Biomedical subjects
Publications and source records attributed to P Romano.
A procedure for inducing mutants of a homothallic strain of Saccharomyces cerevisiae is described. The essential parts of the procedure are long incubation in Glusulase, which preferentially kills vegetative cells instead of spores, and treatment in 9% ethyl methanesulfonate, which also preferentially kills vegetative cells instead of spores. Consequently, the viable population is virtually 100% spores.
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The aim of this work is to describe a system for the mono- and bi-dimensional analysis of brain electrical activity. The analysis was carried on either by visual inspection of mono- and bi-dimensional data, or by automatic feature extraction from the bidimensional data. Because of the importance of visual inspection for the analysis of experimental data, particular care was devoted to optimize the displayed data perceptually. For automatic screening of large amounts of data (and to allow long term studies of clinical records), statistical facilities were also provided. One purpose of the system was to develop image processing algorithms oriented toward biomedical images, that could be easily implemented on special purpose, low cost hardware, like VLSI or microcomputer arrays. This was possible because of the modularity of the larger part of bidimensional processing, such as interpolation and statistical analysis. Results of an experiment on Visual Evoked Response are presented, showing that through abidimensional analysis of the recorded data the resolution achievable in the localization of brain electrical activity can be increased to less than 1 cm.
An 18-month-old white female child presented with severe bilateral exophthalmos. She was thought to have Grave's disease because her orbital CT scan showed massively enlarge extraocular muscles. She was subsequently found to have myelomonocytic leukaemia. This was treated with radiation, with rapid resolution of her exophthalmos and exposure keratitis.
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A law issued on december 22, 1976 and aimed at increasing the number of kidney transplantations in France authorizes the removal of kidneys from deceased persons of full age provided they had not expressed refusal while still alive; for decreased persons under age, removal is subject to written consent of the legal representative. In a general teaching hospital of whose than 1 000 beds, 21 kidneys donors were operated upon between January 1, 1971 and December 31, 1975 (an average of 4.2 per year). A kidney transplantation team was developed in 1976. Between January 1, 1976 and August 31, 1979, 83 kidneys donors were operated, an average of 22.6 per year. Ninety-five per cent (59/62) of the kidneys removed and transplanted in the hospital began to function (diuresis greater than 2 ml/min) within minutes of releasing the clamp, no matter how long cold ischaemia had lasted. The increase in kidney removal and transplantation may be attributed to the fact that motivation was maintained among the various units concerned (anaesthesia and intensive care, neurosurgery, neuroradiology) by sustained information and teaching.
Surgical technique during donor's binephrectomy is one of the most important parameters conditioning early success after kidney transplantation. Experimental studies showed that tractions on the renal pedicle during kidney removal had a detrimental effect upon renal cortical vascularization and subsequent kidney function. Cortical vasoconstriction is equivalent to acute warm ischemia and therefore impedes prolonged kidney preservation. The means of preventing such events are: administration of large volumes of intravenous saline to the donor, renal vasodilation during surgery with furosemide (8 mg/kg I.V.) repeatedly administered, continuous I.V. infusion of dopamine (less than 10 micrograms/kg/min) and last but not least, surgical technique. Renal pedicles should never be publed. Initial dissection of inferior vena cava, aorta and both renal pedicles is mandatory. Kidney dissection takes place at the very end of the operative procedure. In case of cardiocirculatory arrest, both kidneys are cooled in situ after retrograde cannulation of the aorta above the renal arteries with an indwelling probe inserted into the femoral artery in the groin. From January, 1876 to August 31, 1979, 83 cadavers have been operated upon according to these techniques. Warm ischemic time was less than 5 minutes in all cases. 85 kidneys have been sent to other kidney transplantation centers and 19 kidneys discarded. Sixty-two kidneys have been transplanted in our institution. Cold ischemic time ranged from 2 to 43 hours. Immediate post-transplant massive diuresis (greater than 2 ml/mn) was observed in all recipients but 3 (95%).
