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Biomedical subjects

C Mercier

Publications and source records attributed to C Mercier.

At least 181 records · Page 10Linked to original sources
PubMed1984

Acute dissection of the descending thoracic aorta: repair in an unusual case.

Acute tamponade, although a rare manifestation of a descending thoracic aneurysm, was the dominant clinical feature of a classic type III dissecting aneurysm (arising distal to the left subclavian artery) in a 52-year-old man. High-quality aortography confirmed the diagnosis, ruling out any anomaly of the ascending aorta and the aortic arch. Surgical treatment was carried out 24 hours after the initial episode without cardiopulmonary bypass. Through a left thoracotomy, a Gott shunt was inserted proximally at the apex of the left ventricle and distally in the left femoral artery. Aortic repair with the interposition of a 30-mm woven Dacron prosthesis was successful. Postoperative aortography showed complete restoration of aortic integrity.

Acute Disease↗
PubMed1983

Anterior callosotomy and chronic depth electrode recording in the surgical management of some intractable seizures.

Chronic depth electrode recording has proven to be a safe and indispensable tool for the investigation of intractable seizures. Anterior callosotomy appears as an excellent palliative treatment at least in bifrontal foci. It is hoped that chronic depth electrode recording will be used more widely before callosotomy in order to establish more clearly the best indication for such a surgical procedure.

Corpus Callosum↗
PubMed1983

[Laparoschisis and atresia of the small intestine. Treatment strategy. Apropos of a personal case].

A case of gastroschisis and double small bowel atresia is reported. Primary surgical treatment consisted in jejunostomy located at 28 cm from the ligament of Treits, reinstatement of excluded bowel loops encased in a thick matrix of fibrinous material, and abdominal wall closure. Seven weeks later, the lower part of small bowel was anastomosed to the medium part. Because of uneven bowel caliber, an ileostomy was associated to parenteral nutrition using permanent instillation of secretions recovered from ileostomy was associated to parenteral nutrition. At 4 1/2 month, small bowel continuity was restored with jejunal modeling. Authors stress the necessity to preserve as far as possible, intestinal segments in such a case and emphasize the advantage of the digestive instillation method in order to recover the function excluded intestinal segments.

Abdominal Muscles↗
PubMed1983

[Plasma thromboxane B2 and capacity of the aorta to produce prostacyclin in arteriopathies of the lower extremities].

Plasma levels of thromboxane B2, and 6-Keto-PGF1 alpha, stable metabolites of thromboxane and of prostacyclin were determined by radioimmunoassay in 17 patients with arterial disease and 10 control subjects. The production of prostacyclin from incubates of aortic microsomal fractions of patients was also studied. There was a significant elevation of thromboxane B2 in the peripheral venous blood of patients with arterial lesions (142 +/- 152 pg/ml vs 22 +/- 2 pg/ml, p less than 0.005); levels of 6-KetoPGF1 alpha were equally low in controls and patients. Rate of production of prostacyclin, which was 450 +/- 24 pmol/50 mg of proteins in 10 minutes in controls, was reduced to 97 +/- 86 pmol/50 mg prot. 10 min (p less than 0.01) in patients. Co-existence of raised plasma thromboxane levels and a reduced capacity for prostacyclin synthesis in the same patients is supportive evidence of the thrombogenic theory of arterial disease.

6-Ketoprostaglandin F1 alpha↗
PubMed1983

Major mediastinal vascular injuries.

Surgical repair was carried out in 37 patients who had rupture of the thoracic aorta or major branches. The survival rate was 90% (33 of 37). Three deaths occurred in the acute phase, giving a survival rate of 87% (19 of 22). Two patients had severe coexisting brain trauma and the other had profuse intrathoracic hemorrhage before thoracotomy could be carried out. One death occurred in a chronic case (an arch aneurysm) for a survival rate of 94% (14 of 15). A massive air embolism to the brain caused this fatal outcome. There were no instances of left heart failure or renal shutdown in our series. One case of paraplegia occurred because a shunt was inserted erroneously in the distended adventitia from an enormous surrounding hematoma. The distal end of the shunt was not in the aortic lumen so there was no distal perfusion during the period of aortic clamping.

Accidents, Traffic↗
PubMed1982

[Serum profile of inflammatory reaction proteins in arteriopathies of the lower limbs, stage II].

