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M Carlier

Publications and source records attributed to M Carlier.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Genetic and environmental factors implicated in recurrent calcium lithiasis].

In this prospective study, we compared the frequency of some genetic and environmental factors possibly implicated in the occurrence of calcium stone disease. A group of 439 patients (258 males and 181 females) with one episode of calcium stone was compared to a group of 191 patients (131 males and 60 females) with recurrent calcium stone disease. Population with stones was also compared to control population (n = 78, 40 males and 38 females) matched to age. Major results were as follow: 1) Family history of urinary calculi was more frequent in patients than in controls (28.4% vs 9%, p < 0.01). No difference was observed between patients with one episode and those with recurrent episodes (27% vs 31%, ns). 2) The recurrence was earlier in female than in male, so that in female with family history of urinary calculi (p < 0.05). 3) Mean plasma levels of 1-25OH2D3 was significantly higher in patients with family history than in controls (60% vs 38%, p < 0.01) 5) Restricted calcium diet (< 400 mg per day) was more often observed in patients than in controls (31% vs 14%, p < 0.05) and the most significant difference was found in patients with recurrent calcium stones.

Adult↗
PubMed1992

ABO-incompatible orthotopic liver allografting in urgent indications.

The influence of ABO-compatibility was reviewed in 70 emergency orthotopic hepatic transplantations (OHT) performed at our institution in 60 highly urgent recipients between February 1984 and March 1989. Thirty-eight were ABO-identical (Id); 16, compatible (Comp), and 16, incompatible (Inc) transplants, respectively. The three groups did not differ statistically with respect to the indications, the adult/child ratio and the proportions of first OHT and retransplantations. Graft survival rates of ABO-Id, ABO-Comp and ABO-Inc OHT at one year were 47, 38 and 19 per cent, respectively (p less than 0.02). Incidences of perioperative mortality, arterial thrombosis and irreversible rejection were slightly (although not significantly) higher in the ABO-Inc group. Retransplantation rates were 19, 7 and 36 per cent in the ABO-Id, Comp and Inc groups, respectively. Patient survival rates at one year were 59 per cent for the ABO-Id group versus 43 per cent for both ABO-Comp and Inc combinations (NS). The results of this series of highly urgent OHT confirm that graft survival is lower with ABO-Inc livers; their use should be strictly considered as a short term life-saving procedure. Improvement of patient survival after a first urgent ABO-Inc OHT may require an aggressive policy of retransplantation.

ABO Blood-Group System↗
PubMed1991

Coronary collateral flow reversal.

Coronary collaterals demonstrated angiographically are expected to be usable both ways and to remain on standby even if they are no longer used after flow improvement through the physiological pathway. Evidence of these hypotheses is provided by two case reports, one showing spontaneous reversal of collaterals and one showing recruitable reversed collaterals.

Aged↗
PubMed1991

Cardiac tamponade early after thrombolysis for acute myocardial infarction: a rare but not reported hemorrhagic complication.

Among 392 consecutive patients admitted for acute myocardial infarction and treated with thrombolytic drugs, 4 patients (1%) developed an early hemorrhagic pericardial effusion (without ventricular wall rupture) evolving within 24 h to cardiogenic shock consequent to cardiac tamponade. They all suffered from a large anterior myocardial infarction treated within 4 h after onset of symptoms with intravenous anisoylated plasminogen streptokinase activator complex (one case), recombinant tissue-type plasminogen activator (rt-PA) (two cases) or streptokinase (one case), anticoagulation with heparin (all cases) and aspirin (three cases). As soon as pericardial effusion was established by echocardiography, emergency percutaneous pericardiocentesis was performed at the bedside 20 +/- 6 h after thrombolytic therapy was started. This corrected immediately the clinical and hemodynamic status of each patient and a catheter was left in the pericardial space for 34 +/- 18 h. Thus, in the presence of unexplained clinical and hemodynamic deterioration occurring during the first 24 h after thrombolytic treatment of a large myocardial infarction, cardiac tamponade should be suspected. Immediate percutaneous pericardiocentesis followed by continuous drainage is a simple and definitive treatment for this complication.

Aged↗
PubMed1991

The Y chromosome effect on intermale aggression in mice depends on the maternal environment.

Two parental strains of laboratory mice, NZB and CBA/H, were chosen for their differences in attack behavior. NZB have higher scores than CBA/H. An effect of the Y chromosome on attack behavior was determined for two maternal environments. Each male was tested once in a dyadic encounter with an A/J male as a standard opponent. The two reciprocal F1s and the four reciprocal backcrosses were used. In each group, the proportion of attacking males was used as the dependent variable. In the first experiment, the ovarian graft method was used to test for an effect of variation of the overall maternal environment: parental vs. F1. The results demonstrated an interaction between the Y chromosome and the maternal environment. By use of the adoption method, it was shown in the second experiment that this maternal effect was probably postnatal (and not prenatal).

