esophagoplasty using the stomach, with pyloroplasty and jejunostomy in 4 cases, and gastrostomy associated with esophagoplasty using the colon in 18 cases. Mortality rate was 2.4%. It was about 1 patient, from general causes. Cervical or thoracic fistulae occurred in 4 patients, all of them successfully treated by medical means, and 3 patients had regressive pulmonary infections. The mean follow-up was 4 years, with good results. The authors suggest a surgical attitude in the management of caustic stenosis, every time the medical management is unsuccessfull.

Adolescent↗
PubMed1992

[Tumors of the mediastinal nerves. Diagnosis and possibilities of conservative surgery. Apropos of 2 cases].

Two new cases of tumour of nerves running in the mediastinum are reported; one was a schwannoma of the right phrenic nerve, the other a schwannoma of the vagus nerve. In both cases the diagnosis was suspected on the basis of computed tomography scans. Treatment consisted of nerve-sparing tumour enucleation. The result was incomplete in the first patient, with partial paralysis of the diaphragm, and complete in the second patient, with no disturbance of pharyngeal motility. The authors discuss the diagnosis of these tumours and the validity of nerve-sparing surgery.

Cranial Nerve Neoplasms↗
PubMed1991

[Arterial stenosis in the renal graft. Indication for endoluminal dilatation].

One hundred and thirty eight patients with renal transplant artery stenosis were reported in a series of 1200 renal transplants. These cases included 47 patients in whom hypertension was well controlled by means of hypotensive drugs, 39 patients treated by surgical repair (SR) and 49 treated by percutaneous angioplasty (PTA). The long-term success rate was 81.5 percent in the SR group compared with 40.8 percent in the PTA group. PTA morbidity was greater than that of SR, and we believe that after the initial optimism, the results of this technique should be reevaluated according to the anatomical pattern of the renal artery stenosis.

Adolescent↗
PubMed1991

[Urologic complications in kidney transplantations. Indication for endo-urologic techniques].

We report the incidence of urological complications in a series of 1,200 kidney transplant: 3.8 percent of the patients developed a urinary fistula, due to ureteral necrosis in 48 percent of cases, and 6.5 percent had urinary obstruction. Urinary fistulas are early complications appearing 20 days after the transplantation, while obstructions appear about one year after grafting. These complications are now usually treated by percutaneous and/or endoscopic techniques.

Anastomosis, Surgical↗
PubMed1991

[Late post-pneumonectomy hematogenous pyothorax. Apropos of 3 cases].

The authors describe three cases of patients who had previously undergone a pneumonectomy (two for cancer, one for bronchiectasis) with a favourable postoperative course, who subsequently developed pyothorax in the thoracic cavity. The bacteria isolated where in the first patient, Pasteurella Multocida; in the second, Campylobacter foetus foetus; in the third, a variety of anaerobic organisms. The characteristic of the organisms allow us to exclude the possibility that these cases of pyothorax were due to a contamination during the operation, in favour of transient bacteraemia with contamination of the fluid of the thoracic cavity. In a patient who has undergone pneumonectomy (as in patients with a joint or valve prosthesis) it is important to avoid (or to treat early) any infections which could give rise to bacteraemia, especially dental infections.

Adult↗
PubMed1990

[Autosomal dominant polycystic kidney in adults and transplantation].

Seventy-six patients with polycystic kidneys were followed in the Bicêtre renal transplantation unit. Fifty four were transplanted. Fifty two nephrectomies were performed in these patients essentially because of the size of the kidney and for renal infections. Fifty four patients were transplanted at a mean of 44 years. The actuarial survival of the patients at one year and at three years was 92% and 88% and the actuarial survival of the grafts at one year and at five years was 87% and 71%. These results are comparable to those obtained in other patients transplanted in the unit. Pre-transplantation nephrectomy and the patient's age do not aggravate the prognosis. Nephrectomy may be justified in these patients when they must be transplanted as transplantation currently gives very good results.

Adult↗
PubMed1989

[The destroyed lung. Apropos of 46 surgical patients].

