Search PubMed⌕ Search

Biomedical subjects

F Marchal

Publications and source records attributed to F Marchal.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Usefulness of intraoperative 123I-MIBG during reoperation for malignant pheochromocytoma: a case report].

Intraoperative MIBG radionuclear scanning has been used to improve pathological foci localization and surgical accuracy in patients with neural crest derived tumors. This intraoperative detection has been reported in less than 10 patients during reoperation for pheochromocytoma. We report a case of 123I-MIBG intraoperative detection allowing to improve surgical resection quality during reoperation for pheochromocytoma. The use of intraoperative MIBG radionuclear scanning is helpful when reoperation for pheochromocytoma is performed.

3-Iodobenzylguanidine↗
PubMed2002

Sensitivity of clinical and behavioural tests of spatial neglect after right hemisphere stroke.

OBJECTIVES: The lack of agreement regarding assessment methods is responsible for the variability in the reported rate of occurrence of spatial neglect after stroke. The aim of this study was to assess the sensitivity of different tests of neglect after right hemisphere stroke. METHODS: Two hundred and six subacute right hemisphere stroke patients were given a test battery including a preliminary assessment of anosognosia and of visual extinction, a clinical assessment of gaze orientation and of personal neglect, and paper and pencil tests of spatial neglect in the peripersonal space. Patients were compared with a previously reported control group. A subgroup of patients (n=69) received a behavioural assessment of neglect in daily life situations. RESULTS: The most sensitive paper and pencil measure was the starting point in the cancellation task. The whole battery was more sensitive than any single test alone. About 85% of patients presented some degree of neglect on at least one measure. An important finding was that behavioural assessment of neglect in daily life was more sensitive than any other single measure of neglect. Behavioural neglect was considered as moderate to severe in 36% of cases. A factorial analysis revealed that paper and pencil tests were related to two underlying factors. Dissociations were found between extrapersonal neglect, personal neglect, anosognosia, and extinction. Anatomical analyses showed that neglect was more common and severe when the posterior association cortex was damaged. CONCLUSIONS: The automatic rightward orientation bias is the most sensitive clinical measure of neglect. Behavioural assessment is more sensitive than any single paper and pencil test. The results also support the assumption that neglect is a heterogeneous disorder.

Activities of Daily Living↗
PubMed2002

Respiratory impedance response to a deep inhalation in asthmatic children with spontaneous airway obstruction.

The aim of the study was to determine whether the bronchomotor effect of a deep inhalation (DI) may be detected during tidal breathing in asthmatic children with spontaneous airway obstruction (AO). Two groups of children aged 5-15 yrs were studied. AO was mild in group 1 (n=12, forced expiratory volume in one second (FEV1) > or = 75% predicted) and moderate-to-severe in group 2 (n=9, FEV1 > or = 70% pred). The forced oscillation technique at 12 Hz using a head generator allowed the determination of respiratory resistance in inspiration (Rrsi) and expiration (Rrse) before and after DI, at baseline and after salbutamol. At baseline, Rrsi but not Rrse was found to decrease significantly after DI in group 1 but not in group 2. The change induced by DI was significantly different in group 1 (-1.5+/-0.5 hPa x s x L(-1)) compared to group 2 (0.5+/-0.5 hPa x s x L(-1)) and exhibited significant negative correlation to FEV1 % pred. After salbutamol, DI had no effect. In conclusion, asthmatic children show a bronchomotor response to deep inhalation that depends on the degree of airway obstruction. The effect is more readily demonstrated in inspiration than in expiration.

Adolescent↗
PubMed2002

[Domiciliary assisted ventilation in children].

The concept of assisted ventilation in the home setting has greatly progressed as a routine practice. This technique was used from 1990 to 2000 in 16 children cared for at our center. Ten children had neuromuscular disease (infantile spinal amyotrophy 6, Duchenne myopathy 3, and mitochondrial myopathy 1) or other conditions including central hypoventilation (n = 2), traumatic tetraplegia (n = 2), encephalopathy with chronic bronchitis (n = 1) and bronchopulmonary dysplasia (n = 1). Only 5 children had a tracheotomy, the others were treated successfully with non-invasive ventilatory assistance. Initialization of non-invasive ventilatory assistance had been planned before development of respiratory failure in 4 of the 11 children, but generally was indicated after an episode of acute respiratory distress. Home ventilation, particularly with non-invasive assistance is a reliable method for long-term treatment of chronic alveolar hypoventilation in children. The appropriate time for initiating this therapy should be better defined.

