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Biomedical subjects

B Tremblay

Publications and source records attributed to B Tremblay.

13 recordsLinked to original sources
PubMed2004

[Pneumothorax surgery].

Surgery remains the mainstay treatment of recurrent pneumothorax. We recall the therapeutic modalities and indications of surgery in case of pneumothorax. We then compare postoperative outcome, recurrence rate and chronic pain with regard to techniques and surgical approach. Current video-thoracoscopic or axillary thoracotomy procedures for bullous disease with pleurodesis allow a low rate of morbidity and recurrence after primary or secondary spontaneous pneumothorax.

Humans↗
PubMed1999

Replacement of a tracheal segment by a mixed graft (aorta and prosthesis): an experimental study in rabbits.

OBJECTIVE: To develop a new graft and to verify its technical feasibility, viability, and ability to reduce the risk of infection by interposition of an aortic segment between the airway and the prosthetic component of the graft. DESIGN: Experimental study. SETTING: Multicentre study, France. ANIMALS: 38 New Zealand rabbits. INTRODUCTION: A 1 cm aortic segment was obtained from the thoracic aorta of a rabbit and cryopreserved or stored at +4 degrees C. The aortic segment, surrounded by a ringed expanded polytetrafluoroethylene (ePTFE) prosthesis was used to replace 1 cm of cervical trachea in two groups of rabbits, either with cryopreserved or fresh aorta. MAIN OUTCOME MEASURES: Macroscopic, microbiological, and histological studies four months later. RESULTS: 12/20 animals in the cryopreserved group survived and 13/18 in those had had fresh aorta inserted. Partial or total necrosis of the aortic muscular layer was replaced by connective tissue, which was a guide for epithelialisation from the anastomoses. CONCLUSION: This new graft is worthy of further investigation, as it is technically feasible and easy to insert.

Animals↗
PubMed1998

Videothoracoscopic lung biopsy in diffuse infiltrative lung diseases: a 5-year surgical experience.

BACKGROUND: To establish an accurate diagnosis of diffuse infiltrative lung disease, a surgical lung biopsy may be required. We report our experience with video-thoracoscopic lung biopsy over a period of 5 years. METHODS: From March 1992 through December 1996, videothoracoscopic lung biopsy was performed in 64 patients (17 were women [26.5%]; age, 50.5+/-13 years) with a diagnosis of diffuse infiltrative lung disease of an unknown cause. All patients except one received general anesthesia. Single lung ventilation was used in 61 patients. All lung biopsies were obtained with an endoscopic stapler. RESULTS: Single lung biopsies were performed in 39 patients (61%), two biopsies in 23 patients (36%), and three biopsies in 2 patients. Minithoracotomies were necessary in 10 patients (15.6%) owing to an iatrogenic pulmonary wound (1 patient), extensive pleural adhesions (6 patients), and a stiff lung (3 patients). Postoperative complications were rare and included five discrete pneumothoraces (7.8%), all resolving spontaneously, one prolonged air leak (1.6%), and one hemothorax requiring reoperation. Three preoperatively debilitated patients died (4.7%), 2 with progression of respiratory failure and 1 owing to septic shock. Average chest tube duration was 2.4+/-2 days and average hospital stay was 4.6+/-2.5 days. Lung biopsy contributed to the diagnosis in 59 patients (92%). CONCLUSIONS: Videothoracoscopic lung biopsy using an endoscopic stapler is a safe and effective procedure in most cases and should be performed by trained thoracic surgeons.

Biopsy↗
PubMed1996

[Closure of bronchopleural fistula by video-assisted mediastinal surgery after pneumonectomy].

Disruption of a mainstream bronchus is a rare but dreaded complication of pneumonectomy. When the bronchial tump measures at least 15 mm, the conventional therapeutic strategy is to drain the pleural cavity followed by closure of the fistula via trans-mediastinal sternotomy. After an experimental study on cadavers to test the technical feasibility of main bronchus closure via a cervical approach using a video-mediastinoscope, we used video-assisted mediastinal surgery successfully in a patient with a left main bronchus fistula.

