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Biomedical subjects

C Morin

Publications and source records attributed to C Morin.

At least 91 records · Page 5Linked to original sources
PubMed1994

Supracervical Laparoscopic Hysterectomy (SCLH)

In 50 women without cervical pathology, a SCLH was performed with extraction of the uterus by means of a posterior colpotomy under endoscopic visual guidance. All cases were performed after a diagnosis of dysfunctional uterine bleeding or uterine leiomyomata and treatment with GnRH analogs for 3 months. Uterine fundal measurements ranged from 6-10 cm in greatest diameter. Results, including operating time, blood loss, subjective feelings of nausea, emesis, oral tolerance, and resumption of ambulation were all evaluated in the immediate postoperative period. All patients resumed their normal daily activities at 6 to 10 days postoperatively. A preliminary report addressing sexual function and satisfaction at 3 months postoperatively as compared with the preoperative period was developed. No difference in experience was noted. An economic evaluation was performed at the Clinica Ginemedex that revealed a 30% savings in terms of postoperative care and medication when performing a SCLH as opposed to the more conventional total laparoscopic hysterectomy (LH). SCLH appears to offer several advantages over total LH.

Journal Article↗
PubMed1994

Supra-Cervical Laparoscopic Hysterectomy (SCLH) vs. Total Laparoscopic Hysterectomy (LH): A Comparative Post-Operative Study

One hundred women without cervical lesions underwent hysterectomies for uterine myomas or menometrorrhagia unresponsive to medical therapy after being randomized into two groups (50 for LH and 50 for SCLH), uterine fundal measurements were 6 to 10 cm in greatest diameter. We evaluated operating time, blood loss, the postoperative incidence of nausea and emesis, the need for analgesics, and resumption of oral tolerance and ambulation. Using the Student t Test, a clinically statistically significant improvement was noted in the quality of the postoperative period in women undergoing SCLH as compared with those undergoing LH. Patients undergoing SCLH reported feeling 'less castrate' than those undergoing traditional total LH.

Journal Article↗
PubMed1994

Severe skin necrosis associated with heparin in hemodialysis.

Skin necrosis is a well-recognized although rare complication of continuous heparin therapy. We report the case of a 66-year-old diabetic woman with end-stage renal failure who received intermittent intravenous heparin during hemodialysis. She developed severe necrotic cutaneous ulcers over both legs, with typical histological findings. Thrombocytopenia never occurred but platelet studies demonstrated enhanced aggregation when heparin was added in vitro. Platelet-aggregating immunoglobulins produced in response to heparin can lead to thrombotic events. Thrombocytopenia usually develops prior to the onset of cutaneous lesions, but as in this case, may be absent. Heparin should be discontinued when the condition is recognized. Unfortunately, a poor outcome is frequently observed.

Aged↗
PubMed1994

Vulvar vestibulitis syndrome: an exploratory case-control study.

OBJECTIVE: To assess the prevalence of genital bacterial infection among women with vulvar vestibulitis syndrome and to evaluate the association of several potential risk factors with the occurrence of the syndrome. METHODS: Fifty-seven women referred for dyspareunia who satisfied Friedrich's criteria and had symptoms for at least 6 months were recruited as cases. Controls included 173 patients without dyspareunia seen at a private clinic. Cases and controls were aged 18-35 years and were not pregnant. RESULTS: Among cases, the prevalences were low for genital infection with gonorrhea (0%), Chlamydia (0%), Trichomonas (0%), Mycoplasma (0%), Gardnerella (14%), and Candida (8.8%). Ureaplasma was detected in the Bartholin glands of ten affected women (17.5%). Human papillomavirus DNA was detected in only three cases (5.3%) based on polymerase chain reaction assays on vestibular biopsies. The relative risk (RR) of the syndrome was related to some aspects of sexual and reproductive history. In particular, the RR in women who had used oral contraceptives (OCs) early (before age 17) reached 11.0 (95% confidence interval [CI] 1.3-97.1) relative to those who had never used OCs. Women who had first intercourse at age 15 or earlier had a 3.3-fold increase in RR (95% CI 1.4-8.0) compared to those who had first intercourse at age 16 or later. CONCLUSION: Our data provide little support for the idea that infection causes the vulvar vestibulitis syndrome. Hormonal factors such as early OC use may be involved in the etiology of this condition.

Adolescent↗
PubMed1993

Venous stasis complications of the use of the superficial femoral and popliteal veins for lower extremity bypass.

