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Biomedical subjects

M Julien

Publications and source records attributed to M Julien.

At least 91 records · Page 5Linked to original sources
PubMed1986

[Conservative treatment of breast cancer. Results after 10 years].

Between 1961 and 1975, 300 women with cancer of the breast (T1:72; T2:167; T3:61) were treated conservatively with radiotherapy alone (T3) or with partial or predominant radiotherapy combined with tumorectomy without axillary dissection (T1 or T2). The results, normalized at 10 years, confirmed that the survival rate (crude or NED) was exactly the same as with other conservative treatments or mutilating surgical treatments. Relapses were few (8%) in T1 cases and acceptable in T2 and T3 cases (13% and 18% respectively); in almost every patient they were amenable to surgery, with good local postoperative course. The prevalence of metastases was directly proportional to the size of the tumour; it was neither more nor less frequent than after radical surgery. Complications were rare and not very severe. Cosmetic results were either excellent (T1) or satisfactory (T2, T3). Finally, the proportions of breasts preserved at 10 years among patients alive and NED was very high, ranging from 96% (T1) to 91% (T2) and 87% (T3). These good results were associated with the possibility of high dosage additional endocurietherapy of the tumoral area with iridium 192, particularly in extensive forms where tumorectomy was cosmetically precluded. Since 1975, we have been using the conservative treatment in closer association with non mutilating surgery.

Breast Neoplasms↗
PubMed1986

Oleic acid lung injury in sheep.

Intravenous infusion of oleic acid into experimental animals causes acute lung injury resulting in pulmonary edema. We investigated the mechanism of oleic acid lung injury in sheep. In experiments with anesthetized and unanesthetized sheep with lung lymph fistulas, we measured pulmonary arterial and left atrial pressures, cardiac output, lung lymph flow, and lymph and plasma protein concentrations. We injured the lungs with intravenous infusions of oleic acid at doses ranging from 0.015 to 0.120 ml/kg. We found that oleic acid caused reproducible dose-related increases in pulmonary arterial pressure and pulmonary vascular resistance, arterial hypoxemia, and increased protein-rich lung lymph flow and extravascular lung water. The lung fluid balance changes were characteristic of increased permeability pulmonary edema. Infusion of the esterified fat triolein had no hemodynamic or lung fluid balance effects. Depletion of leukocytes with a nitrogen mustard or platelets with an antiplatelet serum had no effect on oleic acid lung injury. Treatment of sheep before injury with methylprednisolone 30 mg/kg or ibuprofen 12.5-15.0 mg/kg also had no effects. Unlike other well-characterized sheep lung injuries, injury caused by oleic acid does not require participation of leukocytes.

Animals↗
PubMed1985

[Insulinoma: diagnostic elements. 13 cases].

The mean age of the 13 patients studied (9 women, 7 men) was 50.5 +/- 15.7 years. The disease was discovered on account of malaise (3 cases), behavioural disorders (4 cases), coma (3 cases), syncope (1 case) or right hemiparesis (1 case) or in the course of systematic examination (1 case). Eleven patients consulted for evaluation of hypoglycaemia and 2 for behavioural disorders. The history was characteristic, with malaise, loss of consciousness, severe neurological disorders (seizures, hemiparesis, hemiplegia or coma) and psychiatric disorders. These symptoms typically occurred in the morning before breakfast or between meals in 9 patients, and atypically at any point of time or after meals in 4 patients. Their hypoglycaemic nature was demonstrated by blood glucose determination in 11/13 cases and by response to ingestion of sugar in 12/13 cases. The mean period elapsed between the initial symptoms and the final diagnosis was 20.3 +/- 17.3 months. Inappropriate insulin secretion was elicited a.m. before breakfast, during Conn's diet or fasting test, or by calculating the blood insulin/glucose ratio or Turner's coefficient. Prior to surgery, the insulinoma was located by ultrasonography in 3/8 cases, by computerized tomography in 2/6 cases, by selective arteriography in 6/11 cases, and by phlebography with spleno-portal catheterization and staged sampling for insulin and C-peptide assays in 8/9 cases. Histological examination after surgery (11 cases) or necropsy (1 case) showed an adenoma without evidence of malignancy.