Adolescent↗
PubMed2001

Retrograde theory in sialolithiasis formation.

Sialolithiasis is a relatively frequent occurrence; however, cases of sialolithiasis originating around a "foreign body" nidus are rare. We describe a patient with submandibular sialolithiasis organized around a vegetal nidus and discuss the etiology of the case.

Female↗
PubMed2001

Solitary rectal ulcer syndrome: a series of 13 patients operated with a mean follow-up of 4.5 years.

Solitary rectal ulcer syndrome (SRUS) is an infrequent pathology often associated with pelvic floor disorders. The aim of this retrospective study was to review the long-term results of a surgical series of SRUS. Between 1988 and 1998, 13 patients were operated on for SRUS. Seven patients had associated internal rectal prolapse (58%), two had associated total rectal prolapse (15%), and two had associated mucosal prolapse (15%). We performed simple resection of the SRUS in one case (8%), a stoma as primary operation in one (8%), three rectopexies according to Orr-Loygue (23%), and eight Delorme's operations as modified by Berman (62%). Mean follow-up was 57 months (range 15-112). Simple resection of the solitary rectal ulcer syndrome did not improve symptoms. Colostomy permitted relief of symptoms and healing of the SRUS. Two of the three rectopexies achieved good results, and the third patient relapsed at the 6th postoperative month. A secondary modified Delorme's operation permitted relief of symptoms and healing of the SRUS. Five of the eight patients (62.5%) who received modified Delorme's operations had improved at a follow-up of 46 months. We conclude that, considering the high failure rate after surgery, operations should be performed only in patients with total rectal prolapse or intractable symptoms not amenable to behavioral therapy. Delorme's operation and abdominal rectopexy help in about 60% of cases.

Adult↗
PubMed2001

[Evaluation of somatostatin or octreotide efficacy in the treatment of external pancreatic fistulas].

AIM OF THE STUDY: To evaluate the prevalence of pancreatic pseudocyst after persistent fistula closure with somatostatin or octreotide. To compare the patient characteristics according to the subsequent presence or absence of pseudocyst. PATIENTS AND METHODS: This retrospective study from January 1994 to August 1999 included 15 patients with an external pancreatic fistula. Fistula closure was observed for all patients with somatostatin or octreotide. CT scan was performed 66 +/- 34 days after the end of this treatment. RESULTS: CT scan was normal in 9 patients (favorable group) and showed pancreatic pseudocyst (failure group) in 6 patients. Pancreatic fistula etiologies were different between the two groups. The 5 patients presenting pancreatic fistula after duodenopancreatectomy belonged to the favorable group. Six of the 10 patients presenting pancreatic fistula after pseudocyst drainage belonged to the failure group. There were no other differences between the two groups. CONCLUSION: Persistent pancreatic fistula can be cured with somatostatin or octreotide. However, fistulas occurring after duodenopancreatectomy are more easily cured with somatostatin or octreotide than fistulas occurring after external pseudocyst drainage. Somatostatin or octreotide cannot be considered to be an effective treatment for pancreatic fistula occurring after pseudocyst drainage, despite the fact that 40% of them were permanently cured.

Cutaneous Fistula↗
PubMed2001

Carbachol effect on carotid body dopamine in vitro release in response to hypoxia in adult and pup rabbit.

Dopamine (DA) release from the adult carotid body (CB) is dependent, in part, upon CB cholinergic receptor stimulation. The aim of the present study was to determine the role of cholinergic stimulation on DA release from rabbit pup CB with reference to adult's. CBs sampled from adult (n = 52) and 10-day-old (n = 49) rabbits were incubated in vitro for 1 h in a surviving medium bubbled with either 100 or 8% O2 in N2, without (control) or in the presence of the cholinergic agonist carbachol 1 microM. In adults, DA released (DAr) in the medium was significantly larger with 1 microM carbachol compared with control in either 100 or 8% O(2) (P < 0.01). In pups, carbachol 1 microM had no effect in 100% O2 but significantly increased DAr compared with control in 8% O2 (P < 0.01). The data suggest that cholinergic mechanisms regulating DAr are not fully expressed in pup rabbit CBs, in contrast with adults and thus, exhibit maturation-related functional differences.

