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Biomedical subjects

A Fournier

Publications and source records attributed to A Fournier.

At least 559 records · Page 31Linked to original sources
PubMed1983

[Exploration by high-resolution real-time ultrasonography of the parathyroid glands in 60 chronic hemodialysis. Preliminary results and comparison with other indices of secondary hyperparathyroidism].

Systematic study by high resolution real time ultrasonography of the parathyroïd glands unequivocally showed parathyroid hyperplasia in 13% of 60 patients on chronic hemodialysis. Hyperplasia was associated with greater severity of hyperparathyroidism, as demonstrated by subperiostal bone resorption and increased serum levels of alkaline phosphatase, parathormone and calcium. Correlation between ultrasonographic and surgical findings in 5 patients was excellent, and actual weights of removed hyperplastic glands were correlated to calculated volumes. The demonstration of hyperplastic parathyroid glands by ultrasonography was of great help for surgical indication in cases where the classical biochemical and radiological parameters were unavailable or of uncertain significance. In absence of hypercalcemia and/or of hyperphosphoremia which may hinder "medical parathyroidectomy" by vitamin D metabolites, ultrasonographic demonstration of hyperplastic glands represents an unresolved problem as to the choice of surgical or medical parathyroidectomy.

Adult↗
PubMed1983

Critical role of oxalate restriction in association with calcium restriction to decrease the probability of being a stone former: insufficient effect in idiopathic hypercalciuria.

The probability of being a stone former (PSF) was calculated according to the method of Robertson in three groups of idiopathic calcium stone formers (normocalciuria (NCa), dietary hypercalciuria (DH) and idiopathic hypercalciuria (IH] during four conditions: on a free diet; on a calcium and oxalate restricted diet for four days and after an oxalate load (200 g of spinach) while on a calcium unrestricted or calcium restricted diet. Combined calciuria (Ca) and oxaluria (Ox) restriction significantly decreased PSF only in NCa and DH whereas the decrease was not significant in IH because of a concomitant significant increase in oxalate excretion. Increase of PSF with the oxalate load was significantly greater on calcium restricted than on calcium unrestricted diets in all groups of patients (4-6-12 times greater in NCa, DH and IH respectively). This shows the critical role of oxalate restriction when calcium is restricted in order to decrease the PSF. Combined restriction is not sufficient in idiopathic hypercalciuric patients to decrease their probability of stone formation.

Calcium↗
PubMed1983

[Blood gas and acid-base changes and rhythmologic tolerance of acetate and bicarbonate hemodialysis using a standard dialyser with high sodium and control of ultrafiltration].

In order to demonstrate a possible superiority of bicarbonate dialysis (HDB) over acetate dialysis (HDA) in conditions of standard dialysis (4 hours on a 1 m2 cuprophan dialyser) but with a bath rich in sodium (143 mEq/l) and control of ultrafiltration, we have compared 2 sequences of 3 runs of HDA and HDB with these conditions in 8 patients as regards their acido-basic and cardiologic parameters (continuous monitoring of ECG by Holter, regular measurement of blood pressure). Acid base balance study in AHD led to the distinction of 2 groups according to wether their plasma bicarbonate increased or decreased during the run. Rythmological tolerance was the same in BHD and AHD, wether all patients or both groups were considered. Heart rate was however slightly but significantly higher during AHD than during BHD, in the patients whose plasma bicarbonate decreased. In conclusion, the benefit of HDB is not remarkable when HDA is performed not only in standard conditions but also with a bath rich in sodium and with control of ultrafiltration.

Acetates↗
PubMed1983

Substitution of aluminium hydroxide by high doses of calcium carbonate in patients on chronic haemodialysis: disappearance of hyperaluminaemia and equal control of hyperparathyroidism.

Al(OH)3 was discontinued in 26 patients on chronic haemodialysis as well as vitamin D metabolites in eight. Oral CaCO3 was progressively increased from 4 +/- 3 to 10 +/- 5g/d to keep plasma PO4 less than 6.0mg/dl and P Ca less than 10.5mg/dl. This treatment had to be discontinued in three cases because of diarrhoea and/or uncontrolled hyperphosphataemia. In the remaining patients the control of hyperphosphataemia and of PTH values was as good or even better. Hyperaluminaemia disappeared in most patients demonstrating the role of oral Al(OH)3 in the induction of hyperaluminaemia. Because of frequent transient hypercalcaemia and of the occurrence of vascular calcification in two patients, high doses of CaCO3 after discontinuation of Al(OH)3 are advised only in cases of hyperaluminaemia.

