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Biomedical subjects

P Bour

Publications and source records attributed to P Bour.

At least 19 recordsLinked to original sources
PubMed1992

[Synthesis of collagen in culture of endothelial cells of the human umbilical vein. Effects of cyclosporine A].

Interstitial renal fibrosis and gingival hypertrophy are frequent side-effects of cyclosporin A which have been attributed to a dysfunction of extracellular matrix synthesis. Endothelial cells might participate in the matrix accumulation observed. We studied the effects of increasing concentrations of cyclosporin A on protein synthesis by human umbilical vein endothelial cells. Collagen synthesis decreased significantly to 800 ng/ml in both medium and cell layer. The percentage of hydroxylation of its proline residues decreased significantly as from 400 ng/ml. The main proteins, analysed by SDS-PAGE, were thrombospondin, fibronectin and the alpha 1 and alpha 2 chains of type IV collagen. These fractions did not show any change after 24 hours exposure to 200 ng/ml of cyclosporin A. These results demonstrate an inhibitory effect of cyclosporin A on collagen synthesis by human umbilical vein endothelial cells. Consequently, matrix accumulation by increased collagen synthesis in cyclosporin A treated patient may not be directly related to the drug effect on endothelial cells.

Collagen↗
PubMed1992

Aneurysms of the extracranial internal carotid artery due to fibromuscular dysplasia: results of surgical management.

Between January 1977 and December 1990, eight patients underwent surgical correction of aneurysms of the extracranial internal carotid artery due to fibromuscular dysplasia. Mean age of patients was 50 years (range 31 to 70 years). Five patients presented with neurologic hemispheric symptoms. Most aneurysms were saccular and occurred preferentially at the level of C2 or C3. All of these patients underwent operation through conventional cervicotomy. Resection-anastomosis was performed in three cases whereas resection-graft was performed in five. Histopathological examination of the eight specimens was consistent with fibromuscular dysplasia of the media. There was no central nervous system-related mortality and morbidity. Seven patients were alive and free of new neurological manifestations at mean follow-up of 156 months (18 to 180 months). One patient died of myocardial infarction at 96 months. All patients had postoperative duplex scanning or arteriograms. These revealed that carotid restorations were patent in seven whereas one patient had asymptomatic occlusion at 18 months.

Adult↗
PubMed1991

Long-term results of thrombectomy for late occlusions of aortofemoral bypass.

Sixty-two first episodes of aortofemoral (eight patients) or aortobifemoral (42 patients) bypass thrombosis were operated upon in 50 patients between 1980 and 1985. There were 47 men and three women whose mean age was 58 years. Retrograde thrombectomy through the distal anastomosis was achieved in all cases by using either a balloon catheter or Vollmar rings. If thrombectomy was impossible, revascularization was ensured by an extraanatomic bypass or complete replacement of the graft. Angioplasty, repeat distal anastomosis or femoropopliteal bypass of the native runoff artery were done in 55 (89%) operations. The cause of thrombosis was elucidated in 45 cases. Suture line stenosis and atheromatous stenosis of the native runoff artery were the two most common causes. Three patients died and two required above-knee amputation in the immediate postoperative period. Contralateral embolism occurred in two patients undergoing retrograde thrombectomy. Mean follow-up was 47 months. Thrombectomy was possible in 51 or 62 prosthetic thromboses (Group I). Thirty-nine of these grafts have remained patent. Twelve instances of repeat thrombosis occurred, requiring either repeat thrombectomy or a new bypass. Primary patency in group I was 97.8%, 81.2%, and 71.3% at one, three, and five years, respectively. Thrombectomy was impossible in 11 graft thromboses (Group II). A new bypass was performed in all 11 cases. Primary patency in Group II was 100%, 75% and 50% at one, three, and five years, respectively. Retrograde thrombectomy combined with treatment of native runoff artery anomalies can restore long-term patency when thrombosis occurs late after aortofemoral bypass and is associated with low mortality and morbidity.

Adult↗
PubMed1991

Persistent proatlantal artery associated with carotid artery stenosis treatment by percutaneous transluminal balloon angioplasty.

A 58-year-old man had an asymptomatic tight stenosis of the internal carotid artery associated with a persistent proatlantal artery. This as well as other compositional arterial anomalies of the basilar artery were discovered on arteriograms. The stenosis was successfully treated by percutaneous transluminal balloon angioplasty. Therapeutic choices are discussed in this setting because of the risk of carotid clamping in the presence of persistent carotid-basilar anastomoses.

Angioplasty, Balloon↗
PubMed1991

[Popliteal vascular trauma: therapeutic management].

The functional severity of popliteal artery injury is intimately related to the direct consequences of tissue ischaemia increased by the associated traumatic attrition. The conservation of a functional limb requires: limitation of the duration and repercussions of ischaemia, by the use of a rigorous therapeutic protocol; "functional" surgical or even microsurgical reconstruction whose limits are still confused with the degree of traumatic myolysis and the potential of nervous recovery. Therefore, it seems obvious that the major difficulty lies in the definition of the limits for limb preservation.

Anastomosis, Surgical↗
PubMed1991

[In situ bypasses in limb salvage. Late results and patency factors].

