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Biomedical subjects

M Lamy

Publications and source records attributed to M Lamy.

At least 235 records · Page 13Linked to original sources
PubMed1979

[Effect of drugs used in anesthesia on endocardial viability ratio (EVR) in cardiac surgery].

Endocardial viability ratio, arterial blood pressure, heart rate, central venous pressure and left ventricular diastolic pressure were examined in 50 patients undergoing one or more aorto-coronary grafts. General anaesthesia was obtained by morphine, diazepam, pancuronium and a mixture of oxygen and nitrous oxide. Morphine anesthesia did not effect EVR. Only mean arterial pressure showed a significant increase at the time of surgical stimulation. During sternotomy, EVR fell progressively in patients with hypertension. Tachycardia alone did not modify it. This hypertension was better treated by sodium nitroprussiate than by halothane or enflurane with regard to protection of the sub-endocardial layer against ischaemia. Under the influence of sodium nitroprussiate EVR rapidly reached values greater than those obtained under halothane or enflurane. In the hour following extra-corporeal circulation, endocardial viability ratio improved without any significant variation in classical haemodynamic parameters.

Anesthetics↗
PubMed1979

[Thaumetopoea pityocampa caterpillar and man. Morphology of its venom apparatus. Epidemiological investigation (author's transl)].

The combination of a mechanical phenomenon (penetration of the hair) and a chemical phenomenon (discharge of a toxic substance) accounts for the pathological symptomatalogy induced by the processional pine caterpillar. Epidemiological study has pin-pointed the regions infested by the pine caterpillar and has described in detail the dermatitis inflicted by this caterpillar with special emphasis on the frequency of ocular lesions. Also, a close correlation was noted between the geographical density of the populations of Thaumetopoea pityocampa Schiff and the geographical density of the clinical cases recorded. Skin tests have confirmed that the urticant substance is histamino-liberating. A morphological study of the urticant apparatus of this caterpillar ("mirror" and urticant hairs) was undertaken with the scanning electron microscope. The progressive coming into place of the bristles on the cuticular pads of the "mirror" was followed during the last three larval stages (L3, L4 et L5). The urticant hair, hollow on the inside, carries pointed spikes directed towards its distal end. There is no hole or pores on the hair and the necessity to grind the bristles in order to extract the urticant substance leads us to believe that the hair is really a bulb which must be broken, for example in the skin, in order to release its urticant substance (histamino-liberating).

Adolescent↗
PubMed1978

Spontaneous breathing with continuous positive airway pressure in adult respiratory distress syndrome.

The authors describe three systems of spontaneous respiration with positive end expiratory pressure (P.E.E.P.) : the system of continuous positive airway pressure (C.P.A.P.), the bubble and the intermittent mandatory ventilation with C.P.A.P. (I.M.V.-C.P.A.P.) by Servo-Ventilator 900 B. The results are conclusive with the C.P.A.P. unit used for post-traumatic adult patients in acute respiratory distress and for patients who have been anesthetized for more than three hours. The PaO2 significantly increase in subjects whose PaO2 in the ambient air without P.E.E.P. is lower than 70 mm Hg. The bubble is less used due to its drawbacks. The Servo 900 B offers many possibilities, one of which is reported in this paper.

Acid-Base Equilibrium↗
PubMed1978

Measurement of endocardial viability ratio (E.V.R.) during anesthesia for cardiac surgery.

Since sub-endocardial ischemia is the consequence of a discrepancy between the blood demand and supply of oxygen at this level, the study of the myocardial performance by the measurement of the endocardial viability ratio (E.V.R.) is both useful and possible during anesthesia. E.V.R. is the ratio between the oxygen supply and demand of the myocardium. It is equal to the diastolic pressure time index (D.P.T.I.) over the tension time index (T.T.I.). Measurements are made at different times, by means of the arterial pressure and the left atrial pressure, as well as with the Datascope-E.V.R. Computer. During gradual morphine administration (0.5-1-1.5 mg/kg) and if no major surgical stress occurs, E.V.R. remains excellent and stable (1.46 - 1.48 - 1.43). It deteriorates more or less (1.29 - 1.09) during tachycardia or hypertension. Within the hour following the end of extracorporeal circulation, E.V.R. significantly improves (1.04 - 1.06 - 1.09 - 1.23). Although E.V.R. measurement is easy during cardiac surgery, it is impossible to carry out in case of arrhythmia. While morphine anesthesia induces no variation in E.V.R., tachycardia or hypertension require the addition of therapeutic drug. Within one hour following the end of extra-corporeal circulation, E.V.R. measurement shows improved endocardial viability, although the hemodynamic parameters undergo no significant change.

