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Biomedical subjects

F Philippe

Publications and source records attributed to F Philippe.

47 records · Page 3Linked to original sources
PubMed1993

[Effects of ultrasound energy on femoral artery occlusion. Angiographic and angioscopic results].

Ultrasonic energy has been shown to be able to disrupt atherosclerotic plaques and thrombi. The authors used an ultrasonic angioplastic technique developed by the group in 10 patients with a femoral arterial occlusion. The ultrasonic angioplasty was attempted before surgical bypass using a 130 cm long titanium guide wire with a 0.8 mm diameter and a round distal tip measuring 2 or 2.5 mm. Angiographic and angioscopic examinations were performed before and after the procedure in 9 patients. It was not possible to perform the angioplasty in 1 patient. Angioscopy showed that the proximal part of the occlusion consisted of atheromatous material in 3 cases and of thrombus in 6 cases. Angiography showed complete restoration of flow in 4 cases; distal flow was very slow in 4 cases and no distal run-off was observed in 1 case. Angioscopy showed residual stenosis at the site of entry in only 1 case. In 3 cases, the artery had no significant residual stenosis. In the other 5 patients residual stenosis was present and angioscopy showed persistence of strands of fibrin and small thrombi. These results show that ultrasonic angioplasty was capable of recanalising an occlusion in 9 out of 10 patients with partial or total disruption of thrombi. At the present stage of development of this system, balloon angioplasty would be an essential complement in most cases in order to obtain normal flow without significant residual stenosis. The manoeuverability of the guide wire and the relatively small size of the round distal tip explain why not all the thrombi could be treated.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Effects of ultrasonic energy on blood clots in vitro].

Ultrasound may be used to dissolve arterial and venous thrombi. Its effects depends on the mode of ultrasonic vibration and on the length of the guide wire. The authors studied the in vitro effects of an ultrasonic angioplasty device coupled with a 130 cm long titanium flexible guide wire. The system comprises an automatic scanning function to determine the optimal frequency of resonance and works in the continuous mode of emission. Sixteen thrombi were studied of which 8 were acellular and 8 whole blood. In each group, 4 were treated in association with streptokinase and 4 by ultrasound alone. The ages of the thrombi in each subgroup were 1, 3, 7 and 15 days. All the thrombi were dissolved in 6 minutes or less (3'15" +/- 1'35") at an average optimal frequency of resonance of 19,444 Hz. Ninety six per cent of the debris had a diameter less than 10 microns. Less than 1% of the debris had a diameter larger than 100 microns. These large particles were observed in cellular thrombi and were almost completely absent in dissolved acellular thrombi. They were very fragile. The dissolution of the thrombi was not accelerated by the association of streptokinase. The ultrasonic energy did not induce D-dimer production and its action was probably due to cavitation. Ultrasonic energy could provide an alternative treatment for thrombotic vascular occlusion provided that more flexible guide wires could be designed.

Humans↗
PubMed1982

[Continued evaluation of results of surgical management of female congenital adrenal hyperplasia. Report on 48 cases (author's transl)].

In a continued surgical and medical evaluation of the surgical management of female congenital adrenal hyperplasia, 48 girls were studied. Clitoroplasty (relocation and recession) was considered satisfactory in 22 out of 26 children of pubertal age. Vaginoplasty results were rated as excellent in 8 cases, and fair in 19 cases. Six patients indicated to have normal sexual intercourse. However a second surgical procedure will be necessary in 16 cases (30%) during or at the end of their puberty. These cases are among the more severely masculinized with a vaginal opening located at the upper part of the urethra. A prolonged follow-up is necessary in order to perform an adequate evaluation of these procedures, some of which have to be repeated at the age of adolescence.

Adolescent↗
PubMedDate not supplied

Feasibility, safety, cost-effectiveness and 1 year follow-up of coronary stenting without predilation: a matched comparison with the standard approach.

BACKGROUND: We evaluated the feasibility, safety, procedural cost-effectiveness, radiation dose and time and 1-year target vessel revascularization rate of direct unprotected mounted stenting without previous balloon dilatation (DS) in native coronary artery lesions. METHODS: DS was attempted in 119 patients; 39 had a recent myocardial infarction, 62 had unstable angina, and 18 had stable angina. The clinical follow-up was obtained at 14+/-5 months (range 6 to 24 months). These results were compared with those for a consecutive group of 160 patients matched for type and length of lesions and who had a stent only if the post-balloon residual stenosis was >30%. RESULTS: The feasibility of DS was 112/119 (94%). The number of inflations, the length of the stent/length of the lesion ratio, the time and the dose of radiation were dramatically lower in the DS group (P<0.001). DS conferred a slight reduction in procedure-related cost [$820+/-157 for DS vs. 894+/-427 for standard dilatation (SD) per patient]. The 1-year target vessel revascularization rate was similar in both groups [nine (8%) for DS vs. 17 (11%) patients for SD, ns]. CONCLUSIONS: DS is feasible and safe in selected coronary lesions. This method provides a low rate of repeat revascularization and reduces the time and the dose of radiation compared with the standard approach.

Aged↗
PubMedDate not supplied

[Occurrence of severe striae in adolescents with congenital adrenal hyperplasia and 21-hydroxylation deficiency treated with dexamethasone].

Dexamethasone has been proposed as therapy of congenital adrenal hyperplasia in adolescents with menstrual abnormalities. Seven patients previously treated with hydrocortisone (mean dosage of 26 mg/m2/day) or prednisone (6 mg/m2/day), received dexamethasone doses between 0.3 and 0.73 mg/m2/day during at least 4 months. Regular menses and satisfactory adrenal suppression were obtained in most cases, but the occurrence of severe striae, sometimes with excessive weight gain, led to the cessation of this treatment. Analysis of data indicate that glucocorticoid activity of dexamethasone is 50-90 times more potent than that of hydrocortisone. Its use, after cessation of growth, should be carefully monitored, starting with much lower doses when necessary.

Adolescent↗
PubMedDate not supplied

[Growth retardation after irradiation of a chordoma of the clivus].

In a seven year old boy a chordoma of the clivus has been treated by X-ray therapy after partial neurochirurgical resection. A recurrence of the tumor is noted 10 years after at the the border of the X-ray field. The final size of the sexually mature boy is -- 4 DS below the mean with a complete defect in GH secretion after arginin and insulin stimulation. TSH secretion insuficiency and high HPr levels are shown by TRH stimulation test. The length of survey in this particular case has allowed the demonstration of severe stunting growth which is in part a consequence of hypothalamo-pituitary axis irradiation.

Child, Preschool↗