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Biomedical subjects

J L Michaud

Publications and source records attributed to J L Michaud.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Hydatid cyst of the interventricular septum. Apropos of a case].

A cardiac tumour of the interventricular septum was detected in a young woman presenting with an ejectional systolic murmur. Surgical ablation was carried out before a precise diagnosis was made. Histopathological analysis of the surgical specimen confirmed a hydatid cyst. The main complication was complete atrioventricular block. This case underlines the difficulty of making the diagnosis of intracardiac hydatid disease in a non-specific context, because of the long period of clinical latency, despite the considerable aid of echocardiography and other medical imaging techniques (CT scan and magnetic resonance imaging.

Adult↗
PubMed1994

[Well-differentiated papillary mesothelioma of the peritoneum: an attenuated malignant tumor. Review of the literature apropos of a case].

The authors present a new case of a well-differentiated papillary mesothelioma of the peritoneum. This is an uncommon tumor which have a slow evolution like a low malignant potential tumor. But, because of its tendency to recurrence, the designation of Well-Differentiated Tumor is better. The diagnosis with others peritoneal tumors is sometimes difficult, especially with the Peritoneal Serous Tumors. Tumor recurrence must be treated by curative surgery. Adjuvant therapy is discussed for the diffuse form.

Carcinoma, Papillary↗
PubMed1992

Nutritional vitamin B12 deficiency: two cases detected by routine newborn urinary screening.

We describe two asymptomatic newborns with nutritional vitamin B12 deficiency in whom increased urinary methylmalonic acid was detected by routine neonatal screening at 3 weeks of age. Both infants were exclusively breast-fed. One mother suffered from pernicious anaemia, and the other was a strict vegetarian. Both mothers had no clinical or haematological abnormality, aside from a borderline mean corpuscular volume for the vegetarian mother. This report illustrates the early appearance of functional vitamin B12 deficiency in breast-fed infants of vitamin B12-depleted mothers. It also demonstrates that urinary methylmalonic acid measurement is a sensitive indicator of tissue vitamin B12 deficiency.

Breast Feeding↗
PubMed1992

[Problems posed by the association of streptococcus D infectious endocarditis and colorectal tumor].

The problems arising from the discovery of a colorectal tumor during an infectious endocarditis caused by Streptococci D have rarely been mentioned in the surgical literature. The frequency of association of an asymptomatic colorectal tumor and of a Streptococcus bovi endocarditis is now undisputed. This notion implies the systematic search for an intestinal lesion (adenoma or carcinoma) in case of endocarditis or septicemia without involvement of the valves, caused by a streptococcus of group D. The authors report about 3 cases of enterococcal (1 case) and S. bovis (2 cases) infectious endocarditis revealing a colic adenocarcinoma (2 cases) and a villous adenoma (1 case), all being perfectly latent. The specific therapeutic problems arising from this association are outlined, including the antibiotic therapy, the role of the anticoagulant treatment and the priority given to valve surgery in case of hemodynamic instability.

Adenocarcinoma↗
PubMed1992

[Desmoid tumors: diagnostic and therapeutic difficulties. Apropos of an unusual case].

This observation has been previously reported as a multifocal and recidivant desmoid tumor. The first time, the patient was operated on for a desmoid tumor situated on his left thigh. He was reoperated on fourteen years later for a recurrent tumor implanted on the same place and a new one on the right arm. Recently bilateral pulmonary tumors were discovered. As far as this evolution was concerned, its exceptional pattern induced a new analysis of the microscopic data and the diagnosis of fibrohistiocytic sarcoma was established. This observation suggest to the authors some comments about the difficulty of diagnosis and therapy of such soft tissue tumors.

Diagnosis, Differential↗
PubMed1991

[Pulmonary arteriovenous fistula].

A case of pulmonary arteriovenous fistula in a 6 1/2 year-old girl is reported. The fistula which was first seen on X-ray films resulted in low arterial oxygen saturation, asthenia and dyspnea during exercise. It was confirmed by right catheterism and angiography. The child was cured after left inferior lobectomy. No other vascular malformations could be demonstrated in the child or in her family. Literature data are reviewed.

Arteriovenous Fistula↗
PubMed1989

Retrograde dissections of the aortic arch after exclusion-bypass of the descending thoracic aorta: a report of three cases.

