A self deflating cuff for arterial compression.
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Arteries↗
Biomedical subjects
L Fournier
Publications and source records attributed to L Fournier.
[Use of computers IBM-360: compilation of anesthetic data].
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Age Factors↗
2,3-Dimercaptosuccinic acid treatment of heavy metal poisoning in humans.
14 patients with heavy metal poisoning received 2,3-dimercaptosuccinic acid (DMSA). 12 subjects were given 30 mg/kg/day for 5 days; 1 subject was started on a lower dose because of a history of atopy; another subject was treated for 15 days because of very high initial blood lead concentrations. In the 9 subjects who had lead poisoning, DMSA decreased blood lead concentrations by 35 to 81%, and induced a 4.5- to 16.9-fold increase in mean daily urinary excretion of the metal. In the acutely arsenic-poisoned case, the plasma arsenic concentration on day 7 was half the pretreatment value, while no clear decrease was observed in a chronically exposed subject. In 3 mercury cases, DMSA increased daily mercury urinary excretion 1.5-, 2.8- and 8.4-fold, respectively, while blood mercury concentrations remained below detection limits. No serious side effects were observed and 3 weeks after administration of the drug the clinical condition of all subjects was either stable or improved. These results indicate the efficacy of DMSA for lead poisoning in humans and provide a rationale for further investigating its usefulness in mercury and arsenic poisoning cases.
Adolescent↗
Tumor angiogenesis: pathophysiology and implications for contrast-enhanced MRI and CT assessment.
The process of tumor neoangiogenesis plays a central role in the growth and spread of tumors. It is currently a leading theme in oncology, and many new drugs targeting the tumor neoangiogenic process are under development. Expanding tumors become hypoxic and tumor cells express transcription factors, such as the hypoxia-inducible factor (HIF), which induce the release of proangiogenic growth factors such as vascular endothelial growth factors (VEGF) and transforming growth factors that promote the formation of new capillaries by recruiting, activating, and stimulating endothelial cells. Activated endothelial cells secrete matrix metalloproteases, which degrade the basement membrane and the extracellular matrix, and adhesion receptors such as integrins alphavbeta(3), which allow their migration into the extracellular matrix toward the tumor cells. The newly grown vessels are immature and differ from normal capillaries. They are tortuous and irregular, resulting in poorly efficient perfusion, they are leaky (especially to macromolecules), and they are independent of the normal mechanisms of regulation of the capillary blood flow. Moreover, tumor microcirculation is heterogeneous. Evaluation of angiogenesis can be used as a prognostic marker to evaluate the aggressiveness of tumor and as a potential predictive marker of antiangiogenic treatment response. Histopathologic techniques of microvascular density indexes require invasive tissue sampling and need to be standardized. Hemodynamic characteristics of immature neovessels can be noninvasively assessed by dynamic contrast-enhanced magnetic resonance imaging or computed tomography. Tissue enhancement depends on arterial input function, kinetic of distribution of blood into the capillary bed, leakage across the capillary walls, and volume of the interstitial space. Pharmacodynamic models allow the evaluation of microvascular parameters of tissue blood flow, tissue blood volume, tissue interstitial volume, mean transit time, and permeability by surface of capillary wall. Methods based on dynamic contrast enhancement have been shown to correlate with conventional outcome methods such as histopathologic studies and survival. Radiologists must be convinced that, by using this emerging and promising approach, it is becoming possible to gain functional information during routine tumor imaging.
Contrast Media↗
Computed tomography of superior mesenteric vein thrombosis following appendectomy.
During a 5-year period, superior mesenteric vein (SMV) thrombosis was detected with computed tomography (CT) in six patients shortly after an appendectomy. No sign of SMV was present at appendectomy, and a period of more than 2 weeks free of clinical symptoms had elapsed between the appendectomy and the onset of the SMV thrombosis. In four cases, the appendicitis was complicated. These patients had nonspecific signs and symptoms, although two of them had elevation of blood hepatic enzyme levels. In all cases, postcontrast CT demonstrated enlargement of the SMV, with well-defined enhancement of the vascular wall and an intraluminal clot. In one case, CT showed extension of the thrombus to the portal vein with the presence of low-attenuation areas in the liver, consistent with hepatic infarcts. Two patients had predisposing diseases: idiopathic hypersplenism in one case and chronic hepatic disease in the other. SMV thrombosis is a possible complication of appendicitis, and early appendectomy in appendicitis can prevent this complication. Moreover, as in any abdominal surgery, early appendectomy may be complicated by thrombosis of the SMV, thus creating problems of postoperative diagnosis. The complication is more frequent when the initial operation is performed under difficult conditions (peritonitis), or when the patient presents with a coagulopathy. CT is useful in the diagnosis of SMV thrombosis, thus leading to early management with anticoagulant therapy, with a view to avoiding complications such as intestinal ischemia, portal vein thrombosis, and hepatic infarction.
