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Biomedical subjects

D Mathieu

Publications and source records attributed to D Mathieu.

At least 145 records · Page 8Linked to original sources
PubMed1983

CT features of iatrogenic hepatic arterioportal fistulae.

Peripheral arterioportal fistulae are a relatively frequent complication of hepatic biopsies and transhepatic catheterizations. Three cases were revealed by dynamic computed tomography (CT) and confirmed by angiography. The morphologic and densitometric characteristics of these arteriovenous fistulae on CT in most cases indicate the causal mechanism and eliminate consideration of tumor.

Adolescent↗
PubMed1983

Hepatic angiosarcoma.

The computed tomographic findings of a case of hepatic angiosarcoma are presented. Although many findings are similar to hemangioma, some features can suggest the diagnosis of angiosarcoma.

Angiography↗
PubMed1983

[Hepatic angioscanner in normal subjects and in patients with hepatic tumors. Hemodynamic and morphologic characteristics].

Hepatic angio-CT was performed according to a standardized schedule in 100 healthy subjects and 260 patients with a liver tumor. In normal subjects, it was possible to determine an arterial phase (15 s), a parenchymatous arterial phase (30 s), a parenchymatous portal phase (45 s) followed by a progressive return to liver densities observed before injection. a) Among the 62 cases of hepatocellular carcinoma, 56 were characterized by hypodensity, 3 cases by hyperdensity and 3 cases by isodensity before injection. After injection, slices obtained at the tumor level showed heterogeneous hypervascularisation in 34 cases, and an early homogeneous hypervascularisation (15th-30th s) in 7 small carcinomas (diameter less than 3 cm); a lesion was disclosed in the other hepatic lobe in 12 cases. Slices obtained at the level of the portal vein allowed to assess tumoral involvement in 61 p. 100 of cases. b) Out of 150 cases of hepatic metastases, a hypodense lesion surrounded by hypervascularisation just after injection was the most frequent aspect. c) Out of 40 cases of hemangiomas, lesions were hypodense and well limited in 37 cases; at the 15th s after injection, contrast medium accumulated at the periphery, then diffused to the center of the lesion. d) Adenomas and focal nodular hyperplasias appeared as hypodense lesions with precocious and fugacious hypervascularisation, and were characterized, although inconstantly, by the presence of fat and vessels in the hypodense central zone, respectively. These results provide a rational basis for a better diagnostic approach of liver tumors.

Adenoma↗
PubMed1983

Depressed polymorphonuclear leukocyte functions associated with normal cytotoxic functions of T and natural killer cells during chronic hemodialysis.

The cytotoxic capacities of T lymphocytes and natural killer (NK) cells and the phagocytic functions of polymorphonuclear leukocytes were determined in a group of 20 patients with end stage disease who were being maintained on hemodialysis. The mononuclear cells from these patients were able to mediate normal T-cytotoxic functions in a xenogeneic cell-mediated lympholysis assay and normal NK cytotoxic capacity when tested against K562 target cells. Contrarily, polymorphonuclear functions in these patients were severely impaired. The reduction of Nitroblue tetrazolium in dark formazan (NBT test) and the direct phagocytosis of 2 pyogenic strains (Staphylococcus aureus and Salmonella typhimurium) were equally and deeply depressed in almost all patients. This defect was not restored either by 4 hr of hemodialysis nor by 12 months of treatment. This study confirms a major role for a defect of polymorphonuclear cell functions in the depressed defence of patients on chronic hemodialysis against infections.

Adult↗
PubMed1983

[Radiation arteriopathies].

Disease of the large arterial vessels is a relatively unknown complication of radiotherapy. However, it should be considered in the same manner as the other complications of irradiation when a tumour recurrence is suspected. The authors recall the experimental studies of Kirkpatrick and Konings, demonstrating the synergy between irradiation and hypercholesterolemia in the precocity and gravity of vascular complications. The different localisations reported in the literature are discussed: coronary, pulmonary, thoracic aorta, supra aortic, renal, digestive and ilio-femoral arteries. Finally, the authors underline the difficulty of diagnosis of post-radiotherapy without clinical, radiological or anatomopathological confirmation.

Adult↗
PubMed1983

[Acute kidney failure in a resuscitation milieu: improvement of dialysis tolerance using bicarbonates in the dialysate].

