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Biomedical subjects

P Roux

Publications and source records attributed to P Roux.

At least 163 records · Page 9Linked to original sources
PubMed1983

Metastases of the digestive tract. Report of 77 cases and review of the literature.

In addition to personal observations of 77 patients with one or more metastatic sites in the gastrointestinal tract, the authors reviewed over 1000 similar cases in the literature. The general radiologic aspects of each location (oesophagus, stomach, intestine, colon/rectum) are discussed. The pathophysiology of this type of metastasis explains the radiologic images obtained during barium transit examinations. The lymphatic type of spread observed in the oesophageal region in connection with carcinoma of the breast is the origin of stenosis of the middle third. The haematogenous type of diffusion encountered during melanomas creates intramural or intraluminal radiologic images. Two means of spread can be observed in the stomach. Haematogenous spread can result in frequently multiple and ulcerated nodular submucosal lesions from melanomas and bronchogenic carcinomas; it can also cause a more or less stenotic invasive image, especially in connection with carcinoma of the breast. Dissemination by means of the mesenteric reflections, and in particular around the gastrocolic ligament, explains the spread of a carcinoma of the transverse colon towards the stomach. The most frequent secondary sites in the gastrointestinal tract occur in the small intestine, the majority of these metastases being caused by pelvic tumours. Whether occurring in the small intestine or the colon, the pathophysiology is similar: direct invasion by a non-contiguous primary carcinoma along the fascias and mesenteric attachments (more rarely by lymphatic permeation), dissemination by the peritoneal fluid or haematogenuous spread. In the first two types of dissemination cited, the image encountered is often hard to differentiate from radiation-induced lesions.

Breast Neoplasms↗
PubMed1983

[Echography in tumor pathology of the spleen: limitations and perspectives].

The authors review the symptomatology of splenic tumor pathologies in connection with 93 personal observations (71 non-Hodgkin lymphomas, 12 Hodgkin's disease, 6 metastases, 3 epidermoid cysts, 1 angioma). Nodular forms were observed in 31.2% of the cases reviewed. In most cases of lymphoma, the ultrasonographic finding was a homogeneous splenomegaly. The possibility of false negatives for splenic involvement in lymphomas when spleen volume is normal has led certain authors to suggest fine needle puncture of the spleen under ultrasonographic guidance. Such procedures are unnecessary if ultrasonography has detected an obvious lesion such as multinodular involvement of homogeneous splenomegaly. However, this moderately traumatic technique can provide valuable information until such time as ultrasonic tissue characterization has proven itself in vivo.

Adolescent↗
PubMed1983

[Radiologic study of aberrant pancreas of gastroduodenal topography. Apropos of 11 cases].

In connection with 11 observations of aberrant pancreas in the gastro-duodenal area, the authors review the general and radiological features of this pathology. In ten of the personal cases reported on, radiological examination allowed diagnosis following discovery of an intramural image centered around an umbilication. While not uncommon, pancreatic heterotopias are generally fortuitous findings due to the usual absence of clinical symptoms. They are small, and tend to occur in the digestive tract, especially in the antro-duodenal region. Possible complications include adenomatous transformation which may or may not be insulinogenic, cystic degeneration, cystenadenoma and carcinoma. Such complications are rare, however, and are generally not discovered before surgery. Radiological examinations were negative in 23,7% of the cases reviewed; while the typical image of a rounded filling defect centered around an umbilication is easy to diagnose, the value of radiology is considerably less when dealing with peduncular, subserous or complex forms. Although certain authors recommend only surveillance following radiological and endoscopic detection of a small aberrant pancreas, the majority of authors advise exeresis.

Adolescent↗
PubMed1982

The effect of glucose-6-phosphate dehydrogenase deficiency on the severity of neonatal jaundice in Cape Town.

A study was made of 3718 newborn infants with jaundice in excess of physiological levels. Prematurity, haemolytic disease, haematomas or infections were present in 1278 patients. Of the remaining 2440 neonates, 137 were deficient in glucose-6-phosphate dehydrogenase (G-6-PD) and 2303 had idiopathic hyperbilirubinaemia. Exchange transfusion was necessary in 59 (42,7%) of the patients with G-6-PD deficiency and in 426 (18,5%) of those with idiopathic hyperbilirubinaemia. Kernicterus occurred in 3 infants (2,2%) with G-6-PD deficiency and in 3 (0,13%) with idiopathic hyperbilirubinaemia. These findings indicate that G-6-PD deficiency contributes significantly to the severity of neonatal jaundice in the population group studied and should be regarded as a potentially dangerous condition.

