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Biomedical subjects

E Lemaire

Publications and source records attributed to E Lemaire.

13 recordsLinked to original sources

Transilluminated powered phlebectomy. Mid-term clinical experience.

AIM: Transilluminated powered phlebectomy (TIPP) was first described in 1996 by Sptiz et al. and was designed to allow minimally invasive surgical treatment of varicose veins (VV). We report our updated experience with TIPP technique. METHODS: Between January 2001 and February 2004, 84 patients underwent treatment by TIPP technique for primary symptomatic VV. Saphenofemoral junction with complete stripping of the great saphenous vein was performed in all patients. Incompetent perforating veins was ligated and prominent VV were ablated with TIPP technique. RESULTS: Mean age of patients was 50.6 years (range 29-79 years) and most of patients were women (73%). The major varicose vein risk factors were standing position and parity. Heaviness (62%), pain (57%) and unsightly veins (30%) were the most common indications for surgery. The mean number of surgical incisions was 6 (range 3-10), the average operative time was 59 min (range 30-100 min) and the mean cosmetic score (out of 10) at 6 weeks was 8 (range 2-10). The mean pain score (out of 10) was at 2 days, 7 days and 6 weeks was 5, 3 and 0, respectively. All the complications were documented. CONCLUSIONS: The TIPP technique is safe without any adverse events, presents advantages and inconvenient which are discussed in this paper.

Adult↗

Cohesion induced by a rotating magnetic field in a granular material.

We report experiments on a magnetic cohesive granular material made of steel spheres in the millimeter range. A magnetic field magnetizes the spheres, so that an interaction force between grains appears. A rotating magnetic field is applied parallel to plane of the quasi-two-dimensional cell containing the spheres so that only the time averaged force between two particles will be considered. Both maximum angle of stability and angles of repose are measured. The maximum angle of stability is found to depend linearly on the interaction force. Another noticeable feature is the lack of dependence of the maximum angle of stability on the initial height of the heap. We show that the angle of repose is less sensitive to the magnetic interaction force than the maximum of stability. At last, we discuss the importance of using a rotating field rather than a constant one. In particular, we report some measurements of both the maximum angle of stability and the angle of repose in constant field, which show a strong dependence of the angles of avalanche on the direction of the field.

Journal Article↗

Effect of 4-aminopyridine on gait in ambulatory spinal cord injuries: a double-blind, placebo-controlled, crossover trial.

UNLABELLED: Animal and human research have shown that the drug 4-aminopyridine (4-AP) may improve gait in spinal cord lesions by enhancing nerve transmission to affected muscles. STUDY DESIGN: Prospective, randomized, double-blind, placebo-controlled, crossover trial. OBJECTIVES: To determine the efficacy of 4-AP in improving lower limb muscle strength and biomechanical gait patterns of chronic spinal cord injuries (SCI). SETTING: The Rehabilitation Centre (Ottawa, Canada). METHODS: In all, 15 chronic, ambulatory SCI persons were randomized to an initial 2 weeks of 40 mg/day, oral medication of either placebo or immediate-release, 4-AP and subsequently crossed over to the alternate medication for the following 2 weeks. Evaluations were conducted at baseline (before starting 4-AP or placebo medication), 2 weeks, and 4 weeks. Measures included dynamometer lower limb isometric muscle force and biomechanical gait measures including temporal-spatial parameters, electromyographic activation patterns, joint kinematics and kinetics. Subjective impressions of the drug by the participants were obtained from an exit survey. RESULTS: Despite some positive comments from subjects, statistical and clinical analyses showed no within-subject differences between placebo and 4-AP measures of lower limb muscle force and objective gait analyses (ANOVA statistic P>0.05). CONCLUSION: Results demonstrated the importance of placebo-controlled trials and quantitative outcome measures for the evaluation of 4-AP aimed to enhance gait for chronic, ambulatory SCI persons. Energy expenditure measures and mood may relate more to subjective comments and is suggested for future investigations.

4-Aminopyridine↗

Measurement of anal sphincter muscles: endoanal US, endoanal MR imaging, or phased-array MR imaging? A study with healthy volunteers.

PURPOSE: To compare endoanal ultrasonography (US), endoanal magnetic resonance (MR) imaging, and phased-array MR imaging for anal sphincter muscle measurement. MATERIALS AND METHODS: Sixty healthy volunteers underwent 1.5-T phased-array MR, endoanal MR, and endoanal US examinations. Sphincter muscle thicknesses were measured. Measurement reliability was analyzed, and correlations among the imaging methods were calculated. Multivariate analysis was performed to assess the influence of age, weight, height, sex, parity, and obstetric trauma on sphincter dimensions. RESULTS: Both MR methods had good reliability for measurements of all sphincter components, whereas endoanal US was reliable for internal sphincter measurement only. There was little correlation between the techniques, except between the two MR techniques, with a strong correlation for total sphincter and perineal body thickness. The internal sphincter thickened significantly (P =.002) with age at endoanal US and endoanal MR imaging but not at phased-array MR imaging. There were small sex-based differences in sphincter muscle measurements at phased-array MR imaging only. CONCLUSION: Endoanal US enables reliable measurement of only internal sphincter thickness, whereas both MR imaging methods enable reliable measurement of all sphincter components. Sphincter measurement with phased-array MR imaging is as reliable as that with endoanal MR imaging.

