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Biomedical subjects

L Toty

Publications and source records attributed to L Toty.

At least 37 records · Page 2Linked to original sources
PubMed1985

[The YAG-Nd laser in bronchology. Its role in noncancer pathology].

Whereas the CO2 laser has rapidly become an essential tool in laryngology, only a few teams use the YAG-Nd laser in bronchology. This is due to several factors, these explaining the reason for the slow diffusion of a method that has been available for 5 years. Firstly, indications are and will be very limited, and are mainly palliative in scope, particularly for tracheobronchial cancer, which represents half of the cases treated. Secondly, many endoscopic resections are dangerous and conducted at the price of a risk of asphyxia. They require an operative protocol and follow up surveillance of perfect security. Finally, it is evident that flexible endoscopic material is poorly adapted to this technique and indications have to be restricted by those who refuse to return to the archaic rigid tube.

Adolescent↗
PubMed1984

[Diffuse hepato-pulmonary hydatidosis. Apropos of a case].

The authors report a case of diffuse hydatid disease of the lung and liver. This association accounts for about 20 per cent of cases. Diffuse lesions are, on the other hand, exceptional. In this case the lung and liver functions were both impaired. Surgical management involved resection of the top of the cyst protruding from the liver and pulmonary cystectomy. The relative simplicity of the postoperative course, restoration of liver function and improvement in lung function prompt the authors to recommend surgical management of these cases, which cannot be treated medically.

Adult↗
PubMed1984

[Treatment of an asthmatic crisis by acupuncture. Probable role in the onset of pneumothorax with development to status asthmaticus].

The onset of pneumothorax during acupuncture treatment has been reported since 1973. Usually unilateral, it occurs in patients free from any bronchopulmonary disease, and its consequences are therefore relatively benign. However, rare cases of bilateral pneumothorax have been reported since 1978, as well as a pneumothorax developing in asthmatic patients, with often dramatic consequences. A 15-year-old girl with a severe attack of asthma was treated by implantation of needles, and this coincided with the onset of a pneumothorax, and a subsequent state of status asthmaticus. A fatal outcome was only just avoided. The question is raised as to the technical quality of the implantations practised, as well as the validity and dangers of acupuncture in asthmatics, particularly during the acute attack.

Acupuncture Therapy↗
PubMed1983

[Malignant ameloblastoma. Apropos of a case].

Ameloblastoma is a locally invasive, histologically nonmalignant tumor that may on very rare occasions give rise to metastases. A patient with a mandibular ameloblastoma presenting typical histologic appearances developed a pulmonary metastasis confirmed by histology as arising from the primary tumor. Two groups of these extremely rare malignant ameloblastomas can be distinguished: those without histologic signs of degeneration that give rise to metastases identical to the primary lesion, and those with degenerative signs provoking metastases with the histologic appearance of undifferentiated carcinoma. No relation appears to exist between size of primary tumor, histologic type of ameloblastoma, or its course and tendency to produce metastases.

Ameloblastoma↗
PubMed1982

[Repair of loss of substance of the thoracic wall and pericardium using a net of resorbable material].

After wide excision of the chest wall for primary tumour or bronchopulmonary carcinoma involving the ribs, the gap must be filled to prevent paradoxical respiration and its immediate functional consequences during the post-operative period. This can easily be achieved by using a polyglactin 910 piece of net cut to size out of a 25 X 25 cm plaque and sutured between the ribs under tension. The prosthesis ensures thoracic stability and acts as support for re-adherence of the lung to the chest wall. It resists coughing and is well tolerated. The indications of choice are respiratory failure and excision performed in varying degrees of septic condition which make non-absorbable material unsuitable. Another indication is wide excision of a tumour-invaded pericardium with herniation of the heart.

Bone Neoplasms↗
PubMed1982

[Diaphragmatic eventration in adults. Apropos of 20 cases].

Twenty adults with a mean age of 49 were operated on between 1972 and 1980 for eventration of the diaphragm. The etiology was probably traumatic in 11 cases; it was congenital in 2 and degenerative in 7. The functional signs were usually respiratory (55%) or digestive (10%). In all cases, the diagnosis was based on standard fluoroscopy showing superelevation of the hemidiaphragm, which was visualized fluoroscopically as immobile while a pneumoperitoneum showed a absense of any tear. Spirography confirmed a restrictive deficit which was sited broncho-spirometrically on the eventration side. Surgical repair was achieved in most cases by thoracotomy (19 cases) and consisted in plication (17 cases) or incision followed by suturing of the overlapping edges of the muscle (3 cases). Postoperative complications included the death of the patient with multiple trauma, on the eight postoperative day, as a result of the cerebrovascular accident, and in another case rutpure of the repair on the second day, requiring a second operation. Apart from one patient who died as a result of a fatal accident two years postoperatively, all the surgically treated cases are alive, and, with one exception, symptom free. After an average follow up period of 2 years and 2 months, the control respiratory function tests show a 21% improvement in vital capacity and a 20% increase in FEV1. On the basis of these results, the authors conclude that this functional surgery is justified in the case of patients presenting with typical clinical symptoms, and worth considering in cases where respiratory function tests show a restrictive deficit, but also in patients who do not complain of breathlessness.

Adult↗
PubMed1981

Bronchoscopic management of tracheal lesions using the neodynium yttrium aluminium garnet laser.

We report our first clinical trials with the NdYAG laser in the treatment of tracheal and bronchial tumours and stenoses. The beam is carried through a flexible fibre delivering a power of 50 to 90 watts. It can be introduced through the biopsy channel of a standard bronchoscope, or through a fibrescope. Anaesthesia must avoid inflammable gases. In most cases, general anaesthesia was used, and ventilation achieved with a mixture of 50% nitrogen and oxygen, using a modification of the Sanders injector. One hundred and sixty-four cases have been treated in 317 sessions (from one to five sessions per patient). They comprised: 72 cancers, 24 of which had just been diagnosed and had acute respiratory obstruction. In 16, one single session restored the patency of the airway. Forty-eight other cases were recurrent carcinomas after either surgery or radiotherapy, nine of which were caused by cancers of other origin invading the trachea; 21 benign or moderately malignant tumours; 44 iatrogenic stenoses, including 31 narrow ones. Of those 31 cases, 17 had an immediate satisfactory result, but eight recurred; 24 granulomas on bronchial suture lines. There were two deaths not directly related to surgery or anaesthesia. Bleeding was never more than moderate. The main difficulty lies in the critical respiratory condition of the patients, sometimes seen in acute asphyxia, referred to us as a last resort, especially those with carcinomas involving the trachea or main bronchi.

Adult↗