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Biomedical subjects

M Carlier

Publications and source records attributed to M Carlier.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Epidemiology of calcium calculi in a French region. Initial results after 4 years].

Between July 1, 1980 and August 1984, 222 patients (112 men and 112 women) were referred to the Nephrology out-patient clinic of a hospital serving a population of about 250,000. Urolithiasis was revealed by renal colics in 71% of the cases; 64 patients (29%) had been suffering from one or several attacks of renal colic before the study period. The first clinical symptoms appeared between the ages of 20 and 59 years in over 80% of the cases, with a peak of incidence between 30 and 39 years. Calcium stone lithiasis was as frequent in women as in men; the sex ratio was around 1 whatever the patient's age at the onset of the disease; 65% of patients had hypercalciuria on an unrestricted diet. The annual incidence of urolithiasis (hospital cases) was 15.6 for 100,000 inhabitants, and the theoretical prevalence (distribution of new patients aged about 50) 0.8 for 100 inhabitants. These epidemiological data compared with those in the literature, show a relatively low incidence of urolithiasis, notably among men, in that particular region of France.

Adolescent↗
PubMed1986

Six human pancreas transplants: results and perioperative management.

Satisfactory results were obtained in 5 type I diabetic recipients of 6 human pancreas transplantations. We chose the three following options: diversion of the pancreatic juice by a pancreaticojejunostomy, simultaneous kidney transplantation from the same donor and cyclosporin A as the basic drug in the immunosuppressive regimen. Further conclusions were also drawn from our experience. Firstly, biological data alone might not be relevant for donor selection: histologic examination of the non transplanted cephalic portion of the donor pancreas is needed to rule out pancreatitis. Secondly, donor management usually needs large amounts of fluids and blood. Finally, besides the general rules of recipient management common to kidney transplantation, pancreas transplantation further requires heparinization, insulin therapy and parental nutrition during the immediate postoperative period.

Adult↗
PubMed1986

Anesthetic experience in adult and pediatric orthotopic liver transplantation.

The authors report their experience with orthotopic liver transplantation in 8 adults and 6 children operated during a 14 months period. The anesthetic technique is described and three points of it are underlined: Renal failure is prevented by a systematic low-dose dopamine infusion added to optimal preloading and mannitol given during the anhepatic phase. Donor liver flush via the portal vein with lactated Ringer's solution is checked by serial measurements of K+ concentration in the fluid draining from the infrahepatic vena cava: the flush is assumed adequate if that K+ level is less than 10 mmoles/l. The risk of air embolism at the time of unclamping is minimized by discontinuing N2O, adding a mild PEEP and placing the patient in Trendelenburg position. The values of hemodynamic and metabolic measurements are given and discussed. There was no peroperative mortality.

Adolescent↗
PubMed1986

Anesthetic protocol in human renal transplantation: twenty-two years of experience.

This paper reviews the experience of 22 years of transplantation. From June 1963 to December 1984, 1362 human renal grafts were performed in our center. Throughout this period, advances in surgical techniques, kidney preservation methods and immunosuppressive regimen have improved patient and graft survival. Simultaneously, progress in anesthetic monitoring and techniques (particularly the use of new muscle relaxants and isoflurane) led to better and safer surgical conditions. A protocol of maximal intraoperative hydration using pulmonary arterial pressure monitoring was progressively developed. This protocol has allowed to reduce significantly the incidence of delayed graft function.

Adult↗
PubMed1986

The peroperative management in multiple organ donors: a crucial phase in organ transplantation.

Recent developments in organ transplantation led to the fact that any potential cadaver donor might be considered as a multiple organ donor (MOD). The anesthesiologist's role is to maintain good hemodynamic conditions during the long and complex harvesting procedure, taking into account that in renal cadaver transplantation, donor's stable hemodynamic conditions play a crucial role in the immediate function of the graft. Taking the opportunity of a case of simultaneous liver, pancreas and kidneys procurement in the same cadaver donor performed for the first time in our country, we are reviewing the different phases of the donor peroperative management. This implies a strict control of the systolic blood pressure (SBP) and central venous pressure (CVP). The first step was to maintain the blood volume: during the 3 hours procedure, 5.5 liters of crystalloid, 1.2 liters of colloid and 1 liter of blood were perfused to maintain a CVP higher than 8 mm Hg and a SBP above 110 mm Hg. To obtain the best possible renal and hepatic perfusion, 4 micrograms/kg/min. dopamine is injected continuously, along with 100 mg phenoxybenzamine since the beginning of the operation in order to avoid any local arterial spasm. After heparinization (3 mg/kg 10 minutes prior to clamping), all organs are simultaneously perfused in situ with 3 liters of Euro-Collins solution at 4 degrees C, for cold storage in optimal conditions. The pancreas along with one kidney was transplanted in a diabetic women in preterminal end-stage renal disease: current creatinine (2 months post-transplant) is 1.3 mg/dl and C-peptide is 0.8 pmol/ml. The other kidney was successfully transplanted in another center. The liver graft was implanted in a cirrhotic patient: current bilirubin is 6 mg/dl, S.G.O.T. and S.G.P.T. respectively 50 and 149 U.I.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1985

