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Biomedical subjects

C Mercier

Publications and source records attributed to C Mercier.

At least 19 recordsLinked to original sources
PubMed1992

Fibromuscular disease of the renal artery: a new histopathologic classification.

To evaluate the relationship between clinical, radiologic, and histopathologic features in various types of renal artery fibromuscular disease, the records of 37 patients operated upon for a total of 44 lesions of the renal artery (30 unilateral and seven bilateral) were retrospectively reviewed. Of these, 36 had hypertension associated with stenosis or aneurysm of the trunk or branches of the renal artery; one had aneurysm of the renal artery without hypertension. The histopathologic study included 38 arterial segments retrieved from 33 patients and underscored the difficulties in using topographic criteria to classify lesions. While all arterial aneurysms were associated with involvement of the media, more than one layer of the artery was involved in 65.7% of cases. Topographic forms, such as the perimedial type, were difficult to classify. Based on the study results, it appears essential to distinguish patients with fibrosis and smooth muscular hyperplasia (type I: 19 patients, 23 arteries) from patients with isolated fibrosis (type II: 14 patients, 15 arteries). In group II, preoperative hypertension was more long-standing (p less than 0.04), more lesions were extended distally (p less than 0.05), and the probability of recovery from hypertension at 52 months follow-up was lower. We have distinguished two different evolutive stages of fibromuscular disease of the renal artery, one characterized by fibrosis with smooth muscle hyperplasia and the second, associated with more severe prognosis, characterized by isolated fibrosis.

Anastomosis, Surgical↗
PubMed1992

Amino acid sequence requirements for the epitope recognized by a monoclonal antibody reacting with the secreted antigen GP28.5 of Toxoplasma gondii.

We have characterized in detail, the epitope of the secreted antigen GP28.5 recognized by the mouse monoclonal antibody TG 17-179 using synthetic peptides and a truncated recombinant fusion protein. The screening of a T. gondii expression library with TG17-179 mAb led to the isolation of cDNAs clones, all encoding for the C-terminal region of GP28.5 and with one encoding for only the five last C-terminal residues. Competitive ELISA with longer peptides revealed that the immunoreactivity was retained for peptides of eight residues or longer, and lost when the peptide was reduced to the six last C-terminal residues or less. Experiments with the octapeptide lacking the carboxy-terminal glutamine residue showed it to be 64-fold less active. Moreover, neither addition of residues in the carboxy-end nor substitution of COOH function changed the immunoreactivity of the epitope. Competition experiments between TG17-179 mAb and sera from infected individuals demonstrates that the epitope defined by a mouse monoclonal probe is also a major epitope for human polyclonal antibodies. These results describe the sequence requirements within a probably linear epitope and give rise to some general question concerning experimental test for epitope mapping.

Amino Acid Sequence↗
PubMed1992

[Postoperative re-expansion causing unilateral pulmonary edema].

A case of re-expansion pulmonary oedema is reported. A 7-year-old girl, after having been operated on for a lung tumour, had a postoperative haemothorax combined with atelectasis of the left upper lobe. After she had recovered from the first dose of chemotherapy, the thoracotomy wound was reopened to remove the partially organised and lysed haemothorax, as well as the very thickened pleura. The patient developed clinical signs of pulmonary oedema very shortly after the end of the anaesthetic (tachypnoea, cyanosis, a decrease in oxygen saturation when FIO2 < 1, pink frothy secretions in the endotracheal tube). End-inspiratory crepitations became audible in the left lung field only. The chest film showed left-sided diffuse nodular alveolar opacities. The girl was again ventilated, with + 5 cmH2O positive end-expiratory pressure. She was extubated 36 h later, and discharged a few days later without any sequela. This case was the first to be described in a child after pleural surgery. The death rate, estimated from a literature survey, is about 20%.

Child↗
PubMed1992

[Community services and quality of life: a study of the impact in a remote region].

