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Biomedical subjects

J Jamart

Publications and source records attributed to J Jamart.

At least 181 records · Page 10Linked to original sources
PubMed1983

Efficiency and limitation of Euro-Collins solution in kidney preservation.

The efficiency of Euro-Collins solution against cellular swelling and the reason for its 50-hr upper tolerance limit in kidney preservation prior to human transplantation is investigated. Dog kidneys were removed, flushed with saline, Euro-Collins, or a modified sucrose Euro-Collins solution, and stored at 4 degrees C in the same fluid for 96 hr. Total and intracellular water contents and intracellular sodium and potassium contents were calculated at various times according to a methodology taking into account the weight of the dry matter of the solution and the value of extracellular space determined from the inulin distribution space. Main results show that, in the Euro-Collins group, the intracellular water is unchanged up to 48 hr but is suddenly increased between 48- and 72-hr preservation, after which it remains unchanged. This marked cellular edema does not occur in the sucrose group. Euro-Collins solution is thus able to protect kidneys from cellular swelling and ionic changes during a 48-hr preservation period which corresponds to the upper tolerance limit admitted in clinical transplantation. The limiting factor of the swelling inhibition is the penetration of glucose into the cell and can be related to a first step in membrane injury. Some cellular components are, however, probably lost after 72-hr preservation, which suggests a second step in the membrane deterioration.

Animals↗
PubMed1982

A new technique for closing abdominal incisions in patients with poor wound healing.

A new procedure is described for closing the abdominal wall in patients expected to have poor wound healing. The technique uses rigid steel wires passed through both abdominal thicknesses perpendicularly to the incision with an extraperitoneal course and passed through a large Silastic tube laid on the skin surface parallel to the incision. This method considerably reduces the two detrimental effects of one layer stitches: sawing of tissues by the thread and ischemic compression of the abdominal wall. We have used this procedure in 33 patients, with 31 satisfactory results. In 10 eviscerations that occurred after other methods of closure, only 1 recurrent evisceration was observed.

Abdomen↗
PubMed1982

Arterialization of the portal vein in conjunction with a therapeutic portacaval shunt. Hemodynamic investigations and results in 75 patients.

Seventy-five cirrhotic patients were submitted to peroperative hemodynamic investigations including flow and pressure studies. Sixty-two patients with hepatopedal portal flow underwent a therapeutic end-to-site portacaval shunt (PC) in conjunction with arterialization of the portal vein and 13 with a stagnant flow a PC shunt alone. Thirty-five patients were operated on in emergency and 40 electively. In 61 patients portal flow was correlated with maximum perfusion pressure (r=0.66), and in 33 patients with the reduction of corrected sinusoidal pressure induced by the occlusion of the portal vein (r=0.72). Operative mortality, which was 3.5% for 57 class A and B patients and 55.5% for 18 class C patients, differed significantly (p less than 0.05) in emergency between arterialized (14.8%) and nonarterialized patients (62.5%). At the time this study was ended on July 15, 1981, the follow-up was over two years for all the patients. The five-year actuarial survival rate of the arterialized patients was 48% for the whole group and 56% for class A and B patients; the overall incidence of chronic encephalopathy was 20%. It is concluded that arterialization is a safe surgical procedure that could be beneficial in respect with operative mortality in emergency, late survival, and tolerance to portacaval shunt. However, a prospective randomized study such as the one undertaken in December 1979 is the only method to prove clearly that arterialization is really able to minimize the risk of encephalopathy and to prolong the long-term survival after portacaval shunt.

Adult↗
PubMed1982

Differential effect of swelling and anoxia on kidney function and its consequences on the mechanism of action of intracellular organ preservation solutions.

In order to differentiate the effects of swelling and anoxia on kidney function, a canine experimental model is used. After complete liberation of kidneys and their vessels from adjacent tissues, each kidney is submitted to 10 min of hypotonic flushing, or to 60 min of normothermic anoxia. Swelling resulting from these two procedures are equal and permit the study of the consequences of anoxia independently from swelling. Edema is determined by water content and renal blood flow is measured. Kidney function is studied by time of restoration of urinary flow, creatinine, and inulin clearances and fractional water reabsorption. The results show that nonanoxic edema is much less damaging than anoxic edema and consequently that anoxic injury is not the simple consequence of spatial disruption of cell architecture. Since many works have shown the beneficial effects of intracellular organ preservation solutions and consequently that anoxia is better tolerated in the absence of swelling, it can be deduced that injuries induced by anoxia and by swelling are cumulative and that the efficiency of intracellular solutions cannot be attributed solely to the preventive effect on swelling, considered as lethal for the cell.

