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Biomedical subjects

D Grange

Publications and source records attributed to D Grange.

At least 37 records · Page 2Linked to original sources
PubMed1987

Non-invasive diagnosis of pulmonary hypertension in chronic obstructive pulmonary disease. Comparison of ECG, radiological measurements, echocardiography and myocardial scintigraphy.

The respective value of four non-invasive methods for the diagnosis of pulmonary arterial hypertension (PAH) was investigated in 63 COPD patients, using right heart catheterization as the reference method: 22 patients had no resting PAH (pulmonary artery mean pressure (PAP) less than or equal to 20 mmHg); 26 patients had mild PAH (PAP = 21-30 mmHg); and 15 patients had moderate to severe PAH (PAP greater than 30 mmHg). The specificity of ECG was 86% and the sensitivity 51% (only 38% in mild PAH). The specificity of radiological measurements was 63% and the sensitivity 46% (38% in mild PAH). Echocardiography (echo) had the best results with a specificity of 75% and a sensitivity of 78% (73% in mild PAH), but reliable echo measurements were available in only 52 out of 63 patients. Myocardial scintigraphy had a specificity of 68% and a sensitivity of 66% (58% in mild PAH). A stepwise regression analysis (including one echo, one ECG, one radiological and one functional variable) explained only 43% of the variance of PAP (multiple r = 0.66). These results suggest that no individual method is sufficiently reliable for predicting the presence of PAH, and particularly mild PAH, but the combination of echo + myocardial scintigraphy allows the prediction of PAH with a good probability. The precise level of PAH cannot be estimated, even when using multiple regression equations.

Adult↗
PubMed1986

[Clinical aspects, epidemiology and economic impact of foot epidermomycosis in an industrial milieu].

Fungal infections of the feet are very common in some professions. This has been particularly studied in coal mine workers up to 50 p. 100 of whom were found to have dermatophytosis of the feet. The purpose of this study was to determine the clinical, epidemiological and evolutive characteristics of interdigital and plantar intertrigo of the feet among people working in a coking plant, a potash mine and a motorcar factory. We have also evaluated the cost of treatments in relation to their immediate effectiveness and their preventive effects on relapses. Initially, 208 workers entered the study: 84 (40.7 p. 100) had a mycotic infection (M) and 124 (59.3 p. 100) presented with a non-mycotic (NM) inflammation between the toes and on the soles, characterized by maceration of the skin, hyperhidrosis and bromhidrosis. Change in the lesions under treatment were subjected to statistical analysis. In both M and NM groups the workers were allocated by randomization to a double-blind treatment consisting of: group M: either 2 p. 100 miconazole powder or talcum powder with 2 p. 100 salicylic acid and boric acid; group NM: either 2 p. 100 miconazole powder or ordinary talcum powder. Each subject was seen on at least two occasions after 3 and 12 months of daily foot care and topical treatment. Mycological examinations in group M subjects showed that fungal infections of the feet were primarily due to Trichophyton mentagrophytes or to Trichophyton rubrum. A logistic regression analysis (BMDPLR program) of anamnestic and clinical data (table IV) led to a "mathematical model of the mycotic foot", characterized by 6 main parameters of statistically significant occurrence: a history of interdigital-plantar intertrigo, recurrent in 90 p. 100 of subjects in group M (significant association at 0.1 p. 100); a functional symptom, pruritus, present in 71 p. 100 of subjects with mycosis; the stronger, more disturbing the pruritus, the greater the probability of it being of fungal origin (significant association at 0.1 p. 100); 4 physical signs: lack of maceration (0.1 p. 100), lesions limited to the interdigital spaces and respecting the soles (0.1 p. 100), presence of interdigital fissures (0.5 p. 100) and vesiculation (2.5 p. 100). When the respective diagnostic values of these elementary symptoms were considered, it appeared that their various combinations might have predictive values which could be calculated.(ABSTRACT TRUNCATED AT 400 WORDS)

Computer Simulation↗
PubMed1986

[Sugiura's operation: a Japanese exclusive?].

Fifteen patients with liver cirrhosis (11) or intrahepatic non cirrhotic portal hypertension (4) and previous variceal bleeding were electively treated by Sugiura's operation. There were no operative death. One patient (6.6 p. 100) had recurrent variceal bleeding 58 months postoperatively. One other patient had a self-limited episode of encephalopathy The 5-year actuarial survival rate was 81 p. 100. Four of the cirrhotic patients operated more than 5 years ago were alive at 5 years. The operation resulted in portal vein thrombosis in 2 patients, one of whom died. Results of this small series are quite similar to those of the largest Japanese series. They suggest that Sugiura's procedure has a low operative risk, is very efficient in preventing variceal rebleeding and does not result in encephalopathy.

Adult↗
PubMed1986

[Sclerosing cholangitis, chronic pancreatitis and Sjögren's syndrome].

