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Biomedical subjects

R Houdart

Publications and source records attributed to R Houdart.

At least 19 recordsLinked to original sources
PubMed1991

[Reflections on the law relating to the protection of persons in biomedical research--concerning trials and experiments not about drugs].

This law, called the law of Huriet, was initially meant to control clinical trials of new medications and to protect "normal volunteers". It has been extended to all trials and all human experimentation, including those undertaken as a last resort and those used for research. It also concerns all new interventions or techniques in which experimentation is included in the therapeutic act, and which are the origin of real progress, day after day, in all manual activities. The example of interventional neuroradiology allows us to understand the consequences/risk of this law on the progress of this technique. Because of the lack of structure defining the acquisition of scientific knowledge in this field, this law will not be able to be applied, and the penalties proposed for not applying the law will result in many law suits.

France↗
PubMed1990

[Intravenous cholangiography is not indicated before cholecystectomy for uncomplicated lithiasis].

The purpose of this prospective study was to assess the usefulness of intravenous cholangiograms before elective cholecystectomy for lithiasis. The accuracy of preoperative intravenous cholangiography to detect choledocolithiasis was compared with that of routine operative cholangiography. All patients had preoperative intravenous cholangiography provided that they did not have known common bile duct gallstones or a previous history of adverse reaction to iodine. As well, patients presenting with cholestasis, cholecystitis or cholangitis were excluded. A choledocotomy was performed when the operative cholangiography disclosed choledocolithiasis; the preoperative intravenous cholangiograms were shown to the surgeon only after the operation. One hundred patients were selected among 206 consecutive operations for biliary lithiasis. A choledocolithiasis was detected in 3 preoperative and in 9 operative cholangiographies. Twelve choledocotomies were performed: one or more stones (1 to 12) were found in 9 patients; operative cholangiography was accurate in all these cases whereas preoperative cholangiography was accurate in only 2 (sensitivity = 22 percent). We conclude that preoperative cholangiography is useless before elective cholecystectomy for lithiasis and is unreliable to select patients in which operative cholangiography could be omitted.

Cholangiography↗
PubMed1989

[Criteria for brain death: cessation of cerebral circulation demonstrated by Doppler ultrasonography of the carotid arteries].

If human death is defined by brain death, its diagnosis needs medicolegal criteria based on clinical examination and EEG. However, this evaluation could be difficult because technical or physiological limitations might impair the interpretation, especially after barbiturates and/or hypothermia. Since brain death is characterized by an intracranial circulatory arrest, methods assessing this phenomenon are warranted. Among these methods, conventional or isotopic cerebral angiography appears the most promising, but it cannot be easily performed everywhere. Because superficial blood flow in arteries is now accurately measured by the pulsed Döppler technique, this prompted us to test the specificity and sensitivity of common carotid blood flow data for brain death diagnosis. Two series of age-matched patients (36 yrs in mean) were studied. Series 1 (n = 28) was used to define the discriminant parameters between 14 severe coma patients and 14 brain-dead patients diagnosed by the classical criteria. Then these parameters were prospectively tested in a blind manner on a second series of 28 patients suffering from severe coma. The parameters allowing us to classify patients as brain dead or not with a 100% specificity and sensitivity were: end diastolic blood flow (QED in ml/min), end diastolic blood flow velocity (VED), and cerebral metabolic index (CMI = QED x AV D 02). The most powerful discriminant parameter was QED, allowing a strictly non-invasive diagnosis of brain death.

Adult↗
PubMed1988

Primary gastric peripheral T-cell malignant lymphoma with helper/inducer phenotype. First case report with a complete histological ultrastructural and immunochemical study.

