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Biomedical subjects

F Bouchard

Publications and source records attributed to F Bouchard.

At least 19 recordsLinked to original sources
PubMed2003

[Damage control laparotomy for haemorragic abdominal trauma. A retrospective multicentric study about 109 cases].

AIM OF THE STUDY: Damage control laparotomy is a new approach to the more severe abdominal traumas. It stems from a better understanding of the physiopathology of the haemorragic shock. PATIENTS AND METHODS: A national retrospective study from 27 centers about 109 trauma patients who underwent a damage control procedure between January 1990 and December 2001, is analysed. Surgical procedures included 97 hepatic packing, 10 abdominal packing, 4 exclusive skin closure, 1 open laparotomy technique and 3 digestive stapplings. RESULTS: The mortality rate is 42%. Eleven abdominal compartment syndromes have occurred with 7 decompressive laparomy (4 deaths). CONCLUSION: This study is based on the largest series of damage control laparotomy published in France. Results in terms of mortality and morbidity are similar to those of published studies from the USA.

Abdominal Injuries↗
PubMed2001

Quality assurance for screening mammography: an international comparison.

STUDY OBJECTIVE: In 1998, the International Breast Cancer Screening Network (IBSN) sponsored an assessment of quality assurance policies and practices to define their scope for population-based screening mammography programmes across IBSN countries. DESIGN: Analysis of data from a survey designed to assess multiple elements of screening programme quality assurance, including organisation of quality assurance activities, mechanisms for site visits and accreditation, requirements for quality control and data systems, and inclusion of treatment, follow up, and programme evaluation in screening mammography quality assurance activities. PARTICIPANTS AND SETTING: IBSN representatives in 23 countries completed a comprehensive questionnaire between May and December 1998. MAIN RESULTS: Completed questionnaires were obtained from all 23 countries. Responses indicated that countries vary in their approaches to implementing quality assurance, although all monitor components of structure, process, and outcome. Nearly all have in place laws, surveillance mechanisms, or standards for quality assurance. In all countries, quality assurance activities extend beyond the screening mammography examination. CONCLUSIONS: The assessment has enhanced understanding of the organisation of screening mammography programmes across countries, as well as the comparability of screening mammography data. All countries have established mechanisms for assuring the quality of screening mammography in population-based programmes, although these mechanisms vary across countries.

Breast Neoplasms↗
PubMed2000

Performance of screening mammography in organized programs in Canada in 1996. The Database Management Subcommittee to the National Committee for the Canadian Breast Cancer Screening Initiative.

BACKGROUND: The results of randomized trials show that breast cancer screening by mammography reduces breast cancer mortality by up to 40% in women aged 50-69 years. Because of these results, by 1998, 22 countries, including Canada, had established population-based organized screening programs. This paper presents the results of screening mammography in 1996 for 7 provincially organized breast cancer screening programs in Canada. METHODS: Analyses of interim performance indicators for screening mammography have been calculated from data submitted to the Canadian Breast Cancer Screening database. The data set consisted of data from 7 provincial programs and was limited to mammographic screens for women aged 50-69 years (n = 203,303). Screening outcomes and performance indicators were calculated for abnormalities detected by screening mammography only. RESULTS: The abnormal recall rate was 9.5% for first screens and 4.6% for subsequent screens, and the cancer detection rate per 1000 women screened was 6.9 for first screens and 3.8 for subsequent screens. The positive predictive value (i.e., the proportion of women who tested positive by mammography who were found to have breast cancer on screen-initiated diagnostic work-up) increased from 7.2% at the first screen to 8.2% at subsequent screens. Estimated participation rates within organized programs varied from 10.6% to 54.2%, depending on the province. INTERPRETATION: For 1996, organized breast cancer screening programs met or exceeded many of the interim measures used in international programs. It is possible to translate the benefits of breast cancer screening by mammography, as demonstrated in randomized trials, into population-based community programs. Screening mammography through organized programs should increase to allow more comprehensive monitoring in Canada.

Aged↗
PubMed2000

[Liver transplantation with a graft taken from a heart transplant patient who was brain-dead].

