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Biomedical subjects

M Sellami

Publications and source records attributed to M Sellami.

At least 19 recordsLinked to original sources
PubMed2006

[Algodystrophy of the lower limbs during pregnancy].

Algodystrophy (AD) of the lower limbs during pregnancy is rare and probably underdiagnosed. The physiopathologic mechanisms remain under discussion and seem multiple and complex. This report describes a retrospective survey of 6 patients seen between 1993 and 2004 who had algodystrophy of the lower limbs during pregnancy. Comparing the clinical, radiological and evolutionary results to the literature allows for identifying the main features of AD during pregnancy: disease progression during the second or third trimester, preferential localization of the left hip associated or not with other lower limb joint involvement and decalcification as seen on radiography. Magnetic resonance imaging (MRI), which is accurate, specific and non-invasive, is currently the exam of choice in early and differential diagnosis. The evolution is favourable in a few months, with general recovery without disability.

Adult↗
PubMed2002

[Multifocal bony hemangioendothelioma: a case report].

Hemangioendothelioma is a rare tumor (0.5% of primary malignant bone tumors) generally found in long bones and tarsal bones. We report a case in a 67-year-old man who underwent surgery in 1987 for a tumor of the left ankle. He again consulted in 1998 for pain in the left knee. Standard x-rays of the left lower limb evidenced multiple partitioned bone defects with cortical lysis in the femoral condyle, the upper and lower portions of the tibia and the talus. Computed tomography showed a lytic image of the lower femoral and superior tibial epiphysis without cortical or soft tissue involvement. Laboratory findings were normal. Pathology examination of a biopsy specimen led to the diagnosis of grade I multifocal bony hemangioendothelioma of the medial femoral condyle and the medial upper tibial facet of the left knee. Search for extension was negative. Curettage followed by cement filling of all tumor sites and postoperative radiotherapy were successful. No recurrence has been observed 3 years later. The histological polymorphism of hemangioendotheliomas leads to varying therapeutic management schemes.

Aged↗
PubMed2001

Hydatid disease of the liver with thoracic involvement.

Hydatidosis, caused by Echinococcus granulosus, is an endemic parasitic disease in Mediterranean countries. The most frequent anatomic locations are liver and lung. Intrathoracic rupture of hydatid cysts situated in the hepatic dome is a serious complication resulting in damage to the pleura, pulmonary parenchyma, and bronchi. From January 1984 to December 1997 we operated on 40 patients with intrathoracic rupture of a hepatic hydatid cyst. Chest roentgenograms showed a shadow of varying size at the base of the hemithorax. Hepatic and thoracic ultrasonography was performed in all cases. The diagnosis of intrathoracic rupture of a liver cyst was confirmed preoperatively in 30 of the 40 cases. Posterolateral thoracotomy was performed in all patients. This transthoracic approach allowed adhesiolysis and treatment of the pleural lesions, pulmonary lesions, and hepatic cyst. Treatment of the diaphragmatic gap is easily done. We performed 15 lobectomies, 10 wedge resections, 16 decortications, and in one patient simple drainage of a voluminous pleuropulmonary and hepatic purulent hydatic collection. The postoperative course was uneventful in 26 cases, but 14 patients had complications, from which 3 patients died. The therapeutic approach depends on ultrasonographic findings. We believe ultrasonography to be the best examination for assessing biliary, hepatic, diaphragmatic, and pleuropulmonary lesions. When an intrathoracic collection is present, thoracotomy must be performed and is sufficient if the biliary tract is safe. An abdominal approach is necessary when biliary duct drainage is required, and it may be sufficient in cases of direct rupture into the bronchi.

Adolescent↗
PubMed1996

Swan-Ganz catheter induced pulmonary artery perforation during cardiac surgery concerning two cases.

Two case reports describing patients having cardiac operations under extra corporeal circulation are presented. At the completion of the operation, a massive hemoptysis occurred in both patients after a Swan-Ganz catheter had perforated the pulmonary artery. A hemostasis lobectomy was then immediately required. The immediate and long term prognosis seems satisfactory. This is an unusual but serious complication. The incidence of this complication varies between 0.06 and 0.2%. The more frequently related risk factors include people over the age of 60, pulmonary artery hypertension, anticoagulant therapy, hypothermia and manipulation of the heart by the surgeon. When this accident occurs, many authors suspect the balloon. An early diagnosis is essential in the case of a major or even a minor hemoptysis, because this complication may be a lethal one as the mortality rate may reach 50%. According to us, the appropriate therapy which would reduce this mortality is a surgical one (hemostasis lobectomy).

Aged↗
PubMed1993

[Tracheobronchopathia osteochondroplastica. Personal observation and review of the literature].

