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Biomedical subjects

B Salle

Publications and source records attributed to B Salle.

At least 55 records · Page 3Linked to original sources
PubMed1992

Treatment of malignant peritoneal effusion in digestive and ovarian cancer.

Intra Peritoneal Chemo Hyperthermia (IPCH) with Mitomycin C (MMC) or Cisplatinum (CP) was used to treat 32 patients with far advanced digestive or ovarian cancers and peritoneal carcinomatosis. Surgical resection of the primary tumor has been possible in 18 cases. After closure of the abdominal wall, a 90 minutes IPCH as performed under general anaesthesia and 32 degrees C general hypothermia, through 3 intraperitoneal drainages realizing a closed circuit, using 10 mg/l of MMC or 15 to 25 mg/l of CP in 6 l of peritoneal dialysate heated at the inflow temperature of 46 to 49 degrees C. The mortality rate was 3% and the morbidity rate was 3%. In 11 out of 12 patients with preoperative malignant ascites, no more ascites could be found after IPCH. For peritoneal carcinomatosis from digestive origin, median survival was 11.2 months and 1 year survival rate was 46.9%. These encouraging preliminary results show that IPCH is a safe and reliable treatment for peritoneal carcinomatosis in far advanced digestive or ovarian cancers.

Adenocarcinoma↗
PubMed1992

Leucine kinetics in fed low-birth-weight infants: importance of splanchnic tissues.

Whole body Leu kinetics were determined in fed low-birth-weight (LBW) infants. To assess the importance of first-pass splanchnic extraction of ingested amino acids, two tracers were simultaneously infused by intravenous (L-[1-13C]Leu) and intragastric (L-[5,5,5-2H3]Leu) routes in 13 LBW infants [1,742 +/- 169 (SE) g] fed with protein-enriched human milk (protein intake 3.23 +/- 0.97 g.kg-1.day-1). Splanchnic extraction estimated from plasma [2H3]Leu appearance was 48.2 +/- 15.6% of Leu intake. Total Leu flux, endogenous Leu flux (index of protein catabolism), and nonoxidative Leu disposal (NOLD, index of protein synthesis) were 3.45 +/- 0.57, 1.90 +/- 0.74, and 2.54 +/- 0.62 mumol.kg-1.min-1, respectively. Higher estimates were obtained when using alpha-ketoisocaproate as a precursor pool. There was a wide individual variation of protein intake due to the use of human milk, and, over this range, Leu intake was correlated negatively with endogenous Leu flux (r = 0.88, P less than 0.01) whereas NOLD remained fairly constant. Thus, in LBW infants, 1) splanchnic extraction is two times as high as in adults and might reflect an elevated splanchnic protein turnover and 2) increasing protein intake probably promotes protein gain mainly by inhibiting protein catabolism.

Animals↗
PubMed1992

[Sacrum abnormalities and neural tube closure defect: different manifestations of a same genetic disease?].

The authors report the case of a full-term female infant exhibiting an anterior meningocele, combined with a hemi-sacrum and an anal dysfunction. Both her father and brother had the same although less pronounced abnormalities. The father's sister was anencephalic. This case, together with previously published data, suggests that sacrum malformations and neural tube defects may derive from a unique dominant autosomal gene with variable expressivity.

Female↗
PubMed1991

[Ehlers-Danlos syndrome and pregnancy. Apropos of a case].

Ehlers-Danlos Syndrome is a hereditary dysplasia of connective tissue with an abnormality in collagen synthesis. The syndrome consists of increased elasticity and fragility of the skin, increased laxity of the ligaments of the joints and fragility of the blood vessels. It is rarely associated with pregnancy but when it is several problems arise which are demonstrated in our case. Our patient had a type III syndrome (hypermobility of the joints) or a type IV syndrome (echymoses, Sack-Barabas Syndrome). In the literature the following are reported: premature rupture of the membranes with premature delivery, tears, perineal haematomas and type IV ruptures of the great vessels of the uterus. The best way of delivering and anaesthetising the patient are discussed. The prognosis depends above all on the type of the disease (25% of mothers die in type IV disease). Strict rest and Pfannestiel lower segment Caesarean section operation under general anaesthetic allowed us to achieve a favorable outcome for the mother and for her child.

Adult↗
PubMed1990

Whole body protein turnover measured with 13C-leucine and energy expenditure in preterm infants.

Our study was undertaken in preterm infants to examine the relationship of whole body protein kinetics with protein intake and energy expenditure. Leucine kinetics were determined in seven low birth wt preterm infants fed human milk or human milk enriched with protein (2.5 to 4.3 g protein/kg.d). The infants received a short (4-h) constant infusion of L-[1-13C]leucine and leucine turnover and oxidation were calculated from 13C-plasma leucine and expired 13CO2 enrichments measured by mass spectrometry. Energy expenditure was measured by indirect calorimetry. Nonoxidative leucine disposal (an estimate of protein synthesis) and leucine derived from protein (an estimate of protein breakdown) were, respectively, 2.98 +/- 0.82 and 2.06 +/- 0.74 mumol/kg.min. Whole body protein turnover and deposition, derived from leucine kinetics, were 8.22 +/- 2.31 and 2.17 +/- 0.50 g/kg.d, whereas energy expenditure was 56.3 kcal/kg.day. Protein turnover was correlated with protein intake but not with protein deposition. Energy expenditure was correlated with protein turnover, synthesis, and breakdown but not with protein deposition. These data are in agreement with the fact that protein deposition depends upon protein intake, but they also suggest that an elevated protein deposition is not necessarily the result of a rapid protein turnover or associated with an elevated energy expenditure.

Carbon Isotopes↗
PubMed1990

[Premature infants weighing less than 1000 grams: mortality, morbidity and short-term neurologic outcome].

The outcome of 60 premature infants weighing less than 1,000 g at birth and consecutively born during the years 1986 to 1988 is reported. Forty-two (70%) of them were inborn. The overall mortality rate was 42%, but only 26% in the inborn group instead of 78% in the outborn group (P less than 0.001). The mortality rate was higher for the appropriate for gestational age infants (56%) than for the growth retarded infants (14%, P less than 0.01). The main neonatal problems were the following: hyaline membrane disease (63%), patent ductus arteriosus (7%), bronchopulmonary dysplasia (8%), necrotizing enterocolitis (15%), intraventricular hemorrhages (45%) and periventricular leukomalacia (12%). Twenty percent (7/35) of the surviving infants showed abnormal neurodevelopmental outcome, with only one (3%) having major handicap. No correlation was found between gestational age and neuro-developmental outcome.

Child Development↗
PubMed1990

[The hazards of forceps: the viewpoint of the pediatrician and the obstetrician].

Neonatal and maternal complications observed after 410 forceps deliveries were retrospectively compared to those occurring after spontaneous vaginal delivery. Mild scalp and facial lesions as well as facial palsy were significantly increased in the forceps group. No severe maternal complications were observed. A short literature review was done, and other instrumental extractions were discussed.

Birth Injuries↗
PubMed1989

Are click-evoked BAEPs useful in case of neonate hyperbilirubinemia?

There is still controversy about the usefulness of click-evoked brainstem auditory evoked potentials (BAEPs) for the investigation of neonatal hyperbilirubinemia. The present work concerns the study of click-evoked BAEP responses in a population of 72 hyperbilirubinemic children (conceptional age between 33 and 42 weeks). Their bilirubinemia rates were between 219 and 600 mumol/l. The waves I, III and V were always present, and click BAEP thresholds were normal in all subjects. Latency anomalies were found only for 8 of the 72 subjects. The comparison of subjects having the higher (greater than 307 mumol/l) bilirubin levels with the group having the lower ones failed to show any significant differences for the I-III and I-V intervals. The influence of prematurity in BAEP alteration has not been demonstrated in this study. These data show, on the one hand, normal click-BAEP thresholds but, on the other hand, alterations of central conduction time in some hyperbilirubinemic newborns. It seems that other factors than hyperbilirubinemia might be operating.

Acoustic Stimulation↗
PubMed1989

Is there a difference between extrauterine and intrauterine maturation on BAEP?

A difference between extrauterine and intrauterine maturation on BAEP has not been established, remaining a subject of controversy. The present study involved 76 children, aged between 36 and 37 weeks (conceptional age), with an extrauterine life duration of equal to or less than 2 weeks (N = 46) or more than 2 weeks (N = 30). The latencies for waves III and V, and the I-III and I-V intervals were significantly shorter for the neonates with a greater extrauterine life duration. An explanation for this finding is discussed: the head size is significantly smaller in the group with a greater extrauterine life duration. An influence of extrauterine life duration on BAEP is thus shown, but it seems to reflect the anatomical consideration and not to peripheral auditory system maturation.

Aging↗
PubMed1989

Functional hypersomatotropism in small for gestational age (SGA) newborn infants.

Basal plasma GH levels and the GH responses to an injection of 1 microgram/kg 1-44(NH2) GHRH were determined on day 3 postnatally in 5 small gestational age (SGA) twin newborns and their appropriate gestational age (AGA) co-twins, and in 10 SGA singleton newborns and 6 AGA singleton newborns. The mean basal plasma GH level was higher in the SGA than in the AGA infants but the difference was significant only for singleton newborns (p less than 0.01). The mean peak plasma GH level was markedly increased in SGA compared to AGA infants (p less than 0.05 for twins, p less than 0.01 for singletons). Twelve SGA infants re-tested at 1 month had lower basal and peak plasma GH levels (p less than 0.001 and p less than 0.01). In 21 SGA and 17 AGA infants, serum IGF-I, measured by RIA between 12 and 96 hours after birth, was significantly higher in SGA than in AGA (p less than 0.001). These results suggest that, whatever the mechanism, functional hypersomatotropism is present at day 3 in SGA infants. This hypersomatotropism may participate in the early catch-up growth process.

Gestational Age↗
PubMed1989

[Protein C deficiency and pregnancy. Apropos of 2 case reports].

Protein C is a protein found in the serum, dependent on vitamin K. It is a strong protection against venous thrombosis. Deficiency in protein C, whether constitutional or acquired, can give rise to thrombo-embolic accidents in young patients without any obvious triggering factor. The authors start by describing the physiological features of protein C. Deficiencies of this protein are transferred through a dominant autosome. Two cases are described where protein C deficiency occurred in pregnancy. This association has not been previously described. They then discuss the kinetics of protein C in pregnancy, at delivery and in the newborn. They then point out how important it is to treat with anticoagulants in prophylactic doses during the pregnancy. They use repeated doses of Heparin as an anticoagulant and for its antivitamin K action following the delivery. They give a list of precautions that have to be observed in this relay system which should be slow and carefully worked out later. Obstetrical observation has to look for the onset of pre-eclampsia and intra-uterine growth retardation due to placental microthrombi. The authors conclude, after pointing out the frequency and the seriousness of this condition, by proposing that it should systematically be looked for in families where there have been cases of thrombo-embolic accidents.

Adult↗
PubMed1989

[Neonatal ischemic necrosis of the arm in a premature infant].

A case of gangrene present at birth in the right upper limb of a twin premature infant is reported. As premature rupture of membranes was present, the role of ischemic compression is discussed. The etiology of ischemic lesions observed in the fetus and the newborn and their treatment is reviewed.

Arm↗
PubMed1988

Effect of brainstem auditory evoked potential stimulus intensity variations in neonates of small for gestational age.

The latencies of brainstem auditory evoked potentials were compared first in 25 small for gestational age (SGA) neonates (conceptional age less than 43 weeks) matched with 25 appropriate for gestational age (AGA) neonates, and then in the 8 younger SGA neonates (less than 37 weeks) matched with 8 AGA neonates. In this last subgroup the results showed that the I-V interval is shorter in SGA than in AGA neonates, as previously described. This shortening effect is essentially linked to a lengthening of wave I. So the results are discussed in terms of immaturity of the basal end of the cochlea, rather than of precocious development of the auditory brainstem neural function in SGA infants.

Brain Stem↗
PubMed1988

Effect of stimulus intensity variation on brainstem auditory evoked potentials. Maturational changes.

The effect of stimulus intensity variation on brainstem auditory evoked potentials in premature and full-term neonates has been studied in two experiments. They show that the effects are different according to age and to waves. The variation of latencies is greater the younger the child and it is clearer with wave I than waves III and V. The findings are discussed in terms of the maturation of the basal part of the cochlea.

Acoustic Stimulation↗
PubMed1988

Renal aspects of calcium and phosphorus metabolism in preterm infants.

The aim of this study is to emphasize renal aspects of calcium and phosphorus metabolism from our data of more than 200 metabolic balance studies carried out in preterm infants. Renal production of 1,25-dihydroxyvitamin D increased rapidly after birth provided the concentration of the substrate, 25-hydroxyvitamin D, is adequate. The gut of preterm infants is able to respond to the active metabolite of vitamin D. Mean plasma phosphate threshold for tubular reabsorption of phosphate is high, about 2.1 mmol/l or 6.5 mg/dl. The low fractional excretion of phosphate cannot be explained by immature parathyroid function nor by renal unresponsiveness to parathormone, at least after the first days of life. It is probably due to regulating factors related to the high rate of growth. Because of reduced glomerular filtration rate, a too high phosphorus intake may result in hyperphosphatemia. Conversely, a too low phosphorus intake will lead to a phosphate depletion syndrome characterized by marked increase in urinary calcium excretion, no urinary phosphate, and hypophosphatemia. Preterm infants with chronic metabolic acidosis are able to acidify urine so that titratable acid is directly related to urinary excretion of phosphate. Clinical implications are that calcium:phosphorus ratio in milk must be adapted according to net bone and soft tissue retention.

Acidosis↗
PubMed1988

[Non-immunologic fetal ascites and anasarca. Apropos of 44 cases].

Between January 1980 and July 1987 there were 44 cases of fetal non-immune ascites and generalised oedema. These are presented. This pathological condition which occurs rarely (1/1,600 to 1/3,500), is considered by most authors to have a very high mortality (80-95%). An aetiological study shows that for the main part the causes are fetal (75%) and among those there is an important place for cardiac abnormalities (20.4%). These are principally faults in fetal cardiac rhythm. The second most common abnormalities are chromosomal (13.6%). These should be sought out by ultrasound. A typical malformation should lead to karyotyping. Idiopathic cases (9%) are fewer comparatively than in old series because of more accurate investigation. 34% survived out of the whole series of all the pathological conditions together. The only way to arrive at accurate antenatal diagnosis is by looking hard for the aetiological causes. These, when found, will show the way to handle the cases both obstetrically and after delivery. It will also help to identify the prognosis and to improve the chances of survival for those fetuses that can be saved.

Ascites↗