This longitudinal study with a matched comparison group was conducted in Abitibi, an area in North-West Quebec. Its goal was to observe the impact of community support services on the quality of life of long term psychiatric patients living in a remote area. A cohort of 47 subjects, living in a small town with a comprehensive network of community support services, was compared with a similar group living in a neighbouring city with only outpatient services. The satisfaction with life domains scale developed by Andrews and Withey and adapted by Baker and Intagliata was used at four times during the study. According to the results, the subjective perception of the quality of life in the two groups is comparable, even though the objective conditions are less favorable for the group participating in the community support program. The highest ratings were given to the place of residence, the neighborhood and its commodities; the lowest ratings were given to their love life and financial situation. One can observe a stability of the measures of quality of life over time and for the two groups. The perceptions of the sample living in a remote area are much more favorable than the ones of a comparable group living in the Montreal area. These results are discussed in a double perspective: the role of community support services in the daily life of people who are having severe and persistent problems of mental health, and the interest of measures of quality of life.

Adult↗
PubMed1992

Profiles of alcoholics according to the SCL-90-R: a confirmative study.

The Symptom Checklist-90-Revised (SCL-90-R) has often been used in studies of alcoholic populations. Based on findings reported in the literature and data gathered on 712 alcoholics in treatment, this paper investigates the general trends in the responses of alcoholics to the SCL-90-R. On global measures as well as on each of the symptom scales, the scores of alcoholic groups reveal a symptomatology two to five times as severe as that observed in the general population. The Psychoticism dimension shows the most marked divergence with the general population. In almost each of the study groups, the Depression Scale registers the highest scores, followed by Obsessive-Compulsive, Interpersonal Sensitivity, and Anxiety.

Adult↗
PubMed1992

Intramedullary epidermoid cysts of the spinal cord. Case report.

Epidermoid cysts are tumors familiar to neurosurgeons, but intramedullary epidermoid cysts are rare. The authors report the case of a 6-year-old girl presenting with progressive paraparesis. A midthoracic intramedullary mass was revealed on myelography and magnetic resonance (MR) imaging and confirmed as an intramedullary epidermoid cyst at surgery, at which time the cyst was removed. This is the fourth report documenting a purely intramedullary epidermoid cyst occurring in a child. The pathology and etiology, epidemiology, clinical features, radiology (including MR image characteristics), and surgical treatment of such rare intramedullary benign tumors are discussed. Magnetic resonance imaging reduces the delay in diagnosis of spinal cord tumors but should be guided by clinical judgment.

Child↗
PubMed1992

[Inhibitors of angiotensin-converting enzyme and processus of intima proliferation in atherosclerosis].

The renin angiotensin system is a negative feed-back system of blood pressure control. A number of concordant experimental and clinical results indicate that the angiotensin family has a trophic effect on the vessel wall. These properties of the angiotensins favorise the proliferation of the cells which make up the vessel wall and also amplify the vascular dysfunction in the absence of the inhibitory regulations. Angiotensin converting enzyme inhibitors could be a valuable therapeutic method of counteracting these deleterious effects on the composition and function of the vessel wall.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1992

[Allografts of cryo-preserved and radio-sterilized spongy bone tissue. Their use in orthognathic surgery].

In some circumstances, the orthognathic surgery creates inter-fragmentary spaces which have to be filled to ensure that the osteotomized segments are wedged and consolidated, and to avoid the appearance of unsightly subcutaneous contours. The authors report the results obtained through the use of cryo-preserved radio-sterilized cancellous bone allografts, coming from femoral heads, used as fillers, in diverse types of osteotomy. Thus, 19 centers of osteotomy have been filled. Follow-up periods ranged from 5 to 20 months. In 8 cases, evidence was made through radiology of the blending of the grafts. The stability of the correction was constantly noticed as well as the perfectly harmonious facial contours, which testifies the osteogenic qualities of this material. No sepsis was observed. It is a quantitatively available material, of easy shaping, the use of which does not lead to a lengthening of the operation, nor to the creation of cutaneous scars. The risk of viral transmission through allografts, specially H.I.V. and hepatitis non A - non B - non C virus is nil due to the radiosterilization.

Adolescent↗
PubMed1991

Human gliomas and epileptic foci express high levels of a mRNA related to rat testicular sulfated glycoprotein 2, a purported marker of cell death.

