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Biomedical subjects

L Colin

Publications and source records attributed to L Colin.

At least 37 records · Page 2Linked to original sources
PubMed1993

Ischemic hepatitis in cirrhosis. Rare but lethal.

We report two cases of ischemic hepatitis in patients with alcoholic cirrhosis. In both, hepatic ischemia was induced by hemorrhagic shock and severe sepsis. Despite control of the bleeding and restoration of normal hemodynamics, liver failure deteriorated to hepatic coma and death in both cases. Ischemic hepatitis occurred in 1.5% of 130 consecutive cases of cirrhosis admitted for hemorrhage on our medical intensive care unit. Although cirrhotic patients run an increased risk of ischemic hepatitis, our experience and our review of the literature indicate that this condition is rare in these patients.

Aged↗
PubMed1992

[Thrombosis of the superior vena cava after prolonged catheterization. Treatment by progressive removal of the catheter combined with urokinase-heparin administration].

A retrospective study of 13 cases of complete superior vena cava thrombosis due to prolonged catheterization is reported. All the polyurethane catheters had been inserted by anaesthetists in theatre between January 1985 and December 1989, using Seldinger's technique. On the 10th day after the first catheter had been placed, the catheter was replaced by using a guide wire. Superior vena cava obstruction was diagnosed clinically (eyelid, neck, facial and upper limb oedema, cyanosis, collateral venous circulation, lack of blood reflux in the catheter). The clinical diagnosis was confirmed by phlebography. Treatment consisted in administration of urokinase (1,500 IU.kg-1.h-1), together with 10,000 to 25,000 IU.day-1 of heparin, both being injected via the catheter. The catheter was removed progressively (1 cm every 2 to 4 h). As soon as a venous pressure curve was obtained, the catheter was completely removed. Overall 8,784 catheters were inserted during that period. The incidence of superior vena caval obstruction may therefore be estimated to be 1.48 per 1,000 catheters. The catheters remained in place up to a mean of 14.75 +/- 9.6 days before the obstruction occurred. Treatment with urokinase and heparin lasted a mean of 2.53 +/- 1 days. The clinical picture returned to normal in all 13 patients. Phlebography carried out in three of them, after treatment, showed an excellent degree of venous repermeability. Thrombolysis was confirmed by the increase in the concentration of D-dimers, without any decrease in fibrinogen concentration. There were five haemorrhagic complications, including two haematomas of the psoas muscle, one of which required surgical drainage.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Hypoxic hepatitis. Prospective, clinical and hemodynamic study of 45 cases].

The authors report 45 episodes of centrilobular liver cell necrosis, called ischemic hepatitis, in 43 cardiac patients. In 75 percent of the episodes, centrilobular liver cell necrosis was preceded by a period of progressive deterioration of myocardiac function. In 100 percent of the episodes, liver cell necrosis occurred after an acute clinical event inducing a transient fall of cardiac output. Shock was observed in only 47 percent of the episodes. The biological hallmarks of this centrilobular liver cell necrosis were a massive increase in serum aminotransferase levels and in 85 percent of the episodes, a decrease in the prothrombine time below 50 percent of control level. The mortality rate, 15 days after admission, was 42 percent. Prognosis was mainly related to cardiac function. The hemodynamic comparison between the 45 episodes of centrilobular liver cell necrosis and 22 cases of cardiogenic shock without liver cell necrosis showed that, besides hepatic ischemia, passive venous congestion of the liver and arterial hypoxemia were also involved in the onset of liver cell necrosis in these cardiac patients. Among these 45 episodes of liver cell necrosis of cardiac origin, a unique case of hepatic necrosis secondary to major hypoxemia and passive venous congestion, despite an high cardiac output was observed and is reported in detail. Accordingly, the appellation "hypoxic hepatitis" seems to be more appropriate than "ischemic hepatitis".

Adult↗
PubMed1990

Ludwig's angina and mediastinitis due to Streptococcus milleri: usefulness of computed tomography.

Despite intensive use of antibiotics, Ludwig's angina remains a potentially lethal infection because of the risk of upper airway obstruction and spread into the mediastinum. We present two patients who survived mediastinitis complicating Ludwig's angina due to Streptococcus milleri. Computed tomography performed early in the course of the disease detected pus collections and directed appropriate drainage procedures.

Abscess↗
PubMed1989

[The tooth-amalgam joint: the role of the marginal bevel].

Three amalgams, Standalloy, Dispersalloy and Formibel are used to fill class I cavities (bevelled or not) and applied over fresh-removed wisdom teeth. Macroscopic examination with a binocular lamp shows a better marginal adaptation of amalgams when cavity walls and edges have no asperity nor bevel and regardless of the quality of the amalgam. This MEB examination reveals a gap at dentinal level that might result from the vacuum processing of the samples.

Dental Amalgam↗
PubMed1989

Potential problem with fluorescence polarization immunoassay cross-reactivity to vancomycin degradation product CDP-1: its detection in sera of renally impaired patients.

