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Biomedical subjects

M Marchand

Publications and source records attributed to M Marchand.

At least 145 records · Page 8Linked to original sources
PubMed1979

[Coronary lesions due to aortic valve disease. II -- Results and indications of aortocoronary bypass surgery].

454 cases of aortic valve replacement were studied: 217 had no significant coronary artery disease, 197 had associated aorto-coronary bypass surgery and 40 coronary artery disease without revascularization surgery:-- The early mortality in the three groups was 5.5%, 21% and 12.5% respectively, the only statistically significant difference being between the first two groups. -- The coronary artery disease was signigicantly more severe in the group which underwent associated aorto-coronary bypass surgery. The early mortality was significantly raised in the group without bypass surgery in cases with severe coronary artery disease (28%) and in the group with bypass surgery with unsuitable coronary artery lesions (35.5%). On the other hand, the long term survival and functional capacity of patients who underwent associated bypass surgery approached that of the non-coronary patients. Combined aortic valve replacement and coronary bypass surgery should therefore be continued in selected cases.

Aortic Valve Insufficiency↗
PubMed1978

[Surgical correction of tetralogy of Fallot with an iatrogenic obstruction on 1 branch of the pulmonary artery].

The au;hors report 12 cases of Fallot' tetralogy with stenosis or obstruction of one of the two branches of the pulmonary artery following palliative anterior anastomosis. The complications of correction by open heart surgery include the frequent incidence of pulmonary hypertension, which was responsible for 4 deaths. No satisfactory explanation could be found for these poor results. It is desirable to avoid the creation of asymetry in pulmonary blood supply in Fallot's tetralogy and, if such should be found, suggestions are made for its correction by open heart surgery in order to improve the prognosis.

Child↗
PubMed1978

[Results of the surgical treatment of congenital mitral insufficiency].

The authors report 21 cases of congenital mitral incompetence undergoing surgery between 1972 and 1977. There were 3 operative deaths and 2 late deaths. Of the survivors, 10 had a good result and 5 a fair result. The factors influencing the results have been associated lesions (aortic stenosis and ventricular septal defects are more serious than atrial septal defects and abnormalities of origin of the left coronary artery), the type of repair (which is better if it seeks to correct the frequently complex valvular abnormality at all levels), and especially the degree of dilatation of the left ventricle. By contrast, age had no influence either on the operative risk or on the quality of the results.

Adolescent↗
PubMed1978

[Correction of cardiac malformations after corrected transposition of the great vessels. A series of 18 cases operated on by an open heart technique].

Recent progress in the surgical treatment of malformations after transposition has been dealt with has been made in three directions: 1. By knowledge of the position of the conducting pathways in relation to ventricular septal defects, so that total atrioventricular block, the first complication of this type of surgery, may be avoided; 2. By appreciation of the proximity of the conductive pathways to the elements contributing to pulmonary stenosis, which may contra-indicate direct removal of such stenosis. In such a case, a valved tube must be placed between the sub-pulmonary ventricle and the pulmonary artery; 3. By appreciating the frequency, the difficulty in diagnosis and the grave consequences of failing to recognise lesions of the atrioventricular valves, with the result that their systematic investigation should form part of the operative technique.

Adolescent↗
PubMed1977

[65 orthotopic transplantations of the liver in the pig. Clinical and laboratory results (author's transl)].

The authors report the clinical and laboratory results of 65 orthotopic allotransplantations of the liver in the pig. The operative mortality (8 cases) was nil in the last 23 transplantations. Vascular filling without blood transfusion, blood alkalinisation and precautions to avoid hypothermia, seem essential to reduce early mortality. The various causes of secondary mortality are studied, using certain preventive measures. Thus, deaths due to gallbladder or hepatic ischemia have become rare by conserving end-to-end anastomosis on the hepatic artery and taking certain precautions. The grafts were rejected only in incompatible pigs in the SLA system, but were not rare in this group (13/43) and sufficient to cause death in one case out of two. Gastric ulcers were frequent, even after vagotomy, but vagotomy protects fairly well against ulcer hemorrhage. However, ulcers almost always accompany a disease which is alone sufficient to cause death. Cholangitis appears less frequent after cholecysto-jejunal anastomosis on an excluded omega loop. The mortality from extra-hepatic causes was severe (12 cases), in particular due to mechanical complications at the level of the small intestine. Laboratory analyses showed a definite rise in SGOT transaminase levels and, above all, alkaline prosphatase levels in cases of rejection compared with cases of biliary obstruction or hepatic necrosis.

Animals↗
PubMedDate not supplied

[Species of the genus Vibrio associated with marine products from Arachon Bay].

The distribution of Vibrio species in water and seafood collected from Arcachon Bay (located in the southwest of France) was studied. All invertebrate animals collected were associated with one or more Vibrio species. Eighty strains corresponding to 14 species were precisely identified. The identification of strains with V. parahaemolyticus was checked by DNA/DNA hybridization. The most frequently recovered species were V. alginolyticus, V. parahaemolyticus (non-haemolytic strains), V. harveyi and V. metschnikovii. The three V. cholerae non-O1 strains isolated from water and crab did not produce immunologically detectable cholera toxin and had no DNA fragment hybridizing with a cholera-toxin-gene-specific probe. It is suggested that the sanitary surveillance of seafood in France should include the precise characterization of potentially pathogenic Vibrio species.