3,4-Dihydroxyphenylacetic Acid↗
PubMed2001

Acute mesenteric venous thrombosis: case for nonoperative management.

OBJECTIVE: Initial treatment in the management of acute mesenteric vein thrombosis (MVT) is controversial. Some authors have proposed a surgical approach, whereas others have advocated medical therapy (anticoagulation). In this study, we analyzed and compared the results obtained with surgical and medical treatment to determine the best initial management for this disease. METHODS: We retrospectively reviewed the records of patients treated for MVT in a secondary care surgical department from January 1987 to December 1999. Before January 1995, our departmental policy was to perform surgery in patients with suspected MVT. Since January 1995, we have preferred a medical approach when achievable. Each patient in this study was assessed for diagnosis, initial management (laparotomy or anticoagulation), morbidity, mortality, duration of hospitalization, the need for secondary operation, portal hypertension, and survival rates. RESULTS: Twenty-six patients were treated, 14 before January 1995 (group 1) and 12 since January 1995 (group 2). Morbidity, mortality, secondary operation, portal hypertension, and 2-year survival rates were 34.6%, 19.2%, 15.3%, 19.2%, and 76.9%, respectively. No statistical difference was observed between the two groups. The mean duration of hospitalization was 51.6 days in group 1 and 23.2 days in group 2 (P < .05). Among the 12 patients treated by means of laparotomy with bowel resection, 10 patients (83%) had mucosal necrosis without transmural necrosis at pathologic study. CONCLUSION: Nonoperative management for acute MVT is feasible when the initial diagnosis with a computed tomography scan is certain and when the bowel infarction has not led to transmural necrosis and bowel perforation. The morbidity, mortality, and survival rates are similar in cases of surgical and nonoperative management. The length of hospital stay is shorter when patients are treated with a nonoperative approach. A nonoperative approach, when indicated, avoids the resection of macroscopically infarcted small bowel (without transmural necrosis) in cases that are potentially reversible with anticoagulation alone.

Acute Disease↗
PubMed2001

Specificity of parotid sialendoscopy.

OBJECTIVE: To present our initial experience with sialendoscopy of the parotid duct. STUDY DESIGN METHODS: Diagnostic and interventional sialendoscopy procedures were performed in 79 and 55 cases, respectively. Diagnostic sialendoscopy was used to classify ductal lesions into sialolithiasis, stenosis, sialodochitis, and polyps. Interventional sialendoscopy was used to treat these disorders. The type of endoscope used, the type of sialolithiasis fragmentation and/or extraction device used, the total number of procedures, the type of anesthesia, and the number and size of the sialoliths removed were the dependent variables. The outcome variable was the endoscopic clearing of the ductal tree and resolution of symptoms. RESULTS: Diagnostic sialendoscopy was possible in all cases, with an average duration of 26+/-14 minutes and no complications. Interventional sialendoscopy was successful in 85% of cases, with an average duration of 73+/-43 minutes (+/- standard deviation). Multiple procedures were performed in 45% of cases, general anesthesia was used in 24%, and parotidectomy in 2%. Multiple sialoliths were found in 58% of ducts and associated with more procedures under general anesthesia and longer operations. The average size of sialoliths was 3.2+/-1.3 mm; larger stones were associated with more procedures under general anesthesia, longer and multiple procedures, use of fragmentation, and sialendoscopy failures. Sialolithiasis fragmentation was required in 10% of cases, with a success rate of 70%. Semirigid sialendoscopes performed better than flexible ones. Complications were mostly minor but were encountered in 12% of cases. CONCLUSIONS: Diagnostic sialendoscopy is a new technique for evaluating salivary duct disease, a technique which is associated with low morbidity. Interventional sialendoscopy allows the extraction of sialoliths in most patients, preventing open gland excision.

Adolescent↗
PubMed2001

Endoscopic neck dissection in human cadavers.

