References of "Lamy, Maurice"
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See detailComparison of the Surgical Pleth Index (TM) with haemodynamic variables to assess nociception-anti-nociception balance during general anaesthesia
Bonhomme, Vincent ULg; Uutela, K.; Hans, Grégory ULg et al

in British Journal of Anaesthesia (2011), 106(1), 101-11

BACKGROUND: The Surgical Pleth Index (SPI) is proposed as a means to assess the balance between noxious stimulation and the anti-nociceptive effects of anaesthesia. In this study, we compared SPI, mean ... [more ▼]

BACKGROUND: The Surgical Pleth Index (SPI) is proposed as a means to assess the balance between noxious stimulation and the anti-nociceptive effects of anaesthesia. In this study, we compared SPI, mean arterial pressure (MAP), and heart rate (HR) as a means of assessing this balance. METHODS: We studied a standard stimulus [head-holder insertion (HHI)] and varying remifentanil concentrations (CeREMI) in a group of patients undergoing neurosurgery. Patients receiving target-controlled infusions were randomly assigned to one of the three CeREMI (2, 4, or 6 ng m(1)), whereas propofol target was fixed at 3 microg ml(1). Steady state for both targets was achieved before HHI. Intravascular volume status (IVS) was evaluated using respiratory variations in arterial pressure. Prediction probability (Pk) and ordinal regression were used to assess SPI, MAP, and HR performance at indicating CeREMI, and the influence of IVS and chronic treatment for high arterial pressure, as possible confounding factors. RESULTS: The maximum SPI, MAP, or HR observed after HHI correctly indicated CeREMI in one of the two patients [accurate prediction rate (APR)=0.5]. When IVS and chronic treatment for high arterial pressure were taken into account, the APR was 0.6 for each individual variable and 0.8 when all of them predicted the same CeREMI. That increase in APR paralleled an increase in Pk from 0.63 to 0.89. CONCLUSIONS: SPI, HR, and MAP are of comparable value at gauging noxious stimulation-CeREMI balance. Their interpretation is improved by taking account of IVS, treatment for chronic high arterial pressure, and concordance between their predictions. [less ▲]

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See detailEnd of life care in the operating room for non-heart-beating donors: organization at the University Hospital of Liege.
JORIS, Jean ULg; KABA, Abdourahmane ULg; LAUWICK, Séverine ULg et al

in Transplantation Proceedings (2011), 43(9), 3441-4

Non-heart-beating (NHB) organ donation has become an alternative source to increase organ supply for transplantation. A NHB donation program was implemented in our institution in 2002. As in many ... [more ▼]

Non-heart-beating (NHB) organ donation has become an alternative source to increase organ supply for transplantation. A NHB donation program was implemented in our institution in 2002. As in many institutions the end of life care of the NHB donor (NHBD) is terminated in the operating room (OR) to reduce warm ischemia time. Herein we have described the organization of end of life care for these patients in our institution, including the problems addressed, the solution proposed, and the remaining issues. Emphasis is given to our protocol elaborated with the different contributors of the chain of the NHB donation program. This protocol specifies the information mandatory in the medical records, the end of life care procedure, the determination of death, and the issue of organ preservation measures before NHBD death. The persisting malaise associated with NHB donation reported by OR nurses is finally documented using an anonymous questionnaire. [less ▲]

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See detailIntravenous lidocaine infusion reduces bispectral index-guided requirements of propofol only during surgical stimulation.
Hans, Grégory ULg; Lauwick, Séverine ULg; Kaba, Abdourahmane ULg et al

in British Journal of Anaesthesia (2010), 105(4), 471-9

BACKGROUND: I.V. lidocaine reduces volatile anaesthetics requirements during surgery. We hypothesized that lidocaine would also reduce propofol requirements during i.v. anaesthesia. METHODS: A randomized ... [more ▼]

