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Biomedical subjects

C Pelletier

Publications and source records attributed to C Pelletier.

71 records · Page 4Linked to original sources
PubMed1979

[Early and late outcome after aortocoronary bypass: experience in 500 cases].

Between 1971 and 1976, 500 patients underwent aortocoronary bypass surgery. There were 15 operative deaths (3%) and the total frequency of perioperative infarction was 7%. The operative mortality was 7.4% in unstable angina, as compared with 1.1% in stable angina (P less than 0.01). The proportion of grafts patent at 2 weeks was 92% and at 18 months 87.6%. Postoperative follow-up was complete for 99% of the patients. There were 15 late deaths (3%) and the rates of survival at 2 and 4 years were 94.4% and 92.1% respectively. The actuarial curve of survival after surgery was not significantly different from that of the general population. After a mean follow-up of 27 months 73% of the patients were completely free of angina and 19% were markedly improved. The rate of recurrence of angina averaged 10% per year and the annual infarction rate was 0.7%. Fourteen patients (3%) underwent reoperation during the follow-up period. Thus, coronary revascularization surgery offers effective and sustained relief of incapacitating angina and might also improve survival if the operative mortality is low.

Adult↗
PubMed1979

[Propionic acidemia and sodium dipropylacetate].

After administering sodium dipropylacetate to normal rats and biotin-deficient rats, we observed a slight hyperglycinemia, significant constant hyperglycinuria, but no accumulation of propionic acid in the blood or significant urinary elimination. Hepatic propionyl-CoA carboxylase activity, in vivo and in vitro, did not change, neither did sodium dipropylacetate inhibit propionyl-CoA carboxylase nor induce propionic acidemia resulting from a deficiency in this enzyme.

Acyl Coenzyme A↗
PubMed1979

Vagal inhibitory effects on peripheral circulation in acute coronary occlusion.

The reflex adjustments of the peripheral circulation in response to acute coronary occlusion were studied in anesthetized dogs with isolated vascular beds perfused at constant flow. Coronary occlusion caused significant increases in perfusion pressure which averaged 27 +/- 4 mmHg in the hindlimb, 19 +/- 8 mmHg in skeletal muscle, and 13 + 5 mmHg in the mesenteric artery. These responses were less than half those caused by a similar decrease in aortic pressure obtained with hemorrhage. Coronary occlusion caused no significant changes in renal and paw circulations, while marked vasoconstriction resulted from hemorrhage. When aortic pressure was maintained constant throughout the duration of coronary occlusion, there was a significant vasodilatation in all beds studied. After vagotomy, coronary occlusion caused a constrictor response similar in magnitude to that caused by hemorrhage in each vascular bed and the dilator responses to occlusion at constant aortic pressure were abolished. Both constrictor and dilator changes were prevented by alpha-adrenergic blockade. Mechanical distension of the left ventricle in four dogs with carotid sinus nerves cut caused a significant reflexdilatation in the hindlimb. Thus, coronary occlusion initiates an inhibitory reflex mediated by vagal afferents which opposes peripheral vasoconstriction most effectively in the renal and paw circulations.

Abdomen↗
PubMed1979

Cardiac output measurement by thermodilution.

The accuracy of thermodilution for measuring cardiac output was studied by comparing this method with measurements obtained by an electromagnetic flowmeter in the dog. Thermal curves were computed by a cardiac output computer and absolute flows were obtained by pump calibration of the flowmeter. Regression analysis showed an excellent correlation (P less than 0.001) between thermodilution measurements with injectates at 0 degrees C and flowmeter measurements using either cannulating probes (n = 105, r = 0.98) or periaortic probes (n = 100, r = 0.96). With the use of normal room temperature injectates, a good correlation was also found with absolute flows (n = 75, r = 0.92, P less than 0.001). Thermodilution overestimated cardiac output by 3% to 9%. In 32 pairs of successive cardiac output determinations by thermodilution, there was no significant difference between the two measurements (P greater than 0.05). In eight patients cardiac output was measured postoperatively by thermodilution with injectates at 0 degrees C and 24 degrees C administered in rapid succession. Regression analysis of 50 pairs of measurements at the two temperatures showed a strong correlation between the two techniques (r = 0.96) and the two results were not significantly different (P = 0.00001).

