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Biomedical subjects

A Biron

Publications and source records attributed to A Biron.

At least 37 records · Page 2Linked to original sources
PubMed1979

[Factor analysis fever in the early postoperative period following cardiopulmonary bypass surgery in adults. Correlation with bacteriological data. Statistical study of 518 case histories by computer].

The results of a continuous series of 518 adults undergoing cardiopulmonary bypass surgery, operated on by the same surgeon, comprising valvular replacement and aorto-coronary bypass surgery with a peroperative protocol of asepsis and a short prophylactic course of Penicillin and Streptomycin, a preoperative and postoperative bacteriological study, were treated by computer. The postoperative temperature chart showed a progressively decreasing pyrexia in the first 8 days after cardiopulmonary bypass. The nature of the operation, the bypass time, the quantity of blood used during operation and the blood loss were statistically significant factors. Patients with a clinical infection had significantly higher temperatures from the first on. 8,9% of patients had a febrile reaction which continued after the 10th day after cardiopulmonary bypass. The cause was not always apparent but the appearance of their temperature graphs was distinguishable after the first week. Analysis of the systematic bacterial specimens showed bacterial contamination of nearly 10% of drains, 10% of blood cultures, over 15% of intravenous infusion catheters and 70% of urinary catheters. The significance of these results is discussed. The normal appearance of the temperature chart after cardiopulmonary bypass surgery in the absence of clinical complications and bacterial contamination has been established.

Bacterial Infections↗
PubMed1978

[Results of mitral-aortic valve replacements].

Seventy-five combined mitral and aortic valve replacements were done between 1970 and 1976 with a minimum follow-up of 12 months and a mean of 3.72 +/- 17 months using à Björk prosthesis in the aortic position and the Starr 6120 prosthesis in the mitral position. The early post-operative mortality was 5.3% and the late mortality 8.4%. The actuarial survival curve projected a mortality of 16% at 6 years, including the operative mortality. The survival at 6 years did not differ from that of mitral valve replacement alone during the same period, though it was less than the survival of aortic valve replacement for aortic regurgitation. Among the post-operative complications only 3 embolic complications were seen. Surprisingly, the degree of heart failure, the radiological heart size, and the haemodynamic data showed no satistically significant influence on the post-operative mortality. All of the survivors except one showed a functional improvement. Haemodynamic checks in 13 patients showed a significant reduction in mean pulmonary arterial pressure, in mean capillary wedge pressure and in arteriovenous oxygen difference, but not in the cardiac index. The radiological heart size was significantly reduced but this reduction was usually limited.

Adult↗
PubMed1978

[The humoral immune response in recent pulmonary tuberculosis (author's transl)].

The average serum concentration of immunoglobulins, alpha-1-antitrypsin, haptoglobin and alpha-2-macroglobulin, calculated in 45 adults with pulmonary tuberculosis increased in a variable way for each of the six parameters studied. Tuberculosis does not induce new correlations between the parameters but modifies the intensity of existing links.

Adult↗
PubMed1977

[The late results of aorto-coronary by-pass surgery. Minimum of 4 years follow-up (author's transl)].

Of 340 patients undergoing aorto-coronary surgery over a period of 6 years, the 136 cases in which there was a minimum follow-up of more than 4 years were analysed from the standpoint of the results. Overall amount annual postoperative mortality was low, less than 2,5%, even though the majority of patients undergoing surgery suffered from rest angina and had double or triple coronary stenoses. Analysis of prognostic parameters reveals the importance of the quality of the left ventricule, whilst age, sex, risk factors, the site of the bypass, the number of stenoses and the type of angina had little or no statistical influence on postoperative mortality. Six years after operation, there remained 66% of excellent results and 60% of the patients were able to work. One hundred and forty eight follow-up coronary arteriograms were carried out (including 33 repeated). During the first year after operation (184 by-passes examined) the percentage of permeability of the grafts was 84,8%. Later (86 bypasses examined) this fell significantly to 74,4% but 86,3% still had at least one permeable by-pass. Repeat late studies after four years showed the stability of the result. Investigation into the causes of postoperative infarctions ans analysis of the results in terms of the number of by-passes carried out in relation to the number of coronary stenoses, indicate that multiple by-passes should be avoided when technical conditions are difficult, with a narrowed coronary network and of little functional value.

Adult↗
PubMed1977

[Hemispheric asymmetries of the human brain].

The authors studied 181 brains, 103 of which were dissected. They observed a "T1-T2 bridge" over the first temporal and second temporal gyri more often on the left side than on the right. This asymmetry was more frequent in males than in females. The maximal width of the superior aspect of the second temporal gyrus was greater on the right side in the majority of cases. By contrast, the fusiform gyrus was found wider on the left side in most subjects. The length of the precuneus was greater on the right. The greater size of the left planum temporale could be correlated with the sectional area of the anterior white commissure. The same correlation was found between the length of the precuneus and the area of the latter commissure. Anatomical asymmetries of the two cerebral hemispheres in man seem to be numerous. The interpretation of these asymmetries is difficult; some are likely to be related to functional asymmetries. In the future, the study of morphological asymmetries in routine neuropathology, in patients who have been submitted to detailed neuropsychological examination, would appear to be desirable.

Cerebral Cortex↗
PubMed1977

[Study of survival in angiographically determined ischemic cardiopathies: Apropos of 345 medically treated patients].

