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Biomedical subjects

E Martin

Publications and source records attributed to E Martin.

At least 487 records · Page 27Linked to original sources
PubMed1991

[Nodular regenerative hyperplasia and primary biliary cirrhosis].

We report two cases of nodular regenerative hyperplasia of the liver associated with primary biliary cirrhosis. Cholestasis and presence of antimitochondrial antibodies were noted in both patients. In one patient, the diagnosis of nodular regenerative hyperplasia was supported by the demonstration of disseminated small hepatic nodules without perinodular fibrosis. Twelve years later, the histopathological picture was one of primary biliary cirrhosis. The other patient presented an histological picture of regenerative hyperplasia of the liver and primary biliary cirrhosis. The association of regenerative hyperplasia of the liver and primary biliary cirrhosis is discussed.

Biopsy↗
PubMed1991

[Non-surgical removal of a knotted Swan-Ganz catheter].

Intracardiac knotting is a rare complication of pulmonary arterial catheterization. This paper describes a 68-year-old male patient who had a 7-F Swan-Ganz catheter inserted via the internal jugular vein. The postoperative chest roentgenogram revealed a catheter knot in the right ventricle. Using fluoroscopy it was possible to pull back the knot up to the indwelling introducer. By pulling the knot against the introducer its size was reduced to a minimum. After this manoeuvre, both the introducer and the small knot could be withdrawn from the jugular vein without further incident. The possible complications of this method and of alternative techniques are described and discussed. Surgical intervention in the case of a knotted Swan-Ganz catheter may only be necessary when intracardiac fixing of the knot is encountered.

Aged↗
PubMed1991

[The early diagnosis of cancer of the breast remains insufficient. A study of breast monitoring in women over 50 years of age in Lorraine-Champagne].

Although breast cancer in women over 50 years of age can be detected by physical examination and mammography, in our region many women of that age do not benefit from a satisfactory breast surveillance: 52.4% of women who had a general check-up between February and May 1989 have their breast examined by a physician once a year or more often; only 30% had a mammography less than three years ago; 34.2% examine themselves at least once a month. Overall, only one out of four women aged over 50 is under satisfactory breast surveillance; this small group of women is characterized by a personal history of breast disease or a family history of breast cancer. Women aged between 50 and 59 years tend to have more regular breast examination than older women. Social or geographical particularities do not seem to provide a significant explanation.

Age Factors↗
PubMed1991

Patients' views of the consultation: comparison of a prison and general practice population.

Prisoners' perceptions of why they consulted the doctor, how ill they thought they were and what happened during the consultation were studied in Bedford prison using a questionnaire. Patients' perceptions were compared before and after the consultation and with the perception of the doctor. The figures from this study were compared with comparable groups in a similar general practice survey. Prisoners perceived themselves to be more ill than comparable groups living in the community and both doctor and prisoners perceived that the prisoners received less reassurance. Prisoners were less likely to attend the doctor because their treatment had not worked, or because the doctor had asked them to return than comparable groups living in the community. The perception of the doctor and the prisoners about what occurred in the consultation diverged. The doctors perceived that they provided more advice and support than the prisoners felt they received. These perceptions may reflect a more difficult doctor-patient relationship and poorer continuity of care in prison medicine. These problems might be overcome if the prison medical service were run by the National Health Service and prison doctors had no role in the management of prisoners.

Adolescent↗
PubMed1991

[A comparison of enflurane and propofol in thoracic surgery].

Comparisons between propofol and inhalational anesthetics for maintenance of anesthesia are limited. The purpose of our prospective study was to examine differences between enflurane and propofol during pulmonary resections with one-lung ventilation (1LV). METHOD. 28 patients, ASA risk group II-III, gave written informed consent for inclusion in this institutionally approved study. The patients were randomly allocated to one of the following groups: A: propofol 10 mg kg-1 h-1, B: 1 MAC enflurane, for maintenance of anesthesia. In both groups analgesia was achieved by fentanyl and muscle relaxation, by pancuronium. Ventilation via a double-lumen tube was controlled (FiO2 = 1.0, PaCO2 35-40 mmHg). Measurements, including hemodynamics and arterial and mixed venous blood gases, were obtained before induction (I), during two-lung ventilation (2LV) 15 min after induction in the supine position (II) and 20 min after surgical opening of the chest in the lateral decubitus position (III), 20 min after starting 1LV (IV), and after extubation (V). RESULTS. No significant differences between the two groups were found before induction (I), during 2LV (II, III), or after extubation (V). The only significant differences between the two groups were observed during 1LV (IV): the shunt fraction was 33.9 +/- 2.5% in A and 38.5 +/- 2.6% in B (P less than or equal to 0.05). Hypoxic pulmonary vasoconstriction was not inhibited in A, but was inhibited by 21.5% in group B during 1LV. Since no case of hypoxemia occurred in group A during 1LV (range of PaO2: 75.2-417.0 mmHg), but four patients developed hypoxemia in group B (Range of PaO2: 46.6-431.0 mmHg), regimen A might be of value in high-risk patients during thoracic surgery when 1LV is planned.

