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Biomedical subjects

P Leguit

Publications and source records attributed to P Leguit.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Villous adenoma of Vater's papilla; a therapeutic dilemma].

After a cholecystectomy in 1980, local excision of a villous adenoma of the ampulla of Vater was performed in 1983 in a 69-year-old female; this had to be repeated in 1990 because of recurrence. In case of a tumour of this kind, pancreaticoduodenectomy should be considered because of the relatively high risk of recurrence or malignant degeneration. After a radical local excision regular duodenal endoscopy and if possible endoscopic ultrasonography should be performed.

Adenocarcinoma↗
PubMed1992

Thrombogenicity and procoagulant activity of human mesothelial cells.

Cell seeding may decrease the thrombogenicity of implanted vascular grafts, but its application is hampered by the limited availability of autologous endothelial cells. We studied the interaction of alternate cells, human peritoneal mesothelial cells, with whole blood in a flow chamber. When citrated blood was perfused over mesothelial cells, platelet adhesion was seen on the intercellular matrix but not on the cells themselves. Perfusions with blood anticoagulated with low-molecular-weight heparin resulted in fibrin formation at the surface of mesothelial cells but not at the surface of human umbilical venous endothelial cells. At shear rates of 200 sec-1 fibrin deposition on the mesothelial cell surface increased during the first 5 minutes to 5.7 +/- 1.06 micrograms fibrin per square centimeter, whereafter these values stabilized. The procoagulant activity of cultured mesothelial cells was higher than that of peritoneal membrane studied ex vivo. However, cultured mesothelial cells incubated with polyclonal antibodies against tissue factor showed a significant decrease in procoagulant activity. We conclude that human peritoneal mesothelial cells may be used for cell seeding procedures, provided that their tissue factor expression can be controlled.

Blood Coagulation Factors↗
PubMed1991

[Little extra information with ultrasonic studies of the axillary glands in patients with breast carcinoma].

In order to establish the value of ultrasound examination of the axillary lymph nodes on the presence of lymph node metastases of carcinoma of the breast a prospective survey was carried out in 100 consecutive patients with a carcinoma of the breast on which a lymph node dissection was performed. In the survey the results of the ultrasound examination were compared with the results of the physical and pathological examinations. Although the sensitivity of the ultrasound examination was higher (60%) than that of the physical examination (33%) the ultrasound examination proved insufficiently reliable.

Axilla↗
PubMed1990

Prospective randomized study of once-daily versus thrice-daily netilmicin regimens in patients with intraabdominal infections.

One hundred and ninety-seven patients with intraabdominal infections were enrolled in a prospective randomized multicenter study of netilmicin administered once daily (n = 98) versus thrice daily (n = 99) in combination with tinidazole administered once daily. Randomization was achieved for the infection site, clinical severity score, daily and total netilmicin dose, and duration of treatment. The mean maximum peak and trough levels of netilmicin in serum were 21.1 and 1.3 mg/l respectively for once daily treated patients, and 10.0 and 2.3 mg/l for thrice daily treated patients (p less than 0.05 for both parameters). The clinical response did not differ between patients treated once daily and those treated thrice daily. Overall rates for clinical cure, improvement and failure of therapy were 77%, 17% and 6% respectively. No significant differences were found between once daily and thrice daily regimens in the occurrence of auditory, vestibular and renal toxicity, overall rates being 5%, 1% and 10% respectively. Impairment of renal function was significantly related to higher maximum netilmicin serum trough levels during therapy, a higher clinical severity score and advanced age. It is concluded that netilmicin given once daily is as effective and safe as the multiple dose regimen. However, monitoring of aminoglycoside serum through levels is still advisable, especially in the old and severely ill patient.

Abdomen↗
PubMed1987

The Angelchik anti-reflux prosthesis and postoperative dysphagia.

Dysphagia was studied in 29 patients after implantation of an Angelchik prosthesis for persistent reflux oesophagitis. The incidence of postoperative dysphagia occurred after three months (61%), six months (45%), and one year or more (41%). Severe dysphagia necessitated removal of the prosthesis in five patients (17%). The reoperative findings with regard to a possible explanation of dysphagia are discussed, and comparison is made with reports in literature. Implantation of the Angelchik prosthesis seems only indicated for the treatment of intractable reflux oesophagitis in patients where other operative modalities failed and who are at high risk for operation. The Nissen fundoplication remains the operation of choice.

Adult↗
PubMed1985

Gracilis muscle transposition in the treatment of fecal incontinence. Long-term follow-up and evaluation of anal pressure recordings.

