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Biomedical subjects

B Reigner

Publications and source records attributed to B Reigner.

31 records · Page 2Linked to original sources
PubMed1993

In situ thrombolysis for late occlusion of suprafemoral prosthetic grafts.

Low-dose urokinase was used to obtain in situ thrombolysis in the treatment of 20 late occlusions of suprafemoral prosthetic grafts in 19 patients. Aortofemoral or aortobifemoral bypasses with occlusion of one limb had been performed in nine patients, direct iliofemoral bypasses in six, crossover iliofemoral bypasses in two, and axillofemoral bypasses in three. Sixteen of the grafts were polytetrafluoroethylene and four were Dacron. Vascular surgery had been performed on an average of 3 years earlier. Thrombolysis was inhibited on an average of 3 days after onset of occlusion. The protocol called for penetration of the thrombus with a 5 F catheter inserted through a brachial (12 cases) or femoral (eight cases) route. After initial injection of 2500 units of urokinase a continuous infusion of urokinase was begun at a dose of 2500 units/hr and heparin at 100 units/kg/12 hr. Clinical, biochemical (fibrinogen and activated cephalin time every 6 hours), and arteriographic surveillance was carried out every 12 hours with progressive mobilization of the catheter until complete clearance of the artery. Clearance was achieved in all cases. Anteroposterior and occasionally lateral arteriograms with the hip joint in flexion were obtained. An organic cause amenable to treatment was found in 16 cases, including distal or proximal lesions (two and 10 cases, respectively) and elongation/kinking (four cases). Endoluminal angioplasty, stenting, or endarterectomy (six cases) and conventional procedures (10 cases) were also performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta, Abdominal↗
PubMed1993

[Arterial vascularization of the colon. The middle mesenteric artery].

In its modal disposition, the arterial vascularisation of the colon is on the dependence of the superior and inferior mesenteric arteries anastomosed by the way of "arcade de Riolan". Some more exceptional schemes can complicate this distribution: arteria colica media, medium mesenteric artery, intermesenteric arcus. This rare arterial dispositions can have a big practical importance, in the case of colic transposition, and more recently in the case of the utilization of the right gastroepiploic artery for coronary by-pass.

Arteries↗
PubMed1992

Reconstruction of an abnormal artery observed in an 11 mm embryo: considerations on the embryologic origin of the subclavian artery.

The retro-oesophageal right subclavian a. is a classical variant. We report the first case recognised in the embryo (11 mm subject reconstructed by Born's method). Four other adult cases are analysed (1 dissection and 3 clinical cases) and compared with 250 clinical observations of the supraaortic trunks. In the modal state it arises from the 7th arterial segment. The origin of the subclavian and vertebral aa. and the arrangement of the supraaortic trunks allow the distinction of three types, whose embryologic origin is discussed.

Adult↗
PubMed1992

Transthoracic endoscopy for upper thoracic chemical sympathectomy.

Beginning in April 1989, we have performed eight upper thoracic chemical sympathectomies by transthoracic endoscopy. The indications were occlusive arterial disease in four patients and Raynaud's syndrome and palmar hyperhidrosis in two patients each. Transthoracic endoscopy was performed under general anesthesia, through the third costal interspace on the anterior mid-clavicular line. Five ml of phenol were injected into the parietal pleura covering the three proximal thoracic ganglia. The duration of thoracic drainage was 24 hours. The postoperative course was uneventful except for one case of subcutaneous emphysema and transient Horner's syndrome in three instances. There were no initial failures. Because of its simplicity and the short hospitalization period, chemical sympathectomy by transthoracic endoscopy constitutes a valuable alternative to conventional surgery. This technique is, however, limited in the case of antecedent pleuropulmonary disorders.

Adult↗
PubMed1992

[Paraplegia after surgery of the suprarenal aorta (26 cases reported during a national survey)].

Although their frequency is probably underestimated, medullary complications of abdominal aorta surgery are rare but serious, and may be the cause of medico-legal actions. Referral of a patient allowed the collection of 26 unpublished cases: 18 with aneurysms, including 6 ruptured lesions and 12 undergoing cold surgery, and 8 with aorto-iliac occlusion, these 26 cases representing 0.16% of abdominal aorta interventions performed during the same period. Mortality (6 cases) was due principally to neurological complications, total in 4 cases, partial in 3 and persistent in 13. Risk factors were perioperative collapse (explaining the elevated frequency in ruptured aneurysms) and the occlusion of the internal iliac arteries. Duration of clamping was not significant. No certain method of prevention could be elucidated, either by a literature review or by analysis of the personal series.

Aged↗
PubMed1991

[Angioscopy in peripheral vascular diseases].

Angioscopy is a useful investigation in patients referred for vascular surgery. The material has been improved over the last few years to make available angioscopes with external diameters ranging from 0.55 to 3.2 mm. The angioscopes are either rigid, composed of two groups of fibre optics (image and light transmission) or orientable and more complex. Both systems may carry operating channels. The angioscopy may be performed peroperatively or percutaneously. Other essential equipment includes catheter guides, balloon catheters, counterpulsation balloons or perfusion pumps. This investigation is used for diagnostic evaluation but when used peroperatively it may also help guide therapeutic intervention. Angioscopy is complementary to ultrasonic and radiological methods of vessel imaging.

Catheterization↗
PubMed1990

[Cutaneous closure of peritonitis].