DNA, Bacterial↗
PubMedDate not supplied

[Diabetic cardiac autonomic neuropathy].

Cardiac autonomic neuropathy (CAN) is a common complication of diabetes mellitus, which is associated with a higher risk of morbidity and mortality. It can be detected by analyzing spontaneous (Holter) or provoked (Ewing's test battery) changes in heart rate and arterial blood pressure. Baroreflex gain is a specific index of great interest. Our laboratory has acquired a large experience in the assessment of CAN in diabetic patients. We use the Finapres, a device that allows continuous noninvasive monitoring of blood pressure and heart rate, and a special and discriminative active orthostatic manoeuvre, the "squatting" test (standing-squatting-standing).

Autonomic Nervous System Diseases↗
PubMedDate not supplied

[Arterial pulse pressure in relation to the duration of type 1 diabetes: a cross-sectional controlled study].

Diabetes mellitus and arterial pulse pressure (PP) are two independent cardiovascular risk factors. This cross-sectional study investigated the influence of diabetes duration on PP in type 1 diabetic patients without any cardiovascular disease. PP was measured continuously during 3 minutes (active orthostatic test: 1 min standing--1 min squatting--1 min standing) using a fingertip plethysmograph (Finapres) in 159 type 1 diabetic patients aged 20-60 yrs. They were divided into 4 groups according to diabetes duration: (1) G1 : <10 yrs (n=39); G2: 11-20 yrs (n=45); G3: 21-30 yrs (n=57); and G4: >30 yrs (n=18). In order to separate the effects of age from the effects of diabetes duration, diabetic patients were compared to age- and sex-matched non diabetic controls. PP (expressed in mmHg; mean +/- SD) was higher in men than in women in both diabetic (58 +/- 15 vs. 50 +/- 14; p = 0.001) and non diabetic subjects (55 +/- 14 vs. 47 +/- 12; p = 0.001). Overall PP was higher in diabetic than in non diabetic individuals (54 +/- 15 vs. 50 +/- 13; p = 0.025). PP progressively increased according to diabetes duration: 47 +/- 16 vs. 51 +/- 13 vs. 59 +/- 14 vs. 62 +/- 12, from G1 to G4 respectively; p < 0.0001. Such an increase was not observed in age-matched non diabetic subjects: 50 +/- 11 vs. 52 +/- 12 vs. 49 +/- 14 vs. 52 +/- 18, from G1 to G4, respectively; NS. PP was higher in squatting than in standing position in non diabetic subjects (52 +/- 16 vs. 47 +/- 13; p < 0.0001) and even more in diabetic patients (59 +/- 17 vs. 50 +/- 14; p < 0.0001). Overall, PP difference between diabetic and non diabetic individuals was not significant in standing position (50 +/- 14 vs. 47 +/- 13; NS) although it became highly significant in squatting position (59 +/- 17 vs. 52 +/- 16; p = 0.0005). The squatting-standing difference in PP markedly increased with diabetes duration: 69 +/- 14 during squatting vs. 50 +/- 18 during standing in G4 compared to respectively 50 +/- 17 vs. 44 +/- 15 in G1 diabetic patients. Finally, PP was similar (NS) in diabetic patients with HbA1c < 8% (54 +/- 14) or > or =8% (55 +/- 16), with (57 +/- 17) or without (54 +/- 14) microalbuminuria, treated (56 +/- 14) or not (54 +/- 15) by inhibitors of the renin-angiotensin system. In conclusion, PP progressively increased with the duration of type 1 diabetes, independently of age. Such increase was more marked in squatting than in standing position. The role of such PP rise in the increased cardiovascular risk of patients with type 1 diabetes, although suspected in the recent EURODIAB Prospective Complications Study, deserves further investigation.

Adult↗
PubMedDate not supplied

[Selenium and vitamin E in mucoviscidosis].

Selenium and vitamin E are two important components which protect membrane lipids from oxidative damage. Recently an abnormal fatty acid turnover in the membrane phospholipids was found in cystic fibrosis (CF). We studied vitamin E and selenium status in 26 CF children compared to a control group. we measured selenium concentration in plasma and erythrocytes using flameless atomic absorption. The measure of erythrocyte glutathione peroxidase activity allowed a functional assessment of selenium. Total plasma tocopherol concentrations (HPLC) were referred to total lipids. The vitamin E and selenium levels in not yet treated children (n = 6) were very low, with an important decrease in glutathione peroxydase activity. The antioxidative agents deficiency was mild in children with pancreatic enzyme replacement and vitamin E supplementation (n = 20). In the 2 groups, this deficiency was combined and may play a role in CF membrane abnormalities.

Adolescent↗
PubMedDate not supplied

The single-breath nitrogen test does not detect functional impairment in children with passive exposure to tobacco smoke.

Respiratory symptoms and pulmonary function were compared in 46 nonsmoking children aged 10 to 16 years, whose parents were smokers, and an identical number of children (matched for sex, age and height) whose parents were nonsmokers. Passive exposure to parental tobacco smoke resulted in a higher prevalence of respiratory symptoms, more frequent upper airway infections and a significant decrease in forced expiratory flows; these effects were more marked in boys. The single-breath nitrogen washout test, a sensitive test of small airways obstruction in adults, did not detect any effect of involuntary smoking in this limited sample of children.

Adolescent↗