Carotid Doppler.
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Biomedical subjects
Publications and source records attributed to L Fournier.
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The influence of nitrous oxide on the oxyhaemoglobin dissociation curve (ODC) was studied using blood from twenty healthy patients. When the blood samples were exposed to 50 per cent N2O during the determination of the ODC, a left shift was observed and the P50 was decreased by 1.06 kPa (8 mmHg). This shift cannot be explained by temperature, pH, PCO2, or 2,3-DPG effects. Following exposure of the blood to N2O-free gases, the shift disappeared rapidly, and a normal P50 (3.46 kPa) (26 mmHg) was reobtained. In keeping with this reversibility, blood samples taken before and during 45 minutes of N2O-curare anaesthesia showed identical dissociation curves to those which had been obtained during the in vitro N2O exposure experiment.
A patient with benign intracranial hypertension developed paroxysmal attacks of falling due to loss of consciousness. Prolonged simultaneous recordings of CSF pressure, through a lumbar needle, and of EEG showed that these episodes resulted from bouts of elevation of CSF pressure (120 mm Hg systolic pressure). The pathophysiology of the increased pressure waves, described as Lundberg 's A waves or plateau waves, is discussed. The analogy between EEG records and those observed in normal subjects during Valsalva's manoeuvre is a further argument in favor of cerebral anoxia during the increased pressure plateau, this being apparently the explanation for the clinical disorders.
A review of 26 patients with congenital diaphragmatic hernia, diagnosed in the first 24 hours of life, supports the hypothesis that the postoperative fetal circulation syndrome is an iatrogenic complication, due to the rapid expansion of both lungs, when they are severely hypoplastic. This complication is preventable, when no aspiration of air from the chest cavity is done, and when no tube attached to an underwater seal is inserted. When assisted ventilation is necessary, small volumes at a rapid rate allows satisfactory gaseous exchanges, without pulmonary overinflation.
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The survival of autologous red blood cells (RBCs) collected during operation from the surgical field and processed immediately by the Haemonetics Cell Saver was compared to the survival of autologous nonprocessed RBCs obtained by venipuncture in nine patients undergoing reconstructive vascular operations and four patients undergoing coronary artery bypass. A double isotope technique (Cr-51 and In-111) was used to determine the survival of the different cell populations. Seven patients undergoing coronary artery bypass served as controls to characterize the isotopes by labeling the same population of RBCs with each radionuclide. Comparison of the data in all groups failed to show any significant difference in either the immediate or long-term survival between autotransfused (Cell Saver--processed) blood and nonprocessed RBCs. This study indicates that shed blood collected and processed at operation with the Haemonetics Cell Saver can be autotransfused and that the in vivo survival of these cells is not significantly different from the survival of nonprocessed blood.
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This study shows the application to 20 patients of a very simple formula to estimate A-aDO2 and intrapulmonary shunt, from data commonly available in patients with oxygenation disorders. The values obtained by the "clinical short cut" method and the more sophisticated one are in statistically significant correlation.
A radioimmunoassay for quantitatively measuring the serum concentration of free thyroxine is described. This method does not require equilibrium dialysis, and is rapid and reproducible. The serum values obtained by this radioimmunoassay and by equilibrium dialysis are similar in normal subjects, hyperthyroid and hypothyroid patients, pregnant women, "sick euthyroid" patients, and euthyroid patients with hereditary TBG abnormalities. The method also provides a total serum thyroxine concentration in the same assay procedure.
Application of profile analysis (4) to skinfold thickness (tricipital ; subscapular) experimentally shows that when data are collected under strict control of the measuring technique, the fluctuations ascribale to observers, to left or right body sides, and to replications may be almost entirely eliminated.
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We have presented the anaesthetic technique used during the separation of two female pygopagus conjoined twins. The twins were three months old and weighed 9.2 kilograms on the day of the operation. The main problem during the operation was to evaluate blood volume lost by each patient and a close monitoring of all cardiovascular parameters was necessary to attain this aim. The little pygopagus recuperated well and left the hospital at six months old.
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