Patients hospitalized in critical care unit for acute renal failure (ARF) in a multiorgan failure syndrome have often a poor intra-dialysis tolerance. Change from Ac to Bi for dialysate buffering has been advocated to improve this dialytic tolerance. In a retrospective study, 70 patients who received Bi hemodialysis are compared with 106 patients who received Ac hemodialysis. If the mortality is not different between these two groups, intra-dialysis tolerance is significantly better (p less than 0.001) in the Bi group according to the mean intra-dialysis systolic blood pressure decrease, the collapse occurrence and the mean vascular volume infusion. Ultrafiltration rate is higher and reach more often the desired values. On a biochemical point of view, hemodialysis efficacy is the same in the two groups according to urea and creatinin clearance, but end dialysis Bi plasma concentrations are higher and nearer of the normal range in the Bi group even though predialysis Bi plasma concentrations were similar. The only side effect observed with Bi dialysis was a hypoglycemic episode without clinical consequence, due to the lack of glucose in the bicarbonate dialysate. Nevertheless, in patients under controlled ventilation, a end dialysis alkalosis can occur if a hyperventilation is imposed. Change from Ac to Bi in dialysate buffering improves the intra-dialysis tolerance of patients with ARF in a multiorgan failure syndrome. This kind of hemodialysis is now used routinely in our critical care unit.

Acetates↗
PubMed1983

[Bacteriological study of hands and the use of soap in the hospital environment].

Direct contact, especially by touching, is the most important route for the transmission of hospital infections. To examine this risk, we have investigated the frequency of bacteria present on the hands of the nursing staff on the long and medium stay wards of the Hospital Paul- Brousse in Villejuif. The study showed that the amount of bacteria after tending the patients before and after washing the hands with soap tablets is still far from negligible. Staphylococci were predominant both from the frequency and density of their cultures, the risks of transmitting the infection increased with the level of contamination. Although in far smaller amounts, enterobacteria were isolated, probably a sign of faecal contamination. Some of these organisms belonged to bacteria called "hospital infections", resistant to many types of antibiotics. The results point out the limitations of the present system for washing hands, in particular using soap tablets--the soap is a source of infection as it becomes soft when kept wet. Improvement could be achieved by instituting a few simple measures, such as rehabilitating mobile basin units using a scrubbing-brush, carefully drying the hands, using linen that is kept only for patients who have septic infections, issuing personal soap tablets or even better using liquid soap in disposable containers.

Cross Infection↗
PubMed1982

[Continuous haemofiltration in encephalopathy associated with hepatic failure (author's transl)].

Thirty-one comatose patients (18 with cirrhosis of the liver, 13 with severe hepatitis) were treated with continuous haemofiltration on polyacrylonitrile membrane (AN 69). The mean duration of sessions was 45 +/- 37 h, during which 136 +/- 108 1 of ultrafiltrate were dialyzed. Sixteen patients emerged from coma, 14 (7 with cirrhosis, 7 with hepatitis) completely and 2 partially. Blood ammonium levels decreased by 47 +/- 21% during the first 24 hours. Aminoacid clearance ranged from 20 to 50 ml/min, but only non significant changes were observed in the branched-chain/aromatic aminoacid ratio. Provided the haemodynamic balance is preserved, the technique is well tolerated. The duration of dialysis depends upon the degree of thrombopenia induced. Since the long-term prognosis of both cirrhosis patients and severe hepatitis patients is unmodified, continuous haemofiltration can only be helpful in cases where hepatic regeneration is possible; failing this, liver transplantation should be considered.

Amino Acids↗
PubMed1982

[Acute arsenious hydride intoxication. Four cases (author's transl)].

While engaged in the repair of a zinc furnace, 4 workers were accidentally exposed to arsenious hydride (AsH3) fumes. Acute intravascular haemolysis developed within a few hours. On admission, the patients immediately underwent exsanguino-transfusion; 8.2 to 10.2 l of blood were exchanged through a continuous perfusion pump at the rate of 1 l/hour. Two patients resumed diuresis during transfusion, but the other two required repeated haemodialysis. Between the 10th and 30th days, while renal function was gradually returning to normal, mildly megaloblastic anaemia developed. This was followed during the 3rd month by clinical and electric signs of polyneuritis of the lower and upper limbs, which subsequently regressed. Regular measurements of arsenic levels in the blood and urine were performed between and during exsanguino-transfusion and haemodialysis.

Acute Disease↗
PubMed1982

Cholera-like illness due to Aeromonas sobria.

A Thai woman from Bangkok was admitted to a hospital in Paris for a cholera-like illness. A culture of her "rice-water" diarrhea was negative for Vibrio cholerae and enterotoxigenic Escherichia coli but was positive for Aeromonas sobria. This strain produced enterotoxin, cytolysin, proteolysin, hemolysin, and a cell-rounding factor. Acute -and convalescent-phase sera showed an increase in neutralizing antibodies to enterotoxin, cytolysin, and hemolysin. The enterotoxin, which was labile at 100 C, induced an accumulation of fluid in the rabbit ileal loop model and was not neutralized by antiserum to cholera toxin. Suckling mouse assays and rabbit permeability skin tests were negative, and the Y1 mouse adrenal cell assay produced not true cytotonic effect. This report, the first of an infection due to A. sobria alone, provides evidence that A. sobria is an enteric pathogen of humans that can cause a toxin-mediated, life-threatening illness.

Aeromonas↗