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Biomedical subjects

O Nussaume

Publications and source records attributed to O Nussaume.

At least 55 records · Page 3Linked to original sources

[Standard thoracic radiography in recent pneumonectomized patients. Its contribution to the diagnosis of empyema and bronchopleural fistula].

Case reports of 110 patients undergoing pneumonectomy were reviewed to assess value of standard postoperative chest radiography for detection of early complications, consisting mainly of empyema and/or bronchopleural fistula. Most radiologic modifications observed do not represent abnormal findings, although two signs can contribute to the radiologic diagnosis of empyema: the central superimposed air/fluid levels and the secondary mediastinal displacement, but even these signs are inconstant and of late onset. Five signs may be of significance for the diagnosis of bronchopleural fistula: in addition to the two described above there are the rapid fall in principal air/water level, the increase in subcutaneous emphysema and the late onset contralateral alveolar syndrome. The diagnosis of a bronchopleural fistula prior to the development of clinical symptoms was possible in one of two cases.

Bronchial Fistula↗

[Fatal hematemesis due to erosion of a retro-esophageal right subclavian artery by an esophagogastric tube].

A case of fatal haematemesis due to erosion of a retro-oesophageal right subclavian artery by a nasogastric tube is reported. In view of this exceptional but extremely serious complication, no oesophageal tube should be used in patients known to have this abnormal anatomical arrangement. Systematic treatment of aberrant subclavian arteries should perhaps be considered when it can be performed during thoracic surgery.

Aged↗

[Tissue identification of carotid lesions using ultrasound].

Technical progress in echotomography has made it possible to identify a number of structures within the atheromatous lesion itself. Such echotomographic data were compared with peroperative findings and histology of the endarterectomy specimen in the context of carotid pathology. Appearances were differentiated in terms of the density and homogeneity of the echos obtained. Heterogeneous and relatively undense lesion corresponded in the majority of cases with moveable intraluminal matter or intraplaque hematomas. False negatives were due in one case to technical impossibility (calcifications) and in one case to multiple ulcerations. Regular and homogeneous appearances corresponded to fibrous plaques, rich in collagen and free of potential emboligenic material. Preoperatively, echotomography may be used to assess the histological characteristics of a plaque with a high degree of sensitivity and good specificity. This new approach may help in the choice of treatment and will improve knowledge of the natural history of carotid lesions necessary for the study of preventive treatment, in particular in asymptomatic patients.

Arteriosclerosis↗

[Late renal revascularization].

Late renal revascularization could be indicated in totally occluded renal artery with hypertension and or renal insufficiency. Six cases of secondary revascularization after occlusion of renal artery are reported here. In three cases severe renovascular hypertension was the indication for renal revascularization. In three other cases, indication was proposed for renal insufficiency. In four cases, renal revascularization for totally occluded renal artery have been beneficial for the patients. In two cases of terminal renal insufficiency, chronical hemodialysis could be suppressed. In the others two cases, hypertension was clearly improved. The criteria for renal revascularization before and during surgery are discussed here. The kidney length, the cortico-medullary ratio at kidney echography, and the visualization of a nephrography during angiography are the principal criteria before surgery for renal revascularization. The macroscopic aspect of the kidney, the immediate results of renal biopsy and the importance of a blood reflow in the renal artery are the principal criteria during surgery, but must be discussed because there are no definitive criteria. Renal revascularization shall be proposed when totally occluded renal artery is associated with renal insufficiency and/or hypertension, especially when the other side can be affected by the same disease.

Adult↗

[Stenosis of hemodialysis grafts. Treatment with a short graft].

In elective or emergency operations 363 short venous or polytetrafluoroethylene grafts were inserted to correct stenosis of haemodialysis grafts. Such stenoses are located in the upper part of the graft or in the receiving vein in 80% of the cases. After 2 years, 74% of the short grafts were still permeable. This original technique has several advantages: the initial venous approach is respected, the graft can be used immediately for dialysis, and the patient's venous "capital" is spared.

Arteriovenous Shunt, Surgical↗

[Recent tracheobronchial ruptures caused by closed injuries of the thorax. Diagnosis and complications in 18 cases].

Tracheo-bronchial ruptures are serious complications of thoracic trauma. The authors report their experience of 18 cases: 3 tracheal ruptures, 3 tears in the tracheal or bronchial membrane, 11 unilateral bronchial ruptures and 1 bilateral bronchial rupture. Diagnostic endoscopy was performed immediately in 9 cases, with a delay of 2 to 3 days in 6 cases and with a longer delay (15th, 23rd and 25th days) in 3 cases. The treatment was non-operative in the 3 cases with membranous tears. The other patients were operated by resection of the contused area and end-to-end anastomosis of the ruptured extremities: within 24 hours following the diagnosis in 10 cases, and after a delay in the 5 other cases. The post-operative course was uncomplicated in 13 cases; 1 patient developed a bronchial stenosis requiring pneumonectomy and 4 patients died, including 2 from infective lesions due to delay in the diagnosis.

Adolescent↗

[Treatment of an aneurysm of the abdominal aorta above a transplanted kidney. Renal protection by inert subclavian-femoral bypass].

Opening and grafting of an aneurysm of the abdominal aorta located between and below the renal arteries were carried out in a 44-year old patient with a transplanted kidney in right hypogastric position. Renal ischaemia during clamping of the aorta was prevented by means of an inert bypass between the right subclavian and femoral arteries. The patient's renal function remained normal. The different techniques available to protect renal transplants are compared.

Adult↗

[Ureterovesical reimplantation. A technic derived from Lich and Gregoir's procedure].

Fifty-five uretero-neocystostomies were carried out using a technique derived from the Lich-Gregoir technique. Tightness is ensured anastomosis and burying over the vesical dome, with minimal vesical opening; the anti-reflux system is effective. Urinary complication of this ureter transplantation method are now rare, in our series, only two complications due to necrosis of the ureteral segment were observed. This technique could be used in all obliterations of the ureter, whether accidental or by necessity, located near the bladder.

Humans↗

[Thymic seminomas (author's transl)].

The authors report on three cases of thymic seminoma treated between 1971 and 1981. These tumours, first described by Friedman in 1981. These tumours, first described by Friedman in 1951, belong to the group of extra-gonadal germinal tumours. They constitute about 2.5% of all thymic masses. The most probable pathogenic theory is abnormal migration of germinal cells from the vitelline sac to the embryonic thymus. Thymic seminomas are usually found in young men and are asymptomatic in 30% of the cases. Macroscopically, they present as solid tumours capable of invading the surrounding structures. Histologically, they resemble gonadal seminomas but are sometimes difficult to identify, which is unfortunate since treatment is dependent upon an accurate histological diagnosis. The authors suggest that the tumour should be biopsied under mediastinal fluoroscopy, so that an accurate histological diagnosis can be made. Treatment consists of surgical excision, which should be restricted and on no account should destroy important structures, completed by mediastinal radiotherapy. The mean survival time is 6.3 years; the 5-year survival rate is 75%.

Adult↗