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Ricardo T., aged 20 years, was a passenger in a Varig air-craft which suffered an accident on July 11th 1973. A fire developed on board whilst the plane was in the air, at about 3 p.m. After emergency landing, rescue workers (firemen and emergency ambulance teams) discovered only two survivors amongst the 122 passengers. One was in his forties and died a few moments later. The other (Ricardo) was rapidly transported to the surgical and traumatological intensive care unit of the Henri Mondor Hospital. At the time of arrival, he was in stage 1 coma with skin burns (3rd degree), burns of the airway and a high carbon monoxide blood level. Treatment consisted of assisted ventilation for 24 hours, with intermittent bronchial lavage used to eliminate ashes and calcinated debris, then for 10 days, spontaneous ventilation without intubation, with a tele-expiratory counter-pressure of 4 milibar in a mini-chamber (globe) enriched in oxygen. Intravenous hyperalimentation was started during the first few hours, continued on the 24th day by enteral alimentation. Initial chest XRays showed heavy flaky appearances, predominantly in the hilar region, and more marked on the right. At about the 15th day, XRay showed fibrous with predominance of signs of the apex. These sequellae were confirmed by respiratory function tests which gave objective evidence of a diffusion disturbance with decrease in membrane permeability coefficient. Repetition of RFT indicated a decrease in mechanical problems. On August 31st (on the 51st day) Ricardo was able to return to Rio in a good general condition, dorso-lumbar burns having healed. There was a dysphonia of mixed origin: scarred infiltrate of the vocal cords, but with normal mobility, and a decrease in vital capacity of --30%. Seen again in September 1978, Ricardo was found to be well with normal activity and slight effort dyspnea. Chest XRays showed signs of residual fibrosis.
The Monitor of Cerebral Function, the first apparatus designed for continual cerebral monitoring for prolonged periods, is used frequently as an aid during revival. Due to its ease of operation and its straight-forward displaying of the data, it can supply continual information on the state of cerebral activity. Wem used it in various situations where there was a risk of cerebral circulatory insufficiency. Besides this role in the prevention of emergency, we used the M.C.F. as a diagnostic tool in the assessment of brain death. An early confirmation of the presence of stage IV allows of a more efficient removal and grafting of the kidneys. Finally, we also use the M.C.F. in the study of abnormalities of behaviour in patients whose revival to consciousness is slow.
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After a brief description of the different phases of physiological sleep, the reasons for employing a new appatus, the Monitor of Cerebral Function, are discussed. This instrument, the first designed for continual monitoring of cerebral activity may be employed in neurophysiology. The results obtained are presented, i.e. the demonstration of a perfect correlation between the Monitor of Cerebral Function recording and the polygraphic methods. The paradoxal and rapid phases of sleep are easily distinguished. The study of paradoxal sleep, both in physiology and in pharmacology, could profit greatly from the use of the MCF due to the great advantage of its ease of operation.
Micro-climate tents (pulsed filtered air) are frequently used in burns departments. In the Surgical and Traumatological Intensive Care Unit of the Department of Anaesthesia and Intensive Care of the Henri Mondor Hospital, these tents are used in two types of indications: --placing of a tent over the head end of patients following tracheotomy with free spontaneous ventilation;--placing tents over irregular wounds. In these two categories of use, the aim is to isolate the zone under the tent by protecting it against secondary infection, but also to limit to this micro-climate any possible dissemination from the injured individual placed under the tent. Comparative study of the bacterial flora of the biotopes thus enclosed by micro-climate tents has been attempted.
--A purely bacteriological presentation of the information on the infections of 567 patients hospitalized for 18 months (January 1977 to the end of 1978) in a resuscitation unit for cases of trauma. -- 975 organisms were isolated and identified. 75 p. 100 Gram negative bacilli. -- The various specimens are analysed. Lung infections were present in: 54.6 p. 100 -- urinary infections are rare, giving rise to 10 p. 100. One remarks the low number of septicaemias, only 29 or 5 p. 100 of those hospitalized compared with the 942 vascular catheters that were introduced and all bacteriologically tested.