The authors report results of prospective study about skin closure of peritonitis. Two groups are compared: Group A: continuous suture + suction drain VS Group B: simple suture at wide intervals of 4 cm. 93 patients have been included with a mean age of 53.2 +/- 23.9 and just before surgery randomized. Two groups are homogeneous. The postoperative parietal complications were respectively 12% in group A versus, 29% group B. There is a significant difference of 5% in favor of group A. Because the little size of groups, the authors conclude that closure of the skin peritonitis with "continuous suture" is not forbidden. This procedure doesn't increase morbidity.

Abdominal Muscles↗
PubMed1989

Lack of effect of ponsinomycin on the plasma pharmacokinetics of theophylline.

The influence of ponsinomycin on the pharmacokinetics of theophylline has been studied in 12 young healthy volunteers. They received 10 doses of theophylline 200 mg every 8 h p.o., successively in the absence and then in the presence of ponsinomycin. This new macrolide, structurally related to midecamycin, was given in the therapeutic dose of 800 mg b.d. for 5 days, starting 2 days before the second phase of treatment with theophylline. The pharmacokinetic parameters of theophylline, calculated from its plasma concentration at steady-state, were not affected by the co-treatment. In particular, there was no significant difference between the peak and trough plasma levels, apparent clearance or apparent elimination half-life of theophylline in the absence and the presence of ponsinomycin. Only renal clearance was slightly (27%) but significantly increased by the co-treatment. The results suggest that ponsinomycin would be a good choice if a macrolide antibiotic were needed in patients being treated with theophylline.

Adult↗
PubMed1989

[Pharmacokinetics of ponsinomycin administered in a syrup form in single 400-800 and 1200 mg doses in healthy volunteers].

Ponsinomycin is a new macrolide. Its pharmacokinetics is characterized by an extensive metabolism. Following oral dosing in human, unchanged ponsinomycin is not found in blood, but 3 main metabolites: Mb12, Mb6 and Mb9a can be assayed. Twelve young healthy volunteers received ponsinomycin orally, at doses equal to 400, 800 and 1,200 mg on 3 separate occasions, according to a cross-over design. Metabolites Mb12, Mb6 and Mb9a were measured in plasma by HPLC. The pharmacokinetics of Mb12 was linear in the range of doses administered. A dose-dependent effect leading to a reduction of the apparent elimination rate when dose increased was observed with Mb9a and more importantly with Mb6.

Administration, Oral↗
PubMed1989

[Influence of food intake on the bioavailability of ponsinomycin administered in a syrup form].

Ponsinomycin is a new macrolide. Following oral administration, ponsinomycin is totally metabolized, even before reaching blood circulation. Metabolite Mb12 is the first compound on the main metabolic route, which can be assayed. The influence of food on ponsinomycin bioavailability has therefore been estimated from measurements of Mb12 plasma levels. Twelve young healthy volunteers received 800 mg of ponsinomycin as a syrup on two separate occasions, 2 hours before and during a standard meal. The Mb12 metabolite was assayed in plasma by High Pressure Liquid Chromatography (HPLC). Plasma peak concentrations and areas under curves were not significantly different but time to peak was significantly shorter when ponsinomycin was administered during meal. The results suggest that ponsinomycin absorption is faster when administered with food but quantitatively unchanged.

Adult↗
PubMed1988

[Ovarian metastases of digestive cancers. Diagnostic and therapeutic management].

Although ovarian metastasis of digestive cancers were well known since more 80 years, the management of ovaries is still discussed. The authors reviewed 112 cases of digestive tumors in female patients operated between 1973 and 1987, excluding the peritoneal carcinomatosis, and report 7 cases of ovarian metastasis. The primary carcinoma was gastric (2 cases) colonic (2 cases) appendicular (1 case) small bowel (1 case) and biliary tract (1 case). Because the severe prognosis and the frequent revealing and isolated feature of the ovarian metastases the authors review the literature in order to propose recommendations regarding the diagnosis and treatment according to the localisation, the grading of the primary tumor particularly in non menopausal patients. When the primary tumor is a mucinous signet-ring carcinoma with spread to the serosa and a gross abnormality of an ovary is discovered the oophorectomy should be performed. In every cases an immediate histological examination is absolutely necessary. Clinical and sonographic findings are included in the operative staging and the follow up of patients operated for a digestive adenocarcinoma. Especially if the ovarian tumor is bilateral a complete digestive check-up including appendix and biliary tract is necessary.

Adult↗
PubMedDate not supplied

In vivo and in vitro kinetics of mofarotene in mouse, rat, dog and man.

The pharmacokinetics of mofarotene were investigated in mice, rats and dogs following single intravenous and oral administrations. Healthy volunteers were also given a single oral dose of 300 mg mofarotene. The data indicate a similar disposition for mofarotene in all species studied: low clearance consistent with a high bioavailability following oral dosing, and large volume of distribution indicating an extensive tissue uptake. Also in vitro in liver microsomes, the values for intrinsic clearance were in all species within a 2-fold range. The dog, however, tended to exhibit, both in vitro and in vivo, the lowest clearance. Although (due to the lack of protein binding data) a direct prediction of the in vivo clearance from in vitro data was not possible, the experiments with liver microsomes did provide a clear insight into the rate of elimination of mofarotene in vivo in the different species studied including man.

Absorption↗