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Biomedical subjects

B Gosselin

Publications and source records attributed to B Gosselin.

At least 163 records · Page 9Linked to original sources
PubMed1985

[Silicone inclusions in the spleen in a patient under chronic hemodialysis].

A 67-year-old woman with chronic renal failure, in periodic hemodialysis, presented an hemolytic anemia in relation to splenic sequestration. Light Microscopic examination of the spleen revealed multiple granulomatous reaction. Numerous macrophages contained inclusions which were non-birefringent and non-staining with routine stains. Electron microscopy, scanning electron microscopy and energy dispersive X-Ray analysis were performed and revealed silicone. Its origin was silicone tubing of the hemodialysis equipment. Pathogenic effects of silicone are discussed.

Aged↗
PubMed1985

[Risk of bone disease as a result of fluoride intake in chronic renal insufficiency].

Four cases of osteosclerosis were observed in patients with renal failure. All subjects presented with moderate reduction in renal function which had been stabilized for several years. Osteosclerosis appeared progressively but was clinically symptomatic in only one patient. Fluoride intoxication was ascertained on the basis of X-ray examination and bone biopsy. In addition, the source of fluoride intoxication was easily recognized as the drinking water (2 to 3 1/day), "Vichy Saint Yorre" commercial mineral water (fluoride concentration 9 mg/l) in 3 cases, and tap water in the fourth case. These observations emphasize the risk of high chronic fluoride intake in patients with renal failure, even with mild reduction of glomerular filtration rate.

Adult↗
PubMed1984

[Posttraumatic infarction with a surgically treated floating thrombus of the left ventricle. Apropos of a case].

Forty-two days after severe thoracic trauma which had led to thrombosis of the left renal artery and to nephrectomy, a 22 year old patient developed anterior wall infarction. Echocardiography and coronary and left ventricular angiography showed distal occlusion of the left anterior descending artery and the presence of a large, mobile thrombus at the left ventricular apex. The thrombus was removed surgically without any complications but a small thrombus adherent to the ventricular scar was observed postoperatively. After a discussion on the different possible physiopathological mechanisms, the authors conclude that the patient probably suffered primary myocardial contusion which led to secondary occlusion of the LAD artery, late myocardial infarction and extension of the initial intraventricular thrombus. This case illustrates the value of two-dimensional echocardiography in the detection and follow-up of ventricular thrombosis.

Adult↗
PubMed1983

[Bronchoalveolar lavage in pneumoconiosis of coal miners. Cytologic aspects].

The cytological characteristics of broncho-alveolar fluid were studied in 94 coal workers and six subjects exposed to varied risks of silicosis. In coal worker's pneumoconiosis with the usual micronodular or nodular type, there was a significant increase in the cellularity of the peripheral airways compared to non-exposed controls, making allowances for smoking habits. There were no striking changes in the white cell count nor any correlation with the possible elevation in the serum angiotensin I-enzyme conversion level. On the other hand a striking elevation of the alveolar lymphocyte count was noted in three cases with rapidly developing silicosis. Where there was the co-existence of another disorder (connective tissue disorders, sarcoid, extrinsic allergic alveolitis, radiation lung or diffuse interstitial fibrosis) the anomalies noted were those occurring during the progress of the associated disease. At the time of collection the alveolar macrophages in the dust exposed subjects showed a similar vitality to these observed in control subjects. After 24 hours of observation " in vitro ", the vitality of the cells and their phagocytic and bactericidal activity was markedly diminished.

Adult↗
PubMed1983

[Subacute pre-eclampsia and hydramnios as manifestation of fetal triploidy. In utero diagnosis in the 28th week].

The authors report a case of triploidy that was diagnosed in utero by amniocentesis at the 28th week of amenorrhoea which presented with a classical picture of sub-acute hydramnios and pre-eclampsia and a dermoid cyst in the pelvis below the uterus. This case has given us a chance of showing the clinical evolution that led us to carry out amniocentesis and make the diagnosis of triploidy. A review of the literature gives us the chance of showing the incidence of triploidy and its genetic origin and the characteristics that this chromosome abnormality produces. The value of the study is to show the differences that exist between this condition and partial molar triploidy demonstrating the anatomo-pathological, genetic and developmental changes that can be recognized. The conclusion that this article reaches could be that the term "triploid embryonic mole" should be abandoned because it brings under one heading two quite different pictures.

Amniocentesis↗
PubMed1983

[Acute kidney failure in a resuscitation milieu: improvement of dialysis tolerance using bicarbonates in the dialysate].

Patients hospitalized in critical care unit for acute renal failure (ARF) in a multiorgan failure syndrome have often a poor intra-dialysis tolerance. Change from Ac to Bi for dialysate buffering has been advocated to improve this dialytic tolerance. In a retrospective study, 70 patients who received Bi hemodialysis are compared with 106 patients who received Ac hemodialysis. If the mortality is not different between these two groups, intra-dialysis tolerance is significantly better (p less than 0.001) in the Bi group according to the mean intra-dialysis systolic blood pressure decrease, the collapse occurrence and the mean vascular volume infusion. Ultrafiltration rate is higher and reach more often the desired values. On a biochemical point of view, hemodialysis efficacy is the same in the two groups according to urea and creatinin clearance, but end dialysis Bi plasma concentrations are higher and nearer of the normal range in the Bi group even though predialysis Bi plasma concentrations were similar. The only side effect observed with Bi dialysis was a hypoglycemic episode without clinical consequence, due to the lack of glucose in the bicarbonate dialysate. Nevertheless, in patients under controlled ventilation, a end dialysis alkalosis can occur if a hyperventilation is imposed. Change from Ac to Bi in dialysate buffering improves the intra-dialysis tolerance of patients with ARF in a multiorgan failure syndrome. This kind of hemodialysis is now used routinely in our critical care unit.

