[Anal fistula. Manometric study before and after surgery].
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Anal Canal↗
Biomedical subjects
A Arnaud
Publications and source records attributed to A Arnaud.
Cloning vectors and antibiotic-resistance markers for Brevibacterium sp. R312.
Replication of several cryptic plasmids from coryneform strains was investigated in Brevibacterium sp. R312. Only the Corynebacterium glutamicum pSR1 replicon was found to be suitable for establishing a host-vector system. Two pSR1 derivatives, pRPCG200 and pHYCG1, were used as cloning vectors. They carry a neomycin-resistance-encoding and a tetracycline-resistance-encoding gene, respectively.
Brevibacterium↗
[Treatment of pulmonary artery hypertensions].
The pulmonary hypertension (PAH) in chronic obstructive lung disease include therapy of the respiratory disease i.e. bronchodilator, kinesitherapy. Long-term oxygen therapy (more than 15 h/day) reverse the course of PAH and increase survey. Long-term efficiency of vasodilators is not well demonstrated. Primary PAH could benefit from vasodilators, especially waiting lung or heart-lung transplantation. Patients with PAH secondary to respiratory insufficiency could also be successfully transplanted. In post embolic PAH, antithrombotic agents are useful. Thrombectomy or transplantation are sometimes proposed.
Humans↗
[Professional asthma due to methylmethacrylate].
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Adult↗
[Endothelial mediators regulating vascular tonus].
Vascular endothelium is the unavoidable interface between blood and tissues. Its role as regulator of vascular tone is discussed here. The endothelium possesses different receptors for vasoactive mediators. These receptors activate the endothelial cells which in turn may produce secondary mediators acting on smooth muscle cells by activating or inhibiting their contraction. Such mediators are the endothelins which have a vasoconstrictor effect, and prostacyclin or endothelium-derived relaxation factors (EDRF) which have a vasodilator effect. Thus, the vascular endothelium and the mediators it secretes play a crucial role in vascular tone physiology.
Endothelins↗
N-terminal amino acid sequence of Brevibacterium sp. R312 wide-spectrum amidase.
A wide-spectrum amidase from Brevibacterium sp. R312 was partially purified. The enzyme subunit was purified by reversed phase HPLC and the N-terminal amino acid sequence was found to be identical to that of Pseudomonas aeruginosa aliphatic amidase.
Amidohydrolases↗
Posterior approach to the rectum for treatment of selected benign lesions.
Access to lesions in the mid-rectum can be difficult. This report summarizes our experience with a posterior approach to the rectum in 22 men and 13 women, age range 21 to 96 years. Surgical indications included villous tumours, rectal prolapse, rectal strictures or rectal fistulae. No postoperative complications were observed in 20 patients, but fistulae developed in seven patients, of whom three required proximal colostomy and surgical treatment. Four healed spontaneously. Two patients developed sacrococcygeal hernia. Pathologic examination of villous tumour showed extensive malignant change in three cases requiring rectal resection with end-to-end colo-anal anastomosis. In two patients mild incontinence developed, treated by biofeedback. Residual peri-anal pain was reported by two patients. The posterior approach to the rectum is particularly useful for benign lesions too high for a transanal resection and too low for a transabdominal resection.
Adenoma↗
Sphincter repair without overlapping for fecal incontinence.
Forty patients who had sphincter repair by one surgeon over the last 15 years were reviewed. The etiology of sphincter trauma was previous surgery (22), childbirth (14), and accidental trauma (4). Eleven patients had undergone at least one previous attempt at repair. Prior to operation, 12 patients were incontinent for liquid stool and 28 for formed stool. A technique of sphincter repair without overlapping was used. An associated diverting colostomy was carried out on seven patients who had had a previous failed repair. Follow-up was an average of 17 months after operation (range, 2-96 months). After operation, 25 patients were completely continent, 6 had occasional leaks of liquid stool, 4 were continent for solid stool only, and 5 showed no improvement. Neither diverting colostomy nor overlapping sutures appear to be mandatory for a successful repair of the anal sphincter after trauma.
Adolescent↗
[Respiratory failure in a HIV seropositive heroin addict female].