Aluminum↗
PubMed1982

Orthodontic considerations in the treatment of maxillary impacted canines.

The purpose of this article is to describe and discuss a relatively unknown and underestimated technical approach to the orthodontic extrusion of impacted canine teeth. It constitutes a preliminary report of a researcher project conducted in our undergraduate clinics on patients treated for orthodontic extrusion of impacted teeth. Of these patients, twenty-seven had maxillary canine impaction, sixteen unilateral and eleven bilateral, for a total of thirty-eight teeth. Some surgical considerations and various fixation appliances for impactions are discussed, as well as the advantages and disadvantages of exerting an extrusive force by means of a Hawley type of removable appliance.

Cuspid↗
PubMed1982

Possible link between changes in plasma 24,25-dihydroxyvitamin D and healing of bone resorption in dialysis osteodystrophy.

Histomorphometric studies of bone biopsies were performed on 12 hemodialyzed patients before and after six months of treatment with 25-(OH) and 1 alpha-(OH) vitamin D3. Patients could be classified into three groups according to bone resorption: Group I with normal bone resorption; Group II with elevated initial bone resorption unresponsive to vitamin D treatment; group III with elevated initial bone resorption sensitive to vitamin D treatment. None of the patients had histological signs of osteomalacia. In Group I, plasma concentrations of 24,25-(OH)2D and the ratio of 24,25-(OH)2D to 25-(OH) D remained in the normal range throughout the study; in Group II these parameters were subnormal initially and did not increase above normal except in one case; in Group III, plasma concentrations of 24,25-(OH)2D were high before or at the beginning of vitamin D administration and normal at the time of the second biopsy and wide variations were observed in the ratio of 24,25-(OH)2D to 25-(OH)D. No difference was found between these last two groups with regard to the cumulative dose of vitamin D derivatives administered or the changes in plasma PTH, CT, calcium and phosphate. These observations suggest a specific regulation of plasma 24,25-(OH)2D concentrations in hemodialyzed patients and a possible link (independent of circulating PTH, CT, or phosphate) between this regulation and healing of bone resorption. However, no correlation was found between plasma 24,25-(OH)2D and either one of the simultaneously measured biochemical or histological parameters.

24,25-Dihydroxyvitamin D 3↗
PubMed1982

Synthesis of peptides by the solid-phase method. 7. Substance P and analogues.

Substance P and 21 related peptides containing isosteric or isofunctional groups were prepared by the solid-phase method. After purification by gel filtration and ion-exchange chromatography, the compounds were characterized by thin-layer chromatography, paper electrophoresis, and amino acid and elemental analysis. The biological activities of the peptides were evaluated in vitro on the guinea pig ileum, the rabbit mesenteric vein, and the dog common carotid artery and in vivo on the rat blood pressure. It is shown that the replacement of some residues in the undecapeptide substance P causes variable losses of apparent affinity with a little or no change in the intrinsic activity. All the analogues used in the present study were found to be inactive as antagonists.

Animals↗
PubMed1982

Renin angiotensin aldosterone system and adrenergic system in normotensive and hypertensive pregnancy.

We have measured simultaneously plasma renin activity (PRA), aldosterone and catecholamines in the plasma of 3 groups of pregnant women after the 20th week: group 1 of 16 normotensive controls, group II of 17 women with rest responding hypertension (RRH), group III of 18 women with permanent hypertension (PIH). All the patients were ambulatory on a normal salt diet. PRA was significantly higher in the RRH than in the control and PIH groups (15,8 +/- 2,3ng/ml/l versus 6,7 +/- 0,5 and 8,9 +/- 0,9 respectively). Plasma epinephrine (PE) and norepinephrine (PNE) were significantly higher in the PIH than in the control and RRH groups (respectively 135 +/- 28 pg/ml versus 56 +/- 13 and 63 +/- 17 for PE and 387 +/- 91 versus 206 +/- 32 and 200 +/- 47 pg/ml for PNE). In the PIH group there was a negative correlation between PRA and blood uric acid. It is concluded that the adrenic system is activated in PIH whereas the renin angiotensin system is activated in RRH of pregnancy.

