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Biomedical subjects

L Leger

Publications and source records attributed to L Leger.

At least 55 records · Page 3Linked to original sources
PubMed1980

[Portal hypertension in sarcoidosis. Three cases including one with liver fibrosis and malignant hepatoma with osseous stroma (author's transl)].

The high incidence of hepatic lesions in sarcoidosis contrasts with the extreme rarity of portal hypertension. The mechanism of the latter is as obscure as the pathogeny of the disease. The liver may contain many or very few tuberculoid follicles, and its structure may be normal and non-fibrotic (as in our first two patients) or sclerotic, though rarely cirrhotic. In most cases the spleen is enormous, which raises the problem of portal hypertension by overload. Our third patient seems to be an unique case of progressive change to malignant hepatoma with osseous metaplasia, complicated with cervical metastases.

Bone Neoplasms↗
PubMed1980

[Use of histological criteria to evaluate the quality of vagotomy operations. Does ascending degeneration of the nerve exist? (author's transl)].

Following vagotomy it is a common finding to observe a neuroma at the upper extremity of the nerve. Furthermore, Tinel, quoting Ranson, believes that the sensory fibers of the sectioned pneumogastric may be affected by ascending degeneration. In fact, during thoracic vagotomy after an unsuccessful abdominal vagotomy, histological examination of the resected right thoracic nerve demonstrated disorganization with the appearance of partial ascending degeneration. It appeared possible, therefore, to assess the quality of a vagotomy, by studying the histological appearance of the resected vagus when a further operation using the thoracic approach is necessary. An experimental study was conducted in dogs and the results confirmed the presence, at the upper extremity, of both an amputation neuroma and neuronal changes, though these latter lesions were limited to a region 3 cm above the section level. It is reasonable to assume, therefore, that the lower segment of a vagus resected by the thoracic approach, after an unsuccessful abdominal vagotomy, should show degenerative lesions if the vagotomy had been effective, but these lesions are limited in extent.

Animals↗
PubMed1979

[Clinicopathological profile of pancreatic lithiasis (author's transl)].

Clinical, radiological and histopathological features of 31 duodenopancreatectomies for chronic pancreatitis with lithiasis are analysed in relation to whether or not there was dilatation of the duct of Wirsung. Two groups of patients may be defined in the basis of this criterion: -- the first, without dilatation of the duct of Wirsung, with lithiasis predominantly affecting the head of the pancreas and irregular fibrosis, corresponding patients aged approximately 30 years, suffering from the disease for about 10 years, often already operated upon for pancreatitis; gastrointestinal bleeding is common; -- the second, with dilatation of the duct of Wirsung, with disseminated lithiasis, and very marked fibrosis, affecting patients aged over 50 years, suffering from the disease for less than 5 years and not yet operated upon for their pancreatitis. The problem of the independance of the two groups or of the possibility of progression of forms without dilatation of the duct of Wirsung to dilated forms remains.

Adult↗
PubMed1979

[Endoscopic sphincterotomy. 362 cases (author's transl)].

In addition to its diagnostic value, endoscopic catheterisation of the papilla may be used for the therapeutic purpose of diathermy incision of the papilla and of the intraduodenal portion of the common bile duct. Endoscopic sphincterotomy of this type has been essentially used in choletithiasis and in particular for residual lithiasis. These indications may be widened to include benign stenosis of the sphincter of Oddi, tumours of the ampulla of Vater or even acute pancreatitis. In a total of 362 cases, sphincterotomy was successful in 347 patients, it being possible to remove the calculi present in 279 of the 309 patients treated with success for lithiasis of the common bile duct. Complications occur in approximately 10% of cases, being fatal in 1.4% of cases. These are essentially related to bleeding. Retrospective comparison of mortality after surgical operation and after endoscopic sphincterotomy is in favour of the latter, provided the technique employed is perfect and the indication clearly defined. Performed without general anaesthesia, endoscopic sphincterotomy is above all indicated in the elderly and/or those with other major pathology who can be successfully treated with reduced risk in 93% of cases, as shown by the 140 personal cases of the authors cured between 6 and 36 months ago.