Animals↗
PubMed1980

[Toxic megacolon and its surgical treatment. Results in 21 cases (author's transl)].

The authors present their experience of the toxic colonic dilatation after 21 cases. The frequency of this serious syndrom seems to be in augmentation, and is not any more exclusive of the ulcerative colitis. Actually, pathogeny is not yet known. Diagnosis is established by the standard abdominal X Ray. A continuous clinical, radiological and biological survey is essential, in order to avoid perforation, that is the main complication of the toxic dilatation. The surgical treatment becomes imperative as soon as the failure of the limited medical management is recognized. In this series, total colectomy with or without ileo-rectal anastomosis has been considered as the best surgical operation. Ileo-rectal anastomosis would be possibly protected by a temporary ilestomy.

Adolescent↗
PubMed1979

Pneumatosis cystoides intestinalis. A statistical study of 919 cases.

Pneumatosis cystoides intestinalis, an uncommon disease characterized by the presence of gaseous bubbles in bowel wall, is studied by a review of 919 cases of the world literature. The subserous cysts are more frequently found in the small bowel while the submucous localizations are predominant in the colonic wall. The disease, occurring more frequently in males than in females, is associated with several other lesions: pyloric stenosis and scleroderma for small bowel pneumatosis, chronic cardiopathies and dolichocolon for colonic localizations. Jejunoileal bypass for morbid obesity is an increasing iatrogenic cause. Diagnosis is based on radiology and endoscopy with biopsy but is not yet correctly done in many cases. The treatment is essentially medical.

Adolescent↗
PubMed1978

[Surgery of complicated diverticular sigmoiditis. Report of 138 cases (author's transl)].

The authors analyse a series of 138 cases of complicated diverticular sigmoiditis treated surgically. They noted 50% of pyostercoral peritonitis, 32% of persigmoid abscesses, 13% of case of intestinal obstruction, and 5% of cases of fistual or hemorrhage. The overall mortality was 28% and depended mainly more on the surgical management adopted than on the type of complication. In this respect, simple colostomy with drainage of the septic focus had a mortality of 18%. The results suggest surgical operation in two stages, in the form of colonic resection, with, depending on each case, an anastomosis straight away with transverse colostomy or segmental colectomy with bitubular colostomy (Mikulicz procedure) or, in rarer cases, simple colostomy. The authors emphasise the interest of early surgery in sigmoiditis with complications and contrast the mortality of cold surgery which is now about 5% compared with 28% in emergency cases with complications.

Abscess↗
PubMedDate not supplied

Ferumoxides and Tc-99m sulfur colloid: comparison of the tumor-to-liver uptake in focal nodular hyperplasia.

The tumor-to-liver uptake of two reticuloendothelial agents, namely ferumoxides and technetium-99m (Tc-99m) sulfur colloid, was compared in focal nodular hyperplasia (FNH). Twelve patients with FNH who had undergone ferumoxides-enhanced MR imaging and planar Tc-99m sulfur colloid scintigraphy within 1 year were included from the study. Fourteen patients with FNH with a diameter larger than 3 cm were selected for the comparison. The tumor-to-liver ferumoxides uptake was calculated and the Tc-99m sulfur colloid uptake was assessed visually. Fermuoxides uptake was observed in all but one patient with FNH (mean tumor-to-liver ratio = .36). The six tumors showing normal (n = 5) or increased (n = 1) radiocolloid uptake when compared to the liver accumulated more ferumoxides than the eight tumors showing decreased radiocolloid uptake (P < .01). However, in some tumors, no direct relation was observed between ferumoxides and Tc-99m sulfur colloid uptake. Our observations suggest that ferumoxides uptake might not exactly mimic Tc-99m sulfur colloid uptake in FNH.

Adult↗
PubMedDate not supplied

Chronic lymphocytic leukemia: changes in bone marrow composition and distribution assessed with quantitative MRI.

