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Biomedical subjects

J Guitard

Publications and source records attributed to J Guitard.

At least 55 records · Page 3Linked to original sources
PubMed1988

[Value of magnetic resonance imaging in the follow-up of children operated for portal hypertension].

The authors report their experience concerning nuclear magnetic resonance imaging (NMR) in 7 children. They emphasize its importance in the post-operative study of portal hypertension. All those children got surgically created porto-systemic shunts. NMR imaging is easy, safe and trustable. It is able to visualise the shunt itself and to demonstrate the patency of this shunt. So, it is interesting when the usual controls have failed, particularly abdominal ultrasonography.

Adolescent↗
PubMed1988

[110 surgical arteriovenous fistulas in 89 children].

110 arteriovenous fistulas made for hemodialysis, chemotherapy and extended parenteral nutrition are studied. For authors, the side-end radial arteriovenous fistula is the main used, followed by the humero-basilic shunt. The immediately functional fistula's percentage was of 81% with a net progress in the last year since it is now at 92%. Thrombosis prevails in early complications. 32% of delayed complications are minutely studied. They include thrombosis, infections, trophic disturbance of hands, secondary stenosis, hyper-flow with cardiac consequences. Others more unusual delayed complications are described ("Stealing" syndrome, no venous distention, bleeding, pseudo-aneurysm). The authors advice the side-end arteriovenous fistula for hemodialysis and humero-basilic shunt with immediately basilic superficialization for infant's hemodialysis, for chemotherapy and parenteral nutrition.

Adolescent↗
PubMed1985

[Value of the assay of cholinesterase activity in superficial biopsies of the rectum in the diagnosis of Hirschsprung's disease].

Cholinesterase activity have been estimated in rectal biopsies of 19 children with Hirschsprung's disease and 80 normal children. A high level of acetyl-cholinesterase is a strong argument for the diagnosis of aganglionosis. However the ratio acetylcholinesterase over butyrylcholinesterase seems to be a better sign allowing a right diagnosis in 99% of the cases.

Biopsy↗
PubMed1985

[Esophageal stenosis with tracheo-bronchial heterotopy. Apropos of 3 cases].

Three cases of esophageal stenosis with tracheo-bronchial remnants within the wall of the esophagus, near the cardia, are reported: two girls and one boy; in three, this anomaly contains cartilage remnants. After various procedures, esophagoplasty was necessary when the boy of the first case was fourteen. Two girls was cured by a Thal procedure with follow-up of five and four years respectively. A survey of the references found 43 other cases. This anomaly is more frequent in girls. Tracheo-bronchial remnants are located usually in the esophagus near the cardia and contains cartilage. Rarely the respiratory inclusion is seen in the middle part of the esophagus and no cartilage is then identified. The stenotic segment is lined by squamous cell epithelium and the heterotopic tracheo-bronchial structures are intramural implants. The diagnosis should be suspected in cases of esophageal obstruction presenting in childhood or adult life with a history dating back to infancy or childhood. Radiologically a short stenotic non relaxing segment is the hallmark in the distal esophageal localisation. Resection of the stenotic segment with primary anastomosis is the method of choice in the middle part of the esophagus. That procedure is a good alternative in the distal esophagus.

Adolescent↗
PubMed1984

The ureterovesical junction.

The ureterovesical junction was studied by dissection and serial sections in 50 post mortem specimens. Three points are considered in this paper: the structure of the terminal ureter, the anatomical arrangement of the ureteral hiatus and the ureteral sheath. Study of the structure of the intramural segment of the ureter demonstrated on one hand, the perfect continuity of the terminal ureter with the trigone and on the other hand, the abundance of the fibroelastic connective fibers which like the muscle fibers run longitudinally. The compliance of the intravesical ureter is dependent on the balance between these two components. The modification of this balance can lead to the creation of a functional obstacle. The anatomical arrangement of the ureteral hiatus is described. The inner muscle layer of the detrusor extends almost to the ureteral orifice, the truly submucosal part of the ureter thus being very small. The constitution of the ureteral orifice and its relations to the ureter account for the different positions of juxtaureteral diverticula and transhiatal herniae of the bladder mucosa. The many descriptions of the ureteral sheath appearing in the literature are reviewed in light of the findings from the present study. The juxtavesical segment of the ureter is surrounded by a fibroconjunctive sheath which fixes the ureter to the bladder wall. The transparietal segment of the ureter is ensheathed in its adventitia, whereas a fibromuscular sheath cannot be truly individualized over this ureteral segment.

Adolescent↗
PubMed1983

[Mesocaval H shunt using an external iliac graft in the treatment of portal hypertension in children].