Adolescent↗
Precise diagnosis of infection in burn wound biopsy specimens. Combination of histologic technique, acridine orange staining, and culture.
This study developed a rapid manual histologic technique on burn wound biopsy specimens for an early diagnosis of infection. A total of 86 biopsy specimens were processed using this rapid manual method, acridine orange fluorescent staining for the detection of microorganisms, and a quantitative culture for the identification and counting of bacteria in adjacent homogenized biopsy specimens. Use of these three techniques has shown their complementarity for the evaluation of sepsis in burn wound patients. The histologic study allowed a classification of the depth of bacterial involvement 4 hours after specimen collection, whereas the acridine orange fluorescent staining was useful for quantitative evaluation of infection in the same delay. Thus a rapid therapeutic decision can be made while waiting for the results of quantitative culture and sensitivity tests, which require 24 to 48 hours. We propose routine monitoring of burned patients consisting of these three tests performed simultaneously on each biopsy specimen.
Acridine Orange↗
Pumpless respiratory assistance using a membrane oxygenator as an artificial placenta: a preliminary study in newborn and preterm lambs.
Newborns suffering from severe respiratory difficulties and not responding to conventional methods have been successfully treated by extracorporeal circulation with a membrane oxygenator (ECMO). However, the technique needs a highly specialized staff, excellent laboratory support, and continuous surveillance of the procedure to prevent complications. In a series of experiments on newborn and preterm lambs, we have investigated a relatively simpler technique of respiratory support that involves a pumpless arteriovenous bypass by cannulating both umbilical arteries and the umbilical vein. A highly efficient microporous membrane oxygenator (MO) with very low resistance was selected. This type of perfusion that mimics the placental circulation, besides providing an additional amount of oxygen to the blood, has proven to be very effective for CO2 extraction. Before its application in humans, however, improvements in the catheters to be inserted in the umbilical vessels, some modifications in the design of the MO, and improvements in the blood compatibility of all foreign surfaces in contact with blood are needed.
Animals↗
A research-based risk assessment tool as the cornerstone of a pressure ulcer prevention program.
By highlighting theories of knowledge utilization, we consider some of the factors and issues in planning research utilization projects. By our use of a research utilization model in developing a research-based pressure ulcer prevention program, we help to bridge the gap between research and practice.
Clinical Nursing Research↗
Nail dystrophy and dimercaptosuccinic acid.
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Adolescent↗
[Theoretical and practical problems in the measurement of the mental health of populations. Quebec health survey].
The authors present the process of setting up a mental health inquiry. The "Enquête Santé Québec" was conducted at the request of the Ministry of Social Affairs in order to identify the problems, needs and priority intervention sectors in the health field. The inquiry was carried out on a large scale at the pilot stage, collecting information on 4,000 people in rural and urban areas. The principal options chosen are briefly discussed: type of mental health to be measured, sample methods, choice of instruments, validation work and some results.
Health Priorities↗
[The coxopodopatellar syndrome].
Characteristic features of the coxopodopatellar syndrome are patellar hypoplasia, pelvic skeletal anomalies and morphologic abnormalities of the front of foot. Fifteen cases with variable degrees of anomaly were observed in one family. Since a world-wide literature review failed to demonstrate any perfectly identical observation it was considered that this triple lesion constitutes an original syndrome worth reporting in detail.
Abnormalities, Multiple↗
[Reasons for the hospitalization and length of stay of a homeless population in Montreal].
OBJECTIVE: To compare the hospitalization experience of a homeless population with that of the residents of a low socioeconomic area. METHODS: The homeless hospitalization records (n = 245) were compared with the records of the 3,553 residents of the Département de Santé Communautaire of Saint-Luc Hospital territory who were admitted to the same hospital. RESULTS: The homeless population is mainly composed of young men. Mental health diagnoses are more frequent while cardiovascular and the obstetrical diagnoses are more rarely seen. Homelessness is associated with an 11.2 increased risk of organic psychosis, a 6.1 risk increase of functional psychosis and a 3.8 risk increase of personality disorders, neurosis and substance abuse. Obstetrical diagnoses are 20 times less frequent among homeless women while the cardiovascular risk did not seem to be affected in our sample. The lengths of stay are similar.
Adolescent↗
Intraosseous fat necrosis and metaphyseal osteonecrosis in a patient with chronic pancreatitis: MR imaging and CT scanning.
Necrosis of fatty bone marrow is an unusual complication of several pancreatic disorders. We describe a patient with polyarthritis, sterile subcutaneous abscess and osteolysis arising during the course of alcoholic chronic pancreatitis. MR images of one knee showed multiple foci of abnormal signal intensity within the marrow of the distal femur and proximal tibia, consistent with intraosseous fat necrosis. CT scans showed significant changes in the cancellous bone in these areas compatible with metaphyseal osteonecrosis.
Adult↗