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Biomedical subjects

P Meunier

Publications and source records attributed to P Meunier.

At least 55 records · Page 3Linked to original sources
PubMed1989

[The value of echography in the early diagnosis of renal lesions in the Laurence-Moon-Bardet-Biedl syndrome. Apropos of a case].

The Laurence-Moon-Bardet-Biedl syndrome (LMBB) is characterized by the association of obesity, hypogonadism, polydactyly, mental retardation and pigmentary retinitis. Symptomatic or asymptomatic renal dysplasia (calyceal diverticula, precalyceal tubular ectasia, cysts) is frequently associated with LMBB. The authors consider renal sonography as the convenient investigation for an early detection of such dysplasia as in the case they reported here.

Child↗
PubMed1988

Cerebral evoked potentials after endorectal mechanical stimulation in humans.

Although numerous clinical studies have proved that impaired rectal sensation is a major factor in fecal continence dysfunctions, objective studies in this field are still lacking. To provide information on normal rectal afferents, a study of cerebral potentials evoked by mechanical stimulation of the rectal wall was carried out in 10 healthy volunteers (5 male, 5 female; age, 33-52 yr). The stimulating device consisted of a rectal balloon rhythmically inflated and deflated by means of an animal breathing ventilator. Recordings were obtained 2 cm behind the vertex (C'z, International system 10-20). The responses were averaged from 300 to 800 sweeps. The average was triggered either on inflation ("on effect") or on deflation ("off effect"). Inflation volume and pressure were adjusted to induce a clear but not painful pulsing sensation. Reproducible responses were recorded by both on and off effects. The evoked potentials were polyphasic with a succession of positive and negative waves (peak latencies between 78 and 310 ms). The shape of the response (morphology, latency, and amplitude) was perfectly reproducible in the same subject. With regard to intrasubject reproducibility, variability was displayed: only the early waves (latency less than 100 ms) were perfectly reproducible; late waves exhibited variable latency and morphology. The present findings are the first demonstration of the possibility of recording an evoked potential on the scalp after a mechanical stimulation of the rectum.

Adult↗
PubMed1988

[A case of fetal cystic hygroma. Clinical and echographic study].

In reference to a case of fetal cystic hygroma discovered on ultrasonogram, after 16 weeks of amenorrhea, the authors remind of the need for a karyotype; this is absolutely necessary in the therapeutic decision. Most of the time, it is related to a Turner's syndrome. In case of abnormal karyotype, a therapeutic interruption of pregnancy may be proposed. If the karyotype is normal, the ultrasonogram should be rechecked since hygroma regression has been described. If these images persist or become worse, it is related, most often, to a Noonan's syndrome and interruption of pregnancy may also be indicated.

Adult↗
PubMed1988

[Terminal constipation caused by abdominopelvic asynchrony: analysis of etiological, clinical, manometric data and therapeutic results after rehabilitation by biofeedback].

The aim of this study was to describe the etiological, clinical, rectoanal manometric findings as well as the results of biofeedback therapy in a series of 65 patients (34 males, 31 females, aged between 5 and 77 years) presenting with severe primary constipation due to pelvic abdominal asynchronism. Pelvic abdominal asynchronism was statistically more frequent in males during childhood and in female patients during adult life (p less than 0.005). This study disclosed a high frequency of psychogenic factors in the onset of pelvic abdominal asynchronism (26 p. 100) as well as a high frequency of soiling (46.2 p. 100) in constipated patients. In 36.2 p. 100 of cases, pelvic abdominal asynchronism was the only abnormality. In contrast, in most of the patients, asynchronism was associated with miscellaneous rectoanal disorders: increased anal closure pressure (43.3 p. 100), decreased anal closure pressure (11.8 p. 100), impaired rectal conscious sensitivity (11.7 p. 100), and increased rectal compliance (31 p. 100). This study demonstrated that when high-fiber diet and laxatives fail, biofeedback therapy is a very interesting alternative, providing 80 p. 100 of good results in selected cases. However, we were unable to find any clinical or manometric parameters predictive of results of treatment. Follow-up studies are needed to determine long-term results of biofeedback training.

Adolescent↗
PubMed1987

Endorectal cerebral evoked potentials in human.

Reproducible cerebral evoked responses have been recorded from the vertex in two men and one woman to endorectal electrical stimulation. The first component had a 36 ms latency for the woman, and an average latency of 90 ms for the men.

Adult↗
PubMed1987

[Hemodynamic effects of a new iso-osmotic contrast medium in selective left ventriculography].

To evaluate the myocardial hemodynamic effects of a new iso-osmotic contrast agent (Hexabrix 160: H 16) a randomized cross-over study was performed comparing Hexabrix 160 with Sodium Meglumine diatrizoate (Radioselectan 76: R 76) in 20 patients with ischemic heart disease. H 16 produced substantially smaller (p less than 0.001) increases in heart rate (68 +/- 11 to 73 +/- 12) than R 76 (69 +/- 12 to 88 +/- 15) and smaller decreases in left systolic ventricular pressure (131 +/- 15 to 128 +/- mmHg) than R 76 (132 +/- 14 to 94 +/- 15 mmHg). Both contrast media resulted in an increase in contractility beginning three to five seconds after the onset of the injection and reached its maximum at 45 seconds. However the increases in contractility was smaller with H 16 than R 76: H 16 caused a significantly smaller (p less than 0.01) increases in V max. (0.1 CIRC/s) than R 76 (0.35 CIR/s). The hemodynamic effects of H 16 were probably in relation with the Frank-starling mechanism. The lowest variation of preload observed (left ventricle end-diastolic pressure: 12 +/- 4 to 14 +/- 5 mmHg) showed that this contrast medium appeared to behave like isotonic serum. These results suggest that H 16 may preferable for digital left ventriculography.