The serum content of proteins involved in the inflammatory process was investigated, partly through kinetic immunodiffusion, in 85 men subdivided as follows: 45 men (aged 57 +/- 5 years) with intermittent claudication due to arteriosclerosis obliterans; 20 controls matched for sex and age; 20 sex-matched controls whose mean age was 25 +/- 3 years. Patients with obliterating arteriosclerosis had signs of both subacute and chronic inflammation. Compared to controls, they had a higher sedimentation rate, a lower percentage of serum albumine, higher percentages and absolute serum contents os alpha 1, alpha 2 and beta globulins, and higher serum concentrations of fibrin, orosomucoid, C3 complement fraction and IgA. In addition, the modifications of these proteins were closely correlated. These results are consistent with previous reports concerning patients with coronary heart disease. They point out the relationship between inflammation and atherosclerosis.

Adult↗
PubMed1982

[Should one operate on all asymptomatic carotid lesions?].

Two subgroups in Natali and Thevenet's stage 0 class of asymptomatic diseases are defined. True asymptomatic affections occur in patients with neurologically asymptomatic carotid lesions. The natural history of these diseases when compared with results after surgery is in favor of preventive operative therapy. False asymptomatic affections are seen in patients who, after previous operations for symptomatic carotid lesions, present a lesion on the controlateral carotid which until then had been neurologically silent. The natural history of this group shows that immediate definitive cerebral accidents are rare and that life expectancy is low. In contrast, the course after repeat surgery, the present data being the first to be published, appears to be rather unfavorable. Careful selection of patients in this subgroup is therefore necessary when considering surgical treatment.

Carotid Artery Diseases↗
PubMed1980

Determinants of mortality following coronary bypass surgery.

Factors related to early and late mortality were studied in 663 consecutive patients who had coronary bypass operations. There were 18 operative deaths (2.7%) and 15 late deaths (2.3%). Patients who died were slightly older than surviving patients. Operative mortality was higher (5.3%) in those with congestive heart failure; this correlated directly with the degree of abnormal wall motion shown on left ventriculograms. Preoperative end-diastolic pressure of the left ventricle was not a good predictor of death. While operative mortality was 1.5% in those with stable angina, it increased to 4.2% in patients with unstable angina and to 25% in patients with evolving myocardial infarction. In those with stenosis of the left main coronary artery, early mortality was 12.3%. Although early mortality was unaffected by the extent of coronary disease or by the degree of correction, it increased significantly (P less than 0.05) with the number of grafts inserted and when other cardiac procedures were also performed. Perioperative myocardial infarction was associated with a 28% mortality, but was unrelated to graft failure in 60% of the cases. Late mortality was related only to the number of diseased coronary arteries. Thus, left ventricular function, severity of angina and extent of coronary obstruction appear to be the main determinants of survival following coronary artery operation.

Adult↗
PubMed1980

[Mycotic aneurysm of bronchial artery. Apropos of a case in an infant].

The authors report the case of a 15 day old neonate presenting a beta hemolitic streptococic (group A) infection, followed by cardio-respiratory failure and radiological opacification of the left superior lobe associated with ventilatory troubles at the left lung base. Massive hemoptysis made an angiographic study mandatory with the diagnosis of a mediastinal vascular tumor placed besides the left descending aorta with compression of the left bronchovasculary pedicule. Tumor ressection was not possible during surgical exploration and a left superior lobectomy was performed. Histological examination showed pulmonary infarctus. The child died a few weeks later. Autopsy revealed mycotic arterial aneurysm of the superior bronchic artery, a very rare lesion considering its localisation and the age of the patient.

Aneurysm, Infected↗
PubMed1980

[25 cases of traumatic rupture of the thoracic aorta: current diagnostic elements].

Traumatic rupture of the descending thoracic aorta is lethal within 3 weeks in 95% of patients who do not undergo operation. In this series of 25 patients who were operated on, 84% have survived for 6 years and there have been no cases of paraplegia. The mechanism of injury is most important in the investigation of patients with traumatic injuries and must be sought either from the patient or from witnesses. A history of rapid deceleration (more than 60 km/h) following a highway collision was present in all our cases. Failure to wear seat-belts resulted in 70% of patients being ejected from a vehicle. A side-on collision resulting in lateral deceleration caused trauma to the intrathoracic aorta in 45% of cases. Vertical deceleration resulted from falls from great heights (bridge, overpass) in 25% of cases. Clinical signs of diagnostic importance were: arterial hypertension (60%), systolic murmur (35%) and the pseudocoarctation syndrome (25%). Pertinent signs on chest roentgenograms were present in 95% of cases and included widening of the mediastinum and blunting of the aortic knob. The authors conclude thoracic aortography should be carried out in trauma patients when two or more of the following are present: (a) history of rapid deceleration, ejection from a vehicle or lateral collision, (b) hypertension and (c) blunting or modification of the aortic knob. The presence of a pseudocoarctation syndrome is an absolute indication for aortography.

Accidents, Traffic↗
PubMed1979

[Rape].

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Adult↗