The shortage of organ donors has led to progressive softening of selection criteria for organ donation. We report on hepatic transplantation in a 55-year-old woman with primary biliary cirrhosis, whose donor was a 50-year-old heart transplant recipient who became brain stem dead, due to cerebral bleeding 8 months after transplantation. An orthotopic liver transplantation was performed. The postoperative course was uneventful and the recipient was alive and had normal liver function after a 42-month follow-up. Analysis of the literature included ethical consideration, potential hepatotoxic effects of immunosuppressive drugs and modification of the graft immunogenicity. It confirms that transplanted patients should not be a priori excluded from organ donation.

Brain Death↗
PubMed1999

Molecular cloning and characterization of the cDNA encoding the rat liver gamma-butyrobetaine hydroxylase.

Carnitine biosynthesis from lysine and methionine involves five enzymatic reactions. gamma-butyrobetaine hydroxylase (BBH; EC 1.14. 11.1) is the last enzyme of this pathway. It catalyzes the reaction of hydroxylation of gamma-butyrobetaine to carnitine. The cDNA encoding this enzyme has been isolated and characterized. The cDNA contained an open reading frame of 1161 bp encoding a protein of 387 amino acids with a deduced molecular weight of 44.5 kDa. The sequence of the cDNA showed an important homology with the human cDNA recently isolated. Northern analysis showed gamma-butyrobetaine hydroxylase expression in the liver and in some extend in the testis and the epididymis. During this study, it also appeared that BBH mRNA expression was undetectable by Northern analysis during the perinatal period. During the development of the rat, the amount of BBH mRNA appeared after the weaning of the young rat and reached a maximal expression at the adult stage.

Amino Acid Sequence↗
PubMed1999

Breast cancer screening in 21 countries: delivery of services, notification of results and outcomes ascertainment.

Following clinical trial evidence of mammography screening's efficacy and effectiveness, data are needed from organized population-based programmes to determine whether screening in these programmes results in breast cancer mortality reductions comparable to those demonstrated in controlled settings. The International Breast Cancer Screening Network (IBSN) conducted two international programme assessments: in 1990 among nine countries and in 1995 among 22 countries, obtaining information on the organization and process for screening within breast cancer screening programmes. This manuscript describes procedures for recruitment, service delivery, interpretation and communication of results, case ascertainment, and quality assurance. Practices in more established programmes are compared with pilot programmes. Each IBSN country defined a unique programme of population-based breast cancer screening. Some programmes were sub-national rather than national in scope, while others were in pilot stages of development. Screening took place in dedicated centres in established programmes and in both dedicated and general radiology centres in pilot programmes. Although most countries used personal invitation systems to recruit women to screening, other recruitment mechanisms were used. Most countries used two-view mammography in their screening programmes. About half had implemented independent double reading of mammograms, considering it a key component of high-quality mammography screening. In conclusion, diversity exists in the organization and delivery of screening mammography internationally. Quality assurance activities are a priority and are being evaluated in the IBSN.

Australia↗
PubMed1999

[Surgical treatment of acute cholecystitis. A retrospective study of a series of 192 patients operated on over a period of 3 years].

Emergency conditions make laparoscopic treatment of acute cholecystitis challenging. The aim of this study is to retrospectively analyse our experience of cholecystectomy for acute cholecystitis performed between January 1995 and December 1997. In order to be included, patients had to present (i) symptoms of acute cholecystitis correlated with laboratory blood tests and ultrasonographic studies (ii) evidence of acute inflammation during the operation and (iii) histological confirmation of acute or subacute inflammation of the excised gallbladder. 192 patients were treated: 62 were totally managed laparoscopically (group CCN), 33 managed laparoscopically but required conversion to open cholecystectomy (group CCC) and 97 were managed conventionally by laparotomy (group CL). Mean age was significantly different between the three groups, (CCN: 55.6 +/- 15 years, CCC: 64.2 +/- 13 years, CL: 66.5 +/- 17 years), as was ASA score (CCN: ASA 3 and ASA 4: 16%, CCC: ASA 3 and ASA 4: 48%, CL: ASA 3 and ASA 4: 46%), and initial infectious signs (temp. > or = 38 degrees C: CCN: 35%, CCC: 39%, CL: 63%). Mean operative delay was significantly higher in the converted group [8.7 +/- 13 days (CCC) vs 4.5 +/- 8 days (CCN) and 5.4 +/- 8 days (CL)]. There were two (1%) bile duct injuries, one in the CCC group, the other in the CL group. Operative mortality was 2% (CCC: 0%, CCN: 0%, CL: 4%) and operative morbidity was 40% (CCN: 21%, CCC: 24%, CL: 57%). The mean postoperative hospital stay was shorter in the CCN group (6.5 +/- 3.5 days) and CCC group (9.6 +/- 4.4 days) vs the mean stay in the CL group (14.7 +/- 11.6 days). Appears to be beneficial for selected patients with low surgical risk to conclude laparoscopic cholecystectomy. It has yet to be shown whether this benefit can be extended to patients with a high surgical risk.