Primary gastrointestinal T-cell malignant lymphomas (T-ML) are very rare. In this case report we describe a primary gastric tumor with local lymph node involvement. On the basis of histologic, immunohistochemical, and electron microscopic studies, the authors classified this tumor as a pleomorphic T-ML, large cell variant with peripheral helper/inducer T-cell phenotype (Leu1/CD5+, Leu4/CD3+, Leu5/CD2+, Leu9/CD7+, and Leu3/CD4+). The extreme pleomorphism of lymphoma cells, the numerous giant cells, and the presence of tumor nodules with two or three concentric layers were the three striking morphologic features of our case. Tumor cells showed an inconstant but true positive staining with anti-LeuM1/CD15 and LeuM3/CD14 antibodies. Vimentin positivity could be related to the presence of intermediate filaments at ultrastructural level. Neuron-specific enolase reactivity was a peculiar but unexplained feature. Furthermore, the positivity of the surface markers Ki-1/CD30, anti-Tac/CD25 and HLA-DR, and the nuclear marker Ki-67 suggested an activation state and a high proliferative activity of the tumor cells. This study emphasizes the usefulness of combined pathologic methods in order to rule other diagnoses such as undifferentiated carcinoma, malignant melanoma, malignant histiocytosis, B-cell lymphoma and interdigitating reticulum cells sarcoma, in view of an extremely polymorph tumor proliferation. This is apparently the first completely documented case report of a primary gastric pleomorphic T-ML of peripheral T-cell origin.

Antigens, Neoplasm↗
PubMed1987

[Chlamydia trachomatis perityphlitis, an anatomo-clinical entity? Study of 3 cases].

The authors describe three cases of perityphlitis secondary to Chlamydia trachomatis infection and revealed at laparotomy. Clinically, the symptoms invariably mimicked acute appendicitis. The pathogen was identified by a direct immunofluorescent assay with specific monoclonal antibodies (Microtrak). Prompt cure was achieved by doxycycline therapy. Thus, peroperatively, the discovery of an isolated perityphlitis with a normal appendix should raise the possibility of a C. trachomatis infection, even if there is no salpingitis.

Adult↗
PubMed1986

Polydioxanone in digestive surgery. An experimental study.

An experimental study was carried out to analyze the reaction of polydioxanone suture. Two hundred ten single layer colonic anastomoses were performed in rats and histopathologically studied at nine different times between the 2nd and 180th postoperative days. Eighteen of 105 abdominal wound closures were studied in the same way between the 7th and 90th days. Polydioxanone was resorbed slowly in approximately 6 months with minimum inflammation. We believe that polydioxanone is actually the suture material of choice for all biliary and biliodigestive sutures.

Abdominal Muscles↗
PubMed1985

Vascular evolution of single-layer end-on colonic anastomosis. A microangiographic study of 180 anastomoses in the rat from two to 180 days.

One hundred eighty left colonic single-layer end-on anastomoses performed on 90 rats by microsurgical techniques, using polydioxanone monofilament absorbable sutures, were examined histopathologically and microangiographically at nine different times, from two to 180 days. There was no anastomotic leakage. The vascular state after suturing and the evolution of the neovascularization are described. The neovascularization appeared to follow the same process of evolution as tissue restoration. It began early, was greatest on the seventh day, and diminished thereafter. When granulation tissue was narrow, the anastomoses were barely hypervascular, the neovascularization assured by submucosal plexus. A voluminous granulation tissue was hypervascular, had a slower evolution, and neovascularization was then assured above all by the peritoneal formations adherent to the suture.

Animals↗
PubMed1984

[Revascularization of the distal vertebral artery (3d segment). Indications in the treatment of vertebrobasilar insufficiency].

This article reviews 11 cases of distal revascularization of the extracranial vertebral artery above C2. Revascularization was indicated in 7 cases of extensive atheromatous stenotic or occlusive lesions, 3 cases of dissecting aneurysm, and one case of cervical malformation of the vertebral artery. The procedure of choice was a venous graft - in the C1/C2 space in 10 cases and above C1 in the eleventh. Doppler tests, ultrasound and arteriography demonstrated the patency of all the bypasses, and this was confirmed, 6 months to 3 years postoperatively, by Doppler and ultrasound. No neurological anomalies were observed either during the postoperative course or subsequently. The satisfactory results obtained would seem to justify extension of indications to include the treatment of atheromatous lesions of the supra-aortic trunks, and also adjacent vascular tumors (vertebral bone tumors, or complex cervical malformations of the vertebral artery).

Adult↗