Anesthesia, General↗
PubMed1977

Report of an incident during the use of the Servo-ventilator 900 in paediatric anesthesia.

The authors report the occurrence of an incident during the use of the Servo-ventilator 900 for paediatric anesthesia; it consisted in self-oscillation of the gas column contained in the patient respiratory circuit. After having analysed the incident and outlined the various ways of avoiding it, attention is drawn to the importance of the total circuit volume of the respirator. The respiratory circuit chosen for ventilating children, has a compliance of 1.3 ml/cm H2O.

Anesthesia, General↗
PubMed1977

[Effects of dimilin, a chitin inhibitor 1 (4 chlorophenyl) 3 (2-6 difluorobenzoyl) urea on the oenocytes and molting in the processionary caterpillar (Thaumetopoea pityocampa Schiff.) (Lepidoptera) (author's transl)].

Te oenocytes of the processionary caterpillar show histophysiological variations during their developing cycle. Grafting experiments and culture in vitro, have not so far allowed us to reveal the least participation of the oenocytes in the determinism of molting and in the transformation of cholesterol into ecdysone. On the other hand, histochemical studies of the oenocytes during the last period of their larval state, reveal, just before nymphosis, the existence of polysaccharides which probably correspond to the synthesis of pre-cuticular substance. When the caterpillars are treated with a chitin inhibitor (pH - 60-40 = Dimilin), the polysaccharides are not longer to be seen in the oenocytes. This deficiency in cuticular material could well be the consequence of one of the most spectacular effects of this product that is a profound perturbation in the formation of the cuticle that leads to the death of animals when molting.

Animals↗
PubMed1977

Treatment of gas gangrene. Interest of hyperbaric oxygen therapy.

We report 27 cases of gas gangrene treated at the University Hospital of Liège since the Anesthesiology Department has been using a caisson for hyperbaric oxygen therapy. Frequency of gas gangrene does not appear to have decreased during recent years. The etiologies now encountered are mainly of post-traumatic and post-operative origin (especially surgery on the digestive tract); arterial insufficiency is a predisposing factor. The prognosis depends on the speed with which an effectual treatment is started; the latter consists in intensive hyperbaric oxygen therapy, antibiotic therapy and resuscitation. Surgery should be as conservative as possible and is undertaken only when progress of the disease has been checked by hyperbaric oxygen therapy. The association of these various modes of treatment proves effectual despite a still significant mortality.

Adolescent↗
PubMed1976

Combined azaperone and metomidate anaesthesia in liver transplantation in the pig.

Combined azaperone and metomidate anaesthesia has been used in 86 surgical procedures on 84 piglets, either as such or deepened and prolonged. 51 animals were sacrificed at the end of the procedure as planned before. The anesthesia allowed the performance of various short and long operations. Out of the 33 remaining pigs, submitted to 35 operations, 4 died during the procedure of a technical fault; 2 did not recover from a deep hypothermia (below 10 degrees C); 1 died from the hepatic coma induced through the operative procedure. The other 26 awoke and recovered spontaneous breathing within 1-4 h following the type of anaesthesia and operating procedure they had submitted, which dured from 15 to 330 min.

Anesthesia, General↗
PubMed1976

Pathologic features and mechanisms of hypoxemia in adult respiratory distress syndrome.

