[Revascularization of the distal vertebral artery (3d segment). Indications in the treatment of vertebrobasilar insufficiency].
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Biomedical subjects
Publications and source records attributed to B Georges.
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Four patients' positions were tested in search of increased sensitivity of gastroesophageal scintiscanning for the detection of reflux in children: supine, prone, left lateral, and 30 degrees right posterior oblique. The sensitivity was highest when the child was placed in supine position. A 60-min recording period increased the sensitivity of the technique, and is thus preferred to a shorter recording time.
99mTc colloid scintigraphy is a sensitive technique for the detection of gastro-oesophageal reflux, compared to X-ray studies. A quantification index of reflux is used and can be of value when there is concern about the significance of a positive result. Continuous monitoring during one hour increases by 25% the detection of reflux in comparison with a 30 min test. In our series, no case of lung aspiration was recognized using this technique. The scintiscanning index cannot predict the existence of an associated oesophagitis.
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Long considered dangerous, surgical treatment of lesions of the vertebral artery in its extra-cranial course, may be viewed in parallel with angiographic techniques. Approach to the vertebral artery in its different segments, pre-operative arteriographic assessment, are discussed, and operative indications only mentioned. An aneurysm of the vertebral artery in C2-C3 was treated by exclusion and restoration of continuity by a sub-clavian vertebral vein graft in C1-C2.
The hypervariable domain of the HIV gp120, the V3 loop domain, represents a target for neutralizing antibodies and for HIV vaccine strategies. In this study, we have investigated in murine species the potential cross-reactivity of immune responses elicited by immunization either with individual V3 peptides, derived from distinct HIV sequences (BRU, RF, SF2, MN and ELI sequences), or with a V3 combinatorial peptide library. We observed that individual V3 peptides are immunogenic but elicit a specific B- and T-cell immune response that is mainly restricted to the sequence of the immunizing peptide. In particular, T-cell responses that depend on T-cell receptor recognition of peptides bound to the molecules encoded by the major histocompatibility complex were significantly influenced by small differences in the peptide amino acid sequence. The combinatorial V3 peptide library, previously described as B- and T-cell immunogens, induced a more broadly reactive immune response, specially when T-cell cytokine secretion was used as a readout for restimulation of T-cells with individual V3 peptides. These data suggest that amino acid variations in the sequence of an antigenic peptide could lead to the induction of different transducing signals in the primed T-cell population and to the activation of T-cells with distinct cytokine secretion properties. These observations may have implications in the understanding of antigenic variability and in the design of vaccine strategies.
Hypophosphatemia is a seldom but potentially fatal complication of the nutritional recovery or refeeding syndrome in patients with protein-calorie malnutrition or starvation. We report here the case of a 35-year-old anorexic patient who presented a severe but uncomplicated hypophosphatemia during enteral refeeding, despite phosphorus supplementation. Serum phosphorus monitoring is recommended in severely malnourished anorexic patients, particularly during the first week of refeeding, be it parenteral or enteral.
OBJECTIVE: The aim of the study was to assess the value of the 13C Aminopyrine Breath Test (ABT) when performed using the NonDispersive InfraRed Spectrometry (NDIRS), which is a simple and cheap alternative to the mass spectrometry. METHODS: The results obtained by using the NDIRS method for performing the ABT were compared to the results obtained by a reference method, the 14C Aminopyrine Breath Test. For this purpose, in 32 patients admitted for various liver problems, an ABT was performed by using the 2 methods simultaneously. The repeatability of the results obtained at 120 minutes by the NIDRS method as compared to the 14C test was assessed by the method of Bland and Altman. RESULTS: The mean of difference between the results obtained by both methods at 120 minutes was 0.06 +/- 0.46. The coefficient of repeatability between the two tests was 0.92 for a confidence interval of 95%. A good correlation (r = 0.93) was found between all individual results obtained in breath samples at different times of collection (30, 60, 90, 120 minutes), and between the results obtained at 120 minutes for both 13C and 14C tests (r = 0.94). CONCLUSION: The 13C ABT performed using NDIRS is a valid alternative to the 14C technique in routine clinical practice.
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Intermittent claudication of neurogenic origin can be traced to three basic causes: --either a chronic circulatory deficiency in the arteries leading to the spinal cord, whether these arteries be the site of an atheroma of the ostia, an inflammation or a loco-regional compression. In such cases, the claudication is painless which differentiates it from the arteritis claudication of the lower limbs. --or to a compression of the roots of the cauda equina and to a lesser degree of the spinal cord, through a narrow rachidian canal that is hereditary or acquired, and relative or absolute. --or finally to a sheathing peripheral neuropathy of the lower limbs. The two latter causes are accompanied by pain, and make it necessary to widen the classical notion of the intermittent claudication (Dejerine's non painful intermittent claudication of the spinal cord).
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In maxillo-facial surgery, fibroscopic intubation provides safe and effective control of the airway. This technique has been used successfully for 30 intubations performed on 21 patients. A few minor incidents were recorded, resulting from the anesthetic used. The possibility of asphyxia resulting from bleeding or regurgitation must not, be over looked.
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