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Biomedical subjects

Y Juillet

Publications and source records attributed to Y Juillet.

At least 37 records · Page 2Linked to original sources
PubMed1981

[Evaluation of the spread of atherosclerosis in patients with arteritis. Implications for the therapeutic indications (author's transl)].

The immediate prognosis (operative risk of a revascularization) and also the long-term prognosis for the patient with arteritis depends on the spreading of the atheroma to other vascular regions (coronary or carotid arteries). Conventionally the initial evaluation is made by cervical Doppler examination, effort ECG and profile aortography. Cervical Doppler examination revealed in the present group of 402 patients significant stenoses on the arterial vessels leading to the brain in 67 cases (16.6%), including 13 asymptomatic stenoses. The effort ECG carried out in 140 cases was assurable in 72% of these, being positive in 19% of the cases in patients with no clinical or ECG history of coronary insufficiency. Profile aortography of 125 patients revealed atheromatous lesions in 39 (31%), in many cases multiple lesions: 13 cases in the coeliac trunk and mesenteric artery. The implications of these discoveries, as they affect therapeutic indications and in particular the justification of multiple revascularizations, have been discussed.

Angiography↗
PubMed1981

[Diffusion of atherosclerosis in patients with arterial disease of the lower limbs (author's transl)].

In patients with arteriosclerosis obliterans of the lower limbs immediate (operative risk) and long term prognosis depend on the diffusion of the atheroma to other arterial beds (coronary and carotid). Basic investigations were completed by doppler ultrasonography of the cervical arteries, exercise electrocardiogram and lateral aortogram. Doppler ultrasonography revealed significant degrees of stenosis of the cervical arteries in 67 out of 402 patients (16.6 p. 100). The stenosis were totally latent clinically in 13 patients. Valid results were obtained in 72 p. 100 of 140 after an exercise electrocardiogram. It was positive in 19 p. 100 of patients without clinical or electric sign of coronary heart disease. Lateral aortogram in 125 patients showed atheromatous lesions in 39 cases (31 p.cent). These were often multiple and involved the coeliac and superior mesenteric arteries in 13 cases. These investigations are of great importance in making the therapeutic decision, indications related with risk and resulting priorities. Alarming coronary or carotid lesions may indeed require treatment before arterial disease of the lower limbs.

Aortography↗
PubMed1980

[Current aspects of the treatment of deep venous thromboses by heparin (author's transl)].

The use of heparin by continuous infusion from a electric pump gives very good immediate results in the treatment of venous thromboses. In 58 patients, there was a constant improvement in clinical signs and recurrence of the venous thrombosis was exceptional (2%), pulmonary embolism rare (3.5%) and well tolerated. Constant flow and the surveillance of treatment led to the method ensuring stable blood heparin levels. Mid-term results (8 months) in 43 patients appeared to be less favourable, the prevalence of venous sequelae reaching 50% for iliac phlebitis, 28% for sural phlebitis. The respective advantages and disadvantages of heparin and fibrinolytic agents are discussed.

Adult↗
PubMed1980

Local urokinase in arterial thromboembolism.

Selective intra-arterial urokinase (UK) is effective in treating recent arterial thromboembolism. However, usually only partials lysis is achieved and this treatment seems less effective than intravenous streptokinase. At a dose of 37,500 UCTA/hour it does not produce systemic fibrinolysis. This protocol substantially reduces the risk of systemic bleeding and embolism and extends its applicability to operative patients. The combination of surgery and UK seems particularly promising in patients with atherosclerotic arterial thrombosis.

Adult↗
PubMed1980

[Severe ischemia of the lower limbs after ingestion of LSD].

A case of severe limb ischaemia predominating in the legs in a young female drug addict is reported. Arteriography revealed diffuse spasm of all arteries of the lower limbs associated with localised spasm along the profunda artery in particular. These appearances regressed on control angiography performed 10 days later. The treatment which associated volume expanders and intravenous vasodilatation agents (magnesium sulphate) led to rapid improvement in the clinical condition in 3 days. There were no long-term complications. The causative role of LSD was suggested by the history of greatly increased intake in the period before the onset of symptoms. LSD is a derivative of lysergic acid, the common nucleus of the derivative of the ergot of rye. Analysis of a sample dose taken by the patient showed a very large quantity of LSD and of lysergic acid and a very small amount of other ergot alkaloids known for their peripheral vasoconstrictor effects. The circumstances following peripheral ischaemia are discussed; the association of haschich - LSD does not seem to be a factor. The increased doses and a predisposed vascular system, in common with ergot containing drugs, seem to be the major factors.

Acute Disease↗
PubMed1980

[Sipple's syndrome: a study through three generations. HLA--carcino-embryonic antigen system. Preliminary results (author's transl)].

Sipple's syndrome in three members of the same family (three successive generations) is reported, confirming that this syndrome is hereditary and transmitted in an autosomal and dominant way. Whereas pheochromocytoma was clinically detectable, medullary thyroïd carcinoma could only be detected in two cases by systematic search for high levels of calcitonin before and after stimulation. In 6 other siblings, thyroïd carcinoma was eliminated in view of negative stimulation tests. HLA groups were studied, but definite conclusions as to the interest of these data in Sipple's syndrome cannot be drawn from 10 few cases. Persistingly high levels of calcitonin after surgery is known to be of severe prognosis; in the present cases, the very short delay after surgery did not allow definite conclusion, since, according to some authors, several months are necessary to allow a return to normal levels.

Adrenal Gland Neoplasms↗
PubMed1980

[Thombosis of a persistent sciatic artery: a rare cause of severe ischemia in the lower limb (author's transl)].

Persistence of the primitive axial limb artery is an uncommon developemental anomaly. This artery is called sciatic in account of its connections with the nerve. Usually gluteal aneurysms develop and the anomaly is disclosed by a complication : pain, pulsatile buttock mass, thrombosis or release of emboli. Prophylactic surgical repair of such aneurysms seems reasonable.

Aged↗
PubMed1979

[Thrombosis of the portal and superior mesenteric veins in a patient with a congenital and familial deficiency in antithrombin III (author's transl)].

Thrombosis of the visceral veins is an extremely rare condition in cases of congenital and hereditary deficiency of antithrombin III, associated with recurring venous thorbosis of the limbs. The authors report such a case in a man of 40 years of age, who had this deficiency, associated with thrombosis of the portal and superior mesenteric veins and a portal cavernoma. They stress the frequent association of recurring peripheral vein thrombosis, portal vein thrombosis in adults, and thrombosis of the mesenteric vein, and the importance of systematic measurements of antithrombin III levels in these pathological conditions.

Adult↗