BACKGROUND: I.V. lidocaine reduces volatile anaesthetics requirements during surgery. We hypothesized that lidocaine would also reduce propofol requirements during i.v. anaesthesia. METHODS: A randomized controlled study of 40 patients tested the effect of i.v. lidocaine (1.5 mg kg(-1) then 2 mg kg(-1) h(-1)) on propofol requirements. Anaesthesia was maintained with remifentanil and propofol target-controlled infusions (TCI) to keep the bispectral index (BIS) around 50. Effect-site concentrations of propofol and remifentanil and BIS values were recorded before and after skin incision. Data were analysed using anova and mixed effects analysis with NONMEM. Two dose-response studies were then performed with and without surgical stimulation. Propofol TCI titrated to obtain a BIS around 50 was kept constant. Then patients were randomized into four groups: A, saline; B, 0.75 mg kg(-1) bolus then infusion 1 mg kg(-1) h(-1); C, 1.5 mg kg(-1) bolus and infusion 2 mg kg(-1) h(-1); and D, 3 mg kg(-1) bolus and infusion 4 mg kg(-1) h(-1). Lidocaine administration coincided with skin incision. BIS values and haemodynamic variables were recorded. Data were analysed using linear regression and two-way anova. RESULTS: Lidocaine decreased propofol requirements (P<0.05) only during surgery. In the absence of surgical stimulation, lidocaine did not affect BIS nor haemodynamic variables, whereas it reduced BIS increase (P=0.036) and haemodynamic response (P=0.006) secondary to surgery. CONCLUSIONS: The sparing effect of lidocaine on anaesthetic requirements seems to be mediated by an anti-nociceptive action. [less ▲]

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See detailNorepinephrine and ephedrine do not counteract the increase in cutaneous microcirculation induced by spinal anaesthesia.
Lecoq, Jean-Pierre ULg; Brichant, Jean-François ULg; Lamy, Maurice ULg et al

in British Journal of Anaesthesia (2010), 105(2), 214-9

BACKGROUND: /st> Neuraxial anaesthesia improves tissue perfusion and tissue oxygen tension. Vasodilation induced by this technique may result in hypotension requiring the administration of vasoactive ... [more ▼]

BACKGROUND: /st> Neuraxial anaesthesia improves tissue perfusion and tissue oxygen tension. Vasodilation induced by this technique may result in hypotension requiring the administration of vasoactive drugs. The use of peripheral vasoconstrictors might counteract the improved tissue perfusion and its potentially beneficial effects. We therefore investigated the effect of i.v. norepinephrine and ephedrine on skin perfusion using laser-Doppler flowmetry (LDF) in patients during spinal anaesthesia. METHODS: /st> Skin blood flow expressed in perfusion units (PU) provided by LDF was measured simultaneously at the foot and the manubrium levels in 44 patients during spinal anaesthesia with a sensory level below T5. Norepinephrine infusion was then titrated to normalize mean arterial pressure (MAP) in 23 patients (Group NOR). Ephedrine (max. 10 mg) was administered in 21 patients (Group EPH). Changes in relative PU were compared between the two sites of measurements in each group during drug administration. The same doses of norepinephrine were assessed in 11 normal volunteers to assure comparable vasoreactivity at the foot and manubrium levels. RESULTS: /st> Spinal anaesthesia resulted in a 10% decrease in MAP (P<0.001), an increase in relative PU values at the foot level (P<0.001), and a decrease at the sternum level (P<0.05). Norepinephrine and ephedrine produced a significant increase in relative PU values at the foot level when compared with the sternum level (NOR: P=0.02; EPH: P=0.0035). In volunteers, norepinephrine decreased cutaneous perfusion similarly at the manubrium and foot levels. CONCLUSIONS: /st> Improved skin perfusion induced by spinal anaesthesia was not counteracted by the use of norepinephrine or ephedrine. [less ▲]

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See detailOrgan Procurement After Euthanasia: Belgian Experience
Ysebaert, dirk; Van Beeumen, G.; De Greef, K. et al

in Transplantation Proceedings (2009), 41

Euthanasia was legalized in Belgium in 2002 for adults under strict conditions. The patient must be in a medically futile condition and of constant and unbearable physical or mental suffering that cannot ... [more ▼]

Euthanasia was legalized in Belgium in 2002 for adults under strict conditions. The patient must be in a medically futile condition and of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident. Between 2005 and 2007, 4 patients (3 in Antwerp and 1 in Liège) expressed their will for organ donation after their request for euthanasia was granted. Patients were aged 43 to 50 years and had a debilitating neurologic disease, either after severe cerebrovascular accident or primary progressive multiple sclerosis. Ethical boards requested complete written scenario with informed consent of donor and relatives, clear separation between euthanasia and organ procurement procedure, and all procedures to be performed by senior staff members and nursing staff on a voluntary basis. The euthanasia procedure was performed by three independent physicians in the operating room. After clinical diagnosis of cardiac death, organ procurement was performed by femoral vessel cannulation or quick laparotomy. In 2 patients, the liver, both kidneys, and pancreatic islets (one case) were procured and transplanted; in the other 2 patients, there was additional lung procurement and transplantation. Transplant centers were informed of the nature of the case and the elements of organ procurement. There was primary function of all organs. The involved physicians and transplant teams had the well-discussed opinion that this strong request for organ donation after euthanasia could not be waived. A clear separation between the euthanasia request, the euthanasia procedure, and the organ procurement procedure is necessary. [less ▲]