OBJECTIVE: To evaluate the feasibility and efficacy of endoscopic neck dissection (END) in human cadavers. STUDY DESIGN: Experimental self-controlled study. METHODS: END on five human cadavers through three openings: one for the camera, one for the dissecting instrument, and one for a grasping one. The tissue specimens removed were divided into traditional neck groups (I to V). After the completion of END, open neck dissection was performed using standard surgical techniques and the remaining tissue within each neck group was retrieved. The important neck structures (carotid artery, internal jugular vein, cranial nerves X, XI, and XII, phrenic nerve) were evaluated for lesions. A pathologist evaluated each specimen, without knowing its exact origin in terms of neck group or side, and type of surgical technique used. For each specimen, the number of retrieved lymph nodes and their anatomic integrity was analyzed. RESULTS: Ten neck dissections were performed on 5 cadavers, without any major difficulty. An injury of the internal jugular vein occurred twice and once the phrenic nerve was cut. Little tissue was usually left for open surgical dissection. The average number of retrieved lymph nodes by endoscopy was 4.9 +/- 2.7 (mean +/- standard deviation). Completion open neck dissection retrieved an additional 0.5 +/- 0.5 lymph nodes. Efficacy of END was 92 +/- 10%. The majority of retrieved lymph nodes were intact but exhibited important postmortem autolysis artifacts. CONCLUSIONS: Endoscopic neck dissection is possible in human cadavers and is free of lesions to major structures. The majority of neck lymph nodes can be removed endoscopically.

Aged↗
PubMed2001

Age-dependent effect of domperidone on dopamine release by the hypoxic carotid body in the rabbit.

The aim of this study was to identify the mechanisms that regulate dopamine release (DA(r)) by the hypoxic carotid body (CB) during development. CBs sampled from adult (n = 58) and 10-day-old (n = 53) rabbits were incubated for 1 h in a medium equilibrated with 8% O(2) in N(2) without or in the presence of the specific DA D(2) receptor antagonist domperidone, 0.01, 0.1 and 1 microM. DA and its major metabolite DOPAC were measured in the CB (DA(CB)) and in the medium (DA(r)) by HPLC+ED. In adults, each concentration of domperidone significantly decreased DA(CB) and increased DA(r), compared with control (p < 0.01). In contrast, in 10-day old, only the 1 microM domperidone concentration decreased DA(CB) and increased DA(r) compared with control (p < 0.001). The data show that domperidone increases CB DA(r) in response to hypoxia in a concentration- and age-dependent manner and suggest this response depends, in part, on the functional maturation of CB DA D(2) receptors.

Aging↗
PubMed2001

Histopathology of submandibular glands removed for sialolithiasis.

We reviewed the clinical history of 48 consecutive patients who underwent submandibular gland removal for radiologically proven sialolithiasis. The specimens were examined by a pathologist blinded to the clinical data. A histopathologic classification into I of 3 grades was established by evaluating the degrees of atrophy, fibrosis, and inflammation. A correlation between the clinical and pathological variables was sought in order to define clinical variables that would predict abnormal submandibular glands that required extirpation. A significant percentage of the submandibular glands exhibited normal histologic findings. The patients with normal submandibular glands had a clinical evolution similar to that of other patients with severely damaged glands. The only clinical variable that correlated with increased histopathologic alteration was the patient's age. In view of the newly available diagnostic and therapeutic techniques for sialolithiasis, a conservative attitude to submandibular gland resection appears justified.

Adult↗
PubMed2001

[Presenting a battery for assessing spatial neglect. Norms and effects of age, educational level, sex, hand and laterality].

The aim of this study was to build up a battery for assessing spatial neglect, then to analyse the norms and potential effects of age, education level, sex, hand used, and laterality. It was also to contribute evaluating the pseudoneglect phenomenon described by Heilman, which consists in a tendency of normal subjects to neglect the right peripersonal space. Tasks selected were presented to important groups of normal subjects, most often larger than 450. The battery comprised of a bell cancellation test, scene copy, clock drawing, two line bisection tasks, identification of overlapping figures, text reading, writing task, and the representational task of the France map. For each of them, different variables were selected, especially investigating the difference between performance in the right and the left hemispaces. This study allowed defining the threshold values (percentiles 5 and 95) for deciding of the pathological character of a patient performance. It also showed that the pseudoneglect phenomenon is more obvious in some tasks such as line bisection, and probably also in the representational task of the France map and writing. His importance and at times his side were influenced by the factors we studied, with between tasks differences, but also by the nature of the task to be performed, and especially his verbal component.

Adult↗
PubMed2000

Input respiratory impedance measured by head generator in preschool children.

The upper airway wall motion represents a serious problem when measuring the input impedance of the respiratory system (Zrs) by the forced oscillation technique, particularly in young children. To minimize this error, it has been proposed to vary transrespiratory pressure around the head rather than directly at the mouth, using the head generator technique (HGT). The aim of this study was to collect normative data in preschool children in whom the technique may prove most useful. Zrs was measured using HGT and 4-32-Hz pseudorandom noise input in 127 healthy children. Age ranged from 2. 8 to 7.4 years and height (H) from 0.89 to 1.29 m. The fast Fourier transforms of pressure and flow allowed us to calculate respiratory system resistance (Rrs(f)) and reactance (Xrs(f)) at each frequency (f). Resonant frequency (fn), respiratory system inertance (Irs), and compliance (Crs) were derived from the Xrs(f) data. The technique was accepted by more than 95% of the children. A coherence function </=0.95 required us to reject Zrs values in the lower frequency spectrum. These missing data did not allow reliable estimation of fn, Irs, and Crs in 44% of children. Regression equations of Zrs on growth parameters were obtained. H was the only significant predictive variable. The decrease of Rrs with growth was best described by a multiplicative model [e.g., ln (Rrs(20)) = 2. 5301 - 2.3837. ln (H)]. The slope of the regression lines of Xrs on H was dependent on f: positive between 4 and 16 Hz, negative at high frequency (e.g., 32 Hz), and nonsignificant in the intermediate range (e.g., 20 Hz). Irs and fn decreased significantly and Crs increased as H increased. The current study provides reference values for input impedance of the respiratory system in preschool children with upper airway artifacts minimized. HGT should be particularly helpful at or around 20 Hz, where the signal to noise ratio is larger than at lower frequencies but where upper airway artifacts may significantly corrupt measurements with the standard generator.

Airway Resistance↗
PubMed2000

A new morphometric analysis of the hominid pelvic bone.

This study is based upon a new morphometric technique providing both size and shape variables. It has been applied to 189 pelvic bones of extant humans and African apes as well as to 13 hominid pelvic bones of various taxonomic status. The main aim of this work is to include such fossil bones in the same study in order to set a synthetic comparison of their shape in the light of the yardstick given by the African ape/human pelvic bone comparison. To do so, ratio diagrams are chosen because they are simple and very expressive tools with which to present such comparisons. Shape differences are very well illustrated and quantified by this technique. The ilium appears to be the most different of the three parts of the pelvic bone. Compared to these differences, discrepancies between fossil hominid and extant human bones are of a totally different scale. This shows the architectural unity related to the acquisition of bipedalism by hominids. It is nonetheless possible to detect two levels of difference. The first separates Australopithecus from Homo and could be seen as reflecting locomotor differences between both genera. The second splits both Homo erectus and Neanderthal from modern human pelvic bones. It appears from the hominid fossil record of pelvic bones that two periods of stasis exist and are separated by a period of very rapid evolution corresponding to the emergence of the genus Homo. We are of the opinion that the same could be true for the split between African ape and hominid lineages at the end of the Miocene.

Adult↗
PubMed2000

Respiratory and upper airways impedance responses to methacholine inhalation in spontaneously breathing cats.

The upper airways may contribute to the increase in respiratory resistance induced by methacholine (Mch). The aim of this study was to simultaneously assess the Mch response of upper airways and lower respiratory resistances (Rua, Rrs,lo) and reactances (Xua, Xrs,lo), and to test whether the change of total respiratory resistance and reactance after Mch were affected by upper airways mechanisms. Seven cats breathing spontaneously were studied under chloralose, urethane anaesthesia. Forced oscillations were generated at 20 Hz by a loud-speaker connected to the pharyngeal cavity. A pneumotachograph was placed between rostral and caudal extremities of the severed cervical trachea. Pressure drops were measured across the upper airways and across the lower respiratory system. Rua, Xua, Rrs,lo and Xrs,lo were obtained after nebulized normal saline and Mch administered directly through the tracheostomy. The analysis focused on Mch tests showing clear positive upper airways response. Volume and flow dependence of Rrs,lo and Rua were assessed during tidal inspiration using multiple linear regression analysis. After Mch, Rrs,lo increased and became negatively volume dependent, while the increase in Rua was associated with no significant change in volume dependence; Xrs,lo became negative while Xua did not change. The upper airways response to methacholine may thus contribute to the increase in total respiratory resistance but may not account for either its negative volume dependence or the decrease in total resistance. It is surmised that these features more specifically reflect alterations in respiratory mechanics occurring at the level of the intrathoracic airways.

Airway Resistance↗