PURPOSE: The widely accepted durability of autogenous vein for infrainguinal arterial bypass has led the authors to use the superficial femoral and popliteal vein in selected cases. The results of this experience are presented. METHODS: From January through December 1991, during which 92 lower extremity bypass procedures were performed, deep vein bypass was attempted in seven patients (three femoral-popliteal grafts, two femoral-peroneal grafts, one femoral-deep femoral bypass, and one popliteal-posterior tibial bypass). In all cases the saphenous vein was absent or inadequate for use as a bypass conduit. The superficial femoral vein was harvested to below the knee in five patients. RESULTS: At last follow-up six of seven patients had patent grafts with relief of their original symptoms. All the procedures were complicated by venous stasis; acute postoperative phlegmasia developed in two cases. In one of these cases the limb was salvaged by below-knee fasciotomy and deep venous bypass (distal popliteal vein to common femoral vein with polytetrafluoroethylene). In the other case an above-knee amputation was required. Of the five remaining patients three had moderate venous stasis edema unresponsive to limb elevation and compression stockings after operation, and two have had resolution of minimal postoperative venous stasis with simple limb elevation. All cases of severe and moderate venous stasis occurred in patients with popliteal vein harvest to below the knee. CONCLUSIONS: The authors conclude that the use of the deep veins of the lower extremity for bypass is effective but is associated with a significant increase incidence of venous stasis edema. Two instances of phlegmasia were associated with popliteal vein harvest below the knee, and the authors caution against harvest of the popliteal vein to this level.

Aged↗
PubMed1993

Biodegradable nanocapsules containing a lipophilic immunomodulator: drug retention and tolerance towards macrophages in vitro.

Nanocapsules (250 nm diameter) were prepared from poly (D, L-lactide) containing a lipophilic immunomodulator: MDP-L-alanyl cholesterol (MTP-Chol). High encapsulation rates were obtained at 37 degrees C in culture medium or in buffers imitating phagosomes and lysosomes. The tolerance of these particles by rat alveolar macrophages in vitro was tested. A slight toxicity was observed which was the result of two factors: the capacity of the immunomodulator to stimulate the generation of nitrite oxide by the L-arginine-dependent pathway and the polymer itself. The latter toxicity seemed to be mediated by a different mechanism.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1993

A biochemically distinct form of cytochrome oxidase (COX) deficiency in the Saguenay-Lac-Saint-Jean region of Quebec.

We report the results of biochemical and molecular investigations on a group of patients from the Saguenay-Lac-Saint-Jean region of Quebec who have an unusual form of cytochrome oxidase deficiency and Leigh disease. This group can be distinguished from the classical presentation of cytochrome oxidase deficiency with Leigh disease, by the severity of the biochemical defect in different tissues. The activity in skin fibroblasts, amniocytes, and skeletal muscle of cytochrome oxidase is 50% of normal, while in kidney and heart it is close to normal values. Brain and liver, on the other hand, have very low activities. The defect in activity appears to result from a failure of assembly of the cytochrome oxidase complex in liver, but levels of mRNA for both mitochondrially encoded and nuclear-encoded subunits in liver and skin fibroblasts were found to be the same as those in controls. The cDNA sequence of the liver-specific cytochrome oxidase subunits VIa and VIIa were determined in samples from patient liver and skin fibroblasts and showed normal coding sequence.

Acidosis, Lactic↗
PubMed1993

Clinical, metabolic, and genetic aspects of cytochrome C oxidase deficiency in Saguenay-Lac-Saint-Jean.

Thirty-four children with lactic acidosis and Leigh encephalopathy due to cytochrome C oxidase (COX) deficiency distributed in 28 families have recently been identified in northeastern Quebec, particularly in the Saguenay-Lac-Saint-Jean (SLSJ) region. The segregation analysis was consistent with an autosomal recessive mode of inheritance. The incidence was estimated at 1/2,063 live births between 1979 and 1990, and the carrier rate was estimated at 1/23 inhabitants in SLSJ. In SLSJ, the places of origin of the COX-deficient children and their parents did not show a clustered nonuniform distribution. The genealogical reconstruction of 54 obligate carriers identified 26 ancestors common to all of them. Twenty-two were 17th-century Europeans, suggesting that the COX-deficient gene was introduced in the French-Canadian population by early settlers. These results support the hypothesis of a founder effect for COX deficiency in northeastern Quebec. Clinical findings are reported for 15 of these COX-deficient patients, age 6 mo to 11 years. Moderate developmental delay, hypotonia, ataxia, strabismus, and mild facial dysmorphism were frequent. Eleven children died in episodes of fulminant metabolic acidosis. The patients had elevated blood and cerebrospinal fluid lactate levels, decreased blood bicarbonate levels, and normal blood pH. Leigh disease and microvesicular steatosis of the liver were present in all affected patients for whom postmortem examination was performed. This biochemically uniform group of patients showed a wide range of clinical severity.