Aged↗
PubMed1994

[Peri-operative chemotherapy during resection of pulmonary metastases of sarcoma].

The objective of this prospective study was to evaluate the mortality and morbidity of sarcoma pulmonary metastasis resection with continuous chemotherapy. Ifosfamide was administered at the daily dose of 1200 mg/m2/24 h. Twenty-six resections of pulmonary sarcoma were performed from December 1990 to April 1992. The primary lesion was already resected in all patients. Peri-operatory chemotherapy was started 30 minutes before surgery and continued for 6 days. Chemotherapy was associated with an uroprotector, antiemetic drugs and adequate hydration. Patients had a mean age of 30.6 years. The delay between initial and thoracic surgery was 81 months. The following was performed: tumorectomy (32), wedge (18), lobectomy (7), diaphragm resection (1), left pneumectomy (1). All patients had the 6-days chemotherapy course. None of the patients died. Respiratory failure following superinfection, but not necessitating assisted ventilation, was observed in one case. The following adverse events were noted: nausea (34.6%), uncomplicated cystitis (15.4%), leucopenia (7.6%), fever (3.8%). Mean duration of hospitalization was 11.8 days. Chemotherapy adverse effects did not result in significant morbidity. Bronchial fistula was not observed. Following the results of this pilot study, we feel that perioperatory chemotherapy can be added to sarcoma pulmonary metastasis resection surgery without increasing patient morbidity and mortality.

Adult↗
PubMed1990

[Acute ischemia of the legs caused by white clot syndrome after cardiac surgery].

A case of post-surgical heparin-induced thrombocytopenia with bilateral aorto-iliac thrombosis (the so-called "white clot syndrome") is reported. The clinical manifestation was acute ischaemia in both lower limbs, requiring surgery. In view of the patient's poor general condition 15 days after a double aorto-coronary bypass, the surgical treatment was limited to ilio-femoral thrombectomy associated with extra-anatomical bypass. This, combined with medical treatment, resulted in resolution of all thrombotic symptoms and disappearance of the intra-aortic thrombi at control Doppler ultrasonography and arteriography performed one month later.

Aorta, Abdominal↗
PubMed1989

Prostacyclin release induced by neurokinins in cultured human endothelial cells.

The effects of neurokinins (NK) and related peptides on the secretion of 6-keto-prostaglandin F1 alpha, a stable metabolite of prostacyclin, were measured. These peptides enhanced three- to five-fold the basal secretion rate with the following rank order of potency (based on threshold concentrations for a significant output): substance P (SP) greater than or equal to NKA greater than SP 4-11 greater than or equal to [pGlu6]SP 6-11 = SP 7-11.NKB and SP 1-9 were inactive. Ac[Arg6, Sar9, Met(O2)11]SP, a NK1 receptor selective agonist, was more potent than other selective agonists for the NK2 and NK3 receptor subtypes. These results suggest that the NK receptors, which mediate the release of prostacyclin from human endothelial cells, belong to the NK1 subtype.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Relaxant effect of N-formyl-methionyl-leucyl-phenylalanine on rabbit vascular strips.

