Biomedical subjects
Publications and source records attributed to C Girard.
Performance priorities for high quality care, multiprofessional team care and deinstitutionalization of patients among mental health services in England and West Germany were found to be significantly influenced by management practices fostering goal congruence, peer review and staff participation in decision making.
The distribution of [3H]glutamate binding sites was studied in a model of altered cerebellar development obtained by injecting methylazoxymethanol (MAM) in 5-day-old mice. In these mice, at the 25th postnatal day, cerebella were smaller than normal, stratification was normal except for the presence in some lobes of a thin ectopic granule cell layer in the middle of the molecular layer, the proportion of the distribution of [3H]glutamate binding sites between molecular and internal granule cell layers was maintained but site density of both quisqualate- and NMDA-sensitive types was increased in the two layers. In the molecular layer, this increase was uniform in spite of the presence of the ectopic cell layer. In the internal granular layer, the increase of quisqualate-sensitive and NMDA-sensitive [3H]glutamate binding sites is topographically segregated and the first corresponds to areas of lesser cellular density. These results show that MAM treatment induces persistent alterations of the cerebellar glutamatergic system, which consist of receptor over-expression, possibly due to deficit of innervation, reactive gliosis and immaturity of surviving granule cells.
A special software package for interactive display and manipulation of medical images was developed at the University Hospital of Geneva, as part of a hospital wide Picture Archiving and Communication System (PACS). This software package, called Osiris, was especially designed to be easily usable and adaptable to the needs of noncomputer-oriented physicians. The Osiris software has been developed to allow the visualization of medical images obtained from any imaging modality. It provides generic manipulation tools, processing tools, and analysis tools more specific to clinical applications. This software, based on an object-oriented paradigm, is portable and extensible. Osiris is available on two different operating systems: the Unix X-11/OSF-Motif based workstations, and the Macintosh family.
The major adhesin of Actinobacillus pleuropneumoniae, the causative agent of porcine pleuropneumonia, has been previously identified as the lipopolysaccharide (LPS). Experiments in our laboratory have shown that mice immunised with different A pleuropneumoniae serotype 1 LPS preparations were protected against a challenge with a virulent A pleuropneumoniae serotype 1 isolate. The purpose of the present study was to evaluate the protection of pigs against experimental A pleuropneumoniae infection following immunisation with two of these LPS preparations. Groups of five specific pathogen free (SPF) pigs were injected twice with one of the following antigen preparations: detoxified LPS, O-polysaccharide-BSA conjugate, a commercial bacterin, or PBS. Two weeks after the second injection, pigs were challenged intranasally with a virulent A pleuropneumoniae serotype 1 strain. Upon macroscopic examination, fibrino-haemorrhagic pleuropneumonia, compatible with A pleuropneumoniae infection, was observed in one to four pigs in each group. The more extensive lesions were present in control, unimmunised pigs and in animals vaccinated with the O-polysaccharide-BSA conjugate. The highest survival rate was recorded when the pigs had been immunised with detoxified LPS or the commercial bacterin. Taken together, our results suggest that a protection comparable with the one obtained with a commercial bacterin was observed when pigs were immunised with a single class of molecules, detoxified LPS. Most importantly, these results confirm the important role of A pleuropneumoniae LPS in protection against porcine pleuropneumonia. Finally, our results also support the idea that mice are not an appropriate model for the evaluation of porcine pleuropneumonia vaccines.
World Wide Web (WWW) standards have been established for the transmission of and remote consultation on medical information and records, including medical images, extracted from an existing hospital information system. A software package called Osiris is being used for the display and manipulation of medical images in a hospital-based picture archiving and communication system. Recent extensions of Osiris, through the integration of WWW navigational tools, allow easy access to a variety of clinical data from patient records. A special interface allows access to radiologic images, laboratory results, and related textual information through public-domain software programs. These technologic advances offer medical professionals the convenience and ease of use that have made WWW and Internet navigation so popular in the academic community.
This paper describes the PAPYRUS 3.0 file format based on the new DICOM 3.0 Standard which addresses the open interchange of medical images in files or on removable storage media. This specific implementation of the DICOM standard is intended as a generic solution for interchange of multi-modality medical images on removable media. It can also be used for convenient exchange of image data between different computer systems through industry standard file transfer mechanisms. Finally it can also be used for storage and archiving of medical image data in a DICOM-compatible format.
An unusual case of multiple lymphangiomas with lymph node involvement is described. A seven-month-old, spayed female golden retriever was presented with a myriad of cystic masses in the inguinal and caudal mammary regions. She was diagnosed with congenital lymphangiomas (i.e., lymphatic hamartomas). As in human lymphangiomas, lymphatic endothelial cells expressing factor VIII-related antigen and smooth muscle were present in this case. A literature search did not identify similar characteristics in other reported canine lymphangiomas. The dog was treated surgically and had a recurrence. Following a second surgical intervention, she is now disease-free.