Acidosis, Lactic↗
PubMed1992

Influence of remote targets on directionality of striate neurons in rabbits.

The described investigations study the influence of additional targets located well outside the classical receptive field on responses to motion of cortical cells in rabbits. Animals are anesthetized and prepared for acute single cells recordings in a conventional manner. The interactions between remote targets and central stimuli are abolished with microinjections of lidocaine hydrochloride or GABA at the site excited by remote stimuli. Results show that responses to motion of cortical cells are particularly sensitive to these manipulations. Although supplementary targets fail to influence spontaneous activity of all cells, they do influence responses to motion. Overall, the directionality indices (DI) declined. (53 to 45.) This decline may express itself either by a decrease of responses in the preferred direction or an enhancement of responses in the non-preferred direction or both. By contrast, responses to stationary stimuli are unaffected by additional targets in the visual field. Globally, cells whose directionality index was superior to 50% were significantly more affected then cells whose DI was less than 50%. This result suggests that similarly to cats, the directionality of cells in the striate cortex rests on a very fragile convergence of excitatory and inhibitory influences.

Animals↗
PubMed1992

Generation of end-inhibition in striate neurons in rabbits.

Eighty-six rabbit striate neurons were tested with lateral microinjection of lidocaine, GABA or bicuculline. Seven of the neurons expressed different levels of end-inhibition. We examined these end-stopping units by injection of lidocaine or bicuculline in adjacent areas in order to determine if a lateral cortical mechanism is underlying end-inhibition in rabbits as it has been proposed in cats. Microinjection of lidocaine resulted in an attenuation of the end-inhibition strength. Application of bicuculline had the opposite effect; the end-inhibition was reinforced. We suggest that as observed in cats, in rabbits end-inhibition is mediated through horizontal cortical connections which implies a postsynaptic inhibitory input to the end-stopping cell.

Animals↗
PubMed1992

Acetazolamide in hemodialysis patients: a rational use after ocular surgery.

Acetazolamide is a weak diuretic used to decrease production of aqueous humor in the eye. Hemodialysis patients undergoing ocular surgery may benefit from acetazolamide; however, no pharmacokinetic data are available for this group of patients. We report a patient who received acetazolamide 250 mg every 6 hours after ophthalmic surgery and developed reversible neurological side effects associated with very high plasma concentrations. Using pharmacokinetic analysis, we suggest an alternate administration of acetazolamide for end-stage renal patients.

Acetazolamide↗
PubMed1992

Visual responsiveness and direction selectivity of cells in area 18 during local reversible inactivation of area 17 in cats.

We have investigated the effects of inactivation of localized sites in area 17 on the visual responses of cells in visuotopically corresponding regions of area 18. Experiments were performed on adult normal cats. The striate cortex was inactivated by the injection of nanoliters of lidocaine hydrochloride or of gamma-aminobutyric acid (GABA) dissolved in a staining solution. Responses of the simple and complex cells of area 18 to optimally oriented light and dark bars moving in the two directions of motion were recorded before, during, and after the drug injection. Two main effects are described. First, for a substantial number of cells, the drug injection provoked an overall reduction of the cell's visual responses. This nonspecific effect largely predominated in the complex cell family (76% of the units affected). This effect is consistent with the presence of long-range excitatory connections in the visual cortex. Second, the inactivation of area 17 could affect specific receptive-field properties of cells in area 18. The main specific effect was a loss of direction selectivity of a number of cells in area 18, mainly in the simple family (more than 53% of the units affected). The change in direction selectivity comes either from a disinhibitory effect in the nonpreferred direction or from a reduction of response in the preferred direction. It is proposed that the disinhibitory effects were mediated by inhibitory interneurones within area 18. In a very few cases, the change of directional preference was associated with a modification of the cell's response profile. These results showed that the signals from area 17 are necessary to drive a number of units in area 18, and that area 17 can contribute to, or at least modulate, the receptive-field properties of a large number of cells in the parastriate area.

Animals↗
PubMed1992

Patterns of responsiveness of T cell lines and thymocytes reveal waves of specific activity in the post-natal murine thymus.