Animals↗
PubMed1977

A radioimmunoassay for serum ferritin.

We describe the development and evaluation of a serum ferritin radioimmunoassay, in which 125l-labeled ferritin and rabbit anti-ferritin antibody are used. Goat anti-rabbit gamma-globulin antibody, together with polyethylene glycol, is used as the separating reagent. The assay has a working range up to 500 mug of ferritin per litre, and a sample requirement of 75 mul of serum for assay at two dilutions. The assay requires 24 h. it has a sensitivity of 1.5 mug of ferritin per litre and a long-term precision (CV) of 13%. Reference intervals for a population of men were 18-330 mug/litre, with no marked age dependence, while those for a population of women older than 50 years were 18-200 mug/litre. Many apparently healthy women in the 20-50 year age group have much lower concentrations. Serum ferritin concentrations of less than 18 mug/litre are indicative of iron deficiency, defined as the absence of stainable iron in an aspirate of bone marrow.

Adult↗
PubMed1977

Left atrial thrombosis complicating mitral stenosis: results of surgical treatment.

In 343 patients treated surgically for mitral valve disease, there was thrombosis of the left atrium in 40. Massive atrial thrombosis was present in 32 of them, yet the diagnosis was suspected or established preoperatively in only 12, because of insufficient clinical signs. A transventricular mitral commissurotomy was performed in 32 patients and mitral valve replacement in the remaining 8. Surgical mortality was 23% in the patients with atrial thrombosis compared with 7% in the trombus-free patients: 66% of the deaths were due to cerebral embolism. Systemic embolism occurred in 17% of the patients who had a closed approach initially and in 27% following a planned open procedure. Among the survivors, 65% were asymptomatic or markedly improved; the average follow-up was 42 months. Atrial thrombosis increases the surgical risk because of the high incidence of operative embolism, a complication that is not avoided by the use of open procedures, but that could be prevented by earlier surgical treatment of mitral stenosis, before atrial thrombi develop.

Adult↗
PubMed1976

[An unusual case of hydatid cyst].

A hydatid cyst of the spleen developed in a Greek-Canadian woman who had lived on a sheep farm. The cyst extended through the diaphragm to the left lower lobe. Splenectomy and left lower lobectomy and excision of contiguous diaphragm were performed. Histopathologic examination confirmed the presence of hydatid cysts in both spleen and lung. Postoperative course was uneventful. In Canada hydatid disease is rare and its occurrence sporadic. It is commoner among Canadian Indians and immigrants than native Canadians. Treatment is surgical; en bloc excision of tissue eliminates the possibility of anaphylaxis of dissemimination of scolices.

Echinococcosis↗
PubMedDate not supplied

Seventy-six month experience with the Omniscience cardiac valve.

Between August 1978 and September 1984, 440 patients were implanted with the Omniscience cardiac valve at three North American medical centers (210 aortic, AVR; 165 mitral, MVR; and 65 double valve replacements). Total follow-up was 1056 patient years; survivors were followed up to 76 months (mean 32), with 99% accountability. One hundred and eighty-six (42%) also underwent prior or concomitant major cardiac surgical procedures. Mean age was 56 +/- 12 years. Preoperatively, 3% were in New York Heart Association (NYHA) Class I, 18% II, 54% III, 26% IV. The 5 1/2 year actuarial survival rate for death from valve-related causes (thromboembolism, valve thrombosis, perivalvular leak) was 97% overall. The 5 1/2 year actuarial survival rate from all death causes was 78%. The complication rates, expressed as %/patient-year (endocarditis 0.7; anticoagulant-related hemorrhage 1.0; perivalvular leak 1.5; pannus/tissue overgrowth 0.6; and transient ischemic episode 1.2) demonstrate that advanced age at implant and additional major cardiac surgical procedures do not affect occurrence. Actuarial freedom from thrombotic complications (thromboembolism with residual deficit and valve thrombosis) at 5 1/2 years was 95% overall. Postoperatively, of 348 patients with known NYHA, 65% were in NYHA I, 28% II, 5% III, and 2% IV.

Adolescent↗