Clone pTB16 has been isolated by differential screening of a human glioma cDNA library. Northern blot analysis has shown that pTB16 expression is several times (greater than 11-fold) higher in gliomas than in a primitive neuroectodermal tumor. This observation was supported by in situ hybridization and extended to nine other gliomas. Expression was virtually absent in adenocarcinoma cells metastasized to brain. Malignant gliomas showed stronger hybridization than benign gliomas, while blood capillaries did not show hybridization. pTB16 mRNA was also shown to be expressed in established glioma cell lines and at high levels in epileptic foci, indicating that expression of the gene may be limited to certain cell types and that its upregulation is not merely a consequence of cellular proliferation. Nucleotide sequence analysis identified pTB16 as the human counterpart for rat testicular sulfated glycoprotein 2 (SGP-2), whose function in the reproductive system remains unknown. Although SGP-2 transcripts, and hence pTB16, were recently shown to be increased in neurodegenerative diseases such as scrapie in hamsters and Alzheimer disease in humans, our observations with brain tumors and epilepsy are suggestive of a role for pTB16 in neuropathologies in general and support the hypothesis of its involvement in tissue remodeling and cell death.

Blotting, Northern↗
PubMed1991

Unfading acral microlivedo. A discrete marker of thrombotic skin disease associated with antiphospholipid antibody syndrome.

Small erythematous or cyanotic lesions on the hands and feet of four patients with antiphospholipid antibodies are described. These discrete lesions outline capillaries and do not disappear when pressure is applied. The histologic features are identical to those described in skin thrombotic syndrome associated with antiphospholipid antibodies, that is, microthrombi in dermal vessels without inflammation. In addition to indicating antiphospholipid antibodies in apparently healthy patients, this sign could be a marker of risk for large-vessel thrombosis.

Adult↗
PubMed1991

Coordinating community and public-institutional mental health services: some unintended consequences.

Where a target group such as the mentally ill tend to use multiple and varied services over a long period of time, service coordination is often seen as the key to continuity of care. This article argues that coordination also has its perverse effects. To demonstrate, two types of community organizations (COs) working in mental health in the Canadian province of Québec are examined: alternative COs, which have their roots in community action and maintain few formal links with each other or with institutional resources; and transitional structures, COs which are developed with the cooperation of psychiatric professionals, are closely linked to hospitals and are often part of a tightly coordinated system of community services. With respect to access, continuity, programs, internal structure and flexibility, each type of community resource has particular strengths and weaknesses. In the first part of the article, these are described and compared. In the second part of the article, we examine the possible effects of Québec's new mental health policy on COs working in mental health. The policy seeks to create comprehensive systems coordinating all services at the regional level-including alternative organizations, transitional structures and public institutions. The imperatives of the complex planning process risk diluting or even eradicating the differences between the two types of mental health COs described earlier. The process may thus rob certain service users of the particular advantages they found in alternative COs. For those mentally ill who, by choice or by chance, remain marginal to the coordinated system, there may ultimately be no resources available at all.

Community Mental Health Services↗
PubMed1991

Modeling alcohol metabolism with the DARC/CALPHI system.

We present our general system for QSAR search, CALPHI (Computer-Aided Law by Hyperstructure Investigation) set up in the context of the DARC structural language. We use it to construct global, fragmentary, and topological models of the capacity of alcohols to undergo glucuronidation. The DARC/PELCO model, more precisely and more significantly, explains 98% of the total variance with only three parameters, while treating the whole set of primary, secondary, and tertiary alcohols, whereas the best previously reported treatment restricted to primary alcohols, explains only 90% of the variance with two parameters. It provides an explicit and more precise interpretation of alcohol metabolism. The PELCO methodology is extended to evaluate the prediction reliability of both global and fragmentary models. PELCO leads to more predictions when comparison is made at the same level of reliability.

Alcohols↗
PubMed1991

[Crisis centers and mental health services: the experiences in south west Montreal].

Based on data collected during the assessment phase of setting up the crisis centre L'Autre Maison, this article aims to present the services offered by the centre and to examine its integration with other resources within the community. Secondly, the article proceeds with a detailed analysis of the nature of crises that motivated clients to resort to the centre, which allows the authors to confirm the essentially social nature of these crises. Following a presentation of the results, the authors enter a broader discussion on: 1) the training received by personnel that works in the area of crisis intervention; 2) the organization of mental health services; and 3) the prevention programs focused on avoiding the oncoming of a crisis.

Adolescent↗
PubMed1990

Occlusive disease of the renal arteries and chronic renal failure: the limits of reconstructive surgery.