The results after gracilis muscle transposition were studied in ten patients with a follow-up of six months to 17 years. Nine patients were continent for formed feces and the condition of one patient worsened after operation. Anorectal manometry was performed in eight of the ten patients. Evaluation of pressure recordings showed a normal image, both at rest and at maximal squeeze, in five patients. Low-pressure recordings at rest and at maximal squeeze were seen in two continent patients, in whom the tissue scarring resulted in narrowing of the anal canal. One patient with low-pressure recordings was completely incontinent. An attempt was made to explain the continence and low-pressure recordings. The results suggest gracilis muscle transposition to be a method of choice in patients with total incontinence who have no functional and sphincter.

Adolescent↗
PubMed1985

Mucocele of the appendix.

The history of two patients with a mucocele of the appendix is reported. It is stressed that in case of a tumour of the appendix the possibility of a malignant mucocele should always be considered. To prevent a peritoneal pseudomyxoma tumour spill should be avoided and great care should be taken in performing appendectomy. A survey of the literature is given.

Aged↗
PubMed1984

Relaxation biofeedback conditioning as treatment of a disturbed defecation reflex. Report of a case.

The case history is presented of a patient with a disturbed defecation reflex by viral encephalopolyradiculoneuritis. The inability to defecate was thought to be due to hyper-reflexibility and, hence to increased spasm of the external anal sphincter. Normal defecation was eventually brought about by an operant learning technique, as described originally by Haskell and Rovner. The patient was conditioned to relax his external anal sphincter once he felt rectal fullness and the urge to defecate. Defecation was initiated by a Dulcolax suppository.

Adult↗
PubMed1983

Quadruple cancer in a columnar-lined (Barrett) esophagus.

In a 28-year-old man with a long history of esophageal reflux, two polypoid lesions in a columnar-lined (Barrett) esophagus proved to be adenopapillary cancer. Despite extensive preoperative endoscopic evaluation, no other malignant foci were found until after complete postoperative dissection of the esophageal specimen, when two more small flat lesions were diagnosed as adenocarcinoma. Dysplastic changes of specialized columnar epithelium and junctional epithelium were mild, except around the tumors. In the preoperative assessment of patients with a columnar-lined esophagus, physicians should be aware of the possibility of multifocal development of tumors either exophytic or superficial spreading, and multiple biopsies should be taken from normal-looking areas.

Adenocarcinoma↗
PubMed1982

The 'acute' abdomen in heroin addiction.

Twenty-two heroin addicts admitted with an acute abdomen to the surgical department in the years 1971-1981 were reviewed. Fifteen patients had symptoms suggesting intestinal obstruction, 7 proved to have pseudo-obstruction, 4 had withdrawal symptoms, 2 had faecal impaction and only 2 had adhesions which necessitated operation. A haematocrit level of more than 0.46 was found to be indicative of true obstruction. Frequently, elevation of the white blood cell count or erythrocyte sedimentation rate merely reflected a state of accompanying soft tissue infections which were very common in these patients. The remaining 7 patients were admitted with intra-abdominal inflammation, 2 patients had an appendix mass, 1 had gonococcal peritonitis, 3 had appendicitis and 1 had a normal appendix removed. In these 7 patients the history and physical findings were characteristic of the suspected pathology.

Abdomen, Acute↗
PubMed1982

Pre-operative whole-gut irrigation with mannitol.

Whole-gut irrigation preceded by oral mannitol administration as a method of preoperative bowel preparation was studied in 58 patients. Our results did not confirm the advantages described in the literature. Irrigation time, irrigation fluid volume, patient acceptability and the quality of bowel preparation were not improved, compared to our earlier studies with saline alone. Fluid retention was considerably diminished after mannitol preparation. A significant increase in postoperative septic complications was observed. Disadvantages and possible hazards of mannitol administration are discussed. Mannitol cannot be recommended as a safe and useful adjunct in whole-gut irrigation.

Abdomen↗
PubMed1982

Compartment syndrome of the upper arm.

The physical signs of a compartment syndrome of the upper arm are swelling and tenderness, possibly accompanied by functional impairment of all the nerves of the brachial plexus. The most common cause is exposure of the upper limb over a prolonged period to compression by the body-weight against a solid underground. The resulting tissue lesion leads to rhabdomyolysis. Laboratory investigations show an orthotolidin-positive urine reaction (Hemastix), pigmented granular casts in the urinary sediment, together with a markedly elevated level of serum creatine phosphokinase (CPK). The treatment of choice consists of immediate open fasciotomy. The history is given of two patients, in whom a prolonged period of recumbency due to coma caused the development of an upper-arm compartment syndrome. An explanation is offered to account for the rarity of this phenomenon compared to the more frequently encountered compartment syndrome of the lower leg.

Adult↗