A 31-year-old woman, heroin addict since ten years, and infected by the human immunodeficiency virus (HIV) since one year, was admitted to the intensive care unit for respiratory failure (PaO2 = 40 mmHg and PaCO2 = 14.8 mmHg, despite breathing pure oxygen). She had been followed up for 6 months for increasing dyspnoea due to chronic cor pulmonale for which no satisfactory explanation had been put forward. Artificial ventilation with 8 cmH2O positive end-expiratory pressure and 100% oxygen was completely inefficient. She died within a few hours. Postmortem lung biopsy revealed talc particles within interalveolar walls and alveolar macrophages as well as the expected alterations in blood vessels. Pulmonary hypertension due to talc microemboli is a well-known cause of respiratory failure in heroin addicts. Such a diagnosis should not be overlooked in a patient infected with HIV. Respiratory failure may not be only due to opportunist infections, or tumours related to the HIV infection.
Adult↗
Application of high-performance liquid chromatography to the study of the biological transformation of adiponitrile by nitrile hydratase and amidase.
A procedure for the assay of nitrile hydratase and amidase activities by high-performance liquid chromatography is described. The method can be used to assay the intermediate compounds resulting from the hydrolysis of adiponitrile to adipic acid, and to determine the kinetics of the hydrolysis of these compounds using whole cells and enzyme extracts. The precision of the method makes it suitable for the determination of the enzymic parameters.
Amidohydrolases↗
Effects of nicardipine on pulmonary and systemic vascular reactivity to oxygen in patients with pulmonary hypertension secondary to chronic obstructive lung disease.
We compared the acute effects of nicardipine and a placebo on the response of pulmonary and systemic circulation to different inspiratory fractional concentrations of O2 (FiO2) in 10 patients with pulmonary hypertension secondary to chronic obstructive lung disease. After catheterization of the pulmonary and femoral arteries, gas mixtures containing 15, 21, and 30% O2 were randomly administered for 20 min each during infusion of saline and then nicardipine (0.06 mg/kg/min). Plasma nicardipine level was maintained at 30 ng/ml. During nicardipine infusion, cardiac index (CI) was significantly higher (+20%, p less than 0.05) than during placebo infusion, with no change in mean pulmonary artery pressure (MPAP). Pulmonary resistances also decreased significantly (-20%) during nicardipine. No change in arterial or mixed venous O2 contents was noted. Mean arterial pressure (MAP) and systemic resistances decreased significantly with nicardipine. Inhaling a hyperoxic mixture was followed by a significant decrease in arterial pressure during placebo infusion; this was not observed during nicardipine. In contrast with systemic circulation, the response of the pulmonary circulation to different FiO2 levels was unaffected by nicardipine.
Blood Gas Analysis↗
Uvulopalatopharyngoplasty in snorers with sleep apneas: predictive value of presurgical polysomnography.
To determine its predictive value, polysomnography was performed on 14 snorers with sleep apnea syndrome (SAS) before and 3 months after uvulopalatopharyngoplasty (UPPP). In the 8 patients considered as cured (less than 10 apneas per hour after UPPP), total apnea index (TAI) decreased from 29.7 +/- 22.6 to 4.9 +/- 3.5. Rapid eye movement sleep (REM) increased from 10.9 +/- 3.6 to 14 +/- 5.7% of the total sleep period (TSP). In the 6 uncured patients, TAI decreased from 59.7 +/- 15.7 to 32 +/- 15.7 and REM increased from 7.7 +/- 5.6 to 15.8 +/- 7.2% of TSP. Snoring and drowsiness decreased in both cured and uncured patients. A presurgical apnea index less than 40 seems to be a reliable predictor of successful UPPP. The association of obstructive apnea with either central apnea or mixed apnea was not a factor of poor prognosis. Better sleeping could explain in part the clinical improvement in both cured and uncured patients, but postoperative polysomnography is needed to detect asymptomatic SAS.
Adult↗
Unequal day-night terbutaline i.v. dosing in acute severe asthma: effect on nocturnal bronchial patency, heart rate, and arterial pressure.
Our study investigated the differential effects of continuous or unequal day-night terbutaline dosing on circadian bronchial patency, heart rate, and arterial pressure in severe acute asthma. Forty-five hospitalized asthmatic patients (19 women and 26 men, mean age 45.4 years, mean weight 63.5 kg) were included in this multicenter study. Three groups of patients (corresponding to three dosing schedules) were randomized; the three groups were comparable, since no statistically significant difference was detected in the age, weight, or peak expiratory flow values at the beginning of the study. In order to reach immediately the concentrations of terbutaline corresponding to the desired unequal day-night concentrations, a theoretical pharmacokinetic simulation was done to predict the outcome in terms of the plasma concentrations after the three dosing regimens; the results of this simulation allowed us to calculate the initial bolus dose to be given over 5 min to groups A, B, and C, i.e., 1.47, 2.94, and 4.41 micrograms/kg, respectively. This bolus was given to all patients at 0700 h, the beginning of the study.(ABSTRACT TRUNCATED AT 250 WORDS)
Acute Disease↗
[Hydatid cyst of the pancreas. Apropos of 2 cases].
