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Biomedical subjects

M Ribet

Publications and source records attributed to M Ribet.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Funnel chest: objective and subjective aspects].

Forty cases of funnel chests were observed in a majority of 15-20 years old male youngsters. Twenty-six had respiratory or cardiac symptoms. A surgical correction was done for 22 patients; 12 had symptoms. Eighteen patients had no surgery and were advised to undertake physical therapy: 6 had symptoms. With a 1 to 25 years follow-up 12 operated patients were checked up: 10 were satisfied with the correction. None had any symptom. This subjective results were superior to the morphologic and functional criteria. As for non operated patients, 12 were contacted: 7 had followed our advice and felt a functional amelioration in 6 cases and a morphological amelioration in 4 cases. Five patients had no therapy: 4 considered themselves in a stable situation an 1 thought it was worse. Funnel chest symptoms are the expression of anxiety in a majority of cases. The subjective as well as the formal matters are to be considered to appreciate the results of treatment. Physical exercises are an important part of the therapy, either with or without surgery.

Adolescent↗
PubMed1989

[Diagnosis and surgical treatment of abdominal angina caused by atheromatous stenosis of the digestive arteries].

The diagnosis and technical aspects of revascularization are discussed in a series of 14 consecutive cases of intestinal arterial insufficiency. The typical clinical presentation of post-prandial pain and weight loss was found in 12 out of 14 cases. Gastroenterological investigations demonstrated associated lesions in 8 cases, including 5 cases of gastroduodenal ulcer disease where this was initially considered responsible for the symptomatology. No case of malabsorption was noted. Angiography demonstrated involvement of the three splanchnic vessels in 7 cases, two vessels in 6 cases and one vessel only in the remaining case. The revascularization techniques were as follows: reimplantation of the superior mesenteric (n = 1), bypass from the sub-renal aorta (n = 5), or a sub-renal aortic graft (n = 2) or supra-coeliac aorta (n = 6). Control angiography demonstrated permeability in 9 out of 10 cases where this examination was carried out. The early results included one post operative mortality. From a nutritional and functional point of view they were three failures and ten good results. Overall, follow up and survival ranged from 6 months to 9 years. In five cases death was due to secondary causes. Abdominal angina occurs in a population at high vascular risk. In view of this etiology the diagnosis should be considered at an early stage and this also explains the secondary mortality. Gastroduodenal ulcerative lesions may occur as part of the clinical presentation. The angiographic data confirmed the Mikkelsen rule, however the functional effects of stenosis could be better evaluated by pulsed echo-doppler.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Pain↗
PubMed1989

[Congenital cysts of the esophageal wall with a respiratory type mucosa].

Eight patients with congenital esophageal cysts are described. They presented with respiratory or gastrointestinal symptoms or an abnormal mediastinal profile on a standard chest film. All cysts were contained in the middle or inferior portions of the thoracic esophagus. They were excised in a submucosal plane. Their coat was composed of a ciliated, respiratory type epithelium. In the embryo and after separation of the tracheal diverticulum, the esophagus is lined with ciliated cells which are able cover a "cystic duplication", which is surrounded by an esophageal muscular coat or can be "included" in a common mesenchyma, which explains the possible presence of bronchial elements in the wall of an esophageal cyst. In this eventuality the cyst may be defined as being "bronchogenic".

Adult↗
PubMed1988

Lympho-epithelial thymomas. A retrospective study of 88 resections.

Of 113 lympho-epithelial thymomas retrospectively studied, 56 were epithelial, 20 lymphocytic, 30 mixed and 7 were undefined forms. There were 88 resections (20 stage I, 47 stage II, 13 stage III and 8 stage IV). There were 69 primary resections (followed by radiotherapy in 54 cases) of which 57 were complete and 12 were incomplete. There were 19 secondary resections after radiotherapy: 10 were complete and 9 were incomplete and 25 patients were not operated upon and were treated by radio- and chemotherapy. After primary resection, the actuarial 5-year survival is 64.07% and the 10-year survival is 50.86%. After a secondary resection, the 5 year-survival is 43.74%. After non-surgical treatment, it is 18.67%. After surgery, the prognostic importance of staging is confirmed as more important than the cellular structure. Myasthenic patients are subject to late accidents. Postoperative radiotherapy seems to be justified, but its effect is not statistically significant when resection is complete. Post-radiotherapy surgery is beneficial only in cases of complete resection. The metastatic evolution of thymomas has been underrated and seems to depend upon the local control of the tumour. The use of chemotherapy remains to be defined.