Aged↗
PubMed1990

Single chain-urokinase binds to oxidized fibrin(ogen) derivatives.

Single chain- urokinase (scu-PA), in contrast to two chain urokinase, is a physiological plasminogen activator of fibrin selectivity. The mechanism of selective fibrinolysis of scu- PA has not been clarified up to now. This study has shown that fibrin selectivity might involve oxidative processes. Binding studies with immobilized oxidized fibrinogen degradation products (FDP) demonstrated higher affinity of scu-PA to oxidized than to unmodified FDP. The fibrin(ogen) domain responsible for this oxidant mediated increase of scu-PA affinity is localized in the D-subunit of fibrin(ogen). Thus, experimental data upon the interaction of scu-PA with fibrin(ogen) using oxidized and I- labelled fibrin(ogen) might be interpreted with caution: the oxidized product may behave in a distinct manner than the unoxidized, native, one. Activated leukocytes release large amounts of scu-PA and of oxidants of the chloramine type. The oxidants could contribute significantly to fibrinolysis and proteolysis in areas of inflammation, preparing fibrin for its specific degradation. The present data support the concept of an involvement of oxidative processes in the fibrinolytic pathway.

Fibrin Fibrinogen Degradation Products↗
PubMed1990

Murine eosinophils and IL-1: alpha IL-1 mRNA detection by in situ hybridization. Production and release of IL-1 from peritoneal eosinophils.

The presence of IL-1 mRNA in eosinophils from mice infected with larvae of the parasite Mesocestoides corti was investigated by in situ hybridization technique. S35 labeled cDNA probe for alpha IL-1, hybridized with mRNA in murine eosinophils and macrophages. After 6 h of LPS stimulation eosinophils were able to express mRNA in their cytoplasm. This expression was highly increased by the addition of indomethacine. The IL-1 mRNA expression in murine macrophages was higher than in eosinophils in LPS-stimulated cells. This difference was statistically significant, p less than 0.001. To test if eosinophils may produce and release IL-1 in the culture medium, we isolated these cells in a Percoll gradient. Cell preparations with a purity exceeding 94% were cultured with various stimuli and their supernatants were tested for IL-1 activity. Eosinophils produced 169.65 +/- 73 U/ml when stimulated with LPS (n = 14). A dose-dependent response was obtained when the eosinophils were in the presence of the calcium ionophore A23187. Controls were performed to rule out the contribution of the contaminating population on the thymocyte proliferating activity. They were also used to detect other possible causes of interference in the assay, such as leukotrienes or TNF. IL-1 in supernatants was also detected using a conversion assay such as EL-4 thymoma cells. IL-1 activity was first detected in culture supernatants 18 h later, maximal production being in the first 24 h. In accordance with our hybridization results, an increase in IL-1 activity was obtained when eosinophils were stimulated with LPS and treated with indomethacine. The factor had a molecular mass between 16 to 20 kDa that corresponded to the described for murine IL-1. Inasmuch as IL-1 is an important mediator of inflammatory reactions this IL may enhance the proinflammatory action of eosinophils.

Animals↗
PubMed1990

Application of interlaced orientation slices in orthogonal planes for system characterization and as a basis for standardized brain sections in multiple-oblique positions.

Interlaced acquisition of orthogonal spin-echo orientation slices yields saturated intersection lines, which are available for a system characterization (spatial distortions, slice thickness, chemical shift displacement). Additionally, these scout images contain complete information for a transformation of the gradient coordinate system into the oblique coordinate system of the patient, bearing standardized planes for improved image interpretation and quantitative examinations.

Brain↗
PubMed1990

A method for rapid evaluation of saturation factors in in vivo surface coil NMR spectroscopy using B1-insensitive pulse cycles.

For a rapid determination of saturation factors in surface coil NMR spectroscopy, the recently published (90 degrees-tau-180 degrees-tau-90 degrees-tau-) SUFIR sequence was modified with adiabatic pulse cycles. Signals were acquired after each of the two 90 degrees pulses and they were stored in different memory blocks. The deleterious offset-dependent saturation effects inherent in adiabatic 90 degrees excitation pulses were minimized by suitable combinations of adiabatic pulses that sweep from either side of the spectrum onto resonance, and by setting the carrier frequency in the middle of the spectrum. The practical use of the proposed method is illustrated with the determination of 31P NMR saturation factors in human calf muscle.

Humans↗
PubMed1990

Non-invasive 31P magnetic resonance spectroscopy revealed McArdle disease in an asymptomatic child.

A Turkish couple suffering from McArdle disease (myophosphorylase deficiency) and their two sons aged 5 and 9 years, respectively, were studied using 31phosphorus magnetic resonance spectroscopy (31P MRS). During exercise both sons showed the same pathological pattern as their parents. In contrast to healthy volunteers, intracellular pH (pHi) as measured by 31P MRS every 10 s during exercise, never fell below the lower 95% confidence limit (6.94) of pHi at rest (7.06), but tended to be raised. It is of special interest that the 5-year-old boy was completely asymptomatic, although the enzyme defect seems to be fully expressed at the cellular level.

