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1.
Ann Chir ; 127(2): 142-5, 2002 Feb.
Article in French | MEDLINE | ID: mdl-11885375

ABSTRACT

The iliac venous leimyosarcoma is rare, usually malignant, and often occurs with oedema or phlebitis. We report one case of iliac venous leiomyosarcoma revealed by cruralgia. A 69 years old patient, presented with a left cruralgia which had been developing for three months and which happened after an insignificant trauma. The clinical examination objectified a stiff painful mass of the left iliac fossa together with left psoitis. The initial pelvic tomodensitometry showed a mass at the contact of the psoas muscle. At first, the diagnosis of a psoas haematoma complicated by a compressive cruralgia was evocated. Two months ago, the patient had a pulmonary embolism. At his hospitalisation, considering the persistent cruralgia, a tomodensitometry and a pelvic magnetic resonance imaging were carried out and had shown an heterogeneous mass that was including the iliac vessels. The result of the anatomopathologic examination was leiomysarcoma. Due to the disease's evolution (pulmonary metastasis), only a medical treatment by chemotherapy was undertaken and the patient died a few weeks later. The association of phlebitis and cruralgia should let us think of the diagnosis of vascular neoplasm. Indeed, only an early diagnosis enables a curative treatment.


Subject(s)
Iliac Vein/pathology , Leiomyosarcoma/diagnosis , Paresis/etiology , Phlebitis/etiology , Vascular Neoplasms/diagnosis , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Diagnosis, Differential , Fatal Outcome , Humans , Leiomyosarcoma/complications , Leiomyosarcoma/pathology , Male , Tomography, X-Ray Computed , Vascular Neoplasms/complications , Vascular Neoplasms/pathology
2.
Scand J Infect Dis ; 33(10): 774-5, 2001.
Article in English | MEDLINE | ID: mdl-11728048

ABSTRACT

Bacteria of the genus Shewanella are rarely implicated in bacteremia. We report a case of rupture of a primary aneurysm infected with Shewanella alga.


Subject(s)
Aneurysm, Infected/microbiology , Aortic Rupture/microbiology , Gram-Negative Bacterial Infections/complications , Shewanella putrefaciens/isolation & purification , Aged , Humans , Male
3.
Ann Vasc Surg ; 15(2): 186-96, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11265083

ABSTRACT

Arterial allografts can be used for in situ treatment of prosthetic graft infection. The purpose of this in vitro study was to compare the resistance of allografts and synthetic prostheses to infection by five strains of bacteria and to study antibiotic treatments designed to reduce allograft infection. Fresh and cryopreserved allografts were compared with synthetic prostheses made of various biomaterials including PTFE, plain Dacron, gelatine-sealed Dacron, and gelatine-sealed, rifampicine-bonded Dacron. Allografts were used with or without treatment using an antibiotic containing gentamycine, lincomycine, and vancomycine. The bacterial strains tested were Escherichia coli, Staphylococcus aureus, slime-producing Staphylococcus epidermidis, non-slime-producing Staphylococcus epidermidis, and Pseudomonas aeruginosa. Infection was evaluated by counting the number of adherent bacteria on the allograft or synthetic material after rinsing and ultrasonication. Statistical analysis was achieved using nonparametric Mann-Whitney tests. Results showed that allografts not treated with antibiotics were highly susceptible to bacterial infection. Antibiotic treatment decreased infection. Application of antibiotic after thawing cryopreserved allografts led to a significant decrease. None of the biomaterials tested provided sufficient protection against bacteria resistant to the antibiotics used.


Subject(s)
Anti-Bacterial Agents/pharmacology , Aorta, Thoracic/transplantation , Bacterial Infections/prevention & control , Blood Vessel Prosthesis/microbiology , Prosthesis-Related Infections/prevention & control , Surgical Wound Infection/prevention & control , Bacterial Adhesion/drug effects , Bacterial Infections/microbiology , Cryopreservation , Gentamicins/pharmacology , Humans , Lincomycin/pharmacology , Microbial Sensitivity Tests , Prosthesis Design , Prosthesis-Related Infections/microbiology , Surgical Wound Infection/microbiology , Vancomycin/pharmacology
4.
Cardiovasc Surg ; 8(6): 411-21, 2000 Oct.
Article in English | MEDLINE | ID: mdl-10996093

ABSTRACT

In spite of improvements in the diagnosis and treatment of thromboembolic disease, pulmonary embolism continues to be a major cause of morbidity and mortality. Anticoagulation remains the preferred therapy for deep venous thrombosis; however, this form of treatment is either ineffective or contraindicated for some patients. For these patients, partial interruption of the inferior vena cava via percutaneous filter placement has become the procedure of choice to protect against fatal pulmonary embolism. We described in this paper results obtained with the available permanent filters and complications of these filters described in the literature. We highlighted the interest of temporary filters in patients whose thromboembolic risk is temporary, finally we insist on recognised indications for vena cava filters when anticoagulation is contraindicated or ineffective.


Subject(s)
Pulmonary Embolism/etiology , Pulmonary Embolism/prevention & control , Vena Cava Filters , Venous Thrombosis/complications , Contraindications , Equipment Design , Fibrinolytic Agents/therapeutic use , Humans , Vena Cava Filters/adverse effects
5.
Ann Vasc Surg ; 14(1): 89-94, 2000 Jan.
Article in English | MEDLINE | ID: mdl-10629271

ABSTRACT

On the recommendation of several studies, carotid endarterectomy (CEA) should be delayed for at least 6 weeks in patients suffering an acute nondisabling stroke. Our objective was to determine if these patients could be safely operated on earlier, thus decreasing the risk of a recurrent stroke prior to surgery. This prospective study, carried out from January 1990 to December 1997, included 72 consecutive patients having a nondisabling hemispheric stroke with severe ipsilateral carotid stenosis (NASCET 70-99%). All patients underwent CEA within 15 days of stroke onset. Patients were considered to have a nondisabling hemispheric stroke if (1) symptoms of hemispheric ischemia persisted longer than 24 hr and (2) the resulting deficit caused no major impairment in their everyday activities. All patients were examined by a neurologist prior to carotid angiography and contrast CT scan. Hemorrhage seen on the initial CT scan eliminated the patient from the study. If the CT scan with contrast injection was negative, patients underwent magnetic resonance imaging. CEA was performed under general anesthesia with intraluminal shunting. All patients had a postoperative duplex scan and yearly follow-up by a neurologist and a surgeon, with a duplex scan of the carotid arteries. Mean follow-up was 53 months. Our study shows that CEA can be performed relatively safely within 15 days following an acute nondisabling stroke. The arbitrary 6-week delay for CEA may unnecessarily expose patients with high-grade stenosis to a recurrent stroke, which could be prevented by earlier surgery.


Subject(s)
Carotid Stenosis/surgery , Endarterectomy, Carotid , Stroke/surgery , Aged , Aged, 80 and over , Cerebral Infarction/diagnostic imaging , Cerebral Infarction/surgery , Humans , Magnetic Resonance Imaging , Prospective Studies , Time Factors , Tomography, X-Ray Computed
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