The authors reported four cases of mesocaval interposition shunt in children with autogenous vein graft. In three cases, external iliac vein was used as the graft because its appropriate size in diameter and length; for local reasons, jugular graft was used in last case. Post-operative controls by angiography in all patients except the one recent case showed a patent anastomosis; esophago gastric endoscopy three month post operatively in the last case showed regression of varices. External iliac vein is convenient to this shunt. Edema of the lower limb is minimal and well tolerated. The control of hypersplenism and esophogastric varices is progressive with time.

Adolescent↗
PubMed1983

[Treatment of anterior hypospadias. Place of balanoplasty].

Authors report their experience of the treatment of anterior hypospadias which represent more than 71% of these cases operated all along the eight past years. The different aspects of these malformation are emphasized. For the majority of these cases the correction of the malformation may be obtained by a simple balanoplasty which gives the gland a normal form and height though directing the meatus forward; the redundant foreskin is excised and the penile skin torsion is corrected aligning the median raphe; a deficit of the ventral skin case be filled in with preputial flaps. This technic was used in fifty of the reported cases with very good results both functionally and cosmetically. This procedure is comparable to the technic described by J.W. Duckett and called Magpi for meatal advancement and glanduloplasty incorporated. The results reported here corroborate the good results already published.

Humans↗
PubMed1983

[Treatment of anterior hypospadias. Balanoplasty].

The authors present their experience of balanoplasty in the treatment of anterior hypospadias. These forms of hypospadias are defined as those where the meatus is situated at the base of the glans, at the level of the balano-preputial groove or just before, without any real chordee. The treatment involves re-siting the meatus in the penis. These forms represent 70% of all cases of hypospadias. This type of hypospadias is corrected by an extensive meatoplasty towards the tip with reconstitution of the glans and re-centering of the sheath of the penis. This gives good aesthetic and functional results. This technique was designed by J. W. Duckett who named it M.A.G.P.I. (meatal advancement and glanduloplasty incorporated) and has been used in 78 cases; the indications, the method and the results are presented.

Humans↗
PubMed1983

[Pyeloureteral junction syndrome in children. Apropos of 178 cases].

The authors review 178 cases of anomalies of the pyelo-ureteric junction, with a total of 189 anomalies. Almost one half of the cases were less than 5 years old (47.2%) and about 1/4 were less than 1 year old (24.7%). In girls, the incident which reveals the diagnosis is most often an infection and in boys, it is pain or haematuria. 26% of the cases had an associated urological lesion (23 cases of vesico-ureteric reflux, 8 cases of renal stones, 5 cases of mega-ureter and 4 cases of horseshoe kidney). 133 children were operated, essentially by resection of the pyelo-ureteric junction with an upstream by-pass. From the 126 cases with sufficient follow-up, 48 (38.1%) obtained great improvement, 63 (50%) a moderate improvement and 15 (11.9%), a stabilisation of the dilatation. In all cases except 3, the pyelo-ureteric junction was perfectly catheterizable. The histological lesions of the junction were variable and difficult to systematise, but usually extended beyond the junction to involve a large part of the pelvis. The variability of the caliceal dilatation makes any attempt at classification difficult. The authors recommend cystography in every case, as associated reflux was discovered in 16% of cases. Retrograde uretero-pyelography is practically no longer indicated. The isotope kidney scan with DTPA technetium, with a hyper-diuresis test, is often used, as it gives an idea about the clearance of filtration and about the degree of obstruction. Quantitative DMSA kidney scan can reveal the effects on the renal parenchyma. Conservation of the isthmus of a horseshoe kidney never interferes with the uretero-pyelic re-implantation. After correction of the anomaly of the uretero-pyelic junction, 5 cases of unilateral reflux out of 8 and 3 cases of bilateral reflux out of 10 resolved spontaneously.

Adolescent↗
PubMed1981

[Duhamel operation for Hirschsprung disease (author's transl)].

Thirty six patients with Hirschsprung's disease were treated with a Duhamel pull-through procedure. Of the patients 32 were boys, 31 were diagnosed in the first three months of life, 30 had aganglionosis restricted to the rectum and to the sigmoid colon. The absence of mortality and the low complication rate confirmed that the Duhamel operation is a benign procedure. Highly satisfactory clinical and radiological results were observed during the follow-up period. Some patients presented a clear pressure fall of anal tonus with inflation of the pelvic digestive tract balloon. The sensing capabilities and the efficacy of this reflex were not so high than in normals controls. The relationship between the existence of this reflex and the clinical story of the patients might be interesting to follow-up in the future.