Actuarial Analysis↗
PubMed1988

[Lympho-epithelial thymoma. Anatomo-clinical and therapeutic study of 113 cases].

One hundred and thirteen cases of lympho-epithelial thymomas were studied retrospectively: 56 were of epithelial type, 20 of lymphocytic type, 30 were mixed and 7 were not defined. Eighty-eight were operated on (20 stages I, 47 stages II, 13 stages III and 8 stages IV). There were 69 primary resections (57 complete and 12 incomplete), followed by radiotherapy in 54 cases and 19 secondary resections after radiotherapy (10 complete and 19 incomplete). Twenty-five patients did not have an operation and were treated with radio- and chemotherapy. After primary resection the actuarial survival at 5 years was 64.07% and at 10 years 50.86%. After a secondary resection it was 43.74% at 5 years. After radiotherapy it was 18.67% at 5 years. In operated cases the prognostic importance of staging was confirmed. The cytological structure was not. In myasthenic cases the secondary respiratory complications worsened the prognosis. Post-operative radiotherapy seems to be justified in all cases, but its effect is not statistically significant when resection was complete. Those operated after radiotherapy only showed a benefit if the resection was complete. The outcome of metastatic disease in TLE has been under-estimated and seems to depend on local control of the tumour. The use of chemotherapy remains to be defined.

Adolescent↗
PubMed1988

[Lipoblastic liposarcoma of the lung. Ultrastructural study of a case].

A case of fatal lipoblastic pulmonary liposarcoma in a 20 year-old female is reported. A thoracotomy was performed but failed to yield the pathological diagnosis. This diagnosis was obtained by ultrastructural study of a cerebral metastasis. To our knowledge, only seven cases of pulmonary liposarcoma have been previously described in the literature and the lipoblastic aspect was never mentioned.

Adult↗
PubMed1987

[Surgery of giant bullae of emphysema in adults].

Over a 20 years period 50 patients with giant emphysematous bullae (bilateral in 20 cases) were operated upon. Fifteen had been exposed to an occupational risk (coal mining, steel milling, chemicals); all were, or had been, tobacco smokers; 11 were in acute respiratory distress at the time of surgery. Respiratory function tests showed mixed restrictive and obstructive impairment. Ten patients had chronic cor pulmonale. There were 8 post-operative deaths, 4 of them with right-sided heart failure. Mortality was highest in patients with bilateral lesions and in emergency situations. Late complications involved the lungs in 10 cases and the heart in 2 cases. The results of pre- and post-operative lung function tests could be compared in 13 patients.

Aged↗
PubMed1987

[Diffuse pulmonary contusion].

Seventy-two cases of diffuse pulmonary contusion, 50 of which concerned multiple injury patients, are retrospectively described. The pleuro-parietal and associated lesions, the clinical, radiological and laboratory findings and the extent of the damage are analyzed. Treatment of shock (50 cases), mechanical ventilation (51 cases), thoracotomy (7 cases) and surgery of associated lesions are studied. Morbidity and mortality (34.7%) are detailed. The nosology of pulmonary contusion is discussed in relation to several factors, including shock, perfusions and associated lesions. The principles of treatment are restated. The most important complication is pulmonary superinfection. Diffuse pulmonary contusion is a serious condition. Associated lesions and their treatment contribute to its outcome.

Adult↗
PubMed1987

Barrett's esophagus and adenocarcinoma.

Sixty-two cases of Barrett's esophagus were observed among 707 patients with hiatal hernia (8.7%). The symptomatology of this condition is described. An additional 10 adenocarcinomas were associated with a Barrett's esophagus--a carcinoma prevalence of 13.8%. Differences in pathology and clinical manifestations of nonmalignant and malignant cases were determined. Fifty-one patients with nonmalignant Barrett's esophagus were operated upon conservatively, while 11 underwent resection. Our results favor conservative surgery via an abdominal approach. The patients with adenocarcinomas underwent esophageal resection with six apparent cures from 6 months to 5 years. Histological study showed specialized epithelium in 8 of 10 cases and severe dysplasia in 5. Our clinical study of Barrett's esophagus shows an incidence of malignancy equal to 1 new case per 274 patient-years (1.72%). It is still not firmly established whether correction of reflux will influence the level of columnar epithelium in the esophagus, esophageal dysplasia, and the risk of malignancy.