A study of 345 patients with ischaemic heart disease due to coronary arteriosclerosis which had been demonstrated by coronary arteriography, and seen between November 1967 and December 1974, was directed towards finding out what had happened to the patients so that, by an actuarial study of their survival, the prognostic significance of the arteriographic and ventriculographic studies could be determined. The prognostic value of the clinical findings has shown the importance:--of the presence of clinical left ventricular failure;--of the presence of coronary insufficiency with frequent attacks; of the presence of sequelae of infarction as seen on the ECG at rest;--on the length of the symptomatic history before arteriography. The assessment of the prognostic potential of the arteriographic findings has emphasised:--the fundamental importance of diffusion of stenoses and occlusions of several main coronary trunks;--the high risk if the lesion affects the left coronary trunk; the high risk of prognostic significance of lesions on the IVA. The prognostic significance of ventricular lesions as demonstrated on ventriculography in the right anterior oblique incidence has shown the sinister significance of extensive lesions of more than two or three of the seven ventriculographic segments and of lesions with dilatation, whereas very localised static plaques hardly influence the prognosis at all.

Adult↗
PubMed1977

[Study of various serum proteins in lung cancer. Immunoglobulins A, G, M, haptoglobin, alpha-1-antitrypsin, alpha-2-macroglobulin].

A statistical study of the plasma concentration of immunoglobulin, alpha-1-antitrypsin, haptoglobin, and alpha-2-macroglobulin in 153 patients with primary carcinoma of the lung showed a strong increase in alpha-1-antitrypsin, haptoglobin and A and C immunoglobulins, whilst alpha-2-macroglobulin increases very moderately, and IgM does not vary. The relationships between variables are also modified, thus there appears a correlation between IgA and IgG to the detriment of the IgG/IgM relationship. Furthermore the coefficient of the correlation IgG/alpha-2-macroblobulin is lower in cancer patients.

Female↗
PubMed1976

[Results of isolated aortic valve replacement].

Progress in surgical technique and decreased early and late postoperative risk should lead to a modification in the indications for aortic valve replacement, before irreversible myocardial changes have definitively compromised the result of surgery. One hundred and seventy aortic valve replacements (100 pure or predominant aortic stenoses, 70 cases of aortic insufficiency) were carried out by the same surgeon over a period of 4 years with a minimum follow-up of one year and average of 25.4 months, using à Bjork prosthesis or a homograft. Early postoperative mortality was 5.3%, not differing from that associated with other types of valve replacement (mitral, polyvalvular). It is related more directly to surgical technique than to preoperative prognostic factors. Late mortality was 8.1%. Almost one third of these late deaths were related to the surgical technique or to the model of aortic prosthesis used. Stage IV cardiac failure plays a pejorative role in this late mortality, whilst no prognostic role could be demonstrated with respect to angina, meancardiac surface, Sokolow index, mean pulmonary artery pressure or diastolic pressure in the left ventricule. One year after surgery there was found to be a significantly important decrease in the Sokolow index and a modest decrease in mean radiological cardiac surface area. Beyond one year, no further improvement was seen. The majority of the patients surviving surgery had a good functional result since only 1% of the aortic stenosis patients and 7% of the aortic insufficiency group remained in stage III or IV cardiac failure. 78% of the patients who were working before operation were able to resume their professional activity after an average period of 6.2 months. However only 40% of the patients with stage IV failure who underwent surgery could return to work.

Aortic Valve↗
PubMed1976

[Electrocardiographic and radiographic course after aortic valve replacement].

On a series of 170 aortic valve replacement - 100 aortic stenoses (AS) and 70 aortic regurgitations (AR) - with an early post operative death rate of 5.3% and a late one of 8% (with a minimum follow up of 1 year and an average one of 25.4 months, two electrocardiographic and radiological checks could be done on 123 patients, 12 months on an average after the operation, and again for 116 patients, 21 months after the operation. After a year there was a significant and substantial decrease of the left ventricular hypertrophy (LVH) and a moderate one of the radiological heart area (HA). The decrease of LVH (Sokolow's index and AVL) tended to be more marked for the AS group and that of HA for the AR. At the second check no further significant change of LVH or HA was noted for either group, and the average HA of the patients remained high. The mean post-operative decrease of LVH and HA was all the greater as the pre-operative value was higher; but it was independent of the stage of heart failure and of the pre-operative hemodynamic data. There was no correlation demonstrated between the amplitude of post-operative variations of HA or LVH and the main operative stages (aortic clamping, ventricular fibrillation, coronary infusion). There was no significant difference between the mean values of LVH or HA of the survivors and those of the early post-operative deaths. The mean value of pre-operative HA was higher in the patients who were to die late than in the survivors, but the difference was not statistically significant after 25.4 months. The mean pre-operative values of HA and LVH did not influence the quality of the post-operative functional result.

Aortic Valve Insufficiency↗
PubMed1976

[Computer analysis of a method of myocardial protection used in a series of 547 operations under extracorporeal circulation in adults].

During 4 years (1970-1974), the numerous pre, per and post-operative datas collected for each adult operated under E.C.C. by the same surgeon, have been analysed on computer (547 cases). The myocardic protection method was unvariable: steady hypothermia of 30 degrees C, induced ventricular fibrillation, myocardic anoxia time less than 15 mn, strict out-bubbles of the left cavities. A direct perfusion of the coronary arteries has been used in case of aortotomy. Analysis of the early post-operative mortality causes and of the various post-operative myocardic complications did not reveal any baneful influence of this myocardic protection method. The average post-operative left auricular pressure, the most reliable test of the left ventricular dynamics, or its post-operative variations are independent of the ventricular fibrillation time, the perfusion time or the coronal output used.

Adult↗