The authors report the results of a retrospective study of 46 patients operated upon for lung destruction of various origins. The main points that emerged were: (1) this type of pathology is regressing in France but persists in North Africa and Black Africa; (2) tuberculosis is the predominant cause of lung destruction; (3) superinfection with aspergillosis is frequent and must always be looked for; (4) surgery is difficult, especially pleuropneumonectomy for tuberculosis or its sequelae which has numerous complications (e.g. haemorrhage and pyothorax) responsible for a high mortality rate in this and other published series. However, in all patients operated upon for complications of lung destruction, when cure was obtained it was complete and permanent.

Adolescent↗
PubMed1989

[False pulmonary metastases. Apropos of 8 cases].

The authors report the cases of 8 patients who had been, or were being, treated for pharyngo-laryngeal carcinoma (n = 7) or cancer of the bladder (n = 1). Because of the finding of one or several peripheral pulmonary opacities, these patients underwent exploratory thoracotomy which showed that these opacities corresponded to benign lesions instead of metastases of these cancers. This leads to a reappraisal of the diagnostic approach of pulmonary opacities in patients with known cancer, since benign lesions unrelated to the malignancy cannot be excluded. The need for an accurate diagnosis of these intrapulmonary lesions is emphasized, using various exploratory methods including thoracotomy if required.

Adult↗
PubMed1989

[Aspergillosis and radiation-induced pneumonia. What relationship? Apropos of 2 cases].

The authors report the cases of 2 patients who underwent lobectomy followed by irradiation for lung cancer and subsequently developed an aspergillus-infected cavity in the irradiated lung parenchyma. It is far from certain that aspergillosis must always develop in a pre-existing cavity. In cases where it developed on post-radiotherapy lung lesions, our 2 patients and a review of the literature encline us to believe that the fungus itself is responsible for the formation of cavities in lesions of radiation pneumonia. Treatment of such disease can only be surgical, and in spite of post-irradiation and post-surgery sclerosis, elective excision of the lesions is the best solution.

Adult↗
PubMed1988

[Surgery ex situ in kidney transplantation].

123 vascular surgical procedures were performed ex situ in the course of 534 renal transplantations performed between 1982 and 1987. This study demonstrates that the elongation of the renal vein facilitates the transplantation and significantly reduces the risk of arterial stenosis and that arterial repairs, in the case of multiple arteries, constitute a reliable technique. The elongation of the renal vein means that all donor right kidneys must be procured with the infra-renal inferior vena cava. Donor kidneys with multiple arteries without patch graft can be repaired on the table in the great majority of cases.

Humans↗
PubMed1988

Multiple drug combinations with "low-dose" cyclosporin for renal transplantation. Multivariate analysis of risk factors determining short-term graft survival within one renal transplant center.

The factors affecting graft survival in transplant recipients receiving cyclosporin (CsA) are still being debated. Our report is based on an analysis of 202 successive transplantations performed in our institution from May 1984 to December 1986, using low-dose CsA as the basic means of immunosuppression. A total of 142 patients received the triple combination CsA, azathioprine (AZA), and corticosteroids. Sixty patients received a prophylactic combination of CsA, corticosteroids, and antilymphocyte globulins (ALG). From January to December 1986, both regimens were compared in a prospective randomized trial. The factors that affect graft survival were analyzed using the Cox multivariate hazard analysis. The relative risks were calculated for pretransplant baseline risk factors and for outcome-dependent post-transplant risk factors for surviving grafts at 1 month. Transplants performed with a prolonged ischemia time and patients whose graft did not function immediately were statistically at higher risk of graft loss. Adding prophylactic ALG to CsA was associated with better graft survival. Patients who experienced more than 1 rejection crisis and patients whose 1-month CsA dose was lower than or equal to 5 mg/kg per day were also at significantly higher risk of further graft loss. Neither HLA matching, peak panel reactivity, age of the recipient, occurrence of post-transplant renal dysfunction nor 1-month renal function affected the short-term graft outcome.

Adrenal Cortex Hormones↗