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See detailVentilatory management during routine general anaesthesia
Hans, Grégory ULg; Sottiaux, Thierry; Lamy, Maurice ULg et al

in European Journal of Anaesthesiology (2009), 26(1), 1-8

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See detailPain and non-pain processing during hypnosis: a thulium-YAG event-related fMRI study.
Vanhaudenhuyse, Audrey ULg; Boly, Mélanie ULg; Balteau, Evelyne ULg et al

in NeuroImage (2009), 47(3), 1047-54

The neural mechanisms underlying the antinociceptive effects of hypnosis still remain unclear. Using a parametric single-trial thulium-YAG laser fMRI paradigm, we assessed changes in brain activation and ... [more ▼]

The neural mechanisms underlying the antinociceptive effects of hypnosis still remain unclear. Using a parametric single-trial thulium-YAG laser fMRI paradigm, we assessed changes in brain activation and connectivity related to the hypnotic state as compared to normal wakefulness in 13 healthy volunteers. Behaviorally, a difference in subjective ratings was found between normal wakefulness and hypnotic state for both non-painful and painful intensity-matched stimuli applied to the left hand. In normal wakefulness, non-painful range stimuli activated brainstem, contralateral primary somatosensory (S1) and bilateral insular cortices. Painful stimuli activated additional areas encompassing thalamus, bilateral striatum, anterior cingulate (ACC), premotor and dorsolateral prefrontal cortices. In hypnosis, intensity-matched stimuli in both the non-painful and painful range failed to elicit any cerebral activation. The interaction analysis identified that contralateral thalamus, bilateral striatum and ACC activated more in normal wakefulness compared to hypnosis during painful versus non-painful stimulation. Finally, we demonstrated hypnosis-related increases in functional connectivity between S1 and distant anterior insular and prefrontal cortices, possibly reflecting top-down modulation. [less ▲]

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See detailThe unexpected hidden face of the Cephalosporin Antibiotic Ceftazidime: From biological to chemical and physical activities against oxidant species produced by phagocytes
Mouithys-Mickalad, Ange ULg; Deby-Dupont, Ginette; Mathy-Hartert, Marianne ULg et al

Conference (2008, October 03)

Background: Over several decades the use of antibiotics to treat infectious and bacterial diseases has been the main challenge. Ceftazidime (CAZ), belonging to the cephalosporin’s family, is known as ... [more ▼]

Background: Over several decades the use of antibiotics to treat infectious and bacterial diseases has been the main challenge. Ceftazidime (CAZ), belonging to the cephalosporin’s family, is known as empiric treatment for severe sepsis. Beside its antibiotic effect, CAZ has been shown to have other properties, making it unique. This study is aimed to investigate unexpected antioxidant properties of CAZ with special emphasis on the mechanism of action. Methods: Four in vitro and ex-vivo experimental models were designed 1) Assay of proteinases inhibitory activity of α2-macroglobulin (α2M) in the presence of trypsine (1.4µg) with or without 10-3 M CAZ, in 0.1 M Tris-HCl at pH 8.1. 2) Assessment of MPO-induced toxicity on endothelial cells or oxidant activities of stimulated phagocytes (PMNs) using 160 µM ferricytochrome C. 3) Effect of CAZ on two models of anoxia/reoxygenation from adherent and suspension alveolar cells (A549, 106 to 1010 cells/ml) using oxymetry coupled to EPR-spin trapping technique. 4) Cell-free systems to investigate: lipoperoxidation of linoleate induced by γ-irradiation, Fe2+/ascorbate system or ferryl species; Quenching of hydroxyl radical (·OH) and singlet oxygen (1O2)-scavenging activity from Mallet’s (H2O2/NaOCl) and Fenton’ reactions. Results: Ex-vivo assays show efficient protective effect of CAZ on plasmatic antiproteinases against oxidative stress; a dose-dependