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Biomedical subjects

J Jougon

Publications and source records attributed to J Jougon.

At least 37 records · Page 2Linked to original sources
PubMed1997

Lobar exclusion after transpericardial herniation in a heart-lung transplantation.

Lobar herniation is a rare complication of heart-lung transplantation (HLT). We describe a case of right lower lobe herniation through the pericardial window into the left pleural space diagnosed 54 days after operation. Extensive adhesions precluded a lobectomy through a right thoracotomy approach, therefore the lobe was simply excluded and left in situ. The subsequent postoperative course, a CT-scan 2 years later and the 7 years survival time demonstrated that the lobe became fibrosed without any major sequelae.

Bronchoscopy↗
PubMed1996

[Treatment of rectal prolapse with elastic circling of the anus: Perspectives of utilization].

The Thiersch technique for treatment of rectal prolapsus has been largely abandoned because the metallic or non-resorbable wire is poorly tolerated and non-extensible. Silastic can fulfil these requirements and was used in 11 patients, including two who underwent reoperations. Good results were obtained in 9. This technique is simple and can be proposed when the general status of the patient does not allow surgical cure of the prolapsus.

Aged↗
PubMed1994

[Acute cervico-mediastinal hematoma of parathyroid origin].

A new case of spontaneous cervico-mediastinal hematoma due to parathyroid adenoma is reported. It is a rare complication of parathyroid adenoma. When mediastinal compression with respiratory distress occurs, endotracheal intubation excludes an intrathoracic vascular injury. Laboratory tests reveal a hyperparathyroid syndrome which may disappear after the acute hemorrhage. Whatever is the outcome of the hyperparathyroid syndrome, surgical treatment is required. As far as possible, it should be performed after the acute hemorrhage.

Acute Disease↗
PubMed1994

[Iatrogenic stenoses of the respiratory tract. Evolution of therapeutic indications. Based on 217 surgical cases].

The authors report a series of 217 non-neoplastic stenoses of the upper airways operated in the period 1978-1991. One hundred and twenty patients with tracheal stenoses underwent tracheal resection and end-to-end anastomosis, with 117 excellent results and 3 deaths. The treatment of 97 patients with laryngotracheal stenoses was much more complex and difficult to manage: Fifty-nine underwent tracheal and subglottic resection-anastomosis with 58 successes and 1 death--Seven had resection-anastomosis with total cricoidectomy and stenting. They were 6 successes and 1 death--Three had supraglottic resection-anastomosis with 3 successes--Twelve underwent laryngeal enlargement over a T-tube with successes in 11 cases and failure in 1 case. Sixteen had complex combinations of resection and modeling with 13 successes, 2 failures, and 1 death. In this series under the same therapeutic options, the results were successful in 96% of cases, with 4% of failures (7% of them resulting in death). The anatomical type, tracheal or laryngotracheal, length of the stenosis, neuropsychological sequelae, and overall poor respiratory status of the patients must be taken into account before deciding the therapeutic strategy. Old age is not a contraindication to tracheal resection, but is certainly a risk factor for morbidity and mortality. The key to success is undoubtedly careful preoperative preparation, treatment of local infection and inflammation, as well as meticulous mucomucosal approximation of healthy margins at the anastomosis.

Adolescent↗
PubMed1993

Long-term functional results after bilateral lung transplantation. Bordeaux Lung and Heart-Lung Transplant Group.

Between February 1988 and January 1992, 61 patients have undergone bilateral lung transplantations (42 heart-lung and 19 double-lung) in Bordeaux. The underlying diseases were primary or secondary hypertension (20), emphysema (22), or other diseases including cystic fibrosis, pulmonary fibrosis, silicosis, and sarcoidosis (19). Actuarial survival for double-lung and heart-lung transplant recipients was 66% and 72% at 1 year and 57% and 53% at 3 years, respectively. Forty-two patients were still alive 6 months after operation, and we studied their pulmonary function at the short and long term. All parameters except arterial carbon dioxide tension had improved dramatically at 6 months (p < 0.0001). Vital capacity, forced expiratory volume in 1 second, and forced expiratory flow rate between 25% and 75% of vital capacity were at 79% +/- 3%, 92% +/- 5%, and 105% +/- 8% of the predicted values, respectively. Arterial oxygen tension was 88 +/- 3 mm Hg. Nine months after operation, a slight decrease in forced expiratory volume in 1 second and forced expiratory flow rate between 25% and 75% of vital capacity appeared but values remained more than 75% predicted. This was related to the occurrence of obliterative bronchiolitis in 6 patients (14%). At 9 months, flow rates and oxygen tension of these 6 patients were highly different from those of patients free of obliterative bronchiolitis (p < 0.0002 for flow rates and p < 0.01 for oxygen tension). Only 1 patient required retransplantation. The others are living an almost normal life. Our results are discussed in view of the published reports on single-lung transplantation. Short-term results of bilateral lung transplantation are thus excellent and maintained on a long-term basis. Therefore, in our opinion, bilateral lung transplantation is the therapy of choice for pulmonary hypertension and emphysema.

Adult↗
PubMed1992

Classification of airway anastomotic healing.