Adult↗
PubMed1990

Brainstem lesion revealed by MRI in a case of Leigh's disease with respiratory failure.

This 6-year-old girl was admitted with insufficient involuntary breathing and generalized hypotonia. T2-weighted MR images showed bilateral symmetrical tubular hyperintense lesions in the medio-caudal part of the medulla oblongata that correlated well with demyelination and gliosis in the regions of the reticular formation and the nucleus solitarius found at autopsy. The typical lesions of Leigh's disease in the basal ganglia were not present, which made the diagnosis uncertain prior to the histopathological findings. MRI was very helpful in deciding on further management of the patient.

Brain Diseases, Metabolic↗
PubMed1990

Deposition and remodelling of elastic fibres in chronic hepatitis.

A longitudinal study of elastic fibres was conducted in liver biopsies from 21 patients with chronic viral hepatitis. Biopsies were taken at the start of treatment with alpha-interferon, and after 6 months or 1 year of treatment. No elastic fibres could be detected in portal tracts or fibrous septa when inflammation and necrosis were present, whatever the duration of the disease. Once the liver lesions had healed, elastic fibres were synthesized. Fibres were of two types and patterns: at first, they were thin, long and parallel to each other. Later, they were thicker, shorter and tortuous and were closely wrapped around thick bundles of collagen fibres. These findings suggest that the deposition of elastic fibres acts as a marker of healing in chronic active hepatitis and that their remodelling occurs concomitantly with the deposit of large bundles of collagen fibres.

Biopsy↗
PubMed1990

Expression of histocompatibility antigens and characterization of the lymphocyte infiltrate in hyperplastic polyps of the large bowel.

HLA-DR expression, lymphocyte subsets, and the distribution of proliferating cells were studied in hyperplastic polyps from the colorectum. The density of T-cells (CD5+) (mean of cells/mm2 of tissue +/- SEM) was higher in the lamina propria of hyperplastic polyps (64.2 +/- 4.2) than in normal colonic mucosa (36.7 +/- 2.6, P less than .001). The CD4/CD8 ratio was higher in hyperplastic polyps (6.3 +/- 0.9, P less than .0001) and in colonic adenomas (5.9 +/- 0.9, P less than .001) compared with normal mucosa (2.3 +/- 0.2). Lymphocytes of the lamina propria were never Ki-67 positive either in normal mucosa or in hyperplastic polyps or adenomas. The epithelial layer of hyperplastic polyps and of normal mucosa did not express the HLA-DR antigen, whereas pericryptal fibroblasts and most of the leukocytes of the lamina propria were strongly positive for this antigen. In the epithelial layer proliferating cells were localized exclusively in the lower part of epithelial crypts, as was the case in normal mucosa, whereas in adenomas Ki-67-positive cells were present throughout the entire height of the mucosa. Thus, in hyperplastic polyps lymphocytes are increased in the lamina propria, with a predominance of the CD4 subset in close contact with HLA-DR positive pericryptal fibroblasts.

Adenoma↗
PubMed1990

Value and accuracy of dual oximetry during pulmonary resections.

During thoracic surgery, one-lung ventilation (1LV) is often required. The purpose of this prospective study was to examine the usefulness and accuracy of dual-oximetry during 1LV. Prior to the induction of anesthesia, 30 patients had a radial artery and a fiberoptic pulmonary artery catheter (15 Edwards, 15 Spectramed by randomization) inserted. Arterial O2 saturation (SpO2) was monitored by pulse oximetry, and mixed venous O2 saturation (SvO2) by oximetry (Edwards or Spectramed). Arterial and mixed venous blood gases were obtained and immediately analyzed by an OSM3-Hemoximeter. Measurements, including hemodynamics and blood gases, were obtained before induction, during two-lung ventilation (2LV) in the supine and lateral decubitus positions, during 1LV, and following extubation. The change from 2LV to 1LV was associated with significant increases in cardiac index (CI) and oxygen delivery index (DO2I), whereas PaO2 and arterial and mixed venous oxygen saturation decreased. The ratio of oxygen consumption to delivery remained stable. Continuous oximetry when compared with in vitro measurements yielded a correlation coefficient for arterial oxygen saturation of r = 0.794 (P less than or equal to 0.001) and a value of bias and precision of -0.5% +/- 1.7%; for mixed venous oxygen saturation of r = 0.874 (P less than or equal to 0.001) and -1.3% +/- 2.8% for the two-wavelength Edwards catheter; and, r = 0.862 (P less than or equal to 0.001) and -0.1% +/- 3.2% for the two-wavelength Spectramed catheter. These findings demonstrate that dual-oximetry is an on-line, reliable method to measure SpO2 and SvO2. SpO2 less than 95% reflects hypoxygenation and hypoxia (PaO2 less than or equal to 70 mm Hg). SvO2 is determined primarily by oxygenation (r = 0.005; P less than or equal to 0.05) rather than by CI (r = 0.001, ns). Since DO2I increased during 1LV to maintain the oxygen supply and demand balance, SvO2 monitoring might be useful as an early indicator in identifying high-risk patients with compromised DO2I resulting from decreased CI.

Adult↗