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Biomedical subjects

L Michel

Publications and source records attributed to L Michel.

At least 109 records · Page 6Linked to original sources
PubMed1985

A simple method for studying chemotaxis, vascular permeability and histological modifications induced by mediators of inflammation in vivo in man.

A new method is described allowing the quantitative and kinetic analysis, in vivo in human skin, of the chemotaxis of inflammatory cells, of the modifications of vascular permeability and of the histological and cytological events induced by certain mediators of inflammation. In order to illustrate the usefulness of the method, the effects of chronic contact to human skin of two potent mediators of inflammation, LTB4 and Paf-acether, are described.

Capillary Permeability↗
PubMed1985

[New possibilities in radiotherapy of endobronchial tumors using the afterloading method in combination with laser technics].

New possibilities for radiotherapy of bronchial carcinomas are provided by the combined application of the recently introduced afterloading method used hitherto in the treatment of stenosing processes of bronchial carcinomas and the neodyme-YAG laser which opens the stenosis in such a manner that the afterloading probe can be inserted. This new method allows to perform without complications or disadvantages further combined therapies such as percutaneous irradiation (telecobalt, linear accelerator or betatron). An irradiation scheme leading to a decisive tumor regression can be established due to the fast reventilation of the lung obtained by both methods. Surprisingly, three patients could be submitted despite the small-field radiotherapy to rather important lung operations such as lobectomy and pneumonectomy which were performed without complications or disadvantages. The patients were not operable without laser and afterloading therapy. This method was applied several times in the treatment of other diseases such as oesophageal cancer and stenosing cancer of the antrum. In these cases, a normal ingestion due to tumor regression was obtained rapidly.

Brachytherapy↗
PubMed1983

Knotting of intracardiac flow-directed balloon catheter. Simple surgical method of removal.

A complete knot occurred in a 7F flow-directed balloon catheter inserted through the right internal jugular vein. The patient was intubated and placed under positive pressure ventilation. After gaining surgical exposure of the venipuncture site, a purse-string of Prolene 4--0 suture was placed around it. The patient was placed in the Trendelenburg position and the knotted catheter withdrawn, while the purse-string suture was immediately tightened avoiding uncontrollable hemorrhage or massive air embolism.

Aged↗
PubMed1983

Avoidance of aggravated hypoxemia during measurement of mean pulmonary artery wedge pressure in ARDS.

A marked drop occurs in mixed venous oxygen saturation during temporary interruption of mechanical ventilation. To avoid this potentially dangerous problem and eliminate possible errors induced by associated hemodynamic changes, a simple electronic circuit was constructed for measurement of mean pulmonary artery wedge pressure without separation of the patient from the ventilator. Its 12-second time constant was sufficient to cover two to four respiratory cycles. In 50 ventilator-supported patients with the adult respiratory distress syndrome, it was shown that the value obtained from the circuit was not different from the instantaneous value obtained at the end of expiration during temporary cessation of mechanical ventilation, but was different from the pulmonary artery diastolic pressure. The circuit value was not affected by positive end-expiratory pressures up to 10 cm H2O. The method is sufficiently accurate for its intended purpose, improves the care of these severely-ill patients, and can be safely used without a physician being present.

Blood Pressure Determination↗
PubMed1982

Esophageal perforation.

Esophageal perforation can be caused by any instrument, device, or foreign body reaching the hypopharynx. Diagnosis remains difficult. If esophageal perforation is suspected, Gastrografin (meglucamine diatrizoate) swallow study, eventually followed by barium swallow study, is the most useful diagnostic test. Absolute rules cannot be made about the selection of nonoperative or surgical treatment. If diagnosed early, cervical or thoracic esophageal perforations can sometimes be treated conservatively if there are no signs of systemic sepsis. Recurrent leakage after surgical closure is not unusual. Local tissue flaps can reinforce the closure, particularly after delayed operation, thereby often avoiding the necessity for a reoperation or an esophageal exclusion.

Esophageal Diseases↗
PubMed1981

Infection of pulmonary artery catheters in critically ill patients.