Black or African American↗
PubMed1982

Echographic aspects of thyroid and parotid localizations in non-Hodgkin lymphomas.

The authors present four observations of rare localizations of non-Hodgkin lymphomas (3 cases of lymphoma of the thyroid, 1 case of lymphoma of the parotid), all of which were studied by echography. In two of the thyroid localizations, the echographic pattern was identical to that observed for nodes in non-Hodgkin lymphomas, and thus differs from that of cysts and necrotized or cystic tumors. In the one case of secondary lymphoma of the thyroid, accompanied by diffuse enlargement of the gland but no histological proof, echography revealed only diffuse enlargement, without any anomaly in the echostructure. In the one case of lymphoma of the parotid, the echographic image was similar to that of a lymphomatous node, but it cannot be formally differentiated from the structure which can be observed for a mixed tumor or a cystic lymphangioma.

Adult↗
PubMed1982

[The liver masses in ultrasonography. Report on 400 cases (author's transl)].

On the basis of 400 cases of liver masses, the authors have drawn conclusions that can be used to orient etiological investigations: --one or more well demarcated transsonic formations always correspond to a cystic etiology: --a hyperechoic metastatic liver points towards a primary cancer of the digestive tract whereas a hypoechoic metastatic liver is only rarely caused by such a cancer. The authors also propose a strategy for the exploration and surveillance of isolated hyperechoic or transsonic nodules of no more than 3 cm.

Carcinoma, Hepatocellular↗
PubMed1982

[Echographic survey of hepatic metastases].

In a study covering 105 patients with hepatic metastases, all of whom underwent at least two echographies, the authors were able to make comparisons with the previous examination in 220 cases. Comparisons dealt with modifications in the echographic aspect (observed in 72 cases among the 220 comparisons), modification in volume and modifications in the number of metastases. In most cases, modification of the echostructure corresponded to a volumetric change. Three evolutionary parameters should be considered: the number of metastases, if there are no more than five; the diameter of the largest liver metastasis, unless it is over 7 cm, in which case it is also advisable to retain two other metastases of 5 cm or less: the size of the liver (left liver measured on the median line and right liver along the right mamillary line). This last parameter appears to be the only valid one when dealing with diffuse metastatic forms.

Diagnosis, Differential↗
PubMed1981

Leiomyoma and leiomyosarcoma of the digestive tract--a report of 45 cases and review of the literature.

The authors discuss the general and radiologic characteristics of leiomyomas and leiomyosarcomas, based on experience with forty-five cases involving the digestive tract and a review of over one thousand cases reported in the literature. Thirty-six leiomyomas (oesophagus 9, stomach 18, small intestine 9) and nine leiomyosarcomas (oesophagus 2, stomach 2, small intestine 4, colon 1) were observed and compared with reports from the literature. Leiomyomas of the oesophagus lend themselves to radiologic surveillance since there is no tendency for lesion degeneration in this location. Leiomyomas of the stomach are frequently asymptomatic and discovered following radiologic or endoscopic examination. With involvement of the small intestine, the most sensitive radiologic examination remains angiography, even though the information provided does not allow evaluation of the evolution of the tumour. Localization in the colon remains rare.

Adult↗
PubMed1981

Blood sugar regulation during treatment with indapamide in hypertensive diabetics.

Eleven insulin-dependent and 30 maturity onset diabetics with essential hypertension were treated with indapamide for 4 and 9 months respectively, to assess its effect on blood sugar regulation. The hypertension responded well to this drug, and fasting and postprandial blood sugar levels did not change significantly. There was no change in the diabetic treatment. Triglycerides, cholesterol and uric acid did not change significantly. Potassium levels fell significantly, but the mean level remained within the normal range.

Adult↗
PubMed1981

Ultrasound evaluation of common bile duct size in normal adult patients and following cholecystectomy. A report of 750 cases.

The authors present the findings of seven hundred and fifty adult patients without biliary tract disease for whom the internal diameter of the common bile duct was measured. Six hundred and seventy-three patients had no biliary tract disease whatever while seventy-seven had no clinical evidence of disease but had undergone cholecystectomy over one year ago. In our series, the mean diameter of the common bile duct in normal patients was 3.67 +/- 0.03 mm. Only 5.9% of normal patients were found to have a bile duct with a diameter greater than or equal to 5 mm. The frequency of this finding increased in patients over fifty years of age. The mean diameter of the common bile duct in the seventy-seven who had undergone cholecystectomy was 4.47 +/- 0.10 mm.

Adult↗
PubMed1976

Respiratory exchanges and acid-base balance during perfusion of ex vivo isolated pancreas.

