Imagix: multimedia software for evaluating the vividness of movement-imagery.

This article presents a new software, Imagix, designed for the evaluation of the vividness of movement-imagery. This multimedia test is comprised of 18 movements in six different psychomotor categories whose vividness of imagery is to be appraised. Imagix has the advantage of offering an evaluation of the vividness of imagery in a normative way. The participant chooses among four films displaying a vividness gradient, which includes contrast and luminosity. The participant is first asked to visualize a movement verbally suggested. The participant is then asked to evaluate the vividness of this mental image by choosing on a computer screen the movie that best corresponds to the vividness of the movement-imagery. The first versions of this freeware (in English and French) are currently being validated.

[Aortic valve replacement in patients over 80 years of age. Short- and medium-term results in 140 patients]. / Remplacement valvulaire aortique chez les patients de plus de 80 ans. A propos de 140 patients, résultats à court et moyen termes.

One hundred and forty aortic valve replacements (AVR) performed between 1986 and 1995 at Rouen University Hospital in octogenarians (52 men and 88 women), including 9 emergency procedures, were analysed. One hundred and fifteen patients had pure aortic stenosis, 25 had mixed aortic valve disease with mainly aortic incompetence. The surgical decision was taken by the patient with the surgeon after an interview, in order to exclude too handicapped or undecided patients. Significant coronary artery disease was observed in 42% of cases. Isolated AVR was undertaken in 74% of cases and associated coronary bypass surgery in 23% of cases. Bioprostheses were used in 90% of cases. The valvular lesions were predominantly those of Monckeberg disease. The operative mortality was of 13 patients (9.3%). Functional recovery was satisfactory in 78% of cases; the average duration of the hospital stay was 12 days. All known risk factors for AVR: age, coronary lesions, cardiac failure, low ejection fraction, aortic regurgitation, were associated with insignificant increases in mortality. The secondary mortality was of 28 patients; 99 patients are still alive 4 to 91 months after surgery. The actuarial survival graph showed a 56.5% probability of 5 year survival. Eighty per cent of survivors live at home without loss of autonomy.

Aortic valvular replacement in octogenarians. Short-term and mid-term results in 140 patients.

Aortic valvular replacements were performed between 1986 and 1995 at Rouen University Hospital on 140 octogenarians (52 male and 88 female). Pure or predominant aortic stenosis was present in 115 patients, 25 had associated aortic stenosis and insufficiency or predominant aortic insufficiency. Significant coronary lesions were present in 42% of patients. An isolated aortic valvular replacement was performed in 74% of patients, associated with a bypass in 23% and a bioprosthesis was used in 90%. Valvular lesions were mainly caused by Mönckeberg disease. Thirteen operative deaths occurred (9.3%). Functional recovery was satisfactory in 78%, mean hospital stay was 12 days. All well-known risk factors for aortic valvular replacement: age, coronary lesions, cardiac insufficiency, impaired ejection fraction and aortic insufficiency, led to an increase in operative mortality but were not statistically significant. Late mortality occurred in 28 patients, 99 patients are still alive at 4-91 months after surgery. The actuarial survival curve shows a 56.5% probability of surviving 5 years. Eighty per cent of survivors are able to live independently at home.

[Neurohormonal factors in congestive heart failure]. / Facteurs neurohormonaux au cours de l'insuffisance cardiaque congestive.

Congestive heart failure is characterized by peripheral circulatory abnormalities including arterial and venous vasoconstriction and redistribution of regional blood flow. These peripheral factors are consecutive to a neurohumoral activation of sympathetic, renin-angiotensin-aldosterone and arginine-vasopressin systems. Clinical consequences of these neurohumoral changes are: excessive increase of aortic impedance and myocardial work, salt and water retention a processus which is angiotensin II-dependent, and eventually, hyponatremia. A growing body of evidences suggests that pharmacological blockade of this neurohumoral activation improves clinical and hemodynamic status in patients with congestive heart failure.

Plasma kinetics of small molecules during and after hemofiltration: decrease in hemofiltration efficiency related to increase in ultrafiltration rate.

The influence of delay in mass transfer on the real efficiency of hemofiltration sessions (HF) was studied in 7 patients during HF at a moderate ultrafiltration rate (UF rate = 100 ml/min) and at a high UF rate (UF rate = 200 ml/min). Real efficiency was expressed as "effective clearance" (KE) and compared to plasma clearance (KP); KE/KP was calculated from the kinetics of small molecules during HF and stabilized rebound post HF. Rebound in urea and uric acid plasma levels stabilized by 90 min post HF; increase in the UF rate from 100 to 200 ml/min was responsible for a decrease in KE/KP of 4% for urea and 11% for uric acid. Plasma creatinine and phosphorus levels had not stabilized by 90 min post HF, and it was thus impossible to calculate effective clearance; on the other hand, the magnitude of the rebound phenomenon for these two molecules was considerably greater than for uric acid. The magnitude of the post HF rebound for creatinine and phosphorus might be associated with delayed diffusion from a bound form in the intracellular space.