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Biomedical subjects

M Bouvier

Publications and source records attributed to M Bouvier.

At least 271 records · Page 15Linked to original sources

Optimal patency rates obtained in coronary artery grafting with circular vein grafts.

Twenty-two patients underwent coronary artery grafting with a circular vein graft comprising four or five distal coronary anastomoses. Postoperative angiographic evaluation showed patency in 90 (95.7 percent) of the 94 coronary anastomoses fashioned in this manner. All four occlusions occurred in the one patient whose graft comprised five anastomoses and was occluded beyond the first anastomosis on the right coronary artery (RCA). Eleven of the 94 anastomoses were made onto arteries with limited runoff. Blod flow averaged 214 ml. per minute (range 130 to 320) in the main portion of the graft and 59 ml. per minute (range 35 to 100) in the most distal segment. Flow doubled (averaged 403 ml. per minute) in the 11 grafts injected with papaverine. The technique of circular vein grafting is described in detail and potential pitfalls are outlined. The reasons for the high early patency rate are believed to be the following: (1) high flow in the proximal segment of the graft insuring patency of said segment, (2) termination on the left anterior descending (LAD) coronary artery providing good distal flow and patency. (3) diamond-shaped side-to-side anastomoses (SSA's) preventing angulation of the graft at these crucial points, and (4) nearly equidistant anchoring at the site of the multiple anastomoses giving the graft a smooth, even contour.

Coronary Artery Bypass↗

A comparison of two methods for the microscopic determination of age at death.

The precision and accuracy of the Kerley and Ahlqvist-Damsten microscopic methods of age determination are compared. Both methods were applied to the same sample of 40 femoral thin sections of documented age at death. The results indicate that (1) both methods can be used with equal precision, as suggested by comparable observer errors; and (2) the Kerley method produces overall more accurate age estimates. The low previously published standard error of the Ahlqvist-Damsten method (6.71 years) apparently results from the uneven age distribution and small size (20) of their sample.

Adult↗

[Fibroblastic constrictive endocarditis. Apropos of a form localized in the left ventricle].

The authors report a case of a localised form of this strange disorder which was confined to the left ventricle, and in which the diagnosis was tentative for a long time. In this case it was possible to carry out a removal of the fibrous plaque after opening the apex of the left ventricle, the mitral valve being preserved, as described by Dubost; the functional and haemodynamic results of this procedure were very satisfactory.

Angiocardiography↗

[Nontuberculous infectious osteoarthritis in adults (excluding spondylodiscitis) in rheumatology].

Analysis of twenty five personal observations of septic osteoarthritis compared with information from the literature led the authors to the following conclusions: 1) Diagnosis of septic osteo-arthritis must be considered when confronted with a picture of acute or subacute arthritis generally inflamed with variable fever, raised sedimentation rates and frequently polymorph neutrophilia, above all especially if there are particular antecedents (local trauma or intra-articular injection, conditions which favor infections: diabetes, alcoholism, impaired immunity, corticosteroid therapy or various therapeutic immuno-suppresives). 2) It may be established on absolute criteria (isolation of the organism at the site of the lesions) or, in the absence of direct bacteriological evidence, by a body of evidence amongst which 4 arguments are of particular value: identification of a pathogenic organism in one or more blood cultures and/or at the site of a closed infection, postive serology and particularly elevation of the antistaphylolysine titres, rapid-onset radiological changes of destruction and/or reconstruction. plus hypercellularity of the fluid greater than 100,000 cells/mm3. 3) Medical treatment sometimes includes local treatment (joint aspiration, local injection of antibiotics) and in all cases immobilisation during the acute phase and systemic antibiotics. The latter will vary according to the organism responsible and its sensitivity. It seems useful to continue this for twelve weeks at the minimum in the normal form, initially making use of the combination of 2 antibiotics and preferably using continuous perfusion and/or intramuscular routes during the first half of treatment. 4) The consistently good results of such medical treatment seem to limit considerably the place of surgery for which the indications have become rare during the acute phase and even more so at later stages.

Adolescent↗

[Fatigue fractures of the femoral neck and pubic rami. Analytical and critical study apropos of 97 case reports from the literature and 5 personal cases].

This investigation involved a study of fatigue fractures of the neck of the femur and of the pubic branches based on the one hand on 97 cases from the literature, which were diagnosed mainly on radio-clinical criteria, and on the other hand on 5 personal cases for which a quantitative histological analysis was undertaken by needle biopsy of the bone of the iliac wing. After describing these fatigue fractures in an unusual site, the authors undertake a critical study taking account of the histological information that was available. They show that only a histological study makes it possible to differentiate clearly fatigue fractures from insufficiency fractures, particularly when the later occur concurrently with a clinically and radiologically latent osteoporosis.

Adult↗

[Osteonecrosis of the femoral condyles in adults. Apropos of 30 personal cases].

On the basis of a series of 30 personal cases, the authors describe the circumstances in which osteonecrosis of the femoral condyles occurs, the clinical and radiological characteristics, the evolution of the disease, and some of the associated therapeutic problems. They emphasize particularly the difference between the primary forms, which are the prerogative of women over 50 years of age and are of a limited character, and the secondary forms that are essentially linked to prolonged corticotherapy. The secondary forms are found in persons of both sexes between the ages of 20 and 40 years and consist of diffuse lesions (frequent extensive epiphyseal reorganization, bilaterality, and associations with other sites). As the evolution of the disorder under simple medical treatment is usually fairly favourable, the authors consider that indications for surgery should be restricted to the infrequent forms (10 to 15% of cases) that progress rapidly towards arthrosis.

Adolescent↗

[Primary hyperparathyroidism. 50 personal cases].

On the basis of a study of a series of 50 personal cases, the results of which are reported, and of a series of 2800 cases from the literature, the authors describe certain radiological and clinical aspects of primary hyperparathyroidism and the conditions under which this disease may appear. They emphasize the value of the different laboratory investigations for determining disturbances in phosphorus-calcium metabolism and of the study of bone histology, particularly the quantitative study of iliac bone biopsies. They discuss the various aspects of their methods of surgical treatment (pre-operative location of the tumour, surgical problems, early and later sequelae) and finally describe the indications for surgery.

Adenoma↗