[Thoracoscopy in the diagnosis and treatment of pleuropulmonary affections (author's transl)].
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Biomedical subjects
Publications and source records attributed to P Rocmans.
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In a retrospective study of 100 patients operated on between 1974 and 1979 in our institution for thyroid cold nodules, an 8% incidence of thyroid cancer was found at surgery. Since 1979, F.N.A. was performed in 160 patients with thyroid cold nodules. Adequate cytological material was aspirated in 90% (144) of the cases; of those, a benign cytological lesion was diagnosed in 128 (89%) and suspicion of cancer in 16 (11%). To date fifty-one patients were operated: 41 with benign cytology and 10 with cancer suspicion; benignity was confirmed in 39/41 cases with benign cytology and malignity in 5/10 with suspect cytology. In conclusion, clinical diagnosis of thyroid cold nodules is greatly improved by the use of F.N.A. Despite the limitations of the technique, preoperative suspicion of cancer was increased 7-fold. Caution is recommended in the follow-up cases with benign cytology since, in these preliminary results, 2 false-negatives were found.
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Hyperactive thyroid are obtained by daily injections of TSH 15 I.U. I.M. in dogs for 8 days. The high secretion rate of butanol-extractible iodide (BE125I) in vitro by prelabelled slices is not related to apical phagocytosis (lack of apical pseudopods and intracellular colloid droplets, insensitivity to cytochalasin, vinblastine, vincristine and colchicine). The secretory process is insensitive to metabolic inhibitors, decreases exponentially with the temperature without step transition and could be related to micropinocytosis.
Hyperactive dog thyroids were prepared by repeated TSH stimulation in vivo. Butanol extractable 125iodine (BE 125I) release in vitro from such hyperactive thyroid slices was enhanced when compared with resting slices. Apical pseudopods an colloid droplets were exceptional in such hyperactive thyroids. Moreover, BE125I release was intensitive to cytochalasin B, microtubules and metabolic inhibitors, and decreased only with temperature. Our data demonstrate that hormonal secretion by hyperactive thyroids is not secondary to apical phagocytosis of colloid droplets.
A 39 year old pneumectomized patient presents a massive pulmonary embolism, dies within 3 hours and is supported inefficiently by cardiac massage with recurrent mydriasis during 2 hours. At that time, under extracorporeal cardiopulmonary bypass with a membrane oxygenator, the cardiac activity recovers immediatly due to right decompression and coronary perfusion. The patient is conscious within 5 hours. The cardiopulmonary bypass with a membrane oxygenator appears to be the best therapy when the cardiac massage fails to restitute a normal myocardial function. No embolectomy was performed. The patient died when the bypass was stopped after 48 hours. We conclude that the prolonged peripheral extracorporeal bypass followed by embolectomy is the best therapy of pulmonary embolism.
Bronchial stapling with the USSC TA-30 device was used in 76 pulmonary resections. There were 6 fistulae i.e. 3.7% less than in a series of 216 bronchial sutures.
The authors report on a personal series of 27 patients with pulmonary metastases; seventeen were operated, 3 for cure. Nine hundred and eighty six operated cases from the litterature are then analysed yielding the following notions. Where the primary tumor is controlled at the time of metastatic resection, when there is no systemic or mediastinal dissemination, and when the growth of metastases was slow, these secondary resection of lung metastases were followed by a 16 to 63% 5- year survival rate. The authors conclude it is necessary to control the hypothesis that 5 to 10% of operated cancers present a second operative indication for cure: slow growing metastases limited to the lungs.
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