Airway complications remain a major problem after lung transplantation. There is no standardised method of assessment of airway healing. We propose a classification of airway healing based on the anastomotic appearances at endoscopy 15 days postoperatively. The system appears to correlate well with the subsequent development of anastomotic sequelae and can be used to assess the effectiveness of therapeutic modalities designed to reduce airway complications.

Anastomosis, Surgical↗
PubMed1992

[Primary malignant melanoma of the small intestine].

The small intestine is a frequent site for metastases of cutaneous or ocular melanoma. When the latter are absent, the diagnosis of primary intestinal melanoma can be proposed. Primary malignant melanoma of the small intestine arises from melanoblastic cells of the neural crests, which migrate to the distal ileum through the omphalomesenteric canal. Incomplete regression of the later leads to persistence of Meckel's diverticulum. We report herein a case of malignant melanoma of the small intestine without evidence of a cutaneous and/or ocular origin. Based on its location in the distal ileum, we propose that this tumor be classified as a primary malignant melanoma of the small intestine.

Female↗
PubMed1992

[Isolated pulmonary choriocarcinoma].

The author report a case of isolated choriocarcinoma of the lung revealed in a young woman by a tumoral syndrome of the right base with haematoma. The diagnosis of isolated pulmonary choriocarcinoma was based on the lack of previous gynaecological history and tumour, on the singleness of the lung tumour at CT, and on the high initial beta-CGH level (3,300 ng/ml) in the absence of pregnancy. Surgical resection confirmed the diagnosis and lowered the beta-CGH level to 7 ng/ml. The various aetiopathogenic theories put forward and their relations with the prognosis disparity found in the literature are reviewed. The authors compare the prognosis of isolated pulmonary choriocarcinoma in a non-nulliparous woman to that of placental choriocarcinoma.

Adult↗
PubMed1992

[Endometriosis and diaphragmatic defect in catamenial pneumothorax].

Two cases of catamenial pneumothorax are reported, a rare condition characterized by its sudden occurrence in a female patient between the ages of 30 and 40 years, always at the onset of the menstrual cycle. Its exact origin is unknown, but the frequent co-existence of endometriosis and a defect in the diaphragm suggests that endometriosis may be important in the etiology both of the pneumothorax and the diaphragmatic lesion. Pelvic endometriosis was present in both our patients, one of whom also had diaphragmatic endometriosis. The treatment of the pneumothorax in both our cases consisted of pleural decortication with excellent results so far.

Adult↗
PubMed1992

[Splenic localization of von Recklinghausen's disease].

The authors report about one case of splenic site in a polyvisceral involvement by von Recklinghausen's disease. This site was not found in the literature. Since it was impossible to confirm the benignancy of the lesions, the degenerative risks of which are well known, the authors carried out partial gastrectomy and splenectomy.

Adult↗
PubMed1991

[Three cases of solid and papillary tumors of the pancreas in black women].

Three cases of solid and papillary epithelial neoplasm of the pancreas are presented. These tumors occur more commonly in young patients with a predilection for young black females. They have a good prognosis allowing conservative surgery. The histological study of the specimens strongly suggests an endocrine tumor but all histological and immunocytochemical endocrine stains are negative. The ultrastructural study of these tumors has revealed the existence of borderline forms between these tumors and endocrine tumors.

Adolescent↗
PubMed1990

[Leiomyosarcoma of the Meckel's diverticulum and multiple diverticulosis of the ileum. Apropos of a case].

We report a case of a leiomyosarcoma arising in a Meckel's diverticulum in a man of 90 years, with multiple ileal diverticulosis. The clinical picture was similar to acute appendicitis and diagnosis was not made until resection of an abdominal mass with histological appearance of leiomyosarcoma. 59 cases of leiomyosarcoma of Meckel's diverticulum have previously been reported in the literature. No case until now has been reported in a patient of Caribbean origin neither in association with ileal diverticulosis. Although rare, leiomyosarcoma is the commonest sarcoma of Meckel's diverticulum, and with full resection of the tumor the prognosis is very good.

Aged↗
PubMed1990

[Anatomic pecularities of the inguinal canal in West Indians. Influence on the management of inguinal hernia].

Inguinal and umbilical hernias are much more frequent in the black and half-breed than in the white population. We have observed anatomical differences in the inguinal region between Whites and Blacks. The latter have a vertical, wide subcutaneous ring and a smaller conjoined tendon, and it is hardly possible to reconstruct the fascia of the obliquus externus abdominis anterior to the cord in them. For Black patients, we propose the suture of the conjoined tendon to the crural arch, like in the Bassini procedure, and the suture of the fascia of the obliquus externus to the arch, but in a retrofunicular position. This technique allows, so to speak, duplicating the caudal connection of the conjoined tendon to the arch by means of the extensive suture of 2 tissues of similar nature, ie. the fascia of the obliquus externus and the crural arch.

Adolescent↗
PubMed1989

[Endometriosis and ureteral stenosis. Apropos of 4 cases].

If endometriosis is particularly well known by Gynecologists, ureteral complications of this disease are very rare. We have had the occasion to observe four cases of ureteral stenosis by extrinsic compression of a pelvic endometriosis, and about these four cases, we have reviewed one hundred and fifty six cases in literature. We have emphasize that the fibrosis provoked by endometriosis can look like a neoplastic lesion, and get involved in very heavy therapeutic gestures. We insist on the fact that every endometriosis discovered should be on surgery of kidneys and ureters.

Adult↗