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Biomedical subjects

J F Morin

Publications and source records attributed to J F Morin.

At least 19 recordsLinked to original sources
PubMed1992

Lack of effect of isradipine on cyclosporin pharmacokinetics.

The influence of isradipine as a long acting form (IcazR LP 5 mg) on cyclosporin pharmacokinetics was studied in six hypertensive renal transplant patients (mean age 37 yrs; mean body weight 62 kg). These patients received a mean daily cyclosporin dose of 307 mg in two equal intakes. Isradipine was orally administered once a day at a dose of 5 mg before the morning cyclosporin intake. Cyclosporin kinetics was assessed over a 0-12-h period, the day before (D-1) and 13 days (D+13) after isradipine treatment. Whole blood concentrations of cyclosporin were determined by radioimmunoassay (RIA) using the SandimmuneR-RIA kit (specific and non-specific monoclonal antibodies). Area under the blood concentration-time curve (AUC), the maximum blood concentration (Cmax) and the time to reach Cmax (Tmax) on D-1 and D+13 were not significantly different whatever the specificity of the RIA method. For example, the mean AUC +/- sd values were 5,247 +/- 2,255 (D-1) vs 5,317 +/- 1,675 (D+13) microgram.1(-1).h for the specific and 20,905 +/- 8,317 vs 19,327 +/- 5,758 microgram.1(-1).h for the non-specific determinations. Therefore, the pharmacokinetics of cyclosporin is not influenced by co-administration of isradipine at a therapeutic dosage. Moreover, the clinical results show that isradipine treatment was effective after 13 days administration (mean systolic blood pressure 132 vs 158 mm Hg, P < 0.05 and mean diastolic blood pressure 77 vs 93 mm Hg, P < 0.05 in supine position), and well tolerated throughout the study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Atrial natriuretic factor release during exercise in patients successively paced in DDD and rate matched ventricular pacing.

Dual chamber pacemakers were implanted in nine patients with permanent second or third degree AV block (eight had complete retrograde block). Two identical exercise tests were performed after at least 1 month after implantation. During the first test (T1) the pacemaker was programmed to the DDD mode and heart rates were recorded every 15 to 30 seconds during exercise and 30 minutes after exercise. Following 30 minutes of rest, the implanted pacemaker was programmed to the VVT mode and driven by an external pacemaker via a skin electrode. The second exercise test (T2) was then performed and the rate of the external pacemaker was progressively changed to reproduce exactly the rate observed during T1 at the same exercise stress. Atrial natriuretic factor (ANF) levels were determined at rest, at regular intervals during exercise, and 30 minutes after exercise. ANF levels and release were statistically higher during rate matched ventricular, than DDD pacing. It is concluded that preservation of AV synchrony reduces ANF release induced by heart rate acceleration during exercise.

Aged↗
PubMed1992

Vascular injury and repair associated with retroperitoneal lymphadenectomy for nonseminomatous germinal cell tumours of the testis.

Metastatic disease adjacent to major vascular structures in the retroperitoneum sometimes necessitates planned removal of portions of these vessels, or the vessels may inadvertently be injured when retroperitoneal lymphadenectomy is performed. In 78 patients who underwent retroperitoneal lymphadenectomy, 17 (22%) required vascular repair intraoperatively. The vena cava was most frequently involved (eight cases) followed by inadvertent injury to the renal arteries (five cases) or the infrarenal aorta (three cases). Resection of the infrarenal aorta was planned in two cases without postoperative complication. In six cases a resection of either the whole inferior vena cava or a portion of it was needed to remove all of the tumour. There were nine cases of inadvertent injury to the aorta, vena cava or a renal artery. The outcome after arterial repair was satisfactory with the exception of the inadvertent renal artery injuries, which required nephrectomy in three cases. Leg swelling was not a long-term sequela of either caval repair or resection.

Adolescent↗
PubMed1991

Successful treatment of steroid-resistant double-lung allograft rejection with Orthoclone OKT3.

An 18-yr-old woman with cystic fibrosis who received a double-lung transplant developed a severe episode of acute lung rejection. Bronchoalveolar lavage and transbronchial biopsy were used to establish the diagnosis. The rejection was refractory to administration of high-dose pulse steroids. OKT3 therapy was successfully used to reverse this episode. This is the first case report of a steroid-resistant double-lung allograft rejection successfully treated with OKT3.

Adolescent↗
PubMed1989

[Analysis of 112 haplotypes carrying the cystic fibrosis gene. Applications in genetic counseling].

Cystic fibrosis (CF) is always a common lethal genetic disease. The locus is localized to human chromosome 7q22-7q31. Genetic linkage between the CF locus and polymorphic DNA marker is used to realize family studies. We have genotyped 56 families (352 patients) with a CF child. The informativeness with the six markers (Met D/Taq I, Met H/Taq I, Met H/Msp 1, XV2c/Taq 1, km19/pst pJ 3.11/Msp 1) is important (96%). The linkage desequilibrium between alleles detected by XV2 c and Km 19 described by Estivill and al, is also showed in our population. The haplotype B (Km 19 = 6.6 kb, XV2 c = 2.1 kb) is present on 84% of our 112 CF chromosomes. We have established the frequencies of the 10 possible genotypes in the pool of the 112 CF chromosomes and in the pool of the normal chromosome and according to Bayes obtained the predictive positive value to be heterozygote. It is possible to precise the genetic counselling in these families.