Acute Disease↗
PubMed1998

Contrast sensitivity with soft contact lenses compensated for spherical aberration in high ametropia.

BACKGROUND: In optical systems, it is usual to compensate for longitudinal spherical aberration. In order to increase image quality, lens surfaces can be made aspheric to bring all object light rays into focus at the image plane. Theoretically, soft contact lenses with high power and spherical surfaces show significant amounts of spherical aberration. The use of spherical aberration-free soft contact lenses could therefore improve retinal image quality in the case of high ametropia. However, because of ocular aberration, accommodation effects, pupil dynamics, contact lens flexure, and positioning, the computation of the spherical aberration induced when a contact lens is placed on the eye is complicated. METHODS: In this study, the spatial contrast sensitivity (CS) of 61 high ametropes wearing soft contact lenses with, and without, in-air spherical aberration compensation is measured. RESULTS: A slightly better overall performance was found with the standard lenses. There was no significant influence by the type of ametropia, age, and gender. If individual results are considered, clinically significant differences between the two lens groups are observed in approximately 30% of the cases. CONCLUSIONS: It seems that correcting in-air soft contact lens spherical aberration systematically is of no clinical interest. However, selective manipulation of spherical aberration could, in high power soft contact lenses, significantly improve CS in individuals.

Adolescent↗
PubMed1998

[Long-term outcome of a false lumen after surgical correction of type A acute aortic dissection].

The long-term outcome (64.3 +/- 45 months) of 44 patients operated for acute dissection of at least the ascending aorta was assessed by regular clinical examination and annual CT scan. The diameter of the aorta at different levels was measured at each CT scan for all patients. Initially, 7 patients (16%) had acute dissection limited to the ascending aorta; none had a false lumen after surgery. No signs of aneurysmal dilatation were observed during follow-up of these patients. In the 37 other cases (84%) dissection of the aorta extended beyond the innominate artery; the false lumen remained patent distal to the prosthetic tube replacing the ascending aorta in 34 patients (92%). The false lumen was partially thrombosed in 8% of patients, leading to distal emboli in 1 patient. Moderate increases (less than 15 mm) in diameter of the false lumen were observed in 32% of patients; more severe dilatation (over 20 mm) was observed in 12% of patients. The management of dilatation of the false lumen is not standard; it depends mainly on the rate of progression and the clinical consequences. It is hoped that extension of the initial repair to the aortic arch, when the intimal tear is situated in this zone, will reduce the short and long-term progression of the false lumen.

Acute Disease↗
PubMed1997

[Primary treatment of left coronary artery diseases by percutaneous implantation of stents].

Left main coronary artery (LM) stenting has only been reported in bail-out situations or absolute contraindications so surgery. The authors report the immediate and midterm results of primary Palmaz-Schatz stent implantation in two young patients without contraindication to surgery. The first patient, 58 year-old, was admitted for unstable angina in October 1994. Coronary angiography showed an isolated severe ostial lesion of the LM. After conferring with the surgical team which remained on stand-by, angioplasty and stent implantation were performed with excellent results, no complications and no restenosis on angiographic controls at 3 and 12 months. The patient remained asymptomatic 24 months later. The second patient, 38 year-old, was admitted in June 1995 for unstable angina, and coronary angiography showed a severe isolated stenosis in the middle of a long and wide LM. Primary coronary stenting was also performed with excellent results, no complication and no restenosis on angiographic controls at 4 and 8 months. This patient was still asymptomatic 16 months after stenting. These excellent immediate and medium-term results are encouraging and suggest that this form of treatment might be extended to patients with an isolated whether primary LM stent implantation could become a suitable alternative to surgery in the future.

