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Biomedical subjects

C Girard

Publications and source records attributed to C Girard.

At least 163 records · Page 9Linked to original sources
PubMed1984

[Impending carotid and coronary artery obstruction. Operative procedure and monitoring].

A 70 year old woman was admitted to the intensive care unit for unstable angina with haemodynamic repercussions which led to a right hemiparesis because of a left carotid stenosis. The worsening neurological deficit required an immediate endarterectomy. Cardiovascular monitoring, particularly during anaesthetic induction and carotid clamping, included a Swan-Ganz catheter which provided continuous control of myocardial damage. At the same time, continuous dopamine and trinitrine infusions were started to maintain adequate cerebral perfusion. This monitoring guaranteed an excellent adaptability throughout the operation. All along, it would have been possible to decide and to carry out a coronary bypass in case of new myocardial damage. The morbidity and mortality of an association of such lesions and its treatment are discussed.

Aged↗
PubMed1984

[Anesthesia with flunitrazepam/fentanyl in the severe coronary patient. Hemodynamic study].

Twenty three patients on class 3 or 4 NYHA were anesthetized with flunitrazepam 30 micrograms/kg. fentanyl 20 micrograms/kg, N2O for coronary bypass surgery. Hemodynamics data before and after induction reveal a 30% fall of cardiac index with stability of systolic vascular resistance. This higher value refer to literature on flunitrazepam. The clinical association with N2O and fentanyl can explain negatively inotropic effect. The bad ventricular function of this patients is probably the cause of a underestimate vascular filling.

Aged↗
PubMed1984

[Prevention of gas microemboli during cardiac surgery. Numerical control of cardiac cavity purging by an ultrasonic detector].

Despite all precautions taken by cardiac surgeons to eliminate air remaining in the cardiac cavities and pulmonary veins at the end of cardiopulmonary bypass, many micro bubbles probably remain and pass into the systemic circulation with a risk of deteriorations of cerebral or myocardial function. Over the last four years we have used ultrasound to try to prevent the risk of preoperative gas microemboli: the machine is equipped with a detector (a quartz oscillator coupled to a piezoelectric transducer emitting a continuous beam of ultrasound at a frequency of 5 Mhz) which allows the following variables to be determined: the time interval from the onset of detection, the total quantity of bubbles (arbitrary units) in the examined regions, the quantity of bubbles detected over a given time interval which can be adjusted from 15 to 120 seconds. The passage of bubbles is also indicated by light and sound alarms. The smallest diameter of bubbles which can be detected is about 10 mu. There are periaortic probes adaptable to the calibre of the ascending aorta, transcutaneous probes for carotid artery detection and a left ventricular probe. In a preliminary series of 74 valve replacements in adults, this apparatus was used immediately after terminating cardiopulmonary bypass after we had thought that the cardiac cavities had been satisfactorily purged of air, and whilst active aspiration was continued in the ascending aorta distal to the periaortic probe: the total quantity of bubbles detected varied from less than 50 to more than 2000 AU, over a variable period of time which may exceed 20 min after termination of cardiopulmonary bypass. The total quantity of bubbles recorded after mitral valve (582 +/- 154 AU) or combined mitral and aortic valve replacement (685 +/- 167 AU) was generally greater than after isolated aortic valve replacement (335 +/- 126 AU). Therefore, after cardiopulmonary bypass, and despite all efforts at purging the air, we showed that numbers of microbubbles were ejected into the ascending aorta for a variable period of time: only some of them were eliminated by active aspiration through a trocar placed distal to the periaortic probe. The right coronary ostium was poorly protected against microbubbles because of its anatomical situation (6 cases in this series). We therefore established a protocol for the use of this apparatus to aid the purging of the cardiac cavities and pulmonary veins before stopping cardiopulmonary bypass: the manoeuvres, guided by the ultrasound probes, are performed before the left ventricle is allowed to eject blood into the ascending aorta.(ABSTRACT TRUNCATED AT 400 WORDS)

Embolism, Air↗
PubMed1983

Experimental transmission of intestinal coccidiosis to piglets: clinical, parasitological and pathological findings.

Twenty-eight piglets coming from a "specific pathogen free" herd were inoculated at three days of age with 50 000 or 100 000 sporulated oocysts of Isospora suis. Fecal samples were examined for oocyst shedding daily and several clinical parameters were recorded. Ten piglets were used as normal controls. Groups of piglets were euthanized from three days to 12 days postinoculation and routine necropsies were performed. Bacteriological, virological, parasitological and histopathological examinations were made on the intestinal tracts. The incubation period was four to five days. Clinical signs and microscopic intestinal lesions observed in the experimentally infected animals were similar to those reported in spontaneous cases of porcine neonatal coccidiosis. Lesions of villous atrophy in the small intestine seemed to result from the destruction of villous epithelial cells mainly during the peak of asexual reproduction which occurred around four to five days postinoculation. Intracellular coccidial organisms were difficult to find during the late atrophic and villous regrowth stages of the intestinal lesions. The prepatent period varied from four to seven days and the most common was five days. Eighty percent of the piglets kept alive more than four days postinoculation have shed oocysts. Piglets dosed with old sporulated oocysts (ten months old) shed many more oocysts than those infected with a fresh inoculum (less than two months old). The patent period was not determined precisely with the design of the experiment but some of the infected piglets shed oocysts for at least five days.

