PubMed Health⌕ Search

Biomedical subjects

J Guerin

Publications and source records attributed to J Guerin.

At least 73 records · Page 4Linked to original sources
PubMed1980

[Accidental overdose of alfatesine in a child with multiple malformations].

An overdosage of alfathesin was accidentally administered to a 4 kg infant with multiple congenital anomalies during an operation for craniosynostosis. The overdose was a consequence of a mistake in adjusting the rate of administration of a constant flow infusion pump. The total dosage corresponded to eight times the necessary dose administered over a period of 30 minutes. The only notable effect was a delayed awakening, which necessitated assisted ventilation. The high therapeutic index of alfathesin is responsible for the absence of serious consequences.

Alfaxalone Alfadolone Mixture↗
PubMed1979

[The treatment of Cushing's syndrome by selective excision of pituitary adenoma. 3 cases (author's transl)].

In three patients suffering from Cushing's disease, exploration revealed an enclosed pituitary adenoma in one case and a microadenoma in two cases. Selective excision via a transphenoidal approach resulted in cure of Cushing's disease as reflected by complete regression of clinical signs and the restoration of circadian rythm of cortisol. Regular follow-up over a period of more than two years showed the persistence of normal regulation of the corticotrophic sector of the pituitary.

Adenoma↗
PubMed1978

[Intra medulla oblongata and cervical ependymoma (surgery, apnea for two months and improvement) (author's transl)].

A 17 years old female was first seen in a neurology department in December 75. She was running a low grade fever; her general status was not good. At the physical examination she presented:--an amyotrophy of both arms, mainly proximal,--a thermo analgesic dissociation which was complete from C1 to C5 and incomplete from C5 to D4, and--a spastic quadriparesis (with a posterior spinal syndrome). The first physical disabilities appeared 15 months before. The myelography revealed an enlarged spinal cord in the upper part of the cervical region and the contrast media could not go through the foramen magnum. At surgery, a solid mass, localized on the right side, inside the medulla oblongata and the spinal cordal, with a cyst at each extremity, reaching C4 in the lower part and the recessus lateralis in the upper part. During surgery the patient was breathing spontaneously. After the removal of the mass, she presented an apnea. The quadriplegia following surgery was very short. She recovered rapidly a normal motor activity in both legs and in the right arm. Respiratory paralysis remained complete for 2 months. The right diaphragm recovered completely in 4 months, the left one only in part. 4 months after surgery, she went back home. One year later for security reason she still has a tracheotomy. The distal paralysis of the left superior arm is still present.

Adolescent↗
PubMed1976

[Neonatal pneumothorax and urinary tract malformation. 3 cases].

Three newborn male infants are reported who presented with a tension pneumothorax in the first few hours of life. Early in one case and after intervals of one month and eight months in the others attention was drawn to the urinary tract. Radiological investigations revealed morphological abnormalities of the kidneys and the urinary tract itself. The pathogenesis is discussed and an intravenous pyelogram is recommended before the development of clinical features. In this way early diagnosis might allow treatment prior to renal involvement.

Abnormalities, Multiple↗
PubMedDate not supplied

[The circle of Willis in children and the factors shaping it].

The pattern of the circulus arteriosus cerebri was studied on the sagittal plane in 41 brains taking off on children from birth to 14 years. Internal diameters were measured on the segments of the circulus, on the cortical efferent vessels and on the internal carotid afferent arteries. In only 17/41 cases, a symetry of the segment of the cortical efferent branches and of the carotid arteries. We found different factors associated with the assymetry of the circulus arteriosus, namely cerebral conditions as demonstrated in our pathological cases and embryological dispositions. Three grades are proposed according anatomic criteria. They are related to a greater complexity and interaction of the conditions mentionned above:-grade 1 "foetal" : symetry is complete;-grade 2 : there is a symetry of the cortical branches, but an assymetry of the circulus arteriosus, which is obtained by compensatory modelling of the circulus arteriosus, working to equalize the cerebral flow; -grade 3 : there is an assymetry of the circulus and of the cortical efferent branches suggesting a failure of adaptation. It is assumed that this modelling of the circulus has consequences on adult anatomic and functional conditions. Indeed, the other modelating factors which affect the adult circulus refer mainly to the grade obtained in childhood.

Adaptation, Physiological↗
PubMedDate not supplied

[Validation of a scale for responsibility (Salkovskis Responsibility Scale)].