Adult↗
PubMed1996

Infrared pupillometry in presbyopes fitted with soft contact lenses.

The influence of pupil size, lens centration, and translation on multifocal contact lens performance suggests that these parameters should be accounted for in the optical design of presbyopic contact lenses. The purpose of the present article is to complete the existing experimental data with clinical measurements of pupil diameter and lens position relative to the pupil in a group of presbyopes, with controlled target luminance, stimulus distance, gaze angle, and convergence. The experiments involve an infrared video-pupillometer and ring-marked contact lenses. Results on pupil aperture show that the effect of changing target distance is comparable in magnitude to that of varying luminance within the photopic range. The measured data on lens position confirm that soft contact lenses are generally decentered from the pupillary axis, usually in inferior temporal direction, and that their average translation between primary and downward gaze is very small. It is also found that the average relative position between lens and pupil centers is slightly modified by changes of luminance in far vision. All these results provide characteristic values which are helpful for the optical modelling of presbyopic contact lenses.

Adult↗
PubMed1996

[Mucinous ductal ectasia of the pancreas].

We report a new case of mucinous ductal extasia of the pancreas observed in a 64-year-old man with a history of chronic exocrine failure. Diagnosis was obtained by CT, duodenal endoscopy and retrograde cholangio-pancreatography. Risk of malignant degeneration and increased CA 19-9 led to duodenopancreatectomy. Histology confirmed the diagnosis but revealed no malignant lesion. After a 3-year follow-up, the patient is in excellent health. Based on this observation and a review of the literature, we present the characteristic features of mucinous ductal ectasia of the pancreas.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1994

Survey of construction workers repeatedly exposed to chlorine over a three to six month period in a pulpmill: I. Exposure and symptomatology.

OBJECTIVE: The admission to hospital of three construction workers with acute respiratory distress caused by inhalation of chlorine gas prompted the inspection of a building site located in a kraft pulpmill. The accidental emissions had taken place in the bleach plant and the construction workers assigned there were surveyed to uncover possible large scale health effects. DESIGN AND PARTICIPANTS: A questionnaire was presented to 281 workers (participation rate = 97%); 257 workers reported an average of 24 exposure episodes to chlorine and derivatives over a three to six month period. The air monitoring data available from the pulpmill's industrial hygienist were not useful in linking specific events reported by the workers to environmental conditions in the bleach plant. RESULTS: Over 60% of the workers described a characteristic flu like syndrome that lasted for an average of 11 days and was exacerbated by new bouts of exposure. Irritation of the throat (78%) and eyes (77%), cough (67%), and headache (63%) were the most often reported symptoms. Shortness of breath was reported by 54% of the participants and was not associated with age, smoking state, or history of asthma or chronic bronchitis. First aid self referral was associated with significantly greater reporting of most symptoms, including dyspnoea and cough. A significantly greater proportion of workers in the dyspnoea group had gone at least once for first aid care after a gassing incident (64% as opposed to 48%, p = 0.008). Throat irritation and cough persisted for mean intervals of eight and 11 days respectively. A flu like syndrome lasted for an average of 20 days. Seventy one subjects were considered to be a moderate to high risk of having persisting respiratory symptoms. CONCLUSION: Throat and eye irritation as well as cough and flu like symptoms are frequent occurrences after repeated accidental inhalation of chlorine. Subjects who consulted first aid care stations after a gassing incident are more likely to have persisting dyspnoea.

Adolescent↗
PubMed1990

[The repair of recurrent postoperative incisional hernias. Objectives and therapeutic indications (68 cases)].