Acute Disease↗
PubMed1979

[The sectorisation of pancreatic pathology (author's transl)].

The existence of dilatation of the Wirsung duct distal to an isthmic calculus, the marked dilatation of the cephalic portion of the duct contrasting with the sub-normal calibre of the corporeo-caudal duct in a case of pancreatic lithiasis, are all against the pathogenic hypothesis of a retrodilatation proximal to an obstruction, a supposition which is apparently satisfactory but not always confirmed by the facts. Thus duct distension would not seem to be a purely mechanical phenomenon. The confusing topography of sectorial dilatation of the Wirsung duct in chronic pancreatitis may be explained by a process affecting in isolation or predominantly one or another embryonic sector. The paradox of the association of cephalic dilatation of the duct with stenosis of the intrapancreatic common bile duct offers further support for this hypothesis.

Calculi↗
PubMed1979

[Primary lymphoid sarcomas of the stomach. Ten cases (author's transl)].

These sarcomas fall within a precise definition and must be differentiated from gastrointestinal involvement in a haematological disorder. For certain histological forms (nodular forms), the prognosis is less bad than that of carcinomas. Pre-operative diagnosis, often difficult, must be established by large biopsies. The best results are likely to result from a combination of surgery and radiotherapy or of surgery and chemotherapy.

Adenocarcinoma↗
PubMed1979

[Heterotopic pancreas. Report of 8 new cases (author's transl)].

The authors report 8 new cases of heterotopic pancreas and the clinical signs of each case. The emphasise the difficulties of preoperative diagnosis owing to their usually small size and the necessity of surgical treatment justified by the same lesions which affect the normally placed pancreas including cancer.

Adult↗
PubMed1978

[Tuberculosis of the oesophagus (author's transl)].

Two cases of tuberculosis of the oesophagus serve as an opportunity to review the clinical and radiological features of this rare condition. Generally situated at the junction of the upper and middle third of the oesophagus, the lesion is found opposite the invaded inter-tracheobronchial mediastinal nodes which may give rise to a fistula. Confirmed by oesophagoscopy, direct bacteriological examination, oesophageal tuberculosis is usually cured without sequelae by antituberculous therapy.

Adult↗
PubMed1978

[The Wirsung's duct of in surgical chronic pancreatitis. Radiologial and anatomical study (author's transl)].

On the basis of pancreatography findings and the study of operative specimens in 32 cases of duodenopancreatectomy, it was possible to distinguish two groups according to whether or not the duct of Wirsung was dilated. When the duct was not dilated, fibrosis was relatively marked, but disseminated and more notable in sections of the head than in sections of the isthmus. Lithiasis was essentially cephalic, but distributed more or less equally between the duct of Wirsung and the canaliculi. When the duct was dilated, there was marked fibrosis, distributed equally. Lithiasis was radiologically diffuse throughout the organ, but situated in particular in the duct of Wirsung itself.

Calculi↗
PubMed1978

[Intra-hepatic gall bladder complicated by post-operative stones in the common bile duct. The value of endoscopic sphincterotomy (author's transl)].

Two cases of migration of stones in the common bile duct following operation of cholecystitis secondary to cholelithiasis in an intra-hepatic gall bladder are reported. The authors emphasise the difficulties of the operation. When it was necessary to limit surgery to external drainage, migration of stones to the common duct from the gall bladder left in place is possible. In the two cases presented, endoscopic sphincterotomy resulted in the early expulsion of the calculi and permanent drainage of the common bile duct, a presumptive guarantee against the complications of new migrations.

Aged↗
PubMed1978

[Gastric acid secretion by vagal electrostimulation (author's transl)].

In the operative verification of vagotomy, electrical stimulation of the vagus nerves with the study of pH should seem to be a reliable method. On the basis of an experiment in the cat, the authors emphasise the effectiveness of electrical stimulation of gastric acid secretion, confirmed by 16 clinical cases. Stimulation of the proximal end of the divided right nerve may be used to detect a nervous strand arising above the level of the section and to confirm the completeness of left vagotomy.

Animals↗