Appraisal of inflated responsibility for harm is the cornerstone of Salkovskis's cognitive theory for obsessive compulsive disorder. The aim of our study is to present the validation study of the French translation of the R scale. The present study compared 50 subjects with obsessive compulsive disorder, 37 patients suffering from social phobia and 183 control subjects on a responsibility questionnaire (R scale). The cognitive hypothesis of Obsessive Compulsive Disorder (OCD) specifies two levels of responsibility-related cognitions: responsibility assumptions (attitudes) and responsibility appraisals (interpretations). The R scale evaluates the responsibility assumptions. Such attitudes should reflect the more generalized tendency to assume responsibility in a given situation, particularly situations involving intrusions and doubts. It is possible that such assumptions may be less specific to OCD. The inclusion of social phobia subjects in the present study allows evaluation of the specificity of any findings to OCD. Patients were diagnosed and classified according DSM IV criteria. The control subjects were taken in the general population. No formal interview was conducted. The three groups were compared for sex, age and educational level. Before treatment, all the participants filled in the Responsibility Scale of Salkovskis (27 items), the Beck Depression Inventory (21 items), the Beck Anxiety Inventory and the Bouvard's Obsessive Compulsive Thoughts Checklist. The results indicate that the two anxious groups scored significantly higher than the control group on Beck Depression and Anxiety Inventories but no significant difference was observed between the two anxious groups. OCD patients scored significantly higher than both social phobic patients and control subjects on the Obsessive Compulsive Thoughts Checklist (OCTC). The social phobic group scored this checklist significantly higher than the control group. In sum, the three groups were different on obsessive compulsive thoughts. On the washing subscale of the Obsessive Compulsive Thoughts Checklist, the OCD patients differed significantly from the control group and the social phobia patients. No difference was observed between the social phobia subjects and the control group. On the two other subscales of the OCTC, the checking and the responsibility scales, the three groups were different: OCD patients scored significantly higher than both social phobic patients and control subjects; the social phobic patients scored higher than the control group. Results support the reliability (test retest) and the internal consistency of the questionnaire. Patients with obsessive compulsive disorder (OCD) and social phobia subjects had significantly elevated score on the total scale compared to control subjects. However social phobia patients did not differ from patients with OCD. So, the responsibility for harm, evaluated by the R-scale seems not to be specific of OCD. This finding does not support the results of two studies (28, 30). But these two studies compared OCD patients with an anxious group including panic disorder with agoraphobia, generalized anxiety disorder and social phobia. The correlations with a measure of OCD symptoms were higher than the correlations with anxiety and depression. Finally, the factor structure was only studied on the control group. The exploratory factor analysis indicates that the R scale is a two-dimensional scale, reflecting a need to prevent risks and the belief that one has power to harm. The first dimension is less specific to the pathology than the second. Only patients with OCD had significantly elevated score on the "need to prevent risks" compared to the non-clinical group. The two anxious groups differed on "the belief that one has power to harm" from the non-clinical group but social phobia patients did not differ from patients with OCD. In sum, the two subscales of the R scale did not discriminate OCD patients and social phobic subjects. Further research is needed to replicate the present findings and to confirm the two dimensions of the R scale. Overall, the results are consistent with the hypothesis that responsibility beliefs are important in the experience of obsessional problems. However, responsibility assumptions such as the belief that one has the power to harm are shared with social phobia.

Adult↗
PubMedDate not supplied

Leukemic dissemination within a glioblastoma in a patient with chronic lymphoid leukemia.

Metastasis from an extracranial tumor to a primary central nervous system tumor is a rare event, and most reported cases concern metastases to meningiomas. The authors describe the first case of leukemic cell dissemination within a glioblastoma. The patient likely presented a genetic predisposition to multiple neoplasms, and the unusual localization of leukemic cells might be partly related to the characteristic microvascular proliferation in glioblastoma.

Brain↗
PubMedDate not supplied

Surgery of the internal acoustic meatus and the cerebello-pontine angle.

Tumoral and functional surgery of the cerebellopontine angle and the internal acoustic meatus has been performed in our department for more than 20 years. Acoustic neurinomas (700 cases operated to date) represent the great bulk of this surgery. Since 1985, we have drastically modified our approach to these tumors (220 cases). Large tumors are now dealt with, regardless of the patient's hearing, through a widened translabyrinthine approach. Small tumors with normal hearing are operated on through a suboccipital or a retrolabyrinthine approach depending on the tumoral extension in the internal acoustic meatus. The facial nerve function was preserved in 83% of the cases. Hearing was saved only 6 times in 45 attempts, despite 23 cases of apparent anatomical conservation of the cochlear nerve. Vestibular neurectomy, carried out through a middle cranial fossa or through a retrolabyrinthine approach, ameliorated vertigo in 95% of cases. The major operative risks are regressive facial paresis and secondary total deafness (10% of cases). Surgical treatment of facial hemispasm by neurovascular decompression is very effective, but not without risk. We now prefer to use botulin toxin therapy.

Cerebellar Neoplasms↗
PubMedDate not supplied

Duodenal ulcer in the new-born (author's transl).

A new-born baby was found to have a duodenal ulcer after developing a severe hematemesis 24 hours after birth. The diagnosis was established by fibroscopic examination, which was also used to follow progress in this case, in which operation for a secondary hypertrophic stenosis of the pylorus led to a favourable outcome. The role of "stress" and, more particularly, gastric hyperacidity in the neonatal period are discussed. Once the critical period is passed, during which hemorrhage and perforation are the cause of the high mortality, recovery is complete.

Duodenal Ulcer↗