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Biomedical subjects

D Brunet

Publications and source records attributed to D Brunet.

At least 37 records · Page 2Linked to original sources
PubMed1989

Thrombotic endocarditis and lupus anticoagulant. A pathogenetic possibility for idiopathic 'rheumatic type' valvular heart disease.

Lupus anticoagulant and anti-phospholipid antibodies are well recognized as being associated with thromboembolic disorders in patients both with and without systemic lupus erythematosus (SLE). There have been recent reports of the association of lupus anticoagulant and antiphospholipid antibodies with severe valvular heart disease in patients with SLE and it has been suggested that organizing thrombus on the surface of the valve may be a cause of distortion and subsequent dysfunction. We describe two patients who did not have SLE, but who did have both lupus anticoagulant and antiphospholipid antibodies. Both had severe valvular heart disease, the pathology of which demonstrates valve distortion by layers of organizing thrombus identical to that of previously described patients with SLE. The gross appearance of these valves is similar to that of the valves in "rheumatic" heart disease. We suggest that in some patients with "rheumatic" heart disease, but without a history of rheumatic fever, the prothrombotic tendency associated with lupus anticoagulant and phospholipid antibodies may either contribute to, or be responsible for, the pathogenesis of "rheumatic" type valve deformities.

Adult↗
PubMed1988

The time course of 'process S': comparison of visually scored slow wave sleep and power spectral analysis.

The sleep of 4 groups (N = 8) of young healthy subjects was recorded during naps at either 09.00, 14.00, 19.00 or 24.00 h. For the first hour of sleep, conventionally scored slow wave sleep (SWS) and computed EEG power density (0-25 Hz) were found to increase exponentially as a function of prior wakefulness (range 3-18 h). The equations based on SWS and spectral analysis of the sleep EEG gave values for r' (the growth rate of the function) that were similar to each other (0.038 and 0.039, respectively) and to that reported by Daan et al. (1984; 0.055). These data are consistent with the proposal that process S, 1 of 2 processes believed to regulate sleep and wakefulness, increases exponentially during the waking day (Daan et al. 1984). In addition, they indicate that in this context SWS and spectral analysis provide measures of slow wave activity that are equally sensitive to changes in prior wakefulness.

Adult↗
PubMed1986

Arterial isoflurane concentration and EEG burst suppression during cardiopulmonary bypass.

Isoflurane (1.5 to 3.0 vol% in oxygen) was used to control intraoperative hypertension in 10 patients undergoing hypothermic cardiopulmonary bypass surgery. Isoflurane was administered through the membrane oxygenator of the bypass pump and yielded plateau concentrations in arterial blood ranging from 36.6 to 84.4 micrograms/ml (0.5 and 1.16 vol%, respectively). Isoflurane dosing resulted in prolonged periods (21 to 63 minutes) of EEG burst suppression and isoelectric activity in nine patients. Burst suppression was not a result of hypothermia. There was a close temporal relationship between isoflurane concentration and the onset of burst suppression (mean onset time: 27.3 +/- 4.56 minutes after isoflurane begun). The mean arterial isoflurane concentration at the onset of burst suppression was 46.5 +/- 10.7 micrograms/ml; the nasopharyngeal temperature was 26.0 degrees +/- 0.61 degrees C. Isoflurane was eliminated rapidly from blood with a mean apparent t1/2 of 18.8 +/- 5.46 minutes.

Adult↗
PubMed1986

[Long-term course after palliative surgery in children with a single ventricle].

Single ventricle or univentricular heart is a rare congenital malformation (1/10 000) which has a very poor prognosis. The cases of 68 children with single ventricles who had palliative surgery between January 1964 and December 1982 were studied. The average age of the patients at surgery was 4.41 +/- 5.8 years; 36% of the children were under 1 year of age. Surgery consisted in 48 systemico-pulmonary anastomoses and 20 pulmonary artery bandings. The global mortality was 22% (16% in the anastomosis group and 35% in the banding group). Age seemed to be an important factor: 25% mortality in children under the age of 1; 2.4% in children over 1 year (p less than 0.05). The 15 year survival rate was 43 +/- 23% overall; 56 +/- 28% in children with anastomoses and 20 +/- 28% at 8 years in children with banding. Although surgery did not appear to improve survival it probably did improve survival it probably did improve the quality of life; 73% of the survivors has satisfactory functional results and the efforts of everyday life were well tolerated. However, the evolution was complicated in 10% of cases by infection and neurological complications, and atrioventricular regurgitation was observed in 7 patients, requiring valve replacement in 2 cases. Our results are globally comparable with those of similar previously reported studies. The best published results of physiological correction of single ventricle (Fontan, septation) are relatively unsatisfactory with a mortality rate of about 35%. Therefore, palliative surgery still appears justified in these cases.