Bacteriologic cultures were performed on the tips of pulmonary artery catheters removed from 153 critically ill patients, who had required pulmonary artery catheterization for management of hypovolemic or septicemic shock or for hemodynamic monitoring during mechanical ventilation with positive end-expiratory pressure. Positive results were obtained in 29 (19%) of the cases. Infection of indwelling pulmonary artery catheters may result from contamination during placement or removal or from transient or persistent bacteremia. Colonization was probable in 17 cases, and contamination in 12. There were no instances of sepsis definitely attributable to the catheter. Positive catheter-tip culture was associated significantly with known presence of a focus of infection before catheter insertion and with periods exceeding four days that the catheter remained in place.

Bacteria↗
PubMed1981

Operative and nonoperative management of esophageal perforations.

During a 21-year period, 72 patients were treated for esophageal perforations; the diagnosis was made only at postmortem examination in 13 other patients. Fifty-eight of 85 patients (68%) sustained iatrogenic perforations, 11 patients (13%) had "spontaneous" perforation, nine patients (11%) had foreign body related perforation, and seven patients (8%) had perforation caused by external trauma. Eleven cervical perforations, contained between the cervical paravertebral structures, plus eight thoracic perforations, contained in the mediastinum, were treated with antibiotics, intravenous hydration, and nasogastric drainage. The mortality rate after this nonoperative approach was 16% (3/19 patients). Indications for operative treatment in 53 patients were hydropneumothorax with mediastinal emphysema, sepsis, shock and respiratory failure. The operative mortality rate in these instances was 17% (9/53 patients). Six of the nine patients who died had been operated on more than 24 hours after the onset of symptoms. For cervical perforations the best results were obtained by drainage plus repair of the perforation (mortality rate: 0%; 0/10 patients) and for thoracic perforations by suturing supported by a pedicled pleural flap (mortality rate: 11%; 1/9 patients). Simple drainage of thoracic perforation was followed by a mortality rate of 43% (3/7 patients).

Esophageal Perforation↗
PubMed1981

[Dose investigations of a surface treatment with Au-198 seeds (author's transl)].

For targets situated on or below the surface of the body, the radiation therapy, successfully practiced up to now, can be improved. Au-198-Seeds are positioned as a two dimensional network. To do this a standard method including the needed dosimetry, has been developed. The parameters necessary, like homogeneity, deep dose curves and exposure time, are written out in diagrams. Additional hints are given to ensure the radiation protecture.

Gold Radioisotopes↗
PubMed1980

Pulmonary dysfunction following traumatic quadriplegia. Recognition, prevention, and treatment.

A prospective study of the pulmonary complications occurring in 22 consecutive patients admitted to hospital within 24 hours after acute traumatic quadriplegia was compared with the findings of a retrospective survey of 22 comparable patients. Patients in the prospective group received therapy designed to prevent or reverse secretion retention. All patients in this group survived. In the retrospective group there were nine deaths; pulmonary complications and the need for tracheal intubation and mechanical ventilation were three times more frequent. Serial pulmonary function testing in the prospective group demonstrated a greater compromise of expiration than inspiration and progressive improvement in diaphragm function with time. It is concluded that vigorous pulmonary therapy in the prospective group was associated with increased survival, a decreased incidence of pulmonary complications, and a decreased need for ventilatory support.

Acute Disease↗
PubMed1980

Mallory-Weiss syndrome. Evolution of diagnostic and therapeutic patterns over two decades.

During a 19-year period ending December 1978, we treated 40 patients with upper gastrointestinal bleeding secondary to the Mallory-Weiss syndrome. Thirty patients had the triad of vomiting, hematemesis and alcoholism. The presence of lacerations within the gastric cardia was associated with the presence of hiatal hernia (p = 0.03). Endoscopic examinations demonstrated 32 of 38 additional upper gastrointestinal lesions associated with the syndrome that could have been mistaken as the actual source of hemorrhage. During the second decade, as compared with the first decade, widespread use of fiberoptic esophagogastroscopy led to the identification of the bleeding lacerations in 71% of the patients (versus 47% in the first decade) and in 80% (versus 0% in the first decade) of the patients who required an operation to control the bleeding. Although there was a 7.5% mortality rate in the two decades, the incidence of operative treatment tended to decrease (42-24%; p = 0.13). More impressive were the decreases in transfusions (14 units to 5 units per patient) and in delays before surgery (38 hours to 17 hours) (p equal to 0.05). Improved endoscopic diagnosis facilitates prompt and economic treatment.

Aged↗