Adult↗

Electrohydrodynamic instabilities and orientation of dielectric ellipsoids in low-conducting fluids.

We study the dynamics of an ellipsoidal particle in a weakly conducting dielectric liquid when submitted to a dc electric field. At low field intensities, the particle long axis is aligned in the field direction. When the field strength is increased, we show that, depending on the initial orientation of the particle, there exist two stable orientations: the one with the long axis parallel to the field direction remains possible while a spinning state with the long axis perpendicular to the field appears. This last striking orientation is due to the finite Maxwell-Wagner polarization relaxation time. For sufficiently high field intensities, each state loses its stability and the particle dynamics becomes chaotic. Those conclusions from the theoretical model are supported by experimental observations.

Journal Article↗

Functional and morphological changes in the pancreatic remnant following pancreaticoduodenectomy with pancreaticogastric anastomosis.

BACKGROUND: The aim was to evaluate pancreatic exocrine and endocrine function, pancreatic atrophy and main pancreatic duct dilatation in the pancreatic remnant following pancreaticoduodenectomy and pancreaticogastrostomy. METHODS: Nineteen patients who underwent pancreaticoduodenectomy and pancreaticogastrostomy for benign or malignant pancreatic tumours with a histologically normal pancreatic resection margin were studied prospectively. The median interval between operation and evaluation was 32 (range 12-120) months. Pancreatic exocrine insufficiency was assessed by measuring 72-h faecal fat concentrations and faecal-1 elastase. Fasting blood glucose, haemoglobin A1c, serum peptide C and insulin levels were used to assess endocrine function. Pancreatic parenchymal thickness and main pancreatic duct diameter were measured before operation and at evaluation using computed tomography (CT). RESULTS: Faecal fat excretion was raised in 16 of 17 patients; faecal-1 elastase was reduced in all 17 patients. None of the 17 non-diabetic patients had developed diabetes mellitus at follow-up. A significant decrease in pancreatic parenchymal thickness and increased dilatation of the main pancreatic duct were observed on CT at evaluation (P = 0.01 and P = 0.01 respectively). Pancreatic atrophy, assessed by subtracting the diameter of the pancreatic duct from the total gland thickness, tended to develop over time, but at the limit of statistical significance (P = 0.06). CONCLUSION: A median of 3 years following pancreaticoduodenectomy and pancreaticogastrostomy, patients remained free from diabetes but developed marked pancreatic exocrine insufficiency. Presented in part to the Societé Nationale Française de Gastroentérologie in Nantes, March 1999, and published in abstract form as Gastroenterol Clin Biol 1999; 23: A81

Adult↗

A CAD analysis programme for prosthetics and orthotics.

A CAD (computer aided design) analysis software package (CADVIEW) was designed for use with prosthetic and orthotic CAD CAM (computer aided design/computer aided manufacture) systems. Using the Microsoft Windows 3.1 environment, CADVIEW provides a series of anatomical shape viewing and analysis tools. These tools include simultaneous display of multiple sockets and multiple views, two dimensional (2D) and three dimensional (3D) measurement, shape statistics, multi-shape alignment, cross-sectional comparison, colour coded 3D comparison, resolution enhancement, and image copying capabilities. This programme should be of benefit to clinicians and researchers who wish to assess and/or compare CAD data generated by MS-DOS based CAD CAM systems.

Computer-Aided Design↗

[Medico legal issues related to driving: the role of the general practitionner].

The Belgian law requires that the physician informs his/her patient when he diagnoses a medical reason that makes him/her unfit to drive a vehicle. This paper lists, as they appear in the official texts, the physical conditions and diseases which may be responsible for the inaptitude to drive. Thus are detailed the rules applied in the presence of neurological diseases, psychic disorders, epilepsia, pathological sleepiness, locomotive disorders, cardiovascular disease, rhythm or conduction disturbances, blood pressure abnormalities, coronary or myocardial disease, and hearing loss or vestibular problems. The reader will also find a summary of the rules related to visual ability, alcohol use, driving under the influence of psychotropic drugs, or medicines in general, renal or hepatic diseases, and to the patient who received an organ transplant or an artificial implant. The responsibility of the physician, primarily the general practionner, may be involved in these matters; this issue is discussed.

Automobile Driving↗

[Management of intrafamily violence issues by general practitioners].

General practitioners often come upon intrafamily abuse cases in their practice. They are either specifically consulted because of these instances of abuse or they discover them by accident. When this happens, they are often unsure of the appropriate procedure to follow, for fear of committing a medical fault or breaking the law. The aim of this short article is not to dwell on the diagnostic methodologies, but to provide a series of general guidelines to follow in everyday practice.

Adult↗