The purposes of this study were (a) to determine the prevalence of bone marrow abnormalities in patients with chronic lymphocytic leukemia (CLL) using quantitative MR assessment of axial marrow composition and peripheral marrow distribution; (b) to assess the agreement between both quantitative MR methods and compare their sensitivities to detect marrow alterations; and (c) to correlate MR findings with clinical and laboratory parameters. Twenty-nine consecutive patients with biopsy-proven CLL were investigated on a .5-T MR imager to determine bulk T1 relaxation times of the vertebral bone marrow and proportion of proximal femur surface area occupied by nonfatty marrow on coronal T1-weighted MR images of one hip. Of the 29 patients, 12 (41%) had abnormal increase in lumbar marrow T1 values (>600 msec) and 16 (55%) had increased proportion of surface area occupied by nonfatty marrow in the proximal femur (>+1 SD compared to normal values determined in sex- and age-matched healthy subjects). The results of both quantitative MR methods were normal in 12 patients and abnormal in 11 patients (agreement, 79%). Patients with alterations in peripheral marrow distribution had significantly higher T1 relaxation times (P = .001) than those with normal peripheral marrow. Patients with abnormal marrow composition or distribution at MRI had significantly higher blood and marrow lymphocytosis than patients without these features. In conclusion, the agreement between both quantitative MR methods suggests a parallelism between changes in axial marrow composition and in peripheral marrow distribution in patients with CLL. The limits of quantitative MRI in CLL must be kept in mind, because quantitative MR methods failed to detect leukemic marrow infiltration in 41% of patients.

Adult↗
PubMedDate not supplied

Magnetic resonance imaging of lower abdominal and pelvic lesions: assessment of oral magnetic particles as an intestinal contrast agent.

To determine the value of oral magnetic particles (OMP) as a superparamagnetic MR contrast agent for the gastrointestinal tract in lower abdominal and pelvic lesions, 30 patients underwent spin-echo imaging before and after ingestion of OMP at a dose of approximately 80 mg of iron in 800 ml water. The preparation was divided into four portions and taken by the patient over a 2-h period. Two readers independently reviewed the MR images. The contrast material was well tolerated and the distribution of the contrast material was good to excellent in the proximal and pelvic small bowel, but was not sufficient in the colon with the dose and timing used in the study. Postcontrast images showed a significantly better delineation of the lesions, the small bowel, and the paraaortic region, but no significant improvement in the delineation of the colon, the iliac vessels area, the bladder or genital tract. Compared with precontrast images, confidence in defining or excluding disease on postcontrast images was better, equal or worse in 40, 60 and 0% of cases, respectively (P less than 0.001) with a substantial agreement between readers (kappa = 0.71). OMP produced susceptibility artefacts of significant intensity in only one case. These results indicate that OMP may be useful in the delineation of lower abdominal and pelvic lesions at MR imaging. Marking of the colon by a contrast agent might improve the results.

Abdominal Neoplasms↗
PubMedDate not supplied

Congenital anomalies of the inferior vena cava and left renal vein: evaluation with spiral CT.

PURPOSE: To determine with spiral computed tomography (CT) the incidence and caval location of left renal vein (LRV) variants that may affect inferior vena cava (IVC) filter placement, spermatic vein embolization, and adrenal or renal venous sampling. MATERIALS AND METHODS: Contrast material-enhanced spiral CT scans of 1,014 patients were evaluated for the incidence and configuration of LRV variants and for the distribution of the entrances of these veins into the IVC. RESULTS: In this series, variants detected were as follows: one azygos continuation of the IVC (0.1%), three bilateral IVCs (0.3%), and 102 LRV variants (10%) including 38 retroaortic renal veins (3.7%) and 64 circumaortic venous rings (6.3%). In the retroaortic renal vein group, the distance between the entrance of the LRV into the IVC and the confluence of the iliac veins was +62.5 mm +/- 8.7. In the circumaortic venous ring group, the distance between the entrances of the retroaortic and preaortic limbs into the IVC was -39.0 mm +/- 17.4; the distance between the entrance of the left retroaortic limb into the IVC and the confluence of the iliac veins was +63.2 mm +/- 17.1. CONCLUSIONS: Detailed knowledge of these anomalies is crucial for IVC filter placement, spermatic vein embolization, and adrenal or renal venous sampling.

Adolescent↗
PubMedDate not supplied

Physician's involvement in the smoking cessation process of their patients. Results of a 1998 survey among 4,643 Belgian physicians.