In 45 consecutive patients referred for severe hypoxemia (Pao2 less than 100 mm Hg on positive end-expiratory pressure of 5 cm H2O and fraction of inspired O2 of 1.0), physiologic studies of gas exchange were correlated with pathologic features from 36 open lung biopsies and 15 autopsies. Three distinct groups were defined. Group 1 included 11 patients with the most severe hypoxia (Pao2, 47 +/- 12 mm Hg), minimal Pao2 response to a 10 cm H2O increase in positive end-expiratory pressure (+2.0 +/- 4.0 mm Hg), and a fixed shunt at all fractions of inspired O2. Pathologic study showed edema, exudation, and hemorrhage to the point of consolidation. In group 2 were 13 patients who had less severe hypoxia (Pao2, 60 +/- 17 mm Hg) and a moderate Pao2 response to a 10 cm H2O increase in positive end-expiratory pressure (+15 +/- 8 mm Hg), but whose maximal response was slowly achieved (30 min to several hours). Pathologic examination showed extensive fibrosis. The 21 patients in group 3 had the least hypoxia (66 +/- 15 mm Hg), and had a rapid and marked improvement in Pao2 with a 10 cm H2O increase in positive end-expiratory pressure (+68 +/- 59 mm Hg). Pathologic features were similar to but less severe than those in group 1. Venous admixture increased with decreasing inspired concentrations of O2, indicating diffusion or ventilation-perfusion abnormalities in groups 2 and 3. Prognosis was best for group 3, with 10 of 21 long-term survivors. Two of 11 group 1 patients survived, but only after prolonged periods of extracorporeal membrane oxygenation. Despite biopsy evidence of extensive fibrosis, 3 of 13 in group 2 survived with moderate to good pulmonary function, including 1 survivor who had had extracorporeal membrane oxygenation. Such combined physiologic and pathologic studies are useful (1) for optimal respiratory care, (2) for prognosis, (3) for development of indications for extracorporeal membrane oxygenation, and (4) for better understanding of the pathophysiology of adult respiratory distress syndrome.

Air Sacs↗
PubMed1976

Pulmonary pathology in acute respiratory insufficiency: lung biopsy as a diagnostic tool.

Forty-two patients underwent open-lung biopsy during the early phase of acute respiratory insufficiency. Correlation between the gross appearance of the lung at operation and the microscopic findings was good. Although only fair correlation was found between lung and tracheal cultures, the findings of two positive cultures in the lung only was of utmost importance. Biopsying multiple areas from the same operation showed identical pathology in 86 per cent of cases. The mortality rate of open-lung biopsy was zero; the morbidity rate was 4 per cent. The over-all survival rate of acute respiratory insufficiency (ARI) due to trauma was 39 per cent; that of pneumonia, 11 per cent. In 17 (33 percent) patients specific diagnoses and/or specific therapies were employed as a direct result of the biopsy or the thoracotomy. The incidence and prognostic implications of fibrosis and microthromboembolism are presented and discussed. Open-lung biopsy has been extremely safe and valuable in characterizing and managing ARI.

Acute Disease↗
PubMed1975

[Vitellogenic protein in a male environment in the silkworm, Bombyx mori L. (Lepidoptera): attempts to obtain experimentally a normal vitellus].

An ovary, implanted in a male silkworm of the same age shows an abnormal vitellus, deprived of the principal vitello-protein. The amino-acid retention due to the removal of sericiglands does not lead to a normal vitellogenesis. On the contrary, the injection of an eggs extract allows the formation of eggs with a normal vitellus. Without this process, in male hemolymph, the vitello-protein did not reach the threshold necessary to be absorbed by the ovary.

Amino Acids↗
PubMed1975

Effects of extracorporeal membrane oxygenation (ECMO) on pulmonary hemodynamics, gas exchange and prognose.

Hemodynamic and gas exchange studies on acute respiratory failure patients treated by extracorporeal membrane oxygenation led to the following conclusions: pulmonary circulation can be influenced to a large extent Lamy, et al. Effects of extracorporeal membrane oxygenation on pulmonary hemodynamics by changes in bypass cannulation mode and bypass flow rate. An increase in pulmonary flow is followed by an increase in mean pulmonary artery pressure, a drop in total pulmonary vascular resistance, and an increase in shunt fraction. Forced opening of previously shut down vascular area (possibly due to hypoxic vasoconstriction) is a potential explantation for these physiological changes. Increase in bypass flow rate leads to increase in total systemic flow (pulmonary and oxygenator), but does not change total CO2 production and possibly total O2 consumption. Mixed cannulation mode (venoarterial and venovenous) guarantees adequate oxygenation of all the organs. Oxygenation of the heart can be jeopardized by venoarterial bypass, although the use of an aortic root cannula may decrease this major risk. Extracorporeal membrane oxygenation reversed the disease process in some of the patients treated. The best criteria of reversibility seem to be an improvement in arterial PO2 decrease in shunt fraction across the lung, and decrease in total pulmonary vascular resistance. The most striking change of these parameters has been observed after 2 to 3 days on bypass.

Adolescent↗