In order to investigate the value of renal revascularization in patients with chronic renal failure and associated occlusive lesions of the renal arteries, the long-term results of 48 revascularizations in 43 patients operated upon between January 1980 and May 1988 were analyzed. There were 36 men and 7 women whose mean age was 61.8 years (range 36 to 79 years). The diagnosis of kidney failure was based on serum creatinine levels greater than 120 micromoles/L on two consecutive determinations. Patients were divided into four groups: Group I (23 patients) had a creatininemia between 120 and 200 mumoles/L, Group II (16 patients) between 200 and 350 mumoles/L, Group III (2 patients) between 350 and 800 mumoles/L and Group IV (2 patients) who had chronic renal failure requiring hemodialysis. Hypertension was found in 37 patients. Renal artery restoration was unilateral in 38 patients, 12 of whom had a solitary kidney. Restoration was bilateral in five patients. In 24 patients, renal artery surgery was associated with reconstruction of the infrarenal aorta. Three patients undergoing associated aortic procedures (7%) died after surgery. Thirty-nine patients were followed for a mean of 35.1 months; one patient was lost to follow-up. Improvement or stabilization of renal function was noted in 24 patients (62%). Deterioration was found in 15 patients (38%), six of whom presently required chronic hemodialysis. In Groups I and II, 69.5% of patients stabilized or improved their kidney function. Renal function worsened in all patients in Groups III and IV. We conclude that restorative renal surgery can improve renal function in patients whose preoperative serum creatinine levels are less than 350 mumoles/L. In this population of patients, associated aortic restoration should be performed only when absolutely necessary.

Adult↗
PubMed1990

Effects of electrical stimulation on the activity of hexokinase in the medial gastrocnemius muscle of aged rats after hindlimb suspension.

1. The activity of the enzyme Hexokinase (E.C. 2.7.1.1.) has been measured after a 21 day period of hindlimb suspension and a 14 day period of recovery with or without electrical stimulation in the old rat Medial Gastrocnemius muscle divided in its white and red parts. 2. After suspension, the activity of the enzyme increased in both parts of the muscle and returned near its control value more rapidly in the red part of the muscle when electrical stimulation was applied.

Adaptation, Physiological↗
PubMed1990

[Organ procurement in pediatrics. General and ethic aspects].

The progress in organ transplantation is leading an increase in the demand for organs. Any non-harvested organs from a dead child mean at least a delay or even the loss of hope for life. All brain dead children do not undergo organ harvesting because there are still obstacles. The definition of brain death must be clear and include the destruction of all the brain system. Intensive care units must be motivated by improved contacts with transplantation teams. The number of parents who refuse could decrease with better public information, good contacts with medical teams and the quality of discussion with parents when a child dies. Energy should be concentrated on improving the collective consciousness about this new aspect of medicine.

Attitude↗
PubMed1990

[Application of ultrasono-micrometric technic to study vasomotility].

An experimental model of simultaneous recording of pressure and flow (instantaneous and mean values) and of the vascular diameter (by ultrasonomicrometry) at the entry of a clearly limited territory of the systemic circulation has been developed in the animal together with a programme of data aquisition and analysis. This programme allows quantification of the different viscoelastic properties of the vessel wall which characterise arterial flow in the arteries of distribution (capacitance vessels) and irrigation (resistance vessels). The model was applied to the study of the pharmacological effects of two antianginal agents, a nitrate derivative (ND) administered acutely by slow intravenous infusion at a dose of 25 micrograms/Kg/mn over 20 minutes (total dose: 500 micrograms/Kg) and a substitute sydronimous substance (SYD) administered in the same manner at a dose of 15 g/Kg/mn over 20 minutes (total dose: 300 micrograms/Kg). The hypotensive effects obtained were comparable and significant (p less than 0.001) in both cases. The ND led to a fall in mean blood pressure of 9.7 +/- 1.3% and SYD of 10.0 +/- 2.1%. However, SYD led to an increase in aortic blood flow (11.7 +/- 3.6%, p less than 0.01) whilst the ND had no significant effect on this parameter (+ 6.07 +/- 5.7%). As a result, there was a much greater decrease of peripheral resistances after administration of SYD (-22.8 +/- 3.1%) than with the ND (-12.7 +/- 4.2%). This difference was also observed when the input impedence of the vascular bed was studied (-31.2 +/- 6.9% after SYD and -12.0 +/- 2.5% after the ND).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