Differences in patterns of pup care in mice. V--Pup ultrasonic emissions and pup care behavior.

Newborn mice, like all newborn rodents, are able to emit high frequency signals, in particular when they are put out of the nest. Moreover, it is known that in this situation retrieving behaviors are induced in the foster mother, which are likely to reveal stable differences across inbred strains of mice. The question that arises is whether these differences are causally linked to differences in the pup rate of signalling and/or to the capacity of the females of these strains to perceive them. To provide insights into this question, the behavior of 8 inbred strains of mice was observed: A/J, BALB/c, CBA/H, C57BL/6, C57Br, DBA, NZB and XLII. Pup ultrasonic calls of each of these strains, emitted in the same conditions as a retrieving test, were recorded and tabulated. Auditory sensitivities of females belonging to these strains were determined by auditory evoked potentials recorded in the inferior colliculus. These two variables were analysed in relation to scores of females of these strains on three variables of a retrieving test. Results show that the presence of other factors than auditory cues must be taken into account to describe differences across strains in retrieving performances. This conclusion has been confirmed by results obtained using cross-fostering procedure. Female mice unable to utilize ultrasonic information may use other sensory channels. Furthermore, female mice capable of perceiving ultrasounds may also be able to use different sensory modalities in different situations.

Animals↗
PubMed1984

Early diagnosis of peritoneal infection by simultaneous measurement of lactate concentration in peritoneal fluid and blood.

The level of lactate in peritoneal fluid has been suggested to be of great value in the early diagnosis of peritoneal infection [5]. However, this value is affected by multiple systemic factors producing lactic acidosis; these contributed to the high rate of false positive results, obtained in that study. In our study, a better correlation has been found between the peritoneal fluid to blood lactate gradient levels and the presence or absence of peritoneal infection. A threshold gradient level of 2.2 mmol/l in a total of 37 infected and 48 non-infected samples gave the best prediction with a sensitivity of 95% and a specificity of 96%.

Ascitic Fluid↗
PubMed1983

Early development in mice: I. Genotype and post-natal maternal effects.

The co-actions of genetic effects and the post-natal maternal rearing environment on the development of weight, 9 reflex responses, and survival have been tested by the cross-fostering method in two inbred mice strains--CBA/H and NZB. Pups of the two strains were not treated differentially by the mothers and experimental handling did not systematically affect pup development. Comparisons of unfostered, infostered, and cross-fostered pups show (1) in 16 cases out of 34, reflex development was affected by the pup strain, and in 10 cases out of 34 by the foster mother strain; (2) survival is only affected by the pup strain; (3) weight development is affected by strain of both the pup and the mother as well as their interactions. The adopted pups' scores were situated outside the range of the two non-adopted groups for certain reflexes as well as for weight. Two non-exclusive hypotheses are proposed: the mother strain can affect pup development (1) either through differences in stimulation provided by the mothers (2) or through differences in milk composition.

Analysis of Variance↗
PubMed1983

[Importance of continuous positive pressure ventilation in kidney transplantation: a pilot study].

Continuous positive airway pressure ventilation (CPAP) tends to reduce the risk of post-operative pulmonary infection by recruiting poorly ventilated areas. In human renal transplantation, pulmonary infection is a major problem with a high mortality rate in these immuno-depressed patients. The risk is further increased by the need for recipient maximal hydration during surgery to ensure satisfactory graft function. We therefore thought that it would be appropriate to use CPAP preventively during the immediate post-operative period. In a series of 60 successive patients who benefited from CPAP, the incidence of pulmonary infections was only 5%, which compared favourably with a 14.3% incidence in a previous series of 77 patients without preventive CPAP. Moreover, the 3 pulmonary infections that occurred were rapidly cured and the transplanted kidney could be saved in 2 cases; one patient required dialysis. No death was recorded.

Adult↗