Age Factors↗
PubMed1980

[Pediatric renal transplantation in Toulouse (author's transl)].

The regional group of renal transplantation in Toulouse includes a medico-surgical team which participates to all the activities of this group. Dialysis and transplantation are covered in a center organized for the care of children. This branch is part of the Regional Hospital. From 15 years old on patients are moved from the pediatric branch to the medico-surgical center taking care of adults. Both teams within the regional hospital share the responsability of taking off kidneys from cadaveric donors and collaborate to France-Transplant and Euro-Transplant. Since the pediatric center in charge of renal failure has opened, 32 children underwent chronic hemodialysis. Some of these patients are presently treated in the center for adults. Fourteen children were grafted and seven are at this moment waiting to receive transplantation. The average number of transplantations per year is from 1 to 4. These fourteen children underwent renal transplantation with kidneys from cadaveric donors. Only one has been provided by Toulouse. Diuresis resumed immediately in 8 cases, later in 5. An extremely acute reject was observed in one case and transplantectomy had to be performed 10 days after transplantation. Eight children presented acute reversible reject which, for 4 of them, evoluated towards chronicle reject. Eight children presented a chronicle reject: 4 of them are again in dialysis. Altogether 8 kidneys are functioning (seven years in the longest case). Five children resumed chronic dialysis. One patient died of acute pancreatitis. He underwent a portocaval shunt for type I glycogenosis which ended in a hyperuricemic nephropathy evoluating towards renal failure forcing a transplantation. The rehabilitation of transplanted children was always satisfactory.

Adolescent↗
PubMed1979

[Xanthogranulomatous pyelonephritis in the infant. A report on 4 cases (author's transl)].

Four cases of xanthogranulomatous pyelonephritis in children are reported. In three cases, the disease took a diffuse form and in the fourth it was of a localised form. Around these cases, the authors review 39 case histories published between 1963 and 1978 and which involve only children. An over-all assessment of the 43 cases thus gathered together allows the general picture of xanthogranulomatous pyelonepn 9 cases, it was of the localised type; and in 4 cases, the pyelonephritis only involved one or another pyelon in patients with re-duplication. The diffuse type is more common in boys and the localised type in girls. Twenty-nine cases were found in children of less than five years. In 23 cases, there was a proteus infection. The etio-pathogenesis of xanthogranulomatous pyelonephritis remains obscure. The main clinical and therapeutic problems are dealt with.

Child↗
PubMed1979

[Treatment of hyperthyroidism in childhood and adolescence (author's transl)].

33 cases of hyperthyroidism have been treated at "L'Hôpital Sainte-Justine" of Montréal, during the period 1961-1974. Nearly all patients were submitted to medical treatment. 15 were cured with medical treatment only, and 18 had to be submitted to a subtotal thyroidectomy. These two groups are compared and show the clear advantage of surgery in the treatment of this disease. There was no major post-operative complication. Two patients became definitively hypothyroid. The mean follow-up is five years and six months.

Adolescent↗
PubMed1976

[The gastro-phrenic ligament].

The present study was carried out in order to investigate if 1) the gastrophrenic ligament was involved in gastric stabilization, 2) the surface of this ligament might be influenced by fundus distension induced by the first deglutition of the newborn. In a series of 23 subjects (15 adults, 8 foetuses) the surface of the gastrophrenic ligament was expressed in % of the postero-inferior surface of the stomach. The gastrophrenic ligament consisted of loose areolar tissue and its surface was rather small (5,89% +/- 3,8 in adults; 4,3% +/- 1,5 in the foetus). These facts led us to conclude that this ligament did not play a very important role in gastric stabilization. Furthermore the difference between adults and foetuses was not statistically significant; so the surface of the ligament could not have been changed at birth.

Adult↗
PubMedDate not supplied

[Lumbar sympathectomy].

The authors undertook a study of the present indications for lumbar sympathectomy in cases of obliterating arteriopathy of the lower limbs. The principal physiological effects are described in addition to its action on the circulation. Apart from the opening of arteriovenous shunts, the lifting of the precapillary block should be emphasized since this increases the flow and consequently leads to the development of the collateral circulation. A recent experiment over a period of three years involving 457 hospitalized patients is then analysed: out of 371 conservative operations performed, 169 involved restorative arterial surgery and 202 involved only lumbar sympathectomy. Lumbar sympathectomy was combined with the arterial surgery in 150 of the 169 cases quoted above. Lumbar sympathectomy alone is required in stages III and IV when arterial is not possible. At stage II, there is a choice, sympathectomy being preferred to direct surgery. The results are analysed and the best were obtained with patients at stage II.

Arterial Occlusive Diseases↗