Biomedical subjects

O Traxer

Publications and source records attributed to O Traxer.

29 records · Page 2Linked to original sources

PubMed1999

[Extracorporeal lithotripsy in children. Study of its efficacy and evaluation of renal parenchymal damage by DMSA-Tc 99m scintigraphy: a series of 39 children].

AIM: The objectives of the study were to confirm the efficacy of extracorporeal shock wave lithotripsy (ESWL) in infants and children and to evaluate potential long-term renal parenchymal damage by 99m Tc DMSA renal scan. MATERIALS AND METHODS: Between November 1989 and November 1997, 39 children between 10 months and 17-1/2 years of age (average: 7 years) were treated by extracorporeal shock wave lithotripsy for kidney or ureteral stones with a Sonolith 3000 lithotriptor (Technomed Corp). Forty-six stones were treated. Eight metabolic and 11 urological abnormalities were identified. The evaluation of the treatment and its consequences were based on a clinical examination, conventional imaging and a DMSA renal scan performed 24 h before extracorporeal shock wave lithotripsy and at least 6 months after treatment. RESULTS: Treatment was successful (stone fragmented and eliminated) in 84.6% at 3 months after one to four sessions. Sixty-one sessions were necessary and two patients underwent open surgery for failed extracorporeal shock wave lithotripsy. Three recurrences were also retreated. At long term follow-up (6 months to 8 years) no incidents of high blood pressure were observed, nor parenchymal lesions imputable to extracorporeal shock wave lithotripsy. CONCLUSIONS: The efficacy of the extracorporeal shock wave lithotripsy for children is proven. This study also confirms the innocuousness of extracorporeal shock wave lithotripsy for renal parenchyma even in infants. However, long term follow-up and further evaluation with the other categories of lithotriptors are necessary to make definitive conclusions.

Adolescent↗

PubMed1999

[Posterior approach to the bladder for implantation of the 800 AMS artificial sphincter in children and adolescents: techniques and results in eight patients].

Blind dissection of the bladder neck during implantation of an artificial urinary sphincter (AMS 800) may lead to injury of either the bladder, genital tract or even the rectum. Significant bleeding may occur. A posterior approach to the bladder neck allowing visual control of the anatomical structures is described. From November 1995 to February 1998, 8 adolescents (12-19 years old) underwent AMS 800 artificial urinary sphincter implantation for the treatment of severe incontinence associated with neurogen bladder; one patient had had a previous augmentation. Three had a simultaneous ileocystoplasty and another patient had a simultaneous bilateral extravesical ureteric reimplant. The procedure consisted of separation of the bladder from the peritoneum, allowing the development of a dissection plane between the rectum and genital tracts posteriorly and the ureters and bladder neck anteriorly; the dissection is extended to the base of the prostate. The endopelvic fascia is then incised laterally and on both sides the neurovascular bundles are perforated under visual control and the cuff is positioned safely around the bladder neck, above the prostate and in front of the genital tract. The bladder was opened only in the case of associated ileocystoplasty, thus avoiding prolonged bladder drainage. The mean operating time was 2.5 hours and the blood loss never exceeded 300 cc. This route was not found to be convenient in the case of the patient with a previous augmentation; 7 sphincters function normally with a follow-up of 18 to 44 months; one was never activated and the patient is dry under CIC. This route for exposure of the bladder neck allows visual control of the anatomical structures, accurate positioning of the cuff, avoids bladder opening and reduces bleeding. It can be used for other procedures such as bladder neck suspension or Müllerian cavity removal.

Adolescent↗

PubMed1999

[Comparison of biomechanical properties of the vaginal fixation in bladder neck suspensions according to the Burch technique and a percutaneous technique].