Cystic Fibrosis↗
PubMed1989

[Value of x-ray computed tomography in evaluating the operability of esophageal cancer. Results of a prospective study].

The authors report their results of a prospective double-blind study of 35 patients with squamous cell carcinoma of the esophagus conducted between February 1987 and February 1988. As all the patients were operated upon, we were able to define diagnostic accuracy (DA) of CT in determining the upper pole of the tumour, position of the tumour, invasion of trachea and bronchi, aorta, left auricle, vertebral column, pleura, pericardium and also abdominal invasion or thoracic lymph node. CT scanning slightly improved pre-operative evaluation of resectability of tumours when compared with routine barium swallow, abdominal US and bronchoscopy. It is not of great help for tumours smaller than 5 cm. CT scanning is particularly useful in evaluation of response to pre-operative chemotherapy.

Carcinoma, Squamous Cell↗
PubMed1988

Factors affecting the continuous wave Doppler spectrum for the diagnosis of carotid arterial disease.

Spectral analysis of continuous wave (CW) Doppler signals is used for the diagnosis of carotid arterial disease. Previous clinical and in vitro studies have documented that the peak Doppler frequency is increased in recordings made directly over a stenosis and that spectral broadening is observed beyond a stenosis in the region of disturbed flow. However, certain hemodynamic and technical factors can effect the Doppler spectrum and in particular cause spectral broadening although they are not related to the severity of the arterial stenosis. In this in vitro study, Doppler spectra were quantified by (1) measurements of the peak, mean and mode frequencies, and (2) measurements that quantify changes in the shape of the spectra and thus can potentially detect the presence of spectral broadening. The latter measurements included the spectral broadening index (SBI), coefficient of variation (CV), coefficient of skewedness (CS), and coefficient of kurtosis (CK). Using straight tubes without a bifurcation in a steady flow model, we found that the peak frequency and the extent of spectral broadening were dependent upon the severity of the stenosis, the relation of the recording site to the stenosis or bulb, and the flow rate. Comparison of the severity of Doppler spectral broadening from bulb and stenosis recordings allowed us to conclude that any observed changes in spectral broadening measurements are probably due to a significant stenosis and not to the presence of a normal bulb. If the tube is not completely insonated by the CW Doppler beam, an error of between 4 and 35% can be read in the spectral broadening measurements. The peak frequency, mean frequency, and SBI are not altered significantly by the automatic gain control or dynamic range and noise level settings usually chosen by the spectrum analyzer. Because of the variability of individual Doppler spectra, one should be cautious about deriving quantitative data from one individual spectrum. The results of quantitative analysis of the amplitude spectrum are different from the power spectrum. In conclusion, this in vitro study identified several hemodynamic and technical factors that affect the CW Doppler spectrum; however, in the clinical setting, their influence on quantitative measurements of the extent of spectral broadening likely can be minimized by a skilled technologist who uses a standardized technique.

Blood Flow Velocity↗
PubMed1988

Thoracoabdominal retroperitoneal approach for repair of abdominal aortic aneurysm associated with horseshoe kidney.

This article describes a patient with an abdominal aortic aneurysm associated with horseshoe kidney that was repaired through a thoracoabdominal retroperitoneal approach. In general we believe that the retroperitoneal approach is preferable to the standard transabdominal approach since it avoids the two major difficulties associated with aneurysm repair in a patient with a horseshoe kidney. These are the renal artery anomalies which can be reanastomosed from within the aneurysm sac and the renal isthmus anterior to the aorta which is retracted with the kidney.

Aorta, Abdominal↗
PubMed1988

[Approaching the gene of mucoviscidosis. New data].

We used 5 polymorphic probes strongly linked to the gene of cystic fibrosis (CF) to perform the genotypical study of 48 families with at least one child presenting with the disease. The last Km19 and XV2c probes showed a very important linkage imbalance with the CF gene (allele 2 = 6.6 kb of Km19/Pstl, chi 2 = 56; allele 1 = 2.1 kb of XV2c/Taql, chi 2 = 21). These two markers define a B haplotype which confers a relative risk of 55 to be gene carrier. From these data, the predictive value for an individual presenting with this haplotype to be heterozygous was computed to be 1/5. Presently, the risk of 1/20 for a randomized subject to be gene-carrier should be reexamined after study of this genotype. These results are very important practically, as they modify the classical data of genetic counselling concerning cystic fibrosis for the couples with a risk higher than 1/4.

Alleles↗
PubMed1987

In vitro study of continuous wave Doppler spectral changes resulting from stenoses and bulbs.