During the development of a homogeneous immunoassay for the antibiotic vancomycin, we observed in certain patient samples a quantitation difference between the enzyme multiplied immunoassay technique (EMIT) method and the comparison method, fluorescence polarization immunoassay (FPIA). This prompted us to evaluate the integrity of vancomycin in samples from renally impaired patients. Since it has been reported in the scientific literature that vancomycin degrades into an antibiotically inactive crystalline degradation product (CDP-1) in vitro, we developed high-performance liquid chromatography (HPLC) and liquid chromatography/mass spectrometry (LC/MS) methods to determine whether CDP-1 is present in patient sera. HPLC and LC/MS analysis on samples from renally impaired patients positively identified CDP-1 in fresh samples. Next, we tested the cross-reactivity of three currently available vancomycin immunoassays, radioimmunoassay (RIA) FPIA, and EMIT, to CDP-1 prepared in our laboratory. Our data suggest that CDP-1 is recognized by FPIA and RIA, both polyclonal antibody-based methods, but not by EMIT, which uses a monoclonal antibody.

Chromatography, High Pressure Liquid↗
PubMed1987

Measurement of intestinal permeability to mannitol and lactulose as a means of diagnosing food allergy and evaluating therapeutic effectiveness of disodium cromoglycate.

Gastrointestinal permeability was evaluated in 90 fasting healthy subjects and 60 patients with food allergy by oral administration to both groups of 5 g of mannitol, a marker of absorption of small molecules, and 5 g of lactulose, a marker of abnormal absorption of large molecules, and subsequent measurement of urinary excretion of mannitol and lactulose. In healthy subjects, mean 5-hour urinary excretion of mannitol was 14.11% and of lactulose 0.26%. In the fasting state, the 60 patients with food allergy exhibited a mean urinary recovery of mannitol of 13.22%, not significantly different from that in healthy subjects. Mean recovery of lactulose in the patients with food allergy was 0.55%, significantly greater than in the healthy patients. After ingestion of food allergens by the patients, mean mannitol recovery fell to 11.57% and mean recovery of lactulose rose to 1.04%, both values being significantly different from those obtained in the fasting patients. On challenging the patients after they had taken sodium cromoglycate, mean mannitol and lactulose recoveries (13.53% and 0.62%, respectively) were not significantly different from those in fasting patients but were significantly different from those obtained on challenging patients unprotected by sodium cromoglycate. Evaluation of intestinal permeability in this way provides an objective means of diagnosing food allergy and assessing the effectiveness of anti-allergic agents such as sodium cromoglycate.

Cromolyn Sodium↗
PubMed1987

[Changes in the granular ducts of the submandibular gland in rats subjected to dietary deficiencies].

Lack of balance in protein diets induced structural modifications of the rat submaxillary glands. The granular ducts underwent a differentiation delay and a hypodevelopment under the effect of hypo and hyperproteinic diets. The optical microscope morphometric analysis showed that the total and single surfaces of the ducts were different in the groups with abnormal hypo or hyperproteinic diets compared to the control group. In TEM, the quantitative study showed that the number of cells with dense granules and the number of these granules were decreased in the hypoproteinic group. The mean number of granules was in contrast increased in the hyperproteinic group. The results are discussed in terms of duct differentiation, secretory function of the granular cells and equilibrium of the oral cavity.

Animals↗
PubMed1985

[Alveolar proteinosis associated with chronic myeloid leukemia].

The association of pulmonary alveolar proteinosis with hematologic malignancy is well known. The prognosis, in this peculiar setting, is poor. Yet, few patients have been treated in due time. We report a case of pulmonary alveolar proteinosis associated with chronic granulocytic leukemia. The evolution was fatal in spite of intensive treatment.

Female↗
PubMed1984

Filtration for free drug level monitoring: carbamazepine and valproic acid.

Free carbamazepine and valproic acid monitoring using the EMIT FreeLevel filtration system was evaluated and compared with reference equilibrium dialysis and gas chromatographic (GC) techniques. For carbamazepine, free levels after filtration or dialysis were essentially identical (mean 1.74 vs. 1.77 mg/L, r = 0.940, n = 28, EMIT assay). Free levels were 16% higher by EMIT than by GC, possibly due to cross-reaction with carbamazepine-10,11-epoxide. Free fractions were not significantly different using any combination of filtration or dialysis with EMIT or GC (means 0.24-0.26). There was a significant correlation between epoxide and parent-drug free fractions (r = 0.642). Free fraction varied from 0.20 to 0.41 among 61 patient samples and was independent of total drug concentration. For valproic acid, there was a strong correlation between filtration and dialysis results for free level (r = 0.974) and free fraction (r = 0.892), but filtration values were 6-7% higher. Free fraction was concentration dependent (r = 0.597), and lower free fractions by dialysis were attributed to dilution of total drug concentration. Free fraction varied from 0.01 to 0.14 among 50 patient samples. For carbamazepine and valproic acid the EMIT FreeLevel filtration system compared favorably with equilibrium dialysis, and had the advantage of being rapid.

Blood Proteins↗
PubMed1983

[Trial modeling of acinous structures of the rat sub-mandibular gland].

The sub-mandibular glands of rats subjected to unbalanced protein diets for six months were submitted to histomorphometric study in optical light microscopy. Protein deficiency led to slower growth although an hyperprotein diet did not alter acini distribution significantly. The results allowed an acinous structure model related to the diet protein ratio to be tested.

Animals↗