Two new cases of pancreatic hydatidosis are reported. The diagnosis of a cystic lesion of the pancreas has been easily established owing to the modern imaging techniques, especially to computed tomography. The hydatid nature has also been recognized before surgery on the basis of the epidemiological data, the existence of a calcified shell in one case, and positive serology in the other. Retrograde endoscopic cholangiowirsungography allowed specifying the relationships between the cyst and the pancreatic duct in one case. The treatment consisted in the resection of the protruding dome and in total cystectomy. There were no postoperative complications. The preoperative diagnosis of the lesion must no longer be regarded as difficult. The treatment does not raise any specific difficulties when there is no fistula into the pancreatic duct. Retrograde endoscopic cholangiowirsungography is a good means of recognizing a possible fistula and makes a scheduled surgical treatment possible.
Adult↗
[Rectoceles. Diagnosis and treatment].
Rectocele generally considered as a gynaecological lesion, may express only by rectal signs. A study conducted on 202 patients with rectal statics disorders allows to observed 49 cases of isolated rectocele. It was 49 women with a mean age of 48 years (24-73). Many of them complained of terminal constipation necessitating digital vaginal assistance. Medical treatment of constipation was always inefficiency. 39 patients underwent a surgical treatment by endo-anal procedure. Results were good in 95% of the cases with only 1 failure. Rectocele with rectal signs must in every case be operated on by endo-anal way.
Adult↗
[Pseudostriction of hiatal hernia. Apropos of a case with incarceration of the transverse mesocolon and small intestine].
Massive hiatal hernia is a lesion at risk of incarceration, volvulus, and obstruction. The true paraesophageal type is a very rare condition and probably often mistaken with end-stage slidind hernia. Furthermore reflux and oesophagitis are always possible. In this case report a small bowel loop was incarcerated with a massive hiatal hernia. This association was only possible because of the existence of an associated transverse mesocolis hernia giving way to the small bowel. An emergency operation was necessary. The need of surgical treatment of such lesions is stressed, if possible before acute complication, even if they are asymptomatic at the time of diagnostic, which is a quite common condition.
Female↗
[Slow-release salbutamol in the treatment of nocturnal asthma. Result of a comparative study vs. long-acting theophylline].
In a multicentre, randomized, cross-over double-blind, double placebo trial the effectiveness and tolerability of slow-release oral salbutamol (SRS) were compared with those of long-acting (LA) theophylline (T) in the treatment of nocturnal asthma of adults. Forty-nine patients (mean age 37 years) entered the study after a pre-trial period during which a placebo and inhaled salbutamol were used as reference and to test the criteria of inclusion. The number of awakenings due to asthma symptoms was the same with SRS, and T, falling from 1.27 in the pre-trial period to 0.44 under SRS and 0.42 under T. The scores of nocturnal asthma symptoms were improved with both types of treatment. The number of puffs of inhaled salbutamol necessary during the night decreased from 1.94 in the pre-trial period to 1.15 under SRS and 0.92 under T. The number of patients improved was exactly the same in both groups. The ventilatory parameters measured by respiratory function tests at different visits and daily by the patients themselves were also improved. The principal minor side-effects were tremor (5 cases) and irritability (3 cases) with SRS, and nausea (6 cases), headache (3 cases) and asthenia (2 cases) with T; an overdose of T resulted in malaise in one patients. It is concluded that slow-release oral salbutamol administered in doses of 8 mg b.d. is effective in controlling nocturnal asthma, easy to take and very well tolerated.
Adult↗
[Pulmonary hypertension secondary to talc microemboli in a HIV seropositive heroin-addict woman].
Severe pulmonary hypertension presenting as acute cor pulmonare was observed in a HIV positive heroin addict. The usual aetiological investigations were negative. The apparently primary pulmonary hypertension was resistant oxygen and vasodilator therapy and was fatal in 6 months. Anatomopathological examination revealed the presence of talc microemboli in the pulmonary arterioles, severe medial hypertrophy and fibrous subendothelial thickening. The presence of the talc suggests that the pulmonary hypertension in this case was due to obstruction of the pulmonary vascular bed by the obstructive arterial lesions, despite the context of HIV infection.
Adult↗