Acetates↗
PubMed1983

[Chronic eosinophilic pneumonia. Apropos of 2 cases].

Pathologic findings in two patients with no previous history of atopic affections were apical pulmonary infiltration, a marked general syndrome with altered general state and hyperthermia, a productive cough, and a circulating eosinophilia. Clinical manifestations and the particular radiographic images of homogeneous condensation of the two apices in the form of "helmet crests", together with the typical course during corticoid treatment and histopathologic findings in one case, established a diagnosis of chronic eosinophil pneumonia. The principal characteristics of this affection, as exemplified by these two cases, are analyzed.

Adrenal Cortex Hormones↗
PubMed1983

[Secondarily infected pneumatocele, eosinophilia and excess production of IgE manifesting as Buckley's syndrome in an adult].

The hyper IgE syndrome develops in childhood and leads to repeated infectious episodes, usually of staphylococcus aureus origin and affecting mainly the skin and pulmonary parenchyma. It may be associated with a predominantly facial atypical dermatitis and more rarely with allergic manifestations. Biological tests show mainly an eosinophilia and a hypergammaglobulinemia E alone without modifications in other immunoglobulin types. Disorders of neutrophil and monocyte chemotaxis are inconstant findings. The initial mechanism of the affection appears related to a deficit in suppressive T function selectively acting on the IgE isotype.

Adult↗
PubMed1982

[Continuous haemofiltration in encephalopathy associated with hepatic failure (author's transl)].

Thirty-one comatose patients (18 with cirrhosis of the liver, 13 with severe hepatitis) were treated with continuous haemofiltration on polyacrylonitrile membrane (AN 69). The mean duration of sessions was 45 +/- 37 h, during which 136 +/- 108 1 of ultrafiltrate were dialyzed. Sixteen patients emerged from coma, 14 (7 with cirrhosis, 7 with hepatitis) completely and 2 partially. Blood ammonium levels decreased by 47 +/- 21% during the first 24 hours. Aminoacid clearance ranged from 20 to 50 ml/min, but only non significant changes were observed in the branched-chain/aromatic aminoacid ratio. Provided the haemodynamic balance is preserved, the technique is well tolerated. The duration of dialysis depends upon the degree of thrombopenia induced. Since the long-term prognosis of both cirrhosis patients and severe hepatitis patients is unmodified, continuous haemofiltration can only be helpful in cases where hepatic regeneration is possible; failing this, liver transplantation should be considered.

Amino Acids↗
PubMed1982

[Acute arsenious hydride intoxication. Four cases (author's transl)].

While engaged in the repair of a zinc furnace, 4 workers were accidentally exposed to arsenious hydride (AsH3) fumes. Acute intravascular haemolysis developed within a few hours. On admission, the patients immediately underwent exsanguino-transfusion; 8.2 to 10.2 l of blood were exchanged through a continuous perfusion pump at the rate of 1 l/hour. Two patients resumed diuresis during transfusion, but the other two required repeated haemodialysis. Between the 10th and 30th days, while renal function was gradually returning to normal, mildly megaloblastic anaemia developed. This was followed during the 3rd month by clinical and electric signs of polyneuritis of the lower and upper limbs, which subsequently regressed. Regular measurements of arsenic levels in the blood and urine were performed between and during exsanguino-transfusion and haemodialysis.

Acute Disease↗
PubMed1982

Massive digitoxin intoxication. Treatment of Amberlite XAD 4 resin hemoperfusion.

Amberlite XAD 4 resin hemoperfusion was studied in the treatment of massive digitoxin overdosage. In vitro experiments using 4 hour resin hemoperfusion showed that digitoxin is removed 100 percent from an isotonic saline reservoir, 83 +/- 14 percent from plasma, and 42 +/- 7 percent from whole blood. In dogs, serum level reduction is fast: 50 +/- 12 percent in 15 minutes, 71 +/- 6 percent in 180 minutes; mean plasma clearance is 24 +/- 6.5 ml/min for a 150 ml/min plasma flow rate. Eleven patients with massive digitoxin overdosage recovered with resin hemoperfusion. Serum level reduction was 32 +/- 14 percent with a 325 g resin column, 59 +/- 6 percent with two 325 g resin columns in series as compared with a 4.5 +/- 1.7 percent reduction without perfusion. Hemoperfusion increased the rate of spontaneous removal of digitoxin 8.6 +/- 3.3 times with a 325 g resin column, and 14 +/- 7.4 times with two 325 g resin columns.

Adult↗
PubMed1982

[Cell populations recovered by bronchoalveolar lavage in pneumoconiosis of coal miners].

Studying the cellular products obtained by broncho-alveolar lavage in 81 patients, 77 coal-miners and 4 other subjects exposed to silicotic risks of various origin, the authors could demonstrate the interest of this new method of exploring the peripheral lung tissues. In 57 cases of usual pneumoconiosis and controls matched for the smoking habits, the repartition of the different cellular types was quite similar. On the contrary, the authors observed an increase of the lymphocytes in three cases of accelerated elution of the pneumoconiosis. Moreover various modifications were noticed in cases with morbid associations as conectivitis, sarcoïdosis, allergic alveolitis, and primitive diffuse interstitial fibrosis as well. At the moment they were collected, the alveolar macrophages of the subjects to dust showed the same properties of vitality and adherence capacity as the controls. After 24 hours of survival their vitality and bacterial activity on staphylococcus aureus was clearly diminished.

Adult↗