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Biomedical subjects

J M Hay

Publications and source records attributed to J M Hay.

172 records · Page 10Linked to original sources
PubMedDate not supplied

[Barium granuloma of the rectum].

The authors report a case of barium granuloma of the rectum. This complication of barium enema is exceptional. During enema, the cannula may ulcerate the mucosa which is blown up secondarily by the barium. Clinically, the granuloma presents like a hard polyp which is suggestive in certain cases of a malignant tumour. The precise diagnosis is made by careful examination of the abdominal films before administration of barium taking in the whole of the pelvis.

Barium Sulfate↗
PubMedDate not supplied

[Experimental autograft of the small intestine in the pig. Histological, histoenzymological and ultrastructural study].

In order to form an opinion of the value of certain precocious rejection tests with a view to ulterior intestinal allograftings, the authors intend first of all to determine the consequences of the operation itself and of the possibility resulting anoxia on the function of the intestinal mucosa. A concomitant biological (xylose test meal, quantitative analysis of the enzymes of the mucosa) and morphological study (lipid test meal, histologic, enzymologic and ultrastructural study of biopsic specimens) was carried out at various intervals after orthotopical intestinal autografting in 22 pigs. Most of the biological tests were strongly perturbated on the 7th day and some of them did not resume their initial value until the 15th day. The morphological and especially ultrastructural studies showed up to that time an important inflammation apparently caused not by the anoxia but by the lymph stasis. Solely conventional histology was only sightly modified (absence of ulcerations and of denudation of the villi) and this relative integrity, contrasting with the known severity of the lesions in case of precocious rejection, allows to consider this examination the only valuable until the 15th day, for the detection of immunologic incompatility reactions in allograftings.

Animals↗
PubMedDate not supplied

Is steroid dependent Crohn's disease a separate entity?

Crohn's disease has been sometimes considered as a syndrome including different entities. In this prospect we tried to assess whether steroid dependent Crohn's disease could be a separate sub-group. Eighty five patients (mean follow-up: 6 years) with documented Crohn's disease were classified into 3 groups: 1--patients never treated with steroids (NS) (N = 37); 2--patients in whom steroids had been given but had been withdrawn (NSD) (N = 37); 3--patients dependent on continuous steroid therapy (SD) (N = 11). Ten variables were considered: age at onset, sex, CDAI, cumulative topography of lesions, extra-intestinal symptoms, albuminemia, ESR, surgical operations, annual frequency of relapses. Monofactorial analysis (analysis of variance and CHI2 test) showed group SD to be significantly different from group NS and in term of age at onset, CDAI, ESR, annual frequency of relapses, extra-intestinal symptoms, surgical operations. In contrast, a multivariate analysis of correspondences applied to the 3 groups and to 9 dichotomous variables showed that group SD is not a separate entity, but the limit of a continuum extending from group NS to group NSD. This was ascertained by a CHI2 test applied to the dichotomous variables. Thus, within the limits of this study Crohn's disease appears to be a homogeneous entity rather than a heterogeneous syndrome.

Adolescent↗
PubMedDate not supplied

[Surgical treatment of Crohn disease of the colon. (38 cases) (author's transl)].

From 1959 to december 1972 thirty-eight patients out of sixty having Crohn disease of the colon alone or with ileal and/or rectal involvement were operated upon. We had four post-operative deaths and one a long time after the intervention, but in relation with the initial Crohn disease. These thirty-eight patients had sixty-seven operations. Only fifty-five per cent of the operated on patients did not have any complications. Twenty-three patients had recurrence of the disease, seven of them were re-operated for this first recurrence, two of them for a second recurrence and one of these two last patients had a third recurrence. That makes twenty-seven recurrences out of forty-three resections. Among these twenty-seven recurrences, in at least seventeen cases, resection was not large enough or was not radical. Three quarters of the recurrences appear during the first year. The more exposed interventions to recurrences are left hemi-colectomies (two out of two) and total colectomies with ileo-rectal anastomosis (six out of eight). The ones that give less recurrences are total colo-protectomies or subtotal colectomies (one recurrence out of nine). Indications for the different types of interventions are analysed. Management of the rectum in Crohn disease of the colon is difficult. Procedures applied for toxic megacolon are equally very critical.

