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Biomedical subjects

D Christmann

Publications and source records attributed to D Christmann.

At least 91 records · Page 5Linked to original sources
PubMed1981

[Echocardiographic evaluation of adriamycin cardiotoxicity during polychemotherapy (author's transl)].

Left ventricular function in 21 patients treated by polychemotherapy including adriamycin (ADM) has been studied by repeated echocardiographic examination. The mean rate of circumferential, the ejection fraction, and the shortening fraction are the most significant data obtained by this investigation. They permit the detection of early damage of left ventricular performance which increases progressively, confirming the dose-dependent nature of the cardiomyopathy. Supervision of patients under ADM is necessary to recognize those who rapidly develop cardiomyopathy. In these cases, treatment interruption may be beneficial. In contrast, patients with little left ventricular damage can be treated by a total dosage of ADM superior to that actually recommended.

Adolescent↗
PubMed1980

Metrizamide demonstration of the subarachnoid space surrounding the Gasserian ganglion.

The chance opacification of the subarachnoid space surrounding the Gasserian ganglion, observed during metrizamide basal cisternography, is reported. This is compared to similar demonstrations of the optic subarachnoid space. Such infrequently observed images should be known because they may be related to the occurrence of trigeminal neuralgia.

Adult↗
PubMed1979

[Corticosteroid-sensitive chemical diabetes in Horton's disease].

We report 5 cases of temporal arteritis associated with a diabetes whose good evolution under corticotherapy suggests a common pathogenesis. Several hypotheses can be formulated to explain the origin of the glycemic abnormality and to understand the way corticotherapy is effective. A moderate posology could at first have a hyperplasic effect on the insulin-secreting cells, and later on a favorable action on the vascular lesion and on an immunological disorder. Any definitive conclusion cannot be evolved yet. Only a more systematical study of the glycoregulation's abnormalities in the temporal arteritis will enable to answer the many remaining questions.

Adrenal Cortex Hormones↗
PubMed1979

[Malabsorption syndrome during the initial phase of a case of severe rheumatoid purpura].

We report a case of severe Henoch syndrome in which the first manifestation was digestive with a prolonged and important intestinal malabsorption syndrome. The clinical, radiological and histological data allow to consider a malabsorption due to lesions of the chorion and submucosa probably secondary to the allergic vasculitis. The malabsorption syndrome, confirmed by the intestinal absorption tests, the study of which must be more systematic, seems to belong to the severe and polyvisceral forms of the Schönlein-Henoch syndrome.

Abdomen, Acute↗
PubMed1977

[Rupture of the free wall of the left ventricle during myocardial infarct. Contribution of echocardiography to its diagnosis. Surgical cure].

Parietal rupture of heart is one of the most dramatic complications in the acute stage of myocardial infarction. Generally it is fatal within few seconds or minutes. The authors report a case of rupture of the left ventricle into the free pericardial cavity, occurred at the 13th hour of an anterior infarction and surgically repaired with favourable result. On this occasion they emphasize the contribution of echocardiography to the diagnosis of cardiac rupture and the exceptional complexion of this case, which, to their best knowledge, is the third to have survived left ventricular rupture associated with ischemic heart disease, more than two months.

Drainage↗
PubMed1977

[Familial mitral valve prolapse and syncopes caused by ventricular tachycardia].

The authors report the case of a female aged 40 who was subject to syncopal attacks, and had an apical end-systolic murmur. The presence of an idiopathic prolapse of the mitral valve was demonstrated, as well as the familial nature of the condition, and the fact that the syncopal attacks were caused by ventricular tachycardia, The case report is followed by a discussion of the cardiac arrhythmias which are likely to accompany this particular mitral lesion, the difficulties in treatment which arise, and finally the danger of sudden death by ventricular fibrillation inherent in this condition, a danger which it is stille difficult to quantify.

Adult↗
PubMed1977

[Massive mitral insufficiency due to spontaneous and isolated rupture of a posterior papillary muscle. Echocardiographic study, treatment by assisted circulation and prosthetic valve replacement].

The authors report a case of a patient of 72 years of age in whom the sudden onset of severe left ventricular failure led to the discovery of massive mitral incompetence. The diagnosis of rupture of the posterior papillary muscle of the mitral valve, which was suggested on clinical and echocardiographic grounds, was confirmed at operation. This was carried out after 72 hours of assisted circulation by counter-pressure, and consisted of a replacement by a prosthetic valve. The authors emphasise, in the light of this case, the importance of echocardiography by ultrasound in the early diagnosis of this type of acute mitral incompetence, clarify the signs, and emphasise the part played by assisted circulation with an intra-aortic balloon in the treatment of this condition.

Aged↗
PubMed1977

[Congenital cystic dilatation of biliary tract (author's transl)].

The congenital cystic dilatation of biliary tract is un frequent affection and there are many types described (classification of Alonso Lej). The authors present the observation of a little girl of 12 years who presented a complete cystic dilatation ob biliary tract, diagnosed before the operation by intravenous biligraphy. This association of intra and extra hepatic cystic dilatation has been described in 1964 by Arthur and Stuart, and the diagnosis is to be done by intraveinous biligraphy in 30% of cases.

Bile Ducts↗
PubMed1976

[Endomyocardial biopsy by venous route. Our initial results].

