Amiodarone-induced thyrotoxicosis: is there a place for surgery?

in World Journal of Surgery (1993), 17(5), 622-6627

Amiodarone-induced hyperthyroidism has on most instances been reported as mild, and thyroid functions return to normal after discontinuation of the drug. Nevertheless, life-threatening amiodarone-induced ... [more ▼]

Amiodarone-induced hyperthyroidism has on most instances been reported as mild, and thyroid functions return to normal after discontinuation of the drug. Nevertheless, life-threatening amiodarone-induced thyrotoxicosis has also been described. Conventional treatments such as antithyroid drugs (thionamide) and corticosteroids are essentially ineffective or fail to alter the dramatic course of the thyroid crisis. This limited effectiveness of medical therapy, particularly in patients with previously neglected or unknown thyroid disease, prompted us to intervene surgically. We report a series of nine patients who underwent total or near-total thyroidectomy as a first-line therapy for five of them. Surgery resulted in rapid resolution of thyrotoxicosis with an uneventful postoperative course. This approach has the advantage of immediate effectivity, low risk of relapse, and appears to be the only treatment that permits continued therapy with amiodarone when the drug appears needed to control a life-threatening arrhythmia. [less ▲]

Flexible Technique for Multiple Organ Procurement in Rats: A Training and Research Tool in Transplantation

in Microsurgery (1993), 14(5), 342-9

Multiple organ procurement techniques are increasingly popular in many transplant centers. This paper describes a technique for multiorgan unit(s) explantation in rats. The procedure involves in situ ... [more ▼]

Multiple organ procurement techniques are increasingly popular in many transplant centers. This paper describes a technique for multiorgan unit(s) explantation in rats. The procedure involves in situ preliminary dissection, cold perfusion of the thoracic and abdominal organ units as separate procedures, explantation, and finally the ex situ isolation of various organ units as single and/or multiple organ combination units. The procedure is feasible, allows for flexibility in the separation of combination organ units, and is reproducible. The exercise is provided as a training and research tool for clinical and research transplant surgeons. The technique is also presented as an animal model for clinical organ sharing. [less ▲]

Combined treatment of liver failure and hepatorenal syndrome with orthotopic liver transplantation

in Acta Gastro-Enterologica Belgica (1992), 55(4), 350-357

Hepatorenal syndrome (HRS) is a severe complication of liver failure with high mortality. The pathogenesis of this reversible functional renal failure is not yet clearly understood. Diagnosis is based ... [more ▼]

Hepatorenal syndrome (HRS) is a severe complication of liver failure with high mortality. The pathogenesis of this reversible functional renal failure is not yet clearly understood. Diagnosis is based upon the association of clinical and biological criteria. A patient was admitted to our institution for severe liver failure secondary to an exacerbation of cirrhosis, where he developed a fulminant hepatorenal syndrome. Both, the renal and hepatic failure were successfully treated by orthotopic liver transplantation. Special attention was paid to the immunosuppressive treatment with Cyclosporine whose use, we believe, should be delayed until function has partially recovered. [less ▲]

Résection hépatique ex situ

in Médecine & Chirurgie Digestives (1992), 21

A technique for multiorgan harvesting in rats--an educational tool in transplantation

in Transplantation Proceedings (1991), 23(5), 2692

Aspects chirurgicaux du traitement des affections surrenaliennes.

in Acta Chirurgica Belgica (1991), 91(2), 107-11

With the greatly enhanced accuracy of current endocrinologic diagnosis assisted by precise diagnostic imaging, together with greatly enhanced preparation of patients with endocrinopathy for safer ... [more ▼]

With the greatly enhanced accuracy of current endocrinologic diagnosis assisted by precise diagnostic imaging, together with greatly enhanced preparation of patients with endocrinopathy for safer anesthetic and surgical procedure (e.g. adrenal cortical cancers, cortisol and aldosterone producing adenomas and pheochromocytomas), operative procedures can be planned and conducted more precisely. For the surgeon, the strategy for treatment of functional and neoplastic disorders of the adrenal glands has essentially to consider the anatomy of the suprarenal glands, the deleterious effects of hormone excess before and during operation, the presumed nature of incidentally discovered adrenal mass and the size of the tumor. [less ▲]

Valvular and Coronary Surgery in Renal Transplant Patients

in Journal of Cardiovascular Surgery (The) (1990), 31(5), 581-3

The Authors report aortic valvular replacement (AVR) and coronary artery bypass graft surgery (CABG) successfully performed in two renal transplant patients. The postoperative blood urea and creatinine ... [more ▼]

The Authors report aortic valvular replacement (AVR) and coronary artery bypass graft surgery (CABG) successfully performed in two renal transplant patients. The postoperative blood urea and creatinine levels were comparable to the preoperative values. The first patient underwent isolated AVR. The second patient had an initial AVR combined with CABG followed two years later by a further AVR for prosthetic dysfunction. For many reasons, coronary artery (CAD) and valvular diseases are not uncommon in renal transplant patients. Cardiac surgery is feasible without impairment of the renal function provided some precautions are taken, ie good mean perfusion pressure during cardiopulmonary bypass (CPB), adequate volume replacement, and selected use of mannitol and dopamine. [less ▲]

Diagnostic précoce du rejet de l'allogreffe pancréatique: intérêt du dosage de l'amylasurie.

in Revue Médicale de Liège (1989), XLIV(11), 388-395

Experience with a totally implantable catheter in adult patients: a single institution retrospective study of 114 cases.

in European Journal of Surgical Oncology (1989), 15(1), 61-4

One hundred and fourteen consecutive totally implantable catheters were inserted in 114 patients between April 1984 and April 1987. Catheters were inserted under neuroleptanalgesia, through the jugular ... [more ▼]

One hundred and fourteen consecutive totally implantable catheters were inserted in 114 patients between April 1984 and April 1987. Catheters were inserted under neuroleptanalgesia, through the jugular vein in 101 cases or the internal saphenous vein in 13 cases. No problem was encountered during the insertion procedure. Infection occurred in 5.2% of the patients but removal of the device was required in only 2.6%. Occlusion of the catheter occurred in 6.1% of the patients but never during the first 2 months. This complication rate is lower than the one observed with external tunnelled catheters. The comfort of the patient is substantially improved and nursing care is greatly facilitated. [less ▲]

Multiple risk factors analysis of non-immunological delayed graft function after kidney transplantation

in Clinical Transplantation (1988), (2), 312-318