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Biomedical subjects

M Meurisse

Publications and source records attributed to M Meurisse.

At least 145 records · Page 8Linked to original sources
PubMed1989

Fluid management and plasma renin activity in organ donors.

Fluid management and assessment of organ perfusion in organ donors with hypotonic polyuria remain poorly investigated problems. In our protocol, urinary losses (565 +/- 202 ml/h) were replaced volume for volume by 3.3% dextrose/0.3% natrium chloride solution (Baxter) with 20 mmol/l potassium chloride. Concentrated red blood cells were administered to maintain hematocrit at about 30%, and volume expansion (central venous pressure above 6 mmHg) was obtained by gelatin (haemaccel) infusion. In all donors (n = 9), plasma electrolytes remained within normal limits despite hypotonic polyuria. Suppression of initial plasma renin activity (PRA: 9.7 +/- 3.6 ng/ml per hour) was obtained by subacute volume expansion. In eight donors the hemodynamic status improved, dopamine administration, when used, was discontinued, and PRA decreased (2.3 +/- 0.7 ng/ml per hour; P less than 0.05). The only donor who failed to respond to fluid therapy had increased PRA (24.2 ng/ml per hour). During fluid challenge, an inverse relationship was demonstrated between mean arterial pressure and PRA in all nine donors (r = -0.61; P less than 0.001), while there were no significant changes in blood urea. creatinine, or urine output. It is concluded that in organ donors, proper maintenance of the hemodynamic status and suppression of the renin stress response may be obtained by an adequate fluid management, involving both qualitative restoration and expansion of intravascular volume.

Adolescent↗
PubMed1989

[Boerhaave's syndrome. Apropos of 2 cases diagnosed at a late stage and treated by a combined surgical and radiologic approach].

Two cases of Boerhaave syndrome are presented which were diagnosed at a late stage. After failure of the primary suture of the perforation, the first case was treated by selective intubation of the oesophagus and percutaneous drainage of the abscess under radiological control. In the second case fistulization was produced first surgically, and secondly with drains of decreasing calibre being inserted percutaneously. The diagnosis of Boerhaave syndrome is often made at a late stage. In cases of important mediastinitis and after failure of primary suture, oesophageal exclusion and oesophagectomy are sometimes recommended. However, these procedures require repeated interventions with a significant morbidity. From this viewpoint a combination of controlled fistulization and percutaneous oesophageal intubation under radiological control is a valuable alternative.

Drainage↗
PubMed1989

Experience with a totally implantable catheter in adult patients: a single institution retrospective study of 114 cases.

One hundred and fourteen consecutive totally implantable catheters were inserted in 114 patients between April 1984 and April 1987. Catheters were inserted under neuroleptanalgesia, through the jugular vein in 101 cases or the internal saphenous vein in 13 cases. No problem was encountered during the insertion procedure. Infection occurred in 5.2% of the patients but removal of the device was required in only 2.6%. Occlusion of the catheter occurred in 6.1% of the patients but never during the first 2 months. This complication rate is lower than the one observed with external tunnelled catheters. The comfort of the patient is substantially improved and nursing care is greatly facilitated.

Adolescent↗
PubMed1987

[Primary pulmonary leiomyosarcoma. Review of the literature apropos of a case].

A 55-year-old patient with primary pulmonary leiomyosarcoma was treated by pneumonectomy. The diagnosis was established by histology of the operative piece. Bronchoscopy and cytology of expectorations were negative. This rare tumor (fewer than 100 cases described) differs from bronchial carcinoma by its method of spread, mainly hematogenic, and its better prognosis. clinical and radiographic data do not provide differential diagnoses. Treatment is essentially surgical since the tumor is only weakly radio-sensitive and responds poorly to chemotherapy.

Humans↗