The authors report their experience of right ventricular endomyocardial biopsy by the technic of Caves and Schulz. The instrument which consists of a spiral metallic catheter covered with synthetic material, includes at one end a hand lever and at the other end a biopsy forceps 3 mm in diameter. It is introduced through the skin into the right internal jugular vein then pushed under direct vision with an image intensifier upto the tip of the right ventricle. The angle of the distal part of the bioptome may be freely modified before use. Passage across the tricuspid orifice from the right atrium is usually easy. 30 good quality samples were thus taken from 10 patients with various forms of heart disease. There were no complications. The simplicity, rapidity and benign nature of this technic are emphasised together with its use in the diagnosis of myocardiopathies.

Biopsy↗
PubMed1976

[Emergency surgical treatment of septal perforations in the acute phase of myocardial infarct. Apropos of 2 cases operated on successfully in the 48th hour and 5th day after development after the necrosis].

The authors report two personal cases of septal perforation during the acute phase of myocardial infarction which under medical treatment would have been rapidly fatal, and which were treated successfully by surgery on the second and fifth days respectively after the infarction, i.e. very early. After briefly recalling the main diagnostic and etiological factors of this serious complication, and the spontaneous prognosis which is usually catastrophic, they emphasise that in presence of poorly controlled heart failure and cardiogenic shock, uncontrollable by intensive medical treatment, only early surgical repair during the first few hours or days of the course of the coronary accident will permit one in certain cases to avoid a fatal issue as proved by their two cases and a review of recent publications. They emphasis the place of circulatory assistance by intraaortic balloon in the preparation of patients for operation and the methods of mycardial revascularisatin during the operation.

Aged↗
PubMed1976

[Familial forms of the mid-end systolic click and murmur syndrome with deviations of left ventricular kinetics].

The aetiology and pathogenesis of the "mid/end-diastolic click and murmur" syndrome, with prolapse of the mitral valves, is obscure in most cases. However, the fact that some cases have had a familial distribution is evidence in favour of a dysgenetic origin. Seven new cases of this type are reported. The authors suggest in this paper that the incidence of the familial form of the syndrome is greater than the literature seems to suggest, and that the syndrome is likely to be due to a malformation. They also emphasise the important part which echocardiography plays in its diagnosis and investigation. Finally, the finding on cine-angiocardiography of specific abnormalities of left ventricular function similar to those found in other studies is indicative of a primary myocardial disorder, associated with subsequent structural alterations of the valvular mechanism.

Adolescent↗
PubMed1975

[Echocardiographic abnormalities in the mitral valve prolapse syndrome].

Eight patients with prolapsed mitral valve syndrome, with a mid - or - end - diastolic click or murmur, underwent echocardiographic examination using ultrasound. Examination of the displacement of the valves by the "time motion" method showed all cases to have an abnormal recoil; in 6 cases this occurred in mid or late systole, and in two from the beginning of systole. The recorded amplitude of the pathological displacement, which gives the systolic tracings a domed appearance, and the consistancy with which it could be recorded (irrespective of the incidence of the ultrasonic waves), seem to afford a method for evaluating the degree of prolapse which, in most cases, involves both the valves. The authors compare their results with those which have already appeared in the literature, and emphasise the very real contribution which echocardiography can make in the diagnosis and assessment of the prolapsed mitral valve syndrome.

Adolescent↗
PubMedDate not supplied

Occupational risk to surgeons of unrecognized HIV infection in a low-prevalence area.

Data are available on the occupational risk to surgeons of the human immunodeficiency virus (HIV) for areas of high HIV prevalence but not for low-risk areas and particularly for unrecognized HIV infection. The 40-year cumulative occupational risk to surgeons caring for patients with unknown HIV serologies in a low-prevalence area was estimated. From May 1989 to May 1991, 4119 consecutive patients with unknown HIV status, hospitalized in our department, were proposed for testing; 100% complied. Acquired immunodeficiency syndrome (AIDS) patients and known seropositive patients operated on during this period were excluded from the study. The prevalence of unknown HIV infection was 0.07%. Taking into account the rate of parenteral injuries, the rate of contamination after an infected parenteral injury, and the total number of operations performed during a 40-year career, we estimated the cumulative risk of unknown HIV infection in our area to be 1%. This risk must be added to those of caring for known infected patients. In high-risk areas (cumulative risk 10%), a high standard of infection control is required for every surgical procedure, even if it is expensive or of doubtful efficacy. It is unrealistic to apply this standard in a low-risk area. HIV testing with informed consent of the patient is an imperfect guard against infection but has the advantage of alerting the surgeon to the risk of contamination on a case-by-case basis; it also offers the seropositive patient the best possibility for a longer life expectancy.

France↗
PubMedDate not supplied

Antenatal diagnosis of brain damage in the survivor after the second trimester death of a monochorionic monoamniotic co-twin: case report and literature review.

At 28 weeks of amenorrhea, 1 fetus of a monoamniotic twin pregnancy died. Ultrasound and Doppler investigations of the surviving twin were normal. Three weeks later, endovaginal ultrasound and magnetic resonance imaging revealed massive bilateral cerebral ischemic necrosis in the surviving twin. In utero fetal blood sampling carried out before the termination did not reveal either anemia or thrombopenia. Current data suggest that cerebral or renal ischemic complications could set in immediately after the death of the first twin as a result of a period of acute hypotension. At least 2 weeks are necessary for them to be identifiable by ultrasound. It seems that they cannot be prevented by prompt delivery of the second twin.

Abortion, Spontaneous↗