UNLABELLED: Bladder neck suspension or colpo-suspension can be performed via retropubic or percutaneous transvaginal approaches. A higher success rate is observed for retropubic procedures. One of the hypotheses proposed, but not yet verified, is that the retropubic approach allows better quality vaginal fixation than the percutaneous approach. OBJECTIVE: The objective of this study was to compare the biomechanical properties of vaginal fixation according to the Burch procedure and according to a percutaneous technique (Vesica; Boston Scientific). MATERIAL AND METHODS: We performed bladder neck suspension according to the Burch technique (2 points) on the left and according to the Vesica percutaneous technique on the right, on 6 fresh cadavers (mean age 8-5 years), using the same suture material. Vaginal fixations were subsequently excised. The depth of penetration into the vagina was measured and a computerized traction test (Lloyd Instruments, France) was performed on these fixations. The maximum force of traction before rupture was measured. RESULTS: No significant difference was demonstrated for any of the measurements. CONCLUSION: Vaginal fixation of bladder neck suspension performed according to the Burch technique or via a percutaneous technique (Vesica) present equivalent biomechanical properties.

Aged↗

PubMed1999

[Acute occlusions of the small intestine caused by adhesions. Indications and results].

Postoperative adhesions are the first cause of small bowel occlusion in developed countries. Nevertheless no progress was done in prevention and treatment of this disease. The aim of this trial is to report results of 276 small bowel occlusions caused by adhesion recently operated and consecutive between first january 1993 and 31 december 1996. These patients had 400 previous surgical procedures, within 67.4% infra mesocolic or pelvic. 15.1% of previous surgical procedures took place less than one year before and 36% less than 5 years. Thirty five per cent of patients were operated during 24 hours following admission 23.2% of patients had a digestive resection, caused by necrosis or iatrogenic dissection. Operative mortality was 4.3% without resection and 16.6% with resection. Progress are warranted to reduce the rate of redux of occlusion and mortality and morbidity in this benign disease: more peri operative attention and place of laparoscopy should be considered.

Acute Disease↗

PubMed1998

[Bulky superinfected tinea capitis of the scalp. Treatment by surgical resection and reconstruction by cutaneous expansion].

BACKGROUND: Tinea capitis are usually cured by medical treatment. We present an unusual case which required a surgical treatment. CASE REPORT: A bulky infected kerion ignored for several weeks extended to a large part of the scalp of a 4-year-old girl. Antibiotics and antifungal agents were ineffective so that a total resection was necessary. The loss of substance was covered by a cutaneous graft; the large alopecia was secondarily repaired by a cutaneous expansion. Evolution has been followed for the past 10 years. CONCLUSION: It is exceptional that surgical treatment should be required for this condition.

Alopecia↗

PubMed1998

[Left aortic arch--right descending aorta--right ductus arteriosus (encircling aortic arch). A rare malformation of the aortic arches].

UNLABELLED: Abnormalities of the aortic arch which are responsible for tracheobronchial compression are well known. This case demonstrates the value of magnetic resonance imaging (MRI) for diagnosis and suggests that recurrent respiratory symptoms should evoke these abnormalities in infancy. CASE REPORT: The authors report a very rare malformation of the aortic arch formed by encircling aortic arch, with left aortic arch, right descending aorta and right ligamentum arteriosum. It was revealed by airway disorders due to the compression of tracheobronchial axis by the ligamentum arteriosum. Section of the ligamentum permitted suppression of obstruction. The diagnosis of these abnormalities is usually established by means of oesophagogram, tracheobronchial endoscopy, angiography and MRI. CONCLUSION: In this case, MRI gave a better picture than angiography. Sections of the ligamentum arteriosum are sometimes ineffective when compression is due to the aorta itself. Aortic uncrossing, a more complex operation, is then necessary.

Abnormalities, Multiple↗

PubMed1998

[Extracorporeal shock-wave lithotripsy in infants. Study of its repercussions on the renal parenchyma].