Adult↗
PubMed1982

[Does 24,25 dihydroxycholecalciferol have a physiological and pathophysiological role?].

The authors review recent experimental and human data concerning the potential physiological and pathophysiological role of 24,25 (OH)2D3, the dihydroxylated metabolite of vitamin D which is synthetisized with preference over 1,25 (OH)2D3 in organisms that have been replenished with vitamin D. For the major known effects of vitamin D such as stimulation of intestinal absorption and bone resorption of calcium and phosphorus, 24,25 (OH)2D3 is less effective than the 1,25 (OH)2D3 metabolite and consequently of lesser physiological importance. Some recent in vitro experiments have shown, however, that 24,25 (OH)2D3 intervenes in the stimulation of proteoglycan synthesis, inhibition of PTH, vitamin A and heparin induced resorption, whereas 1,25 (OH)2D3 does not. Although there is controversy as to its direct inhibitory effect on secretion of PTH, it seems to act with 1,25 (OH)2D3 to prevent hyperplasia of parathyroids in vitamin D deficient chicken. From a pathophysiological point, the presence of 24,25 (OH)2D3 seems vital to allow normal bone formation and mineralisation and possibly to counteract excessive bone resorption.

24,25-Dihydroxyvitamin D 3↗
PubMed1982

[Treatment of peritonitis in continuous ambulatory peritoneal dialysis ].

UNLABELLED: Thirty patients were treated with continuous ambulatory peritoneal dialysis during 313 patients months. 26 episodes of peritonitis defined by a cloudy dialysate with more than 100 cells/mm1 and more than 50 p. cent of polynuclear were observed. The organisms initially responsible were Gram-positive in 11 cases (6 Staphylococcus aureus, 1 Staphylococcus albus, 4 Streptococcus viridans), a gram negative in 3 cases (1 Klebsiella, 1 serratio, one unidentified), a Candida in 2 cases. In 10 cases, the culture was negative, Initial treatment was peritoneal lavage (40 l/day) with in situ antibiotics: in the absence of Candida, the association sulfamethoxazole (SMZ) (80 mg/l) and trimethoprim (TMP) (16 mg/l) was used; when Candida was present amphotericin B (5 mg/l) was used. The association SMZ + TMP led to cure of PT in 17 cases, in 7 +/- 4 days. In 5 cases, this initial treatment was changed at the 48th hour because of initial resistance in one case or secondary resistance of Candida surinfection (2 cases). Candida surinfection occurred later in 2 other cases. For these 6 primary or secondary Candida peritonitis, the catheter was changed within 48 hours. Nevertheless, death occurred in 3 cases and cure was obtained after 51 +/- 11 days in the 3 other cases. CONCLUSIONS: 1) The initial treatment by SMZ + TMP appears quite effective in most cases (73%). 2) The severity and the high incidence of Candida surinfection suggest that its systematic prophylaxis may be appropriate.

Adult↗
PubMed1982

[The renin-angiotensin-aldosterone system and the adrenergic system in normal pregnancy and hypertension induced by pregnancy].

Plasma renin activity (PRA), plasma aldosterone (PA) and plasma catecholamines were measured in 3 groups of women with pregnancy of 20-38 weeks: group I of 16 normotensive controls, group II of 17 women with rest responding hypertension (RRH) and group III of 18 women with permanent hypertension (PH) (supine blood pressure greater than 140-90 mmHg after 8 days of rest, disappearing after delivery). Studies were realized on fasting ambulatory women on a normal salt diet. PRA (mean +/- SEM) was significantly higher in the RRH group than in the control and PH groups (15,8 +/- 2,3 ng/ml/h versus 6,7 +/- 0,5 and 8,9 +/- 0,9). PA was higher but not significantly in the RRH group (736 +/- 122 versus 533 +/- 52 and 502 +/- 103 pg/ml). Plasma epinephrine (PE) and norepinephrine (PNE) were significantly higher in the PH than in the control and RRH groups. 135 +/- 28 pg/nl versus 56 +/- 13 and 63 +/- 17 for PE and 387 +/- 91 versus 206 +/- 32 and 200 +/- 47 pg/ml). These data suggest that PH is linked with activation of the adrenergic system whereas RRH is linked with activation of the RAA system.

Aldosterone↗