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Biomedical subjects

D Mirouze

Publications and source records attributed to D Mirouze.

At least 19 recordsLinked to original sources
PubMed1989

[Chronic hepatic encephalopathy in cirrhotic patients and spontaneous portacaval anastomosis. Portal angiographic and manometric study].

Portal angiographic and manometric studies were prospectively carried out in 9 cirrhotic patients with spontaneous chronic portal-systemic encephalopathy. Hepatic encephalopathy presented as coma in 8 patients, and was the first manifestation of chronic liver disease in 6 cases. Hemodynamic studies showed a) a large single spontaneous portacaval anastomosis (gastrorenal, splenorenal, gradient (mean +/- SD = 16.3 +/- 5.4 mm Hg); c) a wedge hepatic venous pressure higher than portal pressure in 8 cases (difference: 1-11 mm Hg).

Blood Pressure Determination↗
PubMed1987

[Treatment of acute alcoholic hepatitis with prednisolone. 45 patients].

Whether or not prednisolone (or prednisone) should be used to treat alcoholic hepatitis remains controversial. This new controlled study performed on 45 patients with steatosis, fibrosis or cirrhosis of the liver suggests that prednisolone is not effective: after a 3-month follow-up clinical course, biochemical alterations, anatomical lesions and portal hypertension were the same in patients treated with prednisolone and in those who did not receive that drug.

Acute Disease↗
PubMed1985

[Value of the transjugular venous approach to the liver in the diagnosis of cirrhosis. 333 cases].

The transjugular technique is very useful for the diagnosis of cirrhosis since it makes it possible, in one single exploratory procedure, to perform a needle aspiration biopsy (despite coagulation disorders and ascites) and to measure the porto-caval pressure gradient. In our series cirrhosis was diagnosed by liver biopsy alone in 249 out of 333 patients (77%), and the porto-caval gradient was found to be elevated in 313 patients (97%).

Adult↗
PubMed1985

Percutaneous measurement of portal blood flow in the piglet by continuous thermodilution.

The continuous thermodilution method was applied to the percutaneous measurement of portal blood flow in the piglet by inserting a thermodilution probe into the portal vein via the transhepatic transvenous route. The method was compared to electromagnetic flowmetry in three piglets; the two methods yielded statistically identical results. The coefficient of variation of the continuous thermodilution measurements was 4%. The method allows portal blood flow measurements that are instantaneous, reliable, reproducible, and repetitive. It was applied to a study of rapid flow variations in piglets receiving an infusion of posterior pituitary extract.

Animals↗
PubMed1985

[Sclerosing cholangitis following surgical treatment of hydatid cysts of the liver. Probable role of the formol injection of bile ducts].

Three cases of secondary sclerosing cholangitis which developed during the early postoperative phase of surgical treatment of hydatid liver cysts are reported. The cysts had ruptured into the biliary tree and the treatment consisted of infection of formol into the cysts. Evolution was pejorative since one patient died within 3 months and the remaining two underwent liver transplantation following biliary sclerosis. An experimental protocol using dogs has shown that the injection of 5, 10 and 20 p. 100 formalin into normal bile ducts rapidly causes sclerosing cholangitis which often leads to death. In man, it is very likely that the contact of 2 p. 100 formalin with mucosal tissue damaged by episodes of cholangitis could result in sclerosing cholangitis. These observations should be sufficient to discourage the use of formalin to sterilize hydatid cysts of the liver.

Adolescent↗
PubMed1985

[Urinary prostaglandins in the hepatorenal syndrome of cirrhotic patients: role of thromboxane A2 and an imbalance of precursor polyunsaturated fatty acids].