PURPOSE: To evaluate the efficacy of extracorporeal shock-wave lithotripsy (ESWL) in infants (less than 2-years-old) and study the potential long-term renal parenchymal damage by 99 m Tc DMSA renal scan. MATERIALS AND METHODS: Between November 1993 and February 1998, 12 children underwent ESWL treatment for kidney and ureter urolithiasis with a Sonolith 3,000 lithotriptor (Technomed-Corp). All children were less than 2-years-old. Evaluation of treatment and its consequences was based on clinical examination, conventional imaging (plain abdominal radiography excretory urogram) and a DMSA renal scan performed 24 hours before ESWL and at least 6 months after treatment. RESULTS: Treatment was successful in 84.6% of cases, by achieving stone-free status after one session and 100% after 2 sessions. Long-term follow-up (one month to four years) did not reveal any blood pressure or renal function changes. No acquired parenchymal scar was identified. On DMSA renal scan. CONCLUSIONS: The efficacy of ESWL in treating infant urolithiasis is clearly established. Renal parenchymal damage associated with ESWL did not appear in this study, but long-term follow-up mandatory (blood pressure) and each infant should have a DMSA renal scan before and after ESWL to confirm these preliminary results on a larger series.

Humans↗

PubMed1998

[Long-term evaluation with DMSA-Tc 99m scintigraphy of renal parenchymal involvement in children after shockwave extracorporeal lithotripsy].

OBJECTIVES: This study evaluated the long-term effects of extra-corporeal shock-wave lithotripsy (ESWL) on the renal parenchyma of children using DMSA-Tc 99m scintigraphy. MATERIAL AND METHODS: Between November 1989 and April 1997, twenty-three children wee treated for renal stones using a SONOLITH 3000 lithotriptor (Technomed-Corp. Evaluation of treatment and its consequences was based on clinical examination, conventional imaging and comparison with DMSA-TC 99m renal scintigraphy performed the day before and at least 6 months after treatment. RESULTS: The success rate (fragmented and eliminated stones) was 90% at 6 months. Long-term follow-up did not reveal any alteration of blood pressure or renal function. Scintigraphic examinations did not demonstrate any significant parenchymal lesions attributable to treatment. CONCLUSION: Extracorporeal shock wave lithotripsy is effective in adults and young children. Its safety on the renal parenchyma was demonstrated during this study. However, evaluation of larger series with the use of other lithotriptors is necessary before reaching any definitive conclusions.

Adolescent↗

PubMed1997

[Cowper's gland: anatomic, physiological and pathological aspects].

Cowper's glands are small appendages of the male genital tract, that are sometimes observed on intravenous urography voiding films. They are involved in the immune defence of the genitourinary tract, play a role in fertility, and secrete many glycoproteins, including PSA. They can be visualized in the form of a duct image parallel to the urethra, sometimes associated with opacification of the gland on IVU. This image can be differentiated from a fistula, extravasation of contrast agent, urethral duplication, or an artefactual image, by the course parallel to the urethra, the upper limit not exceeding the urogenital diaphragm, and the position of the orifice. These glands can be affected by neoplastic, infectious, stone and especially cystic disease: syringocele. The physician should think of these glands in patients with unusual genitourinary symptoms in order not to miss disease of these organs, and to prescribe appropriate treatment.

Bulbourethral Glands↗

PubMed1996

[Lesions of the iliac arteries secondary to closed traumas. Apropos of 5 cases].

Lesions of the iliac arteries after blunt trauma is uncommon. We observed 5 cases in our unit from 1992 to 1995. This pathology usually is seen in young men and the diagnosis often is made late. A Doppler examination and arteriography should be made in case of clinical doubt. Treatment is exclusively surgical. We present the mechanism of the arterial lesions, the symptomatology caused by the lesions and the therapeutic modalities.

Accidents, Traffic↗

PubMed1996

[Posterior trans-anal-sphincter approach in the management of urethro-prostate-rectal fistula].

Uretroprostatorectal fistulas occur rarely, often due to trauma or iatrogenic causes. We observed a case caused by a gun wound and present our surgical route for treatment. The deep situation of these fistulae explains the difficulty in surgical access. Several routes have been described. We used the posterior transanosphincter route proposed by York Mason. This technique has the advantage of direct access for the fistula. Success rate is high and morbidity is limited. No fecal incontinence has been reported in the literature.

Adult↗