We evaluated myocardial protection with Hamburg oxygenated crystalloid cardioplegic solution in a double study. Part I was a prospective metabolic study, measuring myocardial adenosine triphosphate (ATP) and creatine phosphate (CP) contents before and after ischemia in 30 coronary bypass (CABG) patients. During ischemia, CP levels decreased significantly, whereas ATP did not. After 10 minute of reperfusion, mean ATP contents were 90% of preischemic values and CP levels increased to 85% of preischemic values. Spontaneous myocardial defibrillation was seen in 93.3% of patients. Part II included evaluation of early postischemic myocardial function in 228 patients, 48 with multiple valve replacement (MUVR) and 180 with CABG. Spontaneous myocardial defibrillation was seen in 90.3%. Cardiac index, measured before and 1 and 12 hours after surgery, increased significantly in the postischemic period (from 1.95 +/- 0.9 to 2.5 +/- 0.7 l/min m2 in MUVR, p 0.04; from 2.2 +/- 0.6 to 2.7 +/- 0.7 l/min/m2 in CABG, p 0.01). Myocardial infarction frequency was 3% among CABG patients, and unrelated to the number of distal anastomosis or to aortic cross-clamp time. Early postoperative mortality was 6.2% for MUVR and 0.5% for CABG. Thus, oxygenated cardioplegia with Hamburg solution preserves high-energy phosphate compounds and prevents ischemic injury, with excellent short-term clinical results.
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Since the synthesis of Fentanyl in 1961, many narcotics have appeared which are not yet available in France. Among agonists, all are Fentanyl derivates but are different by either more powerful (sufentanyl, lofentanyl), and longer-acting effects (lofentanyl), or less powerful and shorter-acting effects (alfentanyl). All would have a greater security index and minimal cardiovascular side effects. Among agonists-antagonists, only pentazocine is available in France for analgesic therapy. The interest of other new molecules as butorphenol, nalbuphine and buprenorphine, which are available in other countries, still remains a matter of discussion.
Interaction between kininase II and anaesthesia is not well described. Twenty two patients treated by kininase II for congestive heart failure are studied during anaesthesia for cardiovascular surgery. A first group of seventeen homogeneous hemodynamic data are reported. High cardiac index contrasts with severe clinical cardiac failure. A second group of inhomogeneous patients are separately described. Vasoconstrictor can be codified in the situation of low systemic resistance with high cardiac index. Preoperative treatment can be continued, under requirement of hemodynamic monitoring.
A study of plasmatic volume, extra-cellular liquids and total body water was performed on 83 healthy subjects. This study was realised by dilution of three isotopic tracers. The results are expressed as a function of lean body mass determined by anthropometric method (skin folds). The results obtained for three water compartments studied are given and compared with valours found in literature.
Seven patients in low-output cardiac failure, resistant to conventional vasodilators and inotropic agents, following surgery with extra-corporeal circulation were given oral captopril, an angiotensin converting enzyme inhibitor. The effects of captopril on haemodynamic and renal function were studied after 2, 6, 12 and 24 hours of treatment. After two hours, there was a mean reduction in systemic arterial resistance of 29%, in pulmonary arterial resistance of 18% and in pulmonary wedge pressure of 15%. The mean increase in the cardiac index was 28%. This marked initial haemodynamic improvement was either maintained or increased over the rest of the 24 hours. By 24 hours there had been a mean increase in urinary sodium excretion of 200%. The urinary sodium/potassium ratio increased from 0.62 to 1.45. Oral captopril thus seems suitable for treating low-output cardiac failure following surgery requiring extra-corporeal circulation.
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We designed a general-purpose computer program, Osiris, for the display, manipulation, and analysis of digital medical images. The program offers an intuitive, window-based interface with direct access to generic tools. Characterized by user-friendliness, portability, and extensibility, Osiris is compatible with both Unix-based and Macintosh-based platforms. It is readily modified and can be used to develop new tools. It is able to monitor the entries made during a work session and thus provide data on its use. Osiris and its source code are being distributed, free of charge, to universities and research groups around the world.
The aim of this study was to compare two methods of hypothermic heart preservation. Isolated hearts of pigs were preserved in cold cardioplegic solution (St. Thomas Hospital solution) either by simple storage or continuous microperfusion (with a new perfusion device) for 6 hours (group I, n = 12), 12 hours (group II, n = 12) and 24 hours (group III, n = 12). After storage, the myocardial function was studied for 60 minutes under nonworking conditions with an ex vivo functional testing system. Hearts preserved 24 hours by cold storage (group III) showed ventricular compliance and mean spontaneous left ventricular developed pressure significantly lower than hearts preserved by microperfusion (respectively, 63 +/- 47 versus 14 +/- 18 mm Hg and 16.8 +/- 22.0 versus 83 +/- 33 mm Hg). After 12 hours (group II) of preservation, mean left ventricular developed pressure was higher in microperfused hearts compared to immersed hearts (respectively, 133.3 +/- 39.0 versus 83.1 +/- 27.0 mm Hg, p < 0.05), whereas after 6 hours of preservation, no functional difference was observed between the microperfused and the immersed hearts. Hearts were also studied using myocardial biopsy specimens taken at the end of the preservation. The biopsy specimens were analyzed for high-energy phosphates. After 6 hours of preservation, the microperfusion group showed higher levels of adenosine triphosphate and total adenine nucleotides (adenosine triphosphate + adenosine diphosphate + adenosine monophosphate) (respectively, 4.60 +/- 0.5 mumol/gm and 5.98 +/- 0.5 mumol/gm fresh tissue) versus the cold storage group (respectively, 3.10 +/- 0.4 mumol/gm and 3.75 +/- 0.4 mumol/gm).(ABSTRACT TRUNCATED AT 250 WORDS)