We used the technique of ex vivo isolated pancreas, perfused with whole heparinized blood. The organ was stimulated by secretin (G.I.H. Stockolm, 0.1-5.0 clinic units/hr), and/or carbamylcholine (100-200 mug/hr). Oxygen consumption was increased under stimulation. This increase was a function of the dose of secretin and also of the bicarbonate output in the juice. Oxygen uptake increased further when carbamylcholine was super-imposed on secretin. This extra increase was independent of hemodynamic conditions of the organ perfusion. Arteriovenous difference in oxygen saturation did not increase when the gland was stimulated. It tended to decrease when the stimulation resulted in a marked vasodilatation. Thus, oxygen needs seemed to be neither the limiting factor of the response to a given stimulation nor the triggering mechanism of functional vasodilatation. Values of pCO2 were spread over a wide range from one experiment to another. However, it could be observed that CO2 efflux into the vein decreased under stimulation by secretin; in most experiments, CO2 efflux was even replaced by an apparent consumption of CO2 during the perfusion of the stimulated gland. Furthermore, arteriovenous pH difference increased following secretin stimulation. This increase was dose-related to secretin. These facts are discussed under the background of theories recently proposed for bicarbonate secretion.

Acid-Base Equilibrium↗
PubMed1975

Role of cholinergic mechanisms in the response to secretin of isolated canine pancreas.

The effects of carbamylcholine (CCH, 100 mug per hr) and of atropine (0.25, 1.0, and 10.0 mg per hr) on the response of the exocrine pancreas to secretin (0.1, 0.5, and 5.0 clinic units per hr) were studied using the isolated canine pancreas perfused with whole heparin-treated blood. CCH induced a sharp decrease in D50 (dose of secretin which elicits half the calculated maximal response) but no increase in maximal response to secretin. Experiments performed under different haemodynamic conditions show that this potentiating effect (synergism) is partly due to vasomotor modifications and chiefly to the action of CCH on the receptor of secretin. Although this work indicates that cholinergic tone is not necessary for secretin-induced hydrelatic response to occur, it evidences that this cholinergic tone plays a major role in modulating the pancreatic response to submaximal doses of secretin. It has also been found that large doses of atropine (10 mg per hr) were necessary to achieve a complete inhibition of enzymatic response to CCH. Even at these high doses, however, enzymatic response to secretin and cholecystokinin-pancreozymin were not significantly inhibited.

Animals↗
PubMedDate not supplied

Systemic blood levels after intra-arterial administration of microencapsulated mitomycin C in cancer patients.

Systemic delivery of mitomycin C (MMC) was studied in 6 patients administered microencapsulated MMC (MMC-mc) by an intra-arterial route (IA): 3 IA liver infusions, 3 IA pelvic infusions. Pharmacokinetic data revealed a lower blood MMC availability (peak plasma levels, AUC 0-4 hours) for the pelvis than for the liver; this was attributed to differences in the blood flow infusion rates at these two sites of administration. Direct comparison of systemic MMC exposure was possible for one patient, who received both IA liver MMC (10 mg in standard form, which served as the control) and IA liver MMC-mc (20 mg the day after). The 65% reduction in MMC-mc bioavailability observed for this patient indicates a quantitative local improvement in exposure to the drug and correlates well with the low incidence of systemic side effects noted in preliminary clinical studies.

Aged↗
PubMedDate not supplied

Disseminated BCG infection following bone marrow transplantation for X-linked severe combined immunodeficiency.

An 8-month-old boy with X-linked severe combined immunodeficiency (XSCID) developed disseminated bacille Calmette-Guerin (BCG) infection following BCG vaccination at birth. He initially presented with an abscess at the site of BCG vaccination and was begun on three-drug antituberculous treatment (rifampicin, isoniazid, and pyrazinimide). Dissemination was subclinical prior to a human leukocyte antigen (HLA)-identical bone marrow transplant (BMT) from his sister, following which he presented with an acute erythroderma. A skin biopsy specimen revealed granulomas with epithelial histiocytes and giant cells in the reticular dermis, and numerous acid-fast bacilli (AFB) were present on Ziehl-Nielsen stain. A diagnosis of disseminated BCG disease was made. Despite the addition of a fourth antituberculous agent, ethambutol, he did not recover and developed numerous skin abscesses over the following weeks. Examination of pus from these lesions demonstrated numerous AFB. Clarithromycin was added as a fifth antituberculous agent. Despite five-drug antituberculous therapy and monthly intravenous immunoglobulin infusions, recurrent abscesses containing AFB developed intermittently until 7 months posttransplant. At follow-up 1 year post-BMT he showed good general physical improvement. All abscesses had healed with scarring, and no further skin lesions had occurred.

Abscess↗