Animals↗
PubMed1983

[Rehabilitation and return to work of patients after aortocoronary bypass].

A pilot project with medical, physical and psychosocial evaluation and a physical and psychosocial rehabilitation program included 59 men, under age 60, inactive for less than one year and who underwent aortocoronary bypass surgery between november 1978 and march 1980. A control group of 60 comparable patients was studied by questionnaire one year after the operation. The percentage of return-to-work was not significatively different: respectively 92 p. 100 and 89 p. 100. A previous study on a similar population determined 9 predictive sociodemographic and medical factors: age, angina class, duration of symptoms, associated vascular disease, non cardiovascular illness, education, physical workload, length of preoperative unemployment, annual income. The evaluations of this study showed the importance of the psychosocial factors and alcoholism. In comparison with our previous studies, the increased percentage of return-to-work (from 69 p. 100 to 89 p. 100) is mostly due to a shorter preoperative period of inactivity; the percentage of patients operated on within three months of inactivity increased from 44 p. 100 to 74 p. 100 in the last ten years. In the group of patients with a good or excellent preoperative prognosis, 94 p. 100 were working after one year. We conclude that a strategy for improving return-to-work after surgery is to decrease the period of preoperative inactivity. By using nine objective predictive factors and a psychosocial evaluation, it is possible to screen patients with a poor return-to-work prognosis and to submit them to an individualized rehabilitation program.

Adult↗
PubMed1982

Phase I study of 13-cis-retinoic acid toxicity.

A phase I study of 13-cis-retinoic acid was done in 16 patients with head and neck malignancies using a modified Fibonacci search scheme, with individual doses ranging from 20 to 120 mg/m2. Drug doses greater than 60 mg/m2 induced intense headaches, urethritis, desquamative dermatitis, vertigo, and ataxia. The severity of these side effects precludes the use of 13-cis-retinoic acid as a potential chemopreventive agent at doses greater than 60 mg/m2.

Adult↗
PubMed1981

[Study of the catecholamines in the notochord of Anura Amphibia embryos. Its possible relationships with the adenyl-cyclase activity and the primordial germ cells migration (author's transl)].

Notochord from several Anura Amphibia embryos was investigated by cytochemical study. A green fluorescence was observed, indicating a catecholamine storage in the notochord, during a precise time of their development. A stimulation of the mesoblast area by catecholamine is suggested by the analogy between the catecholamine chordal distribution and the adenyl-cyclase activity of the chordo-mesoderm. This stimulation would be followed by a cAMP production directing the PGC migration. Treatment by L-dopa increases fluorescence in the notochord. Reserpine and alpha-methyl-paratyrosine decreases the notochord fluorescence, either by stocked catecholamine depletion in the case of reserpine, or by inhibition of their synthesis by alpha-methyl-para-tyrosine.

Adenylyl Cyclases↗
PubMed1979

[Influence of cyclic adenosine monophosphate on the migration of primordial germ cells of the anuran Amphibians (author's transl)].

After the treatment in toto of the embryos from various species of Anura by cAMP, the number of primordial germ cells (PGC) in genital ridges is strongly reduced; the most part of the PGC are found in the endoderm. A ventral implant of agar impregnated with a solution of cAMP attracts numerous PGC in the same way as grafted chordomesoderm. The chordomesoderm itself, incubated with 3'-5' cyclic nucleotide phosphodiesterase, then grafted on to the ventral area of normal embryos attracts very few PBC compared with the non-incubated chordomesoderm. The results are analyzed and discussed along the following hypothesis: the migration of the PGC of the Anura is guided by cAMP which, diffusing from the chordomesoderm, is distributed along a concentration gradient increasing in a ventrodorsal direction. The PGC go up the gradient by a chemiotactic mechanism and reach the dorsal parts of the embryo.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1977

[Hepatic and renal desamidinases in swine].

By cellulose acetate electrophoresis we have confirmed the presence of two desamidinasic fractions in aqueous extracts of acetone powder from pig liver. Pig kidney extracts have been partially purified by thermal denaturation and chromatography on Sephadex G-200 and D.E.A.E. Sephadex A-50. Michaelis constants of the two eluted arginasic fractions have been determined.

Animals↗
PubMed1976

[Parapsoriasis].

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Acute Disease↗