Aggression↗
PubMed1991

Mandible shape analysis in Y-congenic strains of mice.

In order to test for the presence of genes influencing morphology on the Y-chromosome of mice, a canonical discriminant analysis of variation in mandible shape was conducted in 4 inbred strains of mice and 4 Y-chromosome congenic partners. Genetic background-dependent differences were observed, as well as a small sex variation in some strains, but it was impossible to detect any difference related to the between-strain exchange of the Y-chromosome.

Animals↗
PubMed1990

Atrial natriuretic factor: a protective role after acute renal ischemia? Is there room for it in kidney transplantation?

Because of the deleterious effects of acute tubular necrosis (ATN) after kidney transplantation, the search for new and effective means of protecting the kidneys from ischemic or nephrotoxic injuries continues. The beneficial effects of hyperhydration with mannitol or furosemide infusions in renal allograft recipients have now been well documented. The recent discovery by De Bold and coworkers that hypervolemia (by atrial distension) induces the release of atrial natriuretic factor (ANF) suggests an important physiopathological, and perhaps therapeutic, role for this natriuretic peptide in kidney transplantation. In addition to providing an overview of the current knowledge about ANF and its effects on both intact and ischemically injured kidneys, the physiological role of ANF in various situations, similar to those found in kidney transplantation, is analyzed. The effects of ANF on arachidonic acid metabolites and on the nephrotoxic side effects of cyclosporin are also reported. If the results of the preliminary experimental studies appear to be effective, further prospective clinical trails must be carried out to confirm them.

Animals↗
PubMed1990

Y chromosome and aggression in strains of laboratory mice.

Intermale attack behavior differences in laboratory strains of inbred mice have Y chromosome correlates in a small number of strain comparisons. Moreover, the Y correlates interact with autosomal or pseudoautosomal genes. Recent data on the genetics of the Y do not contradict these conclusions. The discovery of several polymorphic loci of the Y could pave the way for a direct confirmation of Y correlates of attack behavior by linkage detection. The involvement of the Y in this behavior has been put forward. Plasmatic testosterone concentration reactivity of some target organs to exogeneous testosterone appears to be correlated with two independent loci of the Y acting in an additive or interactive manner with autosomal or pseudoautosomal loci. However, the association between testosterone action and attack behavior in males needs further evidence, and in any case this association does not underline linear mechanisms.

Aggression↗
PubMed1990

Size reduction of the donor liver is a safe way to alleviate the shortage of size-matched organs in pediatric liver transplantation.

The development of pediatric liver transplantation is considerably hampered by the dire shortage of small donor organs. This is a very sad situation because in most experienced centers, liver replacement can offer a long-term hope of survival of more than 70% in a growing variety of pediatric liver disorders. The reported experience with 54 reduced-size grafts on a total of 141 transplants performed in 117 children between 1984 and 1988 demonstrates that the technique of reduced-size liver transplantation not only allows long-term survival but, in fact, offers the same survival hope with the same quality of liver function, regardless of the child's age and clinical condition. The prominent feature of our experience with the reduced liver concerns its deliberate use for elective cases. Seventy-seven per cent of the 30 children who electively received a reduced liver were alive 1 year after transplantation, as were 85% of the 62 children who received a full-size graft. There is no difference in the long-term survival rate of patients who received elective grafts, which is in the range of 75% with both techniques.

Adolescent↗
PubMed1989

Magnum wire for balloon recanalization of chronic total coronary occlusions.

A new guidewire (Magnum wire, Schneider) was developed for balloon recanalization of chronic total coronary occlusions. This 0.021-inch solid-steel wire with a floppy tip equipped with a 1-mm diameter "olive" is used like an ordinary guidewire, fits conventional balloon catheters and provides excellent steerability. Magnum wires were used in 50 consecutive chronic total coronary occlusions (mean +/- standard deviation duration 8 +/- 21 months, range 1 day to 10 years; mean length 1.1 +/- 0.8 cm, range 0.2 to 4.0). All occlusions were reached (in 23 right, 18 left anterior descending, 8 left circumflex coronary arteries and 1 diagonal branch) and 30 (60%) were recanalized (1 reoccluded during the procedure, and in 3 patients the Magnum wire did not completely cross the occlusion but enabled the previously impossible passage of a conventional wire). The mean age of the occlusion was 3 +/- 4 months in successful and 17 +/- 33 months in unsuccessful procedures (p = 0.04) and the mean length was 1.1 +/- 0.9 and 1.3 +/- 0.6 cm, respectively (p = 0.4). In 17 patients, conventional techniques had been exhausted before the Magnum wire attempt, which was successful in 8 (47%). In 33 patients the Magnum wire was tried first, with success in 22 (67%). Conventional techniques were subsequently tried in 9 of the 11 failures (none was successful). Of the 38 procedures carried out with a second, improved version of the Magnum wire, 26 (68%) were successful.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Intraoperative hemodynamic modifications during pediatric orthotopic liver transplantation.