One hundred limbs with critical ischemia (stages III and IV) were saved from 1983 to 1987 by in situ venous bypass at the lower femoropopliteal or femorotibial level. The average age of the patients was 66 (40-89) years. The surgical indication involved 51 cases of stage III ischemia and 49 of stage IV. The etiology of the ischemia was occlusive chronic arteritis (n = 67), diabetic arteritis (n = 20), embolic disease (n = 10) and aneurysmal disease (n = 3). The systolic pressure index in the ankle recovered an average value of 0.42 preoperatively. In 48 cases, the distal implantation of the graft was on the lower popliteal artery, and on the arteries of the leg in 52 cases. During the immediate postoperative period, 8 patients died and 13 underwent amputation. At 5 years, the limb salvage rate was 72%. The primary patency at 5 years, calculated with the actuarial method, was 51% and the secondary patency at 5 years was 62%. Among the factors likely to significantly influence patency, only the site of the lower anastomosis and the quality of the III and IV segments of the popliteal artery were selected (p less than 0.05), while the number of patent vessels in the leg and the clinical stage did not influence patency.

Adult↗
PubMed1990

[The lower radio-ulnar joint in malunion of the lower end of the radius: therapeutic implications].

Malunion of the lower extremity of the radius is frequently accompanied by a lesion of the inferior radio-ulnar joint marked by inversion of the inferior radio-ulnar index. Surgical treatment must always take this parameter into account and should attempt to correct it. The authors' preference in the treatment of malunion consists of Duparc osteotomy, in which the size of the graft is calculated in order to restore the inferior radio-ulnar index. If the correction is insufficient or in the case of moderate malunion, the authors propose the Kapandji-Sauvé operation which allows better preservation of the wrist stability.

Adult↗
PubMed1989

Aortoappendicular fistula after aortoiliac prosthetic replacement.

A 48-year-old patient who had had an aortofemoral reconstruction with a Dacron graft nine years earlier presented with intestinal bleeding. At laparotomy the cause was found to be a fistula between a proximal false aneurysm and the vermiform appendix. The patient recovered after removal of the graft and extraanatomic revascularization associated with appendectomy. Four other similar case reports have been found in the literature.

Aorta, Abdominal↗
PubMed1989

[Value and strategy of paraclinical studies in the diagnosis of aneurysm of the abdominal aorta].

With the development of abdominal echotomography and computed tomography, the abdominal aortic aneurysm is no longer explored by arteriography alone. After a retrospective review of 167 patients with aneurysms, the authors propose a schematic diagnostic procedure in 4 arms: positive diagnosis, extension evaluation, emergency statement and follow-up of the aneurysm. The expenditure with these tools has to be considered because of the large deviations in cost price between them. Arteriography is still selectively used for exploration of renal segment but it can often be replaced by computed tomography which is cheaper, external, simply and repeatedly used.

Aorta, Abdominal↗
PubMed1984

[The ambitio-impulse different from narcissism].

We should not let our dynamic drive bog down in the ambiguous concept of "libido". A concept which disturbed Freud himself as is clearly demonstrated in his latest works and which has been considerably misused afterwards. In order to achieve this aim we have in the light of psychopathology, of the symbolic nature of dreams and of our own personal experience set to describe three fundamental drives-the real roots of Man unseparable from his constitution-namely 1. ambitio: (which prompts Man to assert himself, to develop and dominate); 2. agressio: (the urge to defend our internal territory or to overcome obstacles according to our will); 3. attractio: (the disposition to be moved or attracted by this or that object). The present paper shall deal with ambitio which is not to be mixed up with conscious ambition. This unconscious drive, axial and archaic which nourishes the evolution of all living matter (even a tree trunk) should not be interspersed with guilt but is indispensable to our emergence from the Cosmos. Ambitio can be subject to hypertrophy by a compensatory process in cases of megalomania and on the contrary it can be atrophied in the case of a failure syndrome or inferiority complex for example. The most delicate stage of the process is that of its taming and of its conscious acceptance. All things which if properly dealt with and if we want to avoid the traps of authoritarianism or of the narcissistic delusion will lead us in the interest of others, to the most realistic modesty.

Acute Disease↗
PubMed1983

[The contribution of Jacob Lévy Moreno].

meeting of two days organized has happened at the Chartreuse C.H.S., the 24th and the 25th of March 1983, to give homage to J.-L. Moreno , founder of the groupe dynamic and of the psychodrama, insufficiently honoured in France, it looks. Living exchanges have allowed us to draw the mean lines of his technical innovations based of spontaneousity since "the empty chair", "the doble " and "the upsetting of parts", till the sociometric diagram allowing to locate the interactions in the groupe . Then, the different extensions of the therapeutical psychodrama have been developed, practiced since 35 years in Saint- Venant and in Dijon , according to a original method different with nevrosed illmen and with psychotic patients, those one profiting of "intermediate objects", making easier the relationships. The theater, the groupe psychanalyse , or more recently the development of technics makings intervention of somatic and bio- energetical dimension, have settled fruisful extension of the Moreno 's initiative. It is necessary to locate these activities in the universal and humanist context and in the "living will" of the author.

Group Processes↗