[Homologous transplantation of the small intestine. Surgical technics and functional explorations in dogs].
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Animals↗
Biomedical subjects
L Michel
Publications and source records attributed to L Michel.
[Perineal rupture and anorectal incontinence with traumatic sacroiliac dislocation. Treatment and functional results].
A case of traumatic sacro-iliac disruption with severe perineal rupture and ano-rectal incontinence by total unilateral laceration of the levator ani muscle is reported. The use of parenteral hyperalimentation as a "medical colostomy" has been successfully applied maintaining the patient's nutritional status while healing of the wound occurred. This gives the surgeon an option for the management of such a severe sphincter's laceration: without resorting to preliminary colostomy. The general management of patients with perineal and rectal trauma is reviewed. The prerequisite of bone fracture consolidation prior soft tissue repair is emphasized. Progressive recovery of ano-rectal continence is demonstrated by repeated ano-rectal manometry.
Adult↗
Post-emetic laceration and rupture of the gastroesophageal junction.
The experience of a major general hospital, over the last two decades, with the management of 50 patients presenting post-emetic lesions of the gastroesophageal junction is reviewed. The results of this study clarify the persistent confusion between the Mallory-Weiss syndrome and the Boerhaave's syndrome. The high incidences of upper gastro-intestinal mucosal lesions and hiatal hernia associated with the Mallory-Weiss syndrome, ignored in many previous studies, are emphasized in this report. Widespread utilization of fiberoptic endoscopy during the last 10 years has resulted in more accurate diagnosis of Mallory-Weiss lacerations, with more selective indications for surgical management of these cases of upper gastrointestinal bleeding. On the other hand, in the light of the results of this study, a strong plea is made in favor of early, aggressive surgical treatment for Boerhaave's syndrome. This entity remains one of the challenges of thoracic and abdominal surgery.
Aged↗
[Value of the pentagastrin test in familial hypercalcitoninemia].
This report concerns the history of a portugesian family including one case of MEN II a (female, born 1932, presenting medullary carcinoma of the thyroid--MCT--, hyperparathyroidism and suspected pheochomocytoma), and three others with MCT alone or in association with pheochromocytoma. The diagnosis of MCT has been made possible investigating six members of the kindred by use of IR - calcitonin measurements and pentagastrin injection. This provocative screening test is also of interest to follow operated patients.
Calcitonin↗
[Consciousness of the patient in hospital psychiatry].
In this paper the author outlines the development of ideas in the field of psychiatry related to the way a patient can face his illness. He relates how the concept of craziness was progressively replaced by this of mental illness and how this last concept was no more synonymous of déraison. As a matter of fact the patient has become able to talk about the morbid process which is overwhelming him. The author lists some factors that are supposed to influence the way a patient situates himself toward his illness. Finally, a not sophisticated clinical scale is presented in order to assess the hospitalized psychiatric patient's attitude toward his illness.
Concept Formation↗
[Sclerogenous peritonitis: an unusual complication in the treatment of chronic conditions with practolol (author's transl)].
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Aged↗
Videoendoscopic adrenalectomy: multicentric study from the Belgian Group for Endoscopic Surgery (BGES).
This paper reports the experience of five Belgian surgical teams with 18 videoendoscopic adrenalectomies performed on 16 patients between October 1993 and May 1995. The adrenal gland diseases were pheochromocytoma (4 patients), primary hyperaldosteronism (2 cases), Cushing's adenoma (2 cases), Cushing's disease (1 case), nonfunctional adenoma (3 cases), single metastasis from adenocarcinoma (2 cases), functional adenoma with dehydro-epiandrostenedione (DHEAS) and cortisol hypersecretion (1 case), ACTH secreting metastases from a thymoma (1 case) Two patients underwent bilateral adrenalectomies. Eleven left and three right adrenal glands were removed in 14 other patients. The eight women and eight men range in age from 17 to 72 years (median 47). Six patients demonstrated a body mass index greater than 30. Median tumor size was 3 cm (range 1.3 - 5). Laparoscopic adrenalectomy was successful in 14 patients (87%). The median duration of the procedure was 132 minutes (range 59-360). The median postoperative stay was 6 days (range 2-13). No patient required blood transfusion. We conclude that the videoscopic approach can safely be used for surgical removal of adrenal lesions. However this approach should be performed by surgeons well versed in the techniques of open adrenalectomy for endocrine disorders, but also well trained in videoendoscopic surgery.
Adrenal Gland Diseases↗
[False aneurysm of the external iliac artery. A late complication of hip surgery (author's transl)].
The authors report one case of false aneurysm of the right external iliac artery following perforation of the acetabulum by a Böhler nail, which was placed twenty-two years before. Clinical signs were a no-pulsating tumor of the right fossa iliaca, deep venous thrombosis of the right leg and severe anemia. Treatment included resection of the false aneurysm, suture of the arterial wound and removal of the Böhler nail. The authors report the place held by vascular lesions in bone surgery, and diagnostic difficulties due to the delayed clinical manifestations.
Aged↗
[The problem of the treatment of the operable breast cancer (author's transl)].
Breast cancer is a chronic disease, often generalized at the time of diagnosis. Present treatments are efficient only if the tumor is still localized so that results are relatively disappointing. Careful clinical appraisal will define the chances of a disabling treatment and the limits of a curative treatment. Systematic histologic study of axillary nodes completes the clinical examination, is a reliable measure of the risk of dissemination at the time of treatment and indicates the necessity for complementary chemotherapy. The main choices of treatment for initial stages are presented. Radical mastectomy, according to the literature appears best as it adds a precise diagnosis to a safe result. Mastectomy without resection of the pectoralis major is a cosmetic alternative with statistical and experimental soundness. Complementary prophylactic irradiation for radical mastectomy should be reserved for high risk of local recurrence and for control of metastases to the internal mammary nodes.
Breast Neoplasms↗