OLT is generally associated with important cardiovascular changes occurring during the vascular clamping and at the time of revascularization of the newly transplanted liver. In our series of 60 OLT performed in 52 children, the IVC clamping is generally followed by a fall in the PAP and the PWP, the SBP remaining fairly stable in half of the cases. This good tolerance is confirmed by the fact that a veno-venous bypass was used only in 3 instances and vasopressive drugs were needed in only 6 cases. At unclamping, a severe decrease in SBP is associated with a sharp rise in PAP and PWP in most of the cases, whereas some hypovolemic patients decrease their SBP, PAP and PWP. Therefore, we believe that adequate fluid replacement under careful monitoring of the filling pressures provides a good hemodynamic stability in most of the children during the different stages of OLT.

Adolescent↗
PubMed1989

Prospective evaluation of thoracic-duct drainage in the treatment of respiratory failure complicating severe acute pancreatitis.

Thoracic duct drainage (TDD) may be of value for removing toxic substances released by the inflamed pancreas and which are responsible for lung damage. We have prospectively assessed the efficacy of TDD in improving pulmonary gas exchange in 12 patients with severe acute pancreatitis (SAP) complicated by persistent respiratory failure despite standard conservative treatment including peritoneal dialysis in 8 patients. In group A were 6 patients (mean Ranson score = 7.3) with adult respiratory distress syndrome (ARDS) and in group B were 6 hypoxemic patients (mean Ranson score = 6.6) judged to be at risk of developing ARDS. The duration of TDD ranged from 3 to 10 days and the total amount of drained lymph (L) varied from 770 to 15,600 ml. Immunoreactive trypsin levels were significantly higher in L when compared to blood in both groups. Leukocyte myeloperoxidases in L (normal value less than than 332 +/- 82 ng/ml in plasma) were increased in 5 of 5 group A patients (830 +/- 317 ng/ml) and in 3 of 6 patients in group B (671 +/- 467 ng/ml). After TDD pulmonary gas exchange as measured by median PaO2/FiO2 (mmHg) improved from 148 +/- 60 to 285 +/- 42 in group A and from 192 +/- 37 to 330 +/- 42 in group B (p less than 0.05). All patients were weaned after ventilation for a mean of 8 days in group A and 4 days in group B. All patients survived apart from 1 group B patient who died of sepsis on day 34.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1989

Evidence that atrial natriuretic factor is the humoral factor by which volume loading or mannitol infusion produces an improved renal function after acute ischemia. An experimental study in dogs.

This experimental study in dogs was designed to investigate whether maximal loading produces atrial natriuretic factor (ANF) release and whether this physiological peptide is involved in the improvement of the early renal function recovery after acute ischemia. The experimental protocol included a renal artery occlusion for 45 min in uninephrectomized dogs and the measurement of various parameters of renal function over 2-hr period after declamping. There were 3 experimental groups. In the control group (I) (n = 10), the dogs received, after ischemia, an isotonic saline solution infusion at a rate of 0.2 ml/kg/min. In group II, (n = 10) the animals underwent acute volemic expansion (1 ml/kg/min) with whole blood (hematocrit approximately equal to 25%) during the ischemic period, and after declamping, an isotonic saline infusion (NaCl 0.9%) infusion at the same rate as in the control group. In group III, (n = 8) the dogs only received NaCl 0.9% (0.2 ml/kg/min) before ischemia and alpha human ANF (3.6 ng/kg/min) dissolved in saline after ischemia and during the 2 hr of the renal recovery period. Volemic expansion induced a highly significant increase of the cardiac filling pressures concomitant with a prompt but transient 5-6-fold increase in ANF levels (357 +/- 92 pg/ml versus 60 +/- 4.1 pg/ml in controls at the time of declamping [P less than 0.05]). With these higher plasma ANF levels in overloaded animals, we observed, 2 hr after declamping, considerably improved renal function recovery in terms of glomerular filtration rate--37.5% +/- 8.7 versus 11.8 +/- 3.9%; urinary sodium excretion rate--53.89 mu eq/min versus 5.36 +/- 1.2 mu eq/min (P less than 0.01); total Na reabsorption rate--1.2 +/- 0.23 meq/min versus 0.28 +/- 0.09 meq/min (P less than 0.01) (group II vs. controls, respectively). A 1-28 alpha ANF infusion after the ischemic insult allowed a comparable but more significant improved recovery of renal function--indeed, 2 hr after declamping, the GFR reached 73.7 +/- 14% of the preoperative GFR values. The urinary sodium excretion rate was 15-fold higher than in controls, and the total and fractional sodium reabsorption rates followed a similar increase. These beneficial effects of ANF were obtained with low doses of synthetic ANF (3.6 ng/kg/min) inducing plasma levels slightly higher (120 pg/ml) than in controls and comparable to the levels reached in the overloading group. In addition, maximal loading or ANF infusion produces an inhibition of the aldosterone rise occurring after the ischemic insult.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