Adenocarcinoma↗
PubMed1987

[Splenic complications of chronic pancreatitis. Clinical and experimental study].

Splenic complications of chronic pancreatitis appear to be less exceptional than is usually accepted, particularly since preoperative diagnosis has been facilitated by ultrasound and abdominal scan imaging. Complications noted in 37 cases were: infarcts (2 cases), hematoma or false blood cysts (26 cases) and rupture (9 cases). The splenic infarcts were revealed by digestive hemorrhage, the false blood cysts of spleen by a painful mass in left hypochondrium associated with pleural effusion and rupture of spleen by an acute hemoperitoneum. Treatment included splenectomy in 19 cases, splenectomy caudal pancreatectomy in 17 cases and drainage of a splenic hematoma in one patient. Operative mortality was 16.2% and the long-term prognosis was poor and related to underlying condition. Data from an experimental study suggest that the effect of an episode of acute pancreatitis on the splenic pedicle is the most important physiopathologic factor. A hemorrhagic infarct or infarction of splenic parenchyma are common starting points for all clinicopathologic forms described.

Animals↗
PubMed1986

[Mycotic aneurysm after catheterization of the umbilical artery].

The finding of an abdominal mass in an 18-month old infant ultimately led to the diagnosis of mycotic aneurysm of a common iliac artery. The lesion was resected and the vessel was ligated. The short and long-term outcome was favourable. The child had been operated upon for cervical teratoma and had undergone catheterization of the umbilical artery complicated with Staphylococcus aureus infection. The presence of a mycotic aneurysm must be suspected in infants with a history of umbilical artery catheterization or neonatal staphylococcal infection, or presenting with a posterior mediastinal or abdominal mass, or arterial hypertension. The vessel most commonly involved is the aorta. Surgical resection, when performed, results in cure. The present case is remarkable on three points: the lesion involved an iliac artery, the diagnosis was delayed and calcifications were present around the aneurysm.

Aneurysm, Infected↗
PubMed1986

[Perforations of the esophagus].

The prognosis of esophageal perforations remains poor. In this study 80 cases (26 cervical, 45 thoracic and 9 abdominal) are reported. Pain was the most frequent symptom, present in 56/80 cases. Signs of perforation were detected on standard X-ray films in 85% of the cases, and oesophagography with Hytrast showed a leak in 88%. Treatment was delayed for more than 24 hours in 41 patients. Direct intervention on the esophageal wound (suture, fistulization, drainage, double exclusion, resection) was carried out in 54 patients, whereas 26 were fed parenterally or by tube or through jejunostomy and were given antibiotics with or without drainage of a fluid collection. The overall mortality rate was 35%, death being caused by infection or toxic shock. Treatment and prognosis were dependent upon the course of the infection. No other single prognostic factor was significant, with the exception of age over 60.

Esophageal Perforation↗
PubMed1986

[Barotraumatic rupture of the esophagus. 4 cases. Review of the literature].

Oesophageal barotraumatism is a rare lesion and only 19 cases have been reported in the literature. Four new cases are described, the mechanism involved being either a jet of gas into the oesophagus or an explosion close to the face producing rupture of the oesophagus by increased endoluminal pressure. Four characteristic clinical signs are noted: wounds or burns to the face or mouth, chest or epigastric pain, subcutaneous emphysema and respiratory distress. A pneumomediastinum or pleural effusion is a constant finding, and a perforation is identified regularly by an oesophageal water soluble opacification. Of the 19 cases reported in the literature, 4 were detected at autopsy, one patient died after surgery and 14 recovered after operation. The mediastinal infection was either subacute requiring external thoracic drainage after oesophageal exclusion, or acute, necessitating emergency direct oesophageal repair. Only one of the 4 patients reported in this paper survived the accident.

Accidents, Occupational↗