Quantitative analysis of continuous wave (CW) Doppler spectra by measurements of peak frequency and spectral broadening is an important non-invasive method for detecting disturbed flow caused by carotid arterial stenosis. It is known that severe stenoses can be detected; however, the spectral changes associated with minor or moderate stenoses may not be detected or can potentially be confused with those produced by flow disturbances in the normal carotid bulb. In order to determine if the flow disturbances in a normal bulb and those associated with a minor stenosis produce significant spectral changes, Doppler spectra were recorded from straight tubes with bulbs or stenoses in an in vitro model with steady flow rates of 400, 600, and 800 cc/min (Reynolds numbers of 1700, 2600, and 3500). Stenoses greater than approximately 30% cross-sectional area were associated with an increased peak frequency and increased spectral broadening as measured by spectral broadening index (SBI), coefficient of variation (CV), coefficient of skewedness (CS) and coefficient of kurtosis (CK). Stenoses less than 30% were not detected. With flow rates of 400 and 600 cc/min, the presence of a bulb did not affect peak frequency or the extent of spectral broadening. With a higher flow rate (800 cc/min), there was an increase in SBI, CV and CS but no increase in peak frequency. Based on the results of these in vitro steady flow experiments in straight tubes, we conclude that increased peak frequency and spectral broadening are the result of a stenosis greater than 30% cross-sectional area.(ABSTRACT TRUNCATED AT 250 WORDS)

Carotid Artery Diseases↗
PubMed1987

[Metallic trace elements--A1, Cd, Cu, Fe--in solutions of 111InCl3: determination by flameless atomic absorption and results in 111In-radiolabeling of monoclonal antibodies].

Determination of trace elements in 111InCl3 solution have been carried out by flameless atomic absorption spectrometry. Five successive batches from three European companies have been analysed. The means of measured values range from 4560 to 6930 micrograms L-1 for aluminium, 131 to 874 for cadmium, 49 to 300 for copper, 387 to 698 for iron. Using two molar ration indexes, trivalent metallic traces have been compared to theoretical 111In content. The trace elements largely exceed radioactive material. As Fe and In have similar chemical properties, it results in low specific activity of radioactive complex when labeling monoclonal antibodies by 111In. Using a mathematical model, a detrimental effect of Fe trace levels has been studied.

Aluminum↗
PubMed1987

Ultrasensitive assay of thyroid stimulating hormone in patients with acute non-thyroidal illness.

Serum TSH in critically ill euthyroid patients is generally within the normal range when measured with conventional radioimmunoassays. Sensitive immunoradiometric assays allow detection of low levels of serum TSH. We assessed this method in a prospective study of 34 euthyroid patients admitted to our critical care unit. Serum TSH ranged from 0.12 to 3.60 mU/l and was significantly lower for the whole group than in the controls (P less than 0.001), as also were serum total T4 and T3 values (P less than 0.001). However, 21 patients had a serum TSH within the normal range (group 1) and 13 patients (33%) had a serum TSH less than 0.40 mU/l (group 2). The two groups did not differ in age, sex, type and severity of illness, outcome, and serum T4 and T3 levels. However, the magnitude of TSH increase from the baseline value after the i.v. injection of 200 micrograms of TRH, assessed by the 30 min TSH/basal TSH ratio was significantly higher in group 2 (P less than 0.05). These results suggest that a substantial proportion of patients with acute illness have a clearly low serum TSH, unaccounted for by age, sex, type or quantified severity of illness, serum T4 and T3 levels. In addition, the secretory capacity of the pituitary to exogeneous TRH is significantly enhanced in those patients with low basal TSH.

Acute Disease↗
PubMed1986

Factors that determine the long-term results of percutaneous transluminal dilatation for peripheral arterial occlusive disease.

Seven hundred thirty-one percutaneous transluminal dilatations (TLDs) for peripheral arterial occlusive disease were performed between 1978 and 1984. From this prospective study 666 dilatations were analyzed with a combination of clinical and objective vascular laboratory tests to determine which factors could be used to predict long-term successful results. Eleven variables were recorded at the time of TLD. The proportional hazards model (Cox regression) identified four significant variables predictive of long-term success: the indication for the procedure (claudication or salvage), site of the dilatation (aortoiliac or femoropopliteal), runoff (poor or good), and whether a previous TLD was done at the same site. With these significant variables, the Cox model was used to estimate the chances of success at 1, 2, and 3 years for all combinations of variables. The accuracy of the Cox model was confirmed by the close approximation between the number of observed and predicted successful TLDs at 1, 2, and 3 years. We concluded that the chances of success of TLD in terms of percentage at 1, 2, and 3 years can be predicted from the combinations of these four significant variables. Knowledge of these factors should permit better selection of patients for this procedure.

Aged↗
PubMed1986

Improvement after successful percutaneous transluminal dilation treatment of occlusive peripheral arterial disease.

Six hundred and eighty-one transluminal dilations were performed at the Toronto General Hospital between 1978 and 1984. In this consecutive series, 207 iliac and 65 femoropopliteal successful dilations were performed for claudication in patients with good runoff. Using this ideal group of patients in whom one would expect the greatest improvement, we determined the extent of improvement after successful transluminal dilation. Persistent mild symptoms were frequent and the ankle to brachial blood pressure ratio often remained abnormal. We have concluded that transluminal dilation can be used as an adjunct or alternative to surgical treatment if certain clinical, roentgenographic and technical criteria are met.

Aged↗