Antibody binding of CD3, CD4, or CD8 molecules can induce cytoplasmic calcium mobilization in T lymphocytes, usually interpreted as indicating signal transduction. Using such assays, in a CD4+ CD8+ thymocyte line and its single positive progeny we have identified characteristic patterns of responsiveness that are reproducible in vivo in a subpopulation of newborn 'double positive' thymocytes but virtually absent in adult thymuses. In particular, these cells appear to be high responders to the binding of anti-CD3 F(ab)'2 fragments. We have followed the presence of such highly responsive thymocytes in the perinatal period and the first 15 days of life. Intriguingly, these cells populate the newborn thymus in three distinct waves. Such patterns of responsiveness may define early 'selectable' thymocytes.

Animals↗
PubMed1992

Patent paraumbilical vein: anatomic and hemodynamic variants and their clinical importance.

Fifty-five of 353 patients with suspected portal hypertension studied with Doppler sonography had a patent paraumbilical vein. Of these 55 patients, 39 had the classic intrahepatic venous circulation found in Cruveilhier-Baumgarten syndrome: hepatopetal flow in all segmental portal veins and hepatofugal flow leaving the liver in a paraumbilical vein in the falciform ligament to join veins of the anterior abdominal wall. Sixteen patients had variants of the classic pattern: Flow in one or more segmental portal veins of the left lobe or the entire liver was hepatofugal. In addition, new venous channels connecting the left portal vein with the extrahepatic paraumbilical vein were found. Assessment of liver function with the Pugh score showed severe impairment in the majority of patients with a patent paraumbilical vein. Patients with the classic intrahepatic circulation had smaller esophageal varices than those with hemodynamic or anatomic variants. The presence of a patent paraumbilical vein did not prevent formation of esophageal varices in the patients studied.

Adolescent↗
PubMed1992

Possible implication of lysophosphatidylcholine in cell fusion accompanying implantation in rabbits.

Implantation in rabbits involves the cellular fusion of trophoblastic and uterine epithelial cells resulting in embryo penetration of the uterine endometrium. Since lysophospholipids, known to have fusigenic properties, could be responsible for this cell fusion, the metabolism of lysophospholipids was studied throughout gestation in blastocyst/yolk sac and extracoelic amnioallantoic fluids. Analysis of phospholipid composition revealed that lysophospholipids are present in blastocyst/yolk sac fluid. Their concentrations and haemolytic activity change during pregnancy. They increase and reach their highest values during days 7 to 9, the implantation days in rabbits. A clear correlation was observed between lysophosphatidylcholine concentrations in blastocyst/yolk sac fluid and haemolysis induced by this fluid. Phosphatidylcholine concentrations, phospholipase A2 activity, which generates lysophospholipids, and lysophospholipase A activity which hydrolyses lysophosphatidylcholine into fatty acid, were at their highest value at day 12. These data suggest that a transient accumulation of lysophospholipids could ensure local cell fusion. Moreover, we propose that the lysophospholipid concentrations in blastocyst/yolk sac fluid are dependent upon activities of phospholipase A2 and lysophospholipase.

Animals↗
PubMed1991

Insulin-like growth factor II/mannose-6-phosphate receptors are transiently increased in the rat distal intestinal epithelium after resection.

The levels of insulin-like growth factor II/mannose-6-phosphate (IGF-II/Man-6-P) receptor and the insulin-like growth factor I (IGF-I) receptor were measured in the intestinal epithelium after 50% resection of the small intestine. Controls were either pair-fed to match the reduced food intake of the resected group or fed ad libitum. [125I]IGF-II binding was transiently increased 2-fold in the distal segment of the small intestine 3 days after resection compared with the pair-fed control. Receptor levels increased from 2.60 nmol/mg protein (pair-fed) to 4.63 nmol/mg protein (resected; p less than 0.001) with no significant change in affinity of IGF-II binding (Kd = 11.2 vs. 9.8 nmol/l). The increase in IGF-II/Man-6-P receptors coincided with increased activity of thymidine kinase in the distal intestinal segment after the resection. [125I]IGF-I binding remained unchanged after the resection. However, the decreased food intake of the pair-fed and resected groups caused a 2-fold increase in the amount of IGF-I receptors (0.18 nmol/mg protein; p less than 0.001) compared with the control fed ad libitum (0.08 nmol/mg protein). IGF-II/Man-6-P receptors were only moderately increased during restricted food intake (2.60 vs. 1.78 nmol/mg protein; p less than 0.005). These results suggest that the IGF-II/Man-6-P receptor may play a role in the adaptive regenerative response of the intestinal epithelium.

Animals↗