A 63 year old man was followed up for chronic pancreatitis. After 2 years, he developed features of primary sclerosing cholangitis associated with Sjögren's syndrome. A review of the literature revealed 38 previous cases of chronic pancreatitis associated with sclerosing cholangitis; a sicca complex was also demonstrated in 3 of these cases. Chronic pancreatitis is mostly asymptomatic and the diagnosis is usually made at laparotomy or postmortem. Retrograde pancreatograms are abnormal in 15-75 p. 100 of patients with primary sclerosing cholangitis. The relationship between the two diseases is not a coincidence. On the other hand, the significance of the association with the Sjögren's syndrome remains controversial.

Cholangitis↗
PubMed1985

Surgical resection of segment VIII (anterosuperior subsegment of the right lobe) in patients with liver cirrhosis and hepatocellular carcinoma.

A limited liver resection was performed in two patients with cirrhosis and a hepatocellular carcinoma situated in segment VIII (anterosuperior subsegment of the right lobe). One of the patient had previously bled from esophageal varices. Resection of segment VIII was performed following the anatomical planes of section after complete mobilization of the right lobe of the liver. Both patients were alive and free of recurrence 14 and 30 months after surgery. Hepatocellular carcinomas are thus treatable by limited anatomic liver resection even when they are situated in the vicinity of the major hepatic veins and the vena cava.

Aged↗
PubMed1985

HLA antigens in multiple sclerosis in Alsace.

The distribution of HLA antigens A, B, C and DR was studied in 69 native Alsatian multiple sclerosis (MS) patients. Antigen DR2 was high in MS compared to healthy control subjects, as is known. Given antigens were more frequently, and, above all, more closely linked with certain clinical and organic parameters. Antigens A3, B7 and B40 were preferentially associated with progressive forms, and A32 with remitting forms. B7 may be predictive of the prognosis, as it was correlated with disease severity. B7 and DR2 were more frequent in MS patients presenting intrathecal immunoglobulin synthesis. Sex appeared to be a fundamental factor in the clinical expression of MS, interacting closely with the HLA system. These findings confirm the multi-factor etiology of MS. Several MS susceptibility genes may exist near the HLA complex, and their expression may modulate the clinical and organic signs of MS. Studies of this sort should be carried out on ethnically and geographically homogeneous populations.

Adult↗
PubMed1983

Suppression of the shunt and esophageal transection. A new technique for the treatment of disabling postshunt encephalopathy.

A new surgical procedure was developed for the treatment of disabling postshunt encephalopathy. This procedure consists of an esophageal transection with esophagogastric devascularization, followed by suppression of the shunt. Suppression of the shunt is performed postoperatively using external maneuvers. In the four patients treated, suppression of the shunt led to disappearance of the clinical manifestations of encephalopathy in three and to a significant improvement in one. Providing that the shunt is side-to-side, this new treatment would allow a dramatic improvement in the small number of patients in whom severe encephalopathy develops after portosystemic shunting.

Brain Diseases↗
PubMed1983

[In vitro decondensation of the human spermatozoan nucleus and image analysis].

Between the first stage: differentiation of the human spermatozoa from spermatid in testicle, and the second one: formation of male pronucleus in ovum, the nucleus of spermatozoa undergoes a chromatin condensation and a chromatin decondensation mechanism. Besides it is possible to get this decondensation mechanism in vitro by putting spermatozoa into specific solution with the purpose of carry out an image analysis. The aim of this study was to manage a quantitative analysis of the in vitro nuclear chromatin decondensation of human spermatozoa with an image analyzer of T.A.S. "texture analysis system".

Cell Nucleus↗
PubMed1982

HLA antigens and primary bronchial carcinoma.

A comparative study of HLA, A, and B antigens frequency was undertaken on patients with primary bronchial carcinoma. A prospective study was carried out on 103 patients admitted for the first time to the hospital, and a retrospective study was done on 53 patients who survived at least five years. Forty-seven patients died early while on the prospective study. The results show an increased frequency of B12 antigen both in patients of the prospective study and the retrospective study. This would suggest that the increase is associated with susceptibility to the disease rather than resistance to it. There was no finding in favor of an association between a HLA antigen and survival.

Bronchial Neoplasms↗
PubMed1982

HLA antigens in discoid lupus erythematosus.

HLA-A, B, C and Bf typing was performed in 55 cases of Discoid Lupus Erythematosus (DLE). When both the sex and age of the patient at the onset of the disease were taken into consideration (group I under 40 years, group II over 40), the following increases in antigen frequency were observed: group I: A2 in women, B5, A10 in men; group II: Aw19.2 in women, B8 in both sexes. Nevertheless, if the probability is multiplied by the number of antigens tested, these results are no longer significant.

Adult↗
PubMed1981

Haplotype study. linkage between HLA--A, B, C and Bf alleles: results obtained by different statistical methods.

325 HLA-A, B and Bf haplotypes obtained from family studies were investigated. In addition, 216 of these were tested for HLA-Cw2, Cw4, Cw5. Four different statistical methods were employed to study 2, 3 or 4 loci gametic associations in order to compare the results obtained by these different methods. Our results were then compared with those of other authors who employed similar methods. Piazza's method, used to identify gametic associations, was not able to show any 3 loci associations in our material. The Delta Standard Method employed in conjunction with Factorial Correspondence Analysis was found suitable for the study of chromosomal prevalence in a population.

Complement Factor B↗