Blood Pressure↗
PubMed1987

[A simple method for measuring anteversion of the acetabulum from a frontal radiograph of the hip].

A simple, reproducible and reliable method is proposed for measurement of cotyloid version. Using a standing frontal image of hip, the cotyloid borders are identified and a single-plane geometric projection determines the precise degree of version. This study can also be made from a conventional frontal pelvic image with bipodalic weight bearing. Knowledge of spatial orientation allows a better approach to head-cotyle biomechanical phenomena and thus improved understanding of the genesis of certain hip diseases.

Acetabulum↗
PubMed1986

Physiologic study of the terminal digestive tract in chronic painful constipation.

A manometric study of the sigmoid colon and of the anorectum was undertaken in 65 chronically constipated patients complaining of abdominal pain, and in a control group of 23 healthy volunteers. Rectal compliance was tested in both groups. The sigmoid motility study allowed for the segregation of the constipated patients into three groups: hypokinesia (12 cases), normokinesia (34 cases), hyperkinesia (19 cases). Rectal manometry showed anal hypertony in 24 patients, impaired rectal conscious sensitivity in 12 subjects, and normal functions in the remaining cases. The rectal compliance study disclosed a decreased compliance in 15 cases and increased compliance in 13 other patients. In 12 cases disordered sigmoid motility was the only abnormality; in 10 cases only a rectoanal abnormality was found. Most of the patients (52%) exhibited miscellaneous disorders. In contrast, all parameters were normal in nine subjects. No consistent pattern of motility disorders was thus demonstrated in this clinically homogeneous group of patients with chronic, painful, constipation.

Adult↗
PubMed1984

Physiologic investigation of primary chronic constipation in children: comparison with the barium enema study.

Rectoanal manometry and a rectometrographic study were carried out on 31 control subjects and 63 constipated children. A single contrast barium enema was performed on all constipated children and on 20 children for whom this x-ray study (made for a reason other than constipation) was considered normal. This study allowed the determining of four manometric parameters (rectoanal inhibitory reflex threshold, rectorectal reflex threshold, conscious rectal sensitivity threshold, maximal anal resting closure pressure), of three rectometrographic parameters (maximal rectal tolerable pressure, maximal rectal tolerable volume, maximal rectal compliance), and of one radiologic parameter (rectopelvic ratio). It appeared that the barium enema study was not meaningful. The threshold of the inhibitory reflex and of the rectoanal reflex did not allow for a specific definition of abnormality in constipation. Anal closure pressure was higher in 38% of the constipated patients. The sensitivity threshold was significantly higher in the constipated group. In 79% of the patients an increase in rectal compliance was observed. Finally, in this series of constipated patients who did not have Hirschsprung's disease, organic abnormalities were demonstrated in 97% of the children.

Adolescent↗
PubMed1984

[Treatment of urinary incontinence of neurologic origin in children and adolescents].

Recent advances in the treatment of urinary incontinence of neurological origin in children are discussed. The etiology of the neurological changes is mainly congenital (myelomeningocele, sacral agenesis and hidden dysraphism) other causes such as myelitis, radiculitis or cord injuries being very rarely observed. Two fundamental elements can be evaluated by radiologic and urodynamic investigations of the lower urinary tract: the capacity for compliance of the detrusor muscle and the degree of cervico-urethral resistance. The presence of a cervico-urethral obstruction is no longer an indication for its removal but, on the contrary, a factor that can be retained to assist continence. Intermittent use of self-catheterization enables the obstruction to be used to obtain continence (dryness) and makes the obstruction innocuous, since it enables emptying of the bladder. Of 50 patients (26 girls and 24 boys) treated in this way, 11 were not seen again, but the other 39 are still being followed up after an average of 50 months. This method of bladder emptying maintains the integrity of the upper urinary tract when this was normal previously and improves uretero-pyelo-caliceal distension. Uretero-vesical reimplantation can prevent reflux. Of these 39 children, 23 are continent during the day and 13 among them during the night also. A colocystoplasty was performed in 3 cases to enlarge the bladder capacity. The use of a catheter is well accepted by the girls and young boys but less so by the male adolescents. In the absence of a cervico-urethral obstruction it is impossible to relieve incontinence by re-education, and only three solutions exist: high cutaneous diversion continent cystostomy and artificial sphincter. The high diversion operation should be used as a last resort only. The continent cystostomy uses an appendix isolated on its mesothelium an opening on the abdominal wall and into the bladder in a long anti-reflux tunnel. Catheterization is by a catheter which passes through the newly formed ureter and enables the bladder to be siphoned dry four times daily. This method was used in 25 patients but many complications developed, including febrile attacks with dilatation of the upper urinary tract due to too small a bladder under increased pressure (an enlarging colocystoplasty was required). Eight other children continued to have urine loss through the urethra and required repeated closure of the bladder neck, and one child developed a bladder stone.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