Adolescent↗
PubMedDate not supplied

[Some rare diseases of the esophagus (author's transl)].

Cancer excepted all other diseases of the esophagus are rare. Diverticula, benign tumors, perforations and the pathology of the cardia (hiatus hernia, achalasia and esophageal varices) are not studied here. We took into consideration the following diseases only: spasm of the cricopharyngeal muscle, Plummer-Vinson or Kelly-Paterson syndrome, cervical osteophytosis, dysphagia lusoria, benign and malignant mediastinal lymphatic nodes, Schatzki ring of the lower esophagus and esophageal duplications.

Aged↗
PubMedDate not supplied

[Uroperitoneum].

Explore the source record for details and available documents.

Adult↗
PubMedDate not supplied

[Experience with mesocaval shunt with jugular vein interposition for treatment of portal hypertension in children (author's transl)].

From 1979 until 1981, 10 children aged 2 and a half to 15 years, were treated by mesocaval shunt with jugular vein interposition. In 6 cases, there were liver alterations in relation to Budd-Chiari's syndrome or cirrhosis, but the splenomesenterico-portal axis was uninvolved by thrombosis; in the other 4 cases, without any liver damage except fibrosis in one case, there was extensive thrombosis of the portal system. Thus the jugular graft may be simply set between the superior mesenteric vein and the vena cava, or may have to be anastomosed in an atypical position, between a pancreatic, jejunal, ileal vein and the renal vein or the vena cava. The right jugular vein is the longest and will be more suitable; it should be removed from a point situated above the opening of the facial tributary, so that the length of the graft would be approximately 7 cm. The anastomosis itself is rather a simple procedure if one takes care to mobilize the last segments of the duodenum and the pancreas. Mean fall in portal pressure of 10 mm Hg and a mean gradient of 3 mm Hg after completion of the anastomosis were demonstrated in most cases. Flow measures through the graft done in 8 cases gave a mean result of 800 ml per mn. Postoperative controls by means of ultrasonogram and angiography in all patients except the two most recent ones showed a patent anastomosis. But the longest follow-up is only 2 and a half years, and long term results are yet to be determined, especially in regards to the risk of late encephalopathy in cases with cirrhosis.

Adolescent↗
PubMedDate not supplied

[The surgical treatment of carcinomas of the opening of the oesophagus. Personal experience. Selection of a technique of oesophagoplasty (author's transl)].

The authors describe the principles relating to the excision of carcinomas involving the opening of the oesophagus. They emphasize the need for low section of the oesophagus, or even total oesophagectomy by virtue of the frequent submucosal spread of the tumour process. The need for resection of this type eliminates the possibility of repair by the Bakamgian flap type and involve the need for a long intestinal segment with a difficult digestive anastomosis in the middle of the thorax if a free intestinal transplant is selected. The authors themselves carry out oesophagoplasty using the transverse colon which in common with the majority of other authors, they feel to be the technique of choice. However, on the basis of their brief experience, they wish above all to discuss the criteria of operability, rarely discussed elsewhere, and concerning spread to the membranous trachea and the possibility of perivisceral tumour spread which cannot be detected by classical techniques. They suggest the use of a prior mediatinoscopy incision in order to attempt to assess any such possible spread.

Adult↗
PubMedDate not supplied

[Treatments of inguinal hernia under local anesthesia].

Potentiated local anaesthesia has been generally used for repair of inguinal hernia since the Shouldice technique was first introduced in France in the early 80s. The technique requires a correct understanding of inguinal innervation and the properties of the local anaesthetic. The local anaesthetic is injected into the abdomino-genital and genito-crural nerves and at the line of incision allowing smooth surgical repair. Potentiation relieves patient apprehension. This method can be used for all types of inguinal hernia, whether simple or complicated and in all patients. There is no limitation for age or general condition. Contraindications are rare and include allergy or uncontrolled (no pacemaker) arrhythmias.

Anesthesia, Local↗