The hepatorenal syndrome is considered to be a functional renal failure due to active renal vasoconstriction. The purpose of this work was to study the urinary elimination of prostaglandins and the plasmatic polyunsaturated fatty acid precursors of prostaglandins. The urinary elimination of PGE2 was not significantly different in the groups of patients studied: controls, group I (193 +/- 42 ng/24 h), cirrhotic patients without ascites, group II (274 +/- 43 ng/24 h), cirrhotic patients with ascites, group III (269 +/- 41 ng/24 h). The urinary elimination of PGE1 and PGF2 alpha varied in the same way as PGE2. In cirrhotics with hepatorenal syndrome (group IV) the urinary elimination of vasodilating prostaglandins was greatly decreased (p less than 0.001); PGE2 (53 +/- 16 ng/24 h), PGE1 (65 +/- 11 ng/24 h). The urinary elimination of PGF2 alpha was also decreased (293 +/- 75 ng/24 h). On the other hand, the urinary elimination of thromboxane, a vasoconstrictor, increased progressively from group I (287 +/- 75 ng/24 h) to group IV (980 +/- 266 ng/24 h) (p less than 0.05). Plasmatic arachidonic acid was significantly decreased in group IV (5.0 +/- 0.6 p. 100) compared to group I (10.0 +/- 0.6 p. 100) (p less than 0.001), to group II (10.3 +/- 0.5 p. 100) (p less than 0.001), and to group III (8.5 +/- 0.7 p. 100) (p less than 0.05). In conclusion, in hepatorenal patients, urinary excretion of a vasoconstricting prostaglandin (thromboxane) is increased while urinary excretion of vasodilating prostaglandins is decreased. This decrease could be secondary to a lack of plasmatic arachidonic acid, precursor of prostaglandins.

Acute Kidney Injury↗
PubMed1983

[Transparietal biliary drainage. 27 cases].

During a 2-year period, 27 patients with obstructive jaundice (due to cancer in 27) underwent transhepatic biliary drainage with an 85% success rate. Most of the failures occurred in early attempts and were due to lack of experience. In neoplastic obstructive jaundice, endoprosthesis proved superior to external drainage: jaundice regressed more frequently and more completely, the patients' comfort was improved, survival was significantly prolonged and complications were less frequent. Per-operative biliary drainage, used in a controlled trial, proved useless, as patients developed cholangitis.

Adult↗
PubMed1983

[The hepatorenal syndrome].

The hepatorenal syndrome is a renal failure in patients with decompensated cirrhosis. It is characterized by the absence of histological lesions of the kidneys and a poor prognosis. The functional renal failure is due to active cortical vasoconstriction, the mechanism of which is unknown. Blockade of prostaglandins, which are vasoactive substances necessary to maintain a normal renal blood flow, results in a transient hepatorenal syndrome in cirrhotic patients with ascites. Leukotriens, which are vasoconstrictive substances, might play a major causative role. There is, as yet, no specific treatment.

Diagnosis, Differential↗
PubMed1983

[Anemia caused by acanthocytosis in the cirrhotic patient: diagnosis and prognostic significance. 3 cases].

The authors report the cases of 3 patients with severe alcoholic cirrhosis and spur cell anemia. The spur cell anemia must be suspected when there is haemolytic anemia, highly macrocytic with normal serum level of cholesterol and without fatty liver. The cytologic confirmation is difficult even with a phase contrast microscope. The evolution did not exceed 7 and 8 months in 2 cases; the third patient is still alive but quite sick after 1.5 year. These data lead us to point out the difficulty of the diagnosis by routine light microscopy and to remind the poor prognosis after the spur cell anemia is discovered, as documented in the literature.

Acanthocytes↗
PubMed1981

Left pleural effusion in patients with chronic liver disease and ascites. Prospective study of 22 cases.

In a prospective study of 22 cases of left pleural effusion in patients with chronic liver disease and ascites, 16 patients underwent thoracentesis, revealing ten transudates, considered to be hepatic hydrothorax, and six exudates, four of which turned out to be due to tuberculosis. Unilateral left pleural effusion is rare in chronic liver disease with ascites, but if present it is associated with a high incidence of pleuropulmonary tuberculosis (18%).

Adult↗