We report three cases of fatal retrograde dissection of the aortic arch after exclusion-bypass with metal clamps according to Carpentier's thromboexclusion method. All three patients were male, aged 59, 66, and 73 years. Initial operative indications were chronic dissections in two cases and atheromatous aneurysm of the descending thoracic aorta in the other. Two of these patients were operated on in an emergency setting for a ruptured aneurysm. In all three cases, an extraanatomic bypass between the ascending aorta and abdominal aorta was performed as the first step: The proximal clamp was then placed distal to the origin of the left subclavian artery. Death occurred two hours, 12 hours, and eight days after operation, respectively. Autopsy revealed retrograde dissection initiating in the aortic arch and reaching the aortic ring as the cause of death. Pathological examination of aortic specimens confirmed that the dissections began just proximal to the site of clamping. To explain this complication, two etiologic factors, occurring either alone or together, have been postulated: postoperative hypertension and trauma to the aortic wall from the clamp.

Aged↗
PubMed1989

[Aortico-left ventricular tunnel. Long-term follow-up, therapeutic implications].

Aortico-left ventricular tunnel is a rare entity resulting in a communication between the ascending aorta and the left ventricle, with clinical signs of aortic incompetence. On the basis of two personal cases and a review of the literature including 57 patients, the operative mortality and long-term follow-up of these patients are analysed. 51 patients were operated upon with a mortality rate of 21.5% (11 cases). In this mortality group, 64% of the casualties were less than 2 years' old (7/11). Mortality was unrelated to the surgical technique. Aortic incompetence was the crucial factor of post-operative morbidity. 60% of the patients who were operated upon had significant post-operative aortic incompetence. Among the 21 patients with long-term follow-up (1.5 to 14 years), 17 have aortic incompetence (81%), 8 were reoperated and 7 underwent aortic valve replacement. Surgical repair of this malformation should be considered early in life, and the technique used should aim at consolidating the aortic annulus without deformation and at closing the aortico-ventricular window.

Angiocardiography↗
PubMed1989

[Mechanical obstruction of the duodenum after surgery of the abdominal aorta].

The authors report two cases of duodenal obstruction occurring after insertion of an aorto-iliac prosthesis. This form of mechanical obstruction is much rare than the other forms of post-operative mechanical intestinal obstruction. While the need for surgery is often evident, precise diagnosis before the procedure is seldom obtained. CT scan appears to be the investigation of choice. This complication could be prevented by an epiploplasty covering the graft implant region.

Aorta, Abdominal↗
PubMed1988

[Cardiac transplantation at the University Hospital Center of Nantes. 2 years' experience].

Between March, 1985 and April, 1987, 25 orthotopic heart transplantations were performed in 20 men and 5 women aged from 17 to 58 years (mean 42 years) on account of cardiomyopathy (n = 15), ischaemic heart disease (n = 6) or miscellaneous lesions (n = 4). The immunosuppressive treatment consisted of antilymphocyte serum and corticosteroids during 10 days; cyclosporine was introduced on the 7th day and continued thereafter in association with low-dose corticosteroid therapy. Endomyocardial biopsies were performed. Acute rejection, responsible for 2 deaths (one on the 10th day, the other in the 10th week), usually occurred within the first 3 months. Infections were frequent and often serious, resulting in one death in the 7th week. One out of patients had to be treated for arterial hypertension, and 3 patients presented with renal impairment (blood creatinine over 200 mumoles/l). The actuarial survival rate at 2 years is 84 p. 100. More than one-half of the patients have resumed social and occupational activities.

Actuarial Analysis↗
PubMed1987

[Rupture of the left ventricle into the free pericardium in the early stage of a myocardial infarction. Diagnosis using echocardiography and surgical treatment].

A case of subacute left ventricular rupture on the 4th day of an inaugural antero-septal infarction in a 63-year old woman is reported. The diagnosis, suggested by cardiovascular collapse with acute tamponade, was confirmed by echocardiography. Haemodynamic stability was maintained by needle aspiration followed by pericardial drainage, and right heart catheterization long enough for the patient to be transported to a Cardiovascular Surgery unit where surgical repair was successfully performed 9 hours after the rupture. The elements for a positive diagnosis, the value of echocardiography, the various surgical procedures and the favourable long-term prognosis in patients operated upon are discussed.

Cardiac Surgical Procedures↗
PubMed1985

[Obstructive calcification of the descending thoracic aorta and suprarenal abdominal aorta. 2 cases].

Two cases of obstructive calcification of the aorta treated by surgery are reported. The disease is extremely rare, notably in the aortic segments involved in these two cases. Its clinical features were similar to those of coarctation. Intraluminal proliferative calcifications were present in the descending thoracic aorta of the first patient who underwent aortic resection with Dacron replacement prosthesis and in the suprarenal segment of the abdominal aorta of the second patient for whom an extra-anatomical bypass between the ascending aorta and the upper abdominal aorta was performed. The first patients remains with moderate arterial hypertension after 4 years; arterial pressure returned to normal in the second patient and is still normal after 15 months.

Aorta, Abdominal↗