Among 327 surgical repairs of incisional hernias done between 1974 and 1989, 68 repairs (21%) were performed because of a primary treatment failure. Failed primary attempts of cure had been unique in 71%, and multiple in 29% of cases; their procedure had been essentially suture or herniorrhaphy. Site of recurrent incisional hernia (R.I.H.), was midline or lateral incision in respectively 84% and 16% of cases. Size of R.I.H. was considered as large in two third of cases. Operation was performed electively in majority of cases (93%). More than half of the patients were "prepared" by preoperative pneumoperitoneum and/or weight reducing regimen. Mersilene* mesh was used in 81% of cases. Results of treatment of R.I.H. are reported, depending on procedure. Among 55 cures by use of Mersilene* mesh, 1 patient died (from myocardial infarction), and 5 recurrences occurred, 4 of which from sepsis. Study of complications and failures suggests: 1) careful attention to indications, 2) advantages of a large size Mersilene* mesh, 3) attention to preoperative treatment, especially weight loss regimen and progressive pneumoperitoneum.

Adult↗
PubMed1989

Bone sialoprotein II synthesized by cultured osteoblasts contains tyrosine sulfate.

Isolated mouse osteoblasts that retain their osteogenic activity in culture were incubated with [35S] sulfate. Two radiolabeled proteins, in addition to proteoglycans, were extracted from the calcified matrix of osteoblast cultures. All the sulfate label in both proteins was in the form of tyrosine sulfate as assessed by amino acid analysis and thin layer chromatography following alkaline hydrolysis. The elution behavior on DEAE-Sephacel of the major sulfated protein and the apparent Mr on sodium dodecyl sulfate gels were characteristic of bone sialoprotein II extracted from rat. This protein was shown to cross-react with an antiserum raised against bovine bone sialoprotein II, indicating that bone sialoprotein II synthesized by cultured mouse osteoblasts is a tyrosine-sulfated protein. The minor sulfated protein was tentatively identified as bone sialoprotein I or osteopontin based on its elution properties on DEAE-Sephacel and anomalous behavior on sodium dodecyl sulfate gels similar to those reported for rat bone sialoprotein I.

Animals↗
PubMed1989

A follow-up study of childhood psychosis.

A cohort of 227 children having attended the same day treatment facility during their childhood was followed-up in adult life. A questionnaire was designed to collect data on various aspects of social and personal adjustment. The length of the follow-up period is 17 years. Information was obtained on 99 subjects whose mean age was 27-years. Of these, 55 had been admitted to the facility for childhood psychosis, and the remaining 44 subjects served as a comparison group. The results show that, in adulthood, the psychotic children fare significantly worse than the controls for employment, autonomy, marriage and the need for continuing medical care. Although non significant, a trend is found in the same direction for educational attainment and medication consumption. We then looked at the clinical and therapeutic variables in the childhood of the psychotic group which were the strongest predictors of adjustment in adulthood. We found that those children who had been admitted at a younger age, whose length of stay in the day treatment hospital had been longer, who scored lower on IQ tests and who had been discharged towards other specialised institutions, were less well adjusted. The results of this study must be interpreted with caution in light of the important attrition during the follow-up period. The discussion then focuses on case definition issues. Emphasis is placed on the need for careful diagnostic assessment and for the use of precise diagnostic assessment and for the use of precise diagnostic criteria. Further, our result on the prognostic significance of IQ level suggests that the assessment of cognitive functioning in autistic and psychotic children is key information which should be more systematically taken into account both in clinical practice and in future research projects.

Adult↗
PubMed1988

Defective bone formation by transplanted Hyp mouse bone cells into normal mice.

The hypophosphatemic (Hyp) mouse is a model for human X-linked hypophosphatemia (XLH). To test the hypothesis of an abnormal osteoblast function in XLH, periostea and osteoblasts isolated from normal and Hyp mice were transplanted im into normal and mutant mice. The thickness of the osteoid seams at the periphery of the bone nodules and the osteoid volume were measured in transplants as an index of bone formation. Impaired mineralization was evidenced in transplants of Hyp cells into Hyp mice by excessive osteoid thickness and volume compared with transplants of normal cells into normal mice. When normal cells were transplanted into mutant mice, the osteoid thickness and volume were markedly increased, demonstrating that the extracellular environment is critical for bone formation. In contrast, when Hyp cells were transplanted into normal mice, reduction, but not normalization, of the osteoid thickness and volume was observed. This abnormal bone formation supports the hypothesis of an osteoblast defect in the Hyp mouse.

Animals↗