Aorta↗
PubMed1984

[Compression of the cervical spinal cord in achondroplasia].

Two cases of tetraparesis due to cervico-occipital spinal cord compression in infants with achondroplasia are reported. Neurological disorders in achondroplasia are produced by structural anomalies of the cranium and spinal canal. They can be divided into two categories: hydrocephalus and radicular and spinal cord compression syndromes. Cervico-occipital compression is more frequent in childhood and may occur very early, in the first months of life. Early diagnosis of this complication and anatomic evaluation can now be obtained by computed tomography, which shows the exact dimensions of the foramen magnum, and myelography. Achondroplasia requires very close neurologic monitoring and, when findings are abnormal, radiologic investigations of the cervico-occipital zone. This allows for early surgical management which is the only means of obtaining significant therapeutic results.

Achondroplasia↗
PubMed1983

Thiopental bolus during carotid endarterectomy-rational drug therapy?

Ten studies were performed to examine the time course of arterial and venous thiopental concentrations following the administration of thiopental (4 mg X kg-1 over 3 min) for cerebral protection during carotid occlusion in nine patients undergoing elective carotid endarterectomy; in five patients the time course of EEG change was also studied. The arterial and venous thiopental concentrations were similar with no evidence of a sustained arterial-venous gradient. The average arterial concentration was 20.1 microgram X ml-1 +/- 10 (SD) at 2 min after thiopental, and fell rapidly to 13.0 micrograms X ml-1 +/- 3.2 at 5 min, 10.7 micrograms X ml-1 +/- 4.4 at 10 min and 6.2 micrograms X ml-1 at 30 min. After thiopental the EEG record showed an increase in delta activity and in four patients a burst suppression pattern was seen. The duration of burst suppression activity was variable (130 to 367 seconds) but in all instances cortical activity had returned to the pre-thiopental level by five to ten minutes. Thus concentrations of thiopental of 10-30 micrograms X ml-1 were associated with EEG burst suppression and both were seen only within the first five minutes after drug administration. In contrast the carotid artery was occluded for considerably longer (26 +/- 4) minutes. We conclude that, since there was no sustained arterial-venous gradient, either arterial or venous concentrations are adequate for the study of thiopental pharmacokinetics.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Psoriatic arthritis: risk factors for patients with psoriasis - a study based on histocompatibility antigen frequencies.

Histocompatibility antigen frequencies were studied in a group of 100 patients with psoriatic arthritis (PSA) and were compared to a group of 80 patients whose psoriasis was restricted to skin lesions (PSC). The antigens B13, BW57 (17), CW6 were significantly increased in PSC while BW57 (17), BW39, CW6 and CW7 were increased in PSA. No DR or MT antigen was elevated in frequency when compared to normal controls. The significant information which results from this study includes: 1) a failure to confirm previous reports on HLA-DR antigen increased frequencies; 2) an association, in this population, of BW39 with PSA and not BW38; 3) finding of a closer link of PSC and PSA with HLA-C rather than HLA-B antigens; 4) an estimate of relative risk for patients with PSC to develop PSA.

Adolescent↗
PubMed1980

[Effects of medullary pyramidal stimulation on myocardial contractility in anesthetized dogs].

In anaesthetized dogs, medullary pyramid stimulation produces a decrease of myocardial contractility. The peak of the first derivative of the left ventricular pressure (dP/dt max) was used to assess myocardial contractility; this index is independent of afterload. Medullary pyramid stimulation produces a decrease of dP/dt max and of the maximal left ventricular pressure (L.V.P. max) also, after bilateral vagotomy. But the same stimulation induces only a decrease of L.V.P. max after inhibiting beta-adrenergic efferences and bilateral vagotomy. Just as corticopyramidal fibres inhibiting alpha-adrenergic vascular tone, one does consider the existence of corticopyramidal fibres inhibiting beta-adrenergic efferences to myocardium.

Animals↗
PubMed1980

[Azygography in pre-operative investigation of cancer of the esophagus : a report on 24 cases (author's transl)].

The value of azygography for detecting extension of cancer of the middle third of the esophagus was assessed in 24 patients. The examination was conducted using the retrograde approach, and results were compared with those obtained by the esophagogram and on tracheobronchial fibroscopy. Compression of the azygos vein is a good indicator of the size of the tumor, which can also be evaluated from esophageal transit examinations. The vein can be invaded or even thrombosed due to severe regional spread but this does not mean that excision of the tumor is impossible. The results of azygography alone, therefore, are not a valid reason for contra-indicating esophagectomy. In case of doubt, tracheobronchial fibroscopy appears to be more suitable for deciding whether the tumor is operable, but azygography can assist in making this decision.

Azygos Vein↗