Some types of rabbit isolated blood vessels precontracted with phenylephrine relaxed when exposed to the chemotactic peptide N-formyl-Met-Leu-Phe (FMLP). The thoracic aorta was unresponsive whereas the portal vein and pulmonary artery exhibited concentration-dependent relaxing responses to FMLP (1-100 nM). FMLP-induced relaxations developed over several minutes and occurred after a latency of 30 to 40 sec. An inconsistent, brief and small contractile phase preceded the relaxations in some tissues. Stable responses to FMLP could be obtained repeatedly at 1.5-hr intervals. On both the portal vein and the pulmonary artery, the structure-activity relationship of peptides related to FMLP was similar to the one reported for activating phagocytic leukocytes. The peptide Boc-Phe-D-Leu-Phe-D-Leu-Phe behaved as a competitive antagonist of FMLP-induced relaxations with a calculated pA2 of 7.5 on both types of responsive vessels. Indomethacin inhibited the relaxations completely on the pulmonary artery and partially on the portal vein. FMLP-induced vasorelaxations were unaffected by a platelet-activating factor antagonist, BN 52021, or a 5-lipoxygenase inhibitor, L-651,392. Removal of the endothelium did not prevent the relaxant response to FMLP. The release of 6-keto-prostaglandin F1 alpha in the bathing fluid of portal vein and pulmonary artery exposed to FMLP was demonstrated using a radioimmunoassay. FMLP relaxed rabbit vascular strips in a blood-free environment by releasing secondary mediators tentatively identified as prostaglandins; however, a component of the relaxation in the portal vein was not mediated by cyclooxygenase products.

6-Ketoprostaglandin F1 alpha↗
PubMed1987

Effects of low molecular weight fibrin degradation products 6A and 6D on rabbit aorta strips.

Two small molecular weight fibrin degradation product, the pentapeptide 6A and the undecapeptide 6D, produced relaxations of norepinephrine-contracted rabbit aorta strips. The relaxations were slow-developing and were elicited by both peptides at supramicromolar concentrations; the amplitude of relaxations were small for 6D. The relaxations induced by 6A were not dependent on the presence of endothelium and were not modified by a mixture of indomethacin, pyrilamine, and cimetidine. The amplitude of the relaxations produced by 6A and 6D increased as a function of incubation time in vitro. In another experimental system, peptides 6A and 6D failed to increase 6-keto-PGF1 alpha release from cultured human umbilical endothelial cells. Histamine and bradykinin were both active in this system.

6-Ketoprostaglandin F1 alpha↗
PubMed1986

Mitogenic effect of bradykinin and of des-Arg9-bradykinin on cultured fibroblasts.

Bradykinin (BK) and its fragment des-Arg9-BK failed to stimulate thymidine incorporation in all but one observed fibroblast cultures derived from human amniotic fluid or rabbit dermis. The rabbit dermis fibroblast line designated R51 acquired the capacity to increase its DNA synthesis in response to kinins after several weeks in culture. It was more sensitive to des-Arg9-BK than to BK and the effect of both peptides was antagonized by the analog Leu8, des-Arg9-BK; these features are shared with certain smooth muscle preparations responsive to kinins such as the rabbit aorta. Recently isolated rabbit dermis or human amniotic fibroblasts could not be made responsive to kinins by pre-incubating them with bacterial lipopolysaccharide. The line R51 released more PGE2 than baseline when stimulated with BK or des-Arg9-BK at low concentrations; it was also doubling faster than recently isolated cells of similar origin.

Animals↗
PubMed1982

[The usefulness of an exercise test on a treadmill shortly after a myocardial infarction].

A program of reconditioning through walking was prescribed for 130 patients following an exercise test on a treadmill 3 weeks after a myocardial infarction. At 8 and at 12 weeks the patients again underwent an exercise test. The protocol is safe and permits the detection of angina, arrhythmias and dyspnea during the exercise, thus avoiding delays in treatment. The heart rate and the systolic blood pressure were measured at the end of each stage of the test and after 3 minutes of recuperation. About 75% of the patients attained the target energy output of the two submaximal tests (4 and 7 mets at 3 and 8 weeks respectively); an output of 7 mets permits a patient to resume his or her usual daily activities. The results of the tests at 3 and 12 weeks (the latter a maximal test) showed that the probability of an aerobic capacity of 7 mets or greater at 12 weeks is 86% if the 3-week test is completed. Clinical observations alone did not have the same prognostic value 3 weeks after the infarction.

Aged↗