Tracheobronchobathia osteoplastica (TBO) is a benign disease first described in 1855 and rather rare since only 371 cases have been reported so far. The disease is characterized by the presence of subepithelial osteocartilaginous focal lesions without any relation to tracheal rings. The mechanism of its occurrence remains controverted. We report a case of TBO which is particular in that is was associated with atrophic rhinitis, polydactylia and disorder of oesophageal motricity. From a compilation of 113 cases published by French and Anglo-Saxon authors since 1970, it appears that the clinico-radiological and laboratory picture is of little help in the positive diagnosis which in fact rests on three key-points: bronchial endoscopy, pathological examination of bronchial biopsy fragments and thoracic imaging techniques including computerized topography and magnetic resonance imaging. The usually benign course of the disease can be marked by severe complications, such as infections, haemorrhages, acute dyspnoea by extension to the larynx or significant narrowing of the tracheal lumen which may need tracheotomy or surgical resection of the lesions.

Adult↗
PubMed1992

[Endobronchial neurogenic tumors].

Endobronchial neurogenic tumours are exceptional and little known. The authors report two cases of such tumours: a neurofibroma of the right main bronchus in a 32 year old man and a schwannoma of the left main bronchus in a 10 year old child. Pneumonectomy was necessary in both cases due to destruction of the pulmonary parenchyma distal to the obstruction. The incidence of this type of tumour is estimated to be between 0.2 and 4%. They may be either schwannomas or neurofibromas, the discovery of which always raises the problem of the possible association of von Recklinghausen's disease malignant forms, neurogenic sarcomas or malignant schwannomas may also be encountered. The diagnosis is based on endoscopy which reveals the tumour and allows biopsy. Treatment of these essentially benign tumours should be conservative, provided the diagnosis is made early, prior to parenchymal destruction. The prognosis is poor in the malignant forms and chemotherapy may be useful in malignant schwannomas.

Adult↗
PubMed1991

[Place of thoracotomy in thoracic complications of hydatid cysts of the liver].

The authors present 16 cases of hydatid cyst of the liver with rupture into the thorax, operated by thoracotomy. In 15 cases, the cyst ruptured into the right hemithorax and in one case, it ruptured into the left hemithorax. We adopted the classification proposed by our master S. Mestiri, which completes that proposed by Dévé. The diagnosis is essentially based on thoraco-abdominal ultrasonography, which visualises the hydatid cyst, reveals intrathoracic collections, demonstrates the diaphragmatic tear and studies the biliary tract looking for obstruction or dilatation. The diagnosis was established in 12 out of 16 cases. There were 3 postoperative deaths (18.7%): two from septic shock and one from cerebral vein thrombosis. Only one patient had to be operated via an abdominal incision one month after thoracotomy for cholangitis secondary to stones in the common bile duct which were not seen on the preoperative ultrasonography. Laparotomy is required whenever there is a biliary problem and may be sufficient in type 1 lesions. Thoracotomy is necessary whenever there is an intrathoracic collection (types II, III, IV) and is sufficient in the absence of any biliary tract lesions.

Adult↗
PubMed1990

[Extralobar pulmonary sequestration. A diagnostic pitfall].

The authors report a case of dual malformation: pulmonary (sequestration) and mediastinal (pericardial). This case is original in that clinically and at standard radiography sequestration was mistaken for hydatid cyst. The diagnosis was corrected after anatomico-pathologicale examination of the operative specimen.

Adult↗
PubMed1990

[Small intestine occlusion caused by the silent opening of liver hydatid cysts into the peritoneum. Apropos of an uncommon case].

The authors report one exceptional case of organic small bowel occlusion. The etiological diagnosis was performed by ultrasonographic examination and showed two hydatid cysts of the liver opened into the peritoneum and a peritoneal fluid collection corresponding to the hydatid fluid. The authors emphasize the absence of clinical symptoms during the opening of the hydatid cysts of the liver into the peritoneum and the usefulness of emergency ultrasonographic examination of the entire abdomen in cases of small bowel obstruction without any evident etiology.

Adult↗
PubMed1989

[Malignant para-testicular tumors. Apropos of 3 unusual cases].

Three uncommon cases of malignant para-testicular tumors are described. The first one was a malignant mesothelioma discovered after cervical node biopsy, the second, a high grade lipoblastic liposarcoma and the third a malignant mesenchymoma with 4 components. The literature is reviewed with special regard to these 3 types.

Adolescent↗
PubMed1988

Results of a conservative treatment combining induction (neoadjuvant) and consolidation chemotherapy, hormonotherapy, and external and interstitial irradiation in 98 patients with locally advanced breast cancer (IIIA-IIIB).

Ninety-eight patients with locally advanced breast cancer (Stage IIIA-IIIB) were entered into a pilot study combining intensive induction (neoadjuvant) chemotherapy (VTMFAP) with or without hormonochemotherapy, external and interstitial radiotherapy, and consolidation chemotherapy with or without hormonochemotherapy. Tumor regression over 50% was observed in 91% patients after chemotherapy, and complete clinical remission occurred in 100% patients after irradiation. The rate of local relapse is 13%. The 3-year disease-free survival is 62% and 3-year global survival is 77%. Initial chemotherapeutic tumor regression greater than 75% is the main predictive factor for disease-free survival.

Antineoplastic Combined Chemotherapy Protocols↗