Adenoma, Islet Cell↗
PubMed1985

Effect of hematocrit on vascular pressure profile in dog lungs.

We studied the effect of blood hematocrit (Hct) on the longitudinal distribution of pulmonary vascular pressure profile in an in situ isolated left lower lobe preparation of dog lung using the arterial and venous occlusion technique. The total arteriovenous pressure drop (delta PT) across the lobe was partitioned into pressure drops across an arterial (delta Pa), a venous (delta Pv), and a middle segment (delta Pm). Three levels of Hct were studied: low (18 +/- 5%), normal (41 +/- 4%), and high (66 +/- 5%). Arterial and venous occlusions were performed under constant-flow or constant-pressure perfusion. When flow was maintained constant, the increase in delta PT between low and normal Hct was due to increases in delta Pa, delta Pm, and delta Pv; however, between normal and high Hct, the increase in delta PT was primarily due to an increase in delta Pm. When delta PT was kept constant by adjusting flow, changes in delta Pa and delta Pv were in the same direction as changes in blood flow rate but in opposite direction to changes in Hct. In contrast, changes in delta Pm were in the same direction as changes in Hct. The results showed that the vascular resistance of the middle segment ranged from 7% of total pulmonary vascular resistance at low Hct to 53% at high Hct, suggesting that the vessels within this segment offer the greatest impairment to the transit of blood cells.

Animals↗
PubMed1984

Accurate reference measurement for postmortem lung water.

To test the hypothesis that dry blood-free lung weight is increased during pulmonary edema, thereby leading to an underestimation of the ratio of extravascular lung water-to-dry lung weight, we measured postmortem lung water, dry mass, and hydroxyproline content in 33 sheep with normal lungs (n = 10), high-pressure edema (n = 9), or increased permeability edema (n = 14). Residual blood in the lung, measured using hemoglobin as the intravascular marker in all sheep, and also using 51Cr-tagged red blood cells in 24 sheep, was not different between the two methods or among the three groups of sheep. Extravascular lung water increased 64% in sheep with high-pressure edema and 82% in those with increased permeability edema compared with control values. Dry blood-free lung weight was significantly greater (33% more than control values) in sheep with increased permeability edema, causing the ratio of extravascular lung water-to-dry blood-free lung weight to underestimate accumulated lung water by about 50%. Because hydroxyproline content of the lung was not affected by edema, the ratio of extravascular lung water-to-lung hydroxyproline content was more accurate than the ratio of extravascular lung water-to-dry blood-free lung weight in the quantification of pulmonary edema.

Animals↗
PubMed1983

Influence of chronic obstructive lung disease on the disposition of an acidic drug (sulfamethazine).

The influence of chronic respiratory failure (CRF) on the pharmacokinetics of an acidic drug has been studied in 11 patients and in eight normal volunteers who received 10 mg/kg of oral sulfamethazine. Blood and urine samples were collected for 24 and 48 hours, respectively. No differences were observed in the rate of sulfamethazine absorption, but bioavailability was decreased when compared with control subjects. Sulfamethazine volume of distribution (Vd) was larger in patients than in control subjects. These differences in Vd may be secondary to an increase in sulfamethazine unbound fraction. No differences were observed in sulfamethazine elimination. It is concluded that in patients with CRF sulfamethazine bioavailability decreases, and Vd increases secondary to a decrease in binding. Despite the fact that plasma concentrations of the test drug will be decreased, the administration of higher doses may not be advisable.

Absorption↗
PubMed1980

[Acute haemorrhagic pancreatitis. Criteria of letality (author's transl)].

A retrospective study of severity symptoms in a series of 102 patients operated upon for acute haemorrhagic pancreatitis showed that the risk of death was much significantly higher when shock (p less than 0,00001) and renal failure (p less than 0,0001) were present. The association, during the post-operative period, of shock and renal failure with one of the following symptoms: digestive haemorrhage, psychic disorders, pulmonary oedema, post-operative peritonitis and evisceration invariably proved fatal. It is suggested that controlled therapeutic trials should be carried out in patients presenting with these complications.

Acute Disease↗