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Biomedical subjects

C Dubost

Publications and source records attributed to C Dubost.

At least 127 records · Page 7Linked to original sources
PubMed1980

[Long term hemodynamic results following complete cure of Fallot's tetralogy].

Cardiac catheterisation was carried out on an unselected series of 148 patients who had undergone complete correction of Fallot's tetralogy after an average postoperative period of si and a half years (range 2 to 20 years). 4% residual significant interventricular shunts (Qp/Qs > 1.3), 11% residual stenosis on the infundibulo-pulmonary tract (gradient greater than or equal to 10 mmHg) and 60% pulmonary incompetence was found. These findings do not reflect the excellent clinical results. All patients had normal lives: 89% remain asymptomatic since their operation and symptoms in the other patients are limited to moderate dyspnoea on effort or to arrhythmias which are usually periodic. A synthesis of the clinical and haemodynamic data shows that only a quarter of patients may be considered to be cured, that although the surgical results in 2/3 patients are not perfect, they are satisfactory, and that the results of complete correction in the remaining 12% are poor. The results do not appear to be related to the age at which correction was performed or to previous palliative surgery. On the other hand, the long-term haemodynamic results were related to the surgical method of infundibulo-pulmonary repair. Systolic right ventricular pressures of over 60 mmHg recorded at the end of operation in 33 patients, had returned to normal in 76% cases. These results suggest that the indications for prosthetic remodeling of the infundibulo-pulmonary tract should be increased, although this does not always prevent residual stenosis.

Adolescent↗
PubMed1980

[Myocardial protection during ischemic cardiac arrest. Hemodynamic study of the effects of allopurinol in a cardioplegic solution].

The effects of the addition of 20 mg sodium allopurinate to a litre of ionic cardioplegic solution were studied. The experimental model was the working isolated perfused rat heart in oxygenated Krebs-Henseleit solution. The cardiac outputs were compared after 1 hour of ischaemia with three different methods of myocardial protection; group I: protection by hypothermia at 4 degrees C, group II: protection by ionic cardioplegic solution A, group III: by ionic cardioplegic solution B (with 20 mg Allopurinol). The results were expressed in percentage of the preischemic cardiac output. The best results were obtained in group III, especially after 15 minutes recovery (80.7 +/- 4.5 p. 100 at 15 minutes, 90.6 +/- 3.1 p. 100 at 30 minutes., 88.3 +/- 4.6 p. 100 at 1 hour). The results in group II were significantly better than in group I after 10 minutes recovery. Myocardial protection bu ionic cardioplegia associated with hypothermia at 4 degrees C gives a better post ischaemic recovery than hypothermia alone. When allopurinol is added to the cardioplegic solution, the protection is increased. These effects are similar to the haemodynamic effects of allopurinol on ischaemic myocardium together with the possible limitation of experimental myocardial infarction with regression of the oedema that has been observed with this drug.

Allopurinol↗
PubMed1980

[Lipid levels of epithelial cells and parathyroid activity. Preliminary study of 30 patients].

During surgical cervical exploration of 30 patients with hyperparathyroidism (primary or secondary) 67 specimens have been collected: 22 adenomas, 2 glands of primary hyperplasia and 28 glands of secondary hyperplasia (in 7 patients). Fat content of parenchymal cells has been studied using Oil Red O stain on cryostat cut sections: this content is very low in hyperactive lands (adenomas, primary or secondary hyperplasias) and high in normal or suppressed glands, even enlarged. There is no correlation between parenchymal fat and stromal fat. Practical and theoretical implications of these results are discussed.

Adenoma↗
PubMed1980

Reconstructive surgery of mitral valve incompetence: ten-year appraisal.

Between January, 1969, and January, 1978, 551 patients with mitral incompetence were treated by a system of reconstructive techniques. Mitral valve incompetence was classified into three types according to leaflet pliability; type I normal leaflet motion, 150 cases; type II, leaflet prolapse, 213 cases; and type III, restricted leaflet motion, 188 cases. Associated tricuspid valvular disease was present in 174 cases (31.5%) and was treated by prosthetic ring annuloplasty. The operative mortality rate was 4.2% (16/377) in the mitral group and 14% (25/174) in the mitral-tricuspid group. Follow-up data are available in 341 patients from 1 year to 10 years (average 4 1/2 years). The late mortality rate was 7% (24/341). Actuarial curves including hospital mortality rate show an 82% survival rate at 9 years in the mitral group and a 79% rate in the mitral-tricuspid group. Thirty-seven patients (11%) underwent reoperation mainly for residual (17) or recurrent (16) mitral incompetence. Thromboembolism occurred in 12 patients for an embolic rate of 0.6% per patient-year, even though 48% were not given anticoagulants. Acorrding to the New York Heart Association (N.Y.H.A.) classification, 76% (207/270) of the patients were in Class I, 19% (51/270) were in Class II, 4% (10/270) were in Class III, and 0.7% were in Class IV (2/270). Results of postoperative catheterization and angiocardiography are available in 52 patients. Comparison between the various groups shows that the best results were obtained in type II mitral incompetence, followed by type I and type III mitral incompetence. This experience demonstrates that predictable and stable long-term results have been achieved by techniques of valvular reconstruction with a low incidence of thromboembolism. Reproducibility of the techniques is a limiting factor which can be overcome by adequate training and progressive experience. Patient selection is based on the valvular disease rather than age, physical condition, or cause of valvular disease.

Adolescent↗
PubMed1980

[Acute dissection of the descending aorta with ischemia of the limbs. Value of an axillofemoral bypass operation (author's transl)].

The authors describe a case of acute dissection of the descending aorta with continuation into the abdominal aorta, producing severe ischemia of the lower limbs and sensory-motor disturbances. An axillo-bi-femoral by-pass operation was performed leading to a revascularization syndrome with anuria and local edema. Good results were still apparent after one and a half years and the patient had started work again. Though a palliative operation, not treating the dissection, axillofemoral by-pass surgery appears to be indicated for distal ischemic lesions when the thoracic affection does not require urgent surgical invention.

Aortic Dissection↗
PubMed1979

[Differentiation between parathyroid adenoma and hyperplasia. Proof by peroperative Wang floating test (author's transl)].

It is sometimes very difficult during operation to distinguish a normal parathyroid gland from a hyperplasic gland. The Wang test offers a solution, very simply demonstrating a difference in density between two glandular specimens. Normal parathyroid tissue, with its fat-containing cells, floats, in contrast to hypersecreting glands which are poor in lipid elements. This test was performed in 30 patients and led to the recognition of hyperplasia in 2 cases.

Adenoma↗