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Biomedical subjects

D Mole

Publications and source records attributed to D Mole.

17 recordsLinked to original sources
PubMed1998

Near-infrared spectroscopy in the assessment of cerebral oxygenation at high altitude.

Hypoxia plays a key role in the pathogenesis of acute mountain sickness (AMS), but individual susceptibility is variable and cerebral symptoms do not always correlate with PaO2 measurements. Cerebral hypoxia may be more relevant than PaO2. We studied trends in cerebral regional oxygen saturation by the technique of near-infrared spectroscopy in 20 subjects ascending rapidly to 4680 m. Subjects were enrolled in a placebo-controlled, double-blind trial of medroxyprogesterone for the prevention of AMS. The fall in cerebral oxygen saturation was less than in the periphery. At 4680 m, cerebral oxygenation correlated with peripheral saturation but not with PaCO2 or with cerebral symptoms scores. At 4680 m, subjects on medroxyprogesterone had higher cerebral and peripheral saturation compared with those on a placebo. We conclude that cerebral oxygenation monitored with the Critikon 2020 system provided important information on the complex relationship of hypoxia to AMS and that other factors, such as changes in blood flow or capillary permeability, may be equally important.

Adult↗
PubMed1993

The development of a strategy for the implementation of automation in a bioanalytical laboratory.

Laboratory automation is equipment, instrumentation, software and techniques that are classified into four groups: instrument automation; communications; data to information conversion; and information management. This new definition is necessary to understand the role that automation can play in achieving the aims and objectives of a laboratory within its organization. To undertake automation projects effectively, a laboratory automation strategy is outlined which requires an intimate knowledge of an organization and the target environment to implement individual automation projects.

Automation↗
PubMed1993

Direct coronal view of the shoulder with arthrographic CT.

Direct coronal oblique views of the shoulder were obtained with arthrographic computed tomography (CT) in 35 shoulders with surgical correlation. There were 18 complete cuff tears, four partial ones, two type 3 superior labral, anterior, and posterior (SLAP) lesions, and one type 4 SLAP lesion. The coronal sections were obtained after double-contrast shoulder arthrography and axial CT sections had already been obtained. The patient was seated directly on the slope of the gantry, and the shoulder to be studied was positioned in the center of the gantry. The maximal time needed for this procedure was 5 minutes. Rotator cuff tears were detected with a sensitivity of 95% and a specificity of 100%. The size of the tears as determined on the coronal sections was strongly correlated with surgical measurement (r = .939). All SLAP lesions were detected. The authors' experience shows that obtaining coronal oblique sections is an effective way to improve arthrographic CT.

Adolescent↗
PubMed1993

[Results of endoscopic treatment of tendinopathies of the rotator cuff (excluding total ruptures). 1: Non-calcifying tendinopathies].

The authors have studied the result of endoscopic treatment in 129 non ruptured and non calcified tendinitis of the rotator cuff as well as 33 partial thickness tears included in a multicentric study made by the french arthroscopic society. The files included a revision form using Constant's functional evaluation and filled by a physician different from the operator, and a radiological standardized evaluation allowing to appreciate, from A.P. and lateral views, the acromion shape and the importance of the resection. From the analysis of our results it appears that acromioplasty associated with a section of the coraco-acromial ligament (C.A.L.) under arthroscopic control is very efficient in tears of the superficial, bursal face of the rotator cuff. The same did not apply to the tears of the deep, articular face, as their origin is probably different. In non ruptured and non calcified tendinitis, 90 per cent of our patients were subjectively better. According to Constant's index, we noticed 75 per cent of satisfactory results. The importance of acromioplasty was not related to good results. We therefore think that one should relativise the notion of impingement between the coraco-acromial arch and the tendons of the rotator cuff. Acromioplasty is only effective on one of the factors of tendinous pain. The improvement of our indication by a better knowledge of this pathology should allow us to improve the results of an endoscopic procedure which is now well known and whose advantages do not need to be demonstrated any more.

Activities of Daily Living↗
PubMed1987

[Technical development and radiological surveillance of the Schmitt minimadreporic uncemented total hip prosthesis. Evaluation of 275 arthroplasties with a follow-up of more than 6 years for the oldest cases].

The authors describe a porous-coated uncemented total hip prosthesis which has been used for more than six years: the Schmitt minimadreporic prosthesis. A homogenous series of 275 arthroplasties has been reviewed with a mean follow-up of three years and five months. The method of radiological assessment of the position of the femoral and acetabular components and their possible loosening is described in detail. Infection (0.72%) and aseptic loosening (1.8%) specific to this type of prosthesis was rare. For the series as a whole there were 92% of good, very good and excellent results and for 81 arthroplasties with a follow-up greater than four years the figure was 90%. The frequency of secondary displacement of the femoral component is emphasised, with 15 prostheses sinking downwards and 96 displacing into varus. Statistical analysis has shown the principal factors affecting the clinical result and has demonstrated the effect of resorption of the calcar in causing downward displacement of the femoral stem and insufficient filling of the medullary cavity on the development of varus angulation of the prosthesis.

Bacterial Infections↗
PubMed1987

[The articular cartilage of the patella in scanning electron microscopy].

The authors have studied 50 samples of patellar cartilage, normal and pathological, obtained by biopsy, using a scanning electron-microscope. The normal cartilage shows characteristic regular wave-like undulations. The size of these waves varied between 5,000 and 7,000 nm and the undulations were linked by regularly-spaced fibrillary bridges. In a case with an osteochondral fracture, the fracture site was covered by peripheral cartilage, as had previously been shown by Ghadially. Eighteen cases of patellar chondropathy were divisible into three groups: group I (four cases) showed fibrillary chondropathy, of cerebriform appearance and without fibres. Group II (12 cases) showed a fibrillary chondropathy with loss of geometrical regularity and a staghorn appearance. Group III (two cases) showed an oedematous chondropathy with destruction of fibres. In group II, the presence of bundles of fibres with microfractures indicates a potential for progress to frank arthrosis.

Adolescent↗
PubMed1985

[Determination of the spatial orientation of screwed acetabular rings].

The authors use a type of total hip prosthesis with a screwed acetabular component. They have established a method of radiological assessment of the anteversion of this component by studying the radiological appearances of the threads of the screws in the acetabular component which have either a sharp or smooth appearance, according to its orientation.

Acetabulum↗
PubMedDate not supplied

Descending aortic dissection post coarctation repair in a patient with Turner's syndrome.

Dissection of the descending aorta post coarctation repair in a patient with Turner's syndrome has rarely been described. A 45-year-old woman with Turner's syndrome had repair of coarctation by resection and interposition graft. Her postoperative course was uneventful. Chest X-ray two months postoperatively showed a hematoma in the proximal descending aorta, and a CT scan confirmed dissection distal to the coarctation repair, which was treated medically. Subsequent CT scanning one year later showed the hematoma resolving with no increase in the diameter of the dissected segment.

Aortic Dissection↗
PubMedDate not supplied

A multicenter study of 210 rotator cuff tears treated by arthroscopic acromioplasty.

We followed 210 cases of rotator cuff tears treated in four French centers by arthroscopic acromioplasty in 195 cases and by a tenotomy of the Long Head of Biceps (LHB) in 15 cases. All patients were evaluated by means of the Constant score (CS) and radiographic imaging. The mean age was 61 years and the mean follow-up period was 26.6 months (range, 12 to 93 months). The preoperative CS was 38.2 points; 41% were supraspinatus tears, 40.2% were supra and infraspinatus tears, 10.5% were three-tendon tears, and 8.1% were supraspinatus and subscapularis tears. The LHB was altered or disrupted in 77% of cases, dislocated or subluxated in 44% of cases. Acromioplasty was associated to tear debridement in 183 cases (88%) and to a tenotomy of the LHB in 38 cases (19%) of which 15 did not benefit from an associated acromioplasty. Global objective results shown by the corrected CS reached 79.7% and were satisfying in 73% of cases. Poor clinical factors were preoperative shoulder stiffness, postoperative painful crises, worker compensation, a preoperative history longer than 4 years, and young age. The poor anatomic factors were osteoarthritis, a lesion of the acromioclavicular joint or of the LHB tendon. An isolated supraspinatus tear will produce much better results than a triple-tendon tear. The persistence of an aggressive acromion was a prejudicial factor. The benefits of LHB tenotomy were evident and could be isolated in case of massive rotator tears. It seems that LHB tenotomy was particularly effective for massive tears of two or more tendons. Arthroscopic acromioplasty is an excellent indication for elderly patients without professional activity, functionally less demanding that a younger patient.

Acromion↗