This report relates to the 1,667 responses to a selfadministered mail-back questionnaire sent by BELTA to a sample of 4,643 physicians (17.3% current smokers) who are in professional contact with patients (response rate: 35.9%). Links between active smoking and disease are considered as well-demonstrated by 98.8% physicians and for passive smoking by 85.3%, for foetal consequences of smoking during pregnancy by 96.4%. Nicotine dependence is admitted by 83.3%. Interaction of smoking with drug metabolism is insufficiently known. Modulation of the specific approach of smoking cessation, according to the various stages of the cessation cycle, to the level of nicotine dependence and to the psychological status of the smoker is not sufficiently perceived by the physicians. Patient's smoking status is systematically determined by less than half the physicians, of whom nearly 90% claim to inform their smoking patients on smoking-related risks, and 84.2% to tackle the problem of cessation. The intervention is mostly limited to a firm advice, completed by nicotine replacement for a maximum of 50% of smokers (especially gum and patch). Referral to specialized structures is unfrequent (between 10 and 20%). Follow up after cessation is clearly deficient. In this retrospective study of their activity patterns, physicians' reports may reflect their intentions rather than their actual practices. We conclude that smoking issues and cessation techniques should be more intensively taught both at graduate and postgraduate levels, in order to obtain a more active behaviour of health professionals against smoking.

Attitude of Health Personnel↗
PubMedDate not supplied

Development of vertebral fractures in patients with multiple myeloma: does MRI enable recognition of vertebrae that will collapse?

PURPOSE: We assessed the relationship between the presence and size of focal marrow abnormalities detected with MRI in vertebral bodies and the subsequent occurrence of vertebral fractures at follow-up in patients with multiple myeloma (MM). METHOD: We reviewed 179 follow-up MR examinations of the thoracic and lumbar spine prospectively obtained in 37 patients with Stage 3 MM. For each of 131 vertebral bodies that fractured during follow-up, the status of the vertebral bone marrow was assessed on the last MR study obtained at a mean time interval of 4 months prior to fracture occurrence. When focal lesions were observed before fracture in vertebral bodies that later collapsed, their size was compared with that of the contemporary lesions observed in vertebrae that did not collapse. RESULTS: Of 131 fractures, 82 (63%) appeared in vertebrae previously free of focal bone marrow abnormality at MRI and 49 (37%) appeared in vertebrae in which focal lesions were present on the previous MR study. The size of the lesions that preceded fractures (median 15 mm; range 6-50 mm) was not statistically different from the size of the contemporary lesions (median 15 mm; range 5-60 mm) that did not lead to fracture (p > 0.30). CONCLUSION: This study in patients with MM suggests a lack of correlation between the preexistence of focal vertebral marrow lesions detected with MRI and the subsequent development of vertebral fractures.

Adult↗
PubMedDate not supplied

Focal nodular hyperplasia: natural course observed with CT and MRI.

PURPOSE: The purpose of this work was to assess the natural course of biopsy-proven focal nodular hyperplasia (FNH). METHOD: Eighteen biopsy-proven FNHs in 14 patients (12 women and 2 men) who were followed for at least 6 months with CT and/or MRI were included in the study. The volume of the lesions was calculated twice by two observers using the summation of areas method. Intra- and interobserver variability was assessed by intraclass correlation coefficients. Longitudinal data analysis was performed with generalized estimating equations. RESULTS: The volume of FNH was stable in 6 cases, decreased in 10 cases, and increased in 2 cases. Intra- and interobserver variability in size measurements was 5-10%. Intraclass correlation coefficients were >0.992. Longitudinal data analysis showed that there was a general trend of lesion regression. CONCLUSION: Long-term follow-up and objective measurements performed in patients with biopsy-proven lesions show that the natural course of FNH is variable. In particular, lesion regression is not rare.

Adolescent↗
PubMedDate not supplied

Comparison between the GIRBAS Scale and the Acoustic and Aerodynamic Measures Provided by EVA for the Assessment of Dysphonia following Unilateral Vocal Fold Paralysis.

The aim of this study is to establish relevant objective parameters for evaluating dysphonia following unilateral vocal fold paralysis. To do so, the study compares objective and perceptual voice measures. The objective measures were obtained using a voice analysis software (Evaluation Vocale Assistée), whereas the perceptual measures were established with the GIRBAS Scale (grade, instability, roughness, breathiness, asthenia, and strain). All measurements were performed on 40 voice samples: 28 dysphonic subjects with unilateral laryngeal paralysis, and 12 control subjects. The intra- and inter-judge agreements were fairly good, at least for control subjects. The six GIRBAS measures obtained from the pathological voices were higher than those from the control voices (p < 0.001) and the correlation between both groups was good. Grade, breathiness and asthenia correlated with the objective parameters that express the aperiodicity of the phonatory signal (p < 0.01), namely, the coefficient of variability of the fundamental frequency, the coefficient of variability of intensity, and jitter. Our findings suggest that the perceptual reality of laryngeal paralysis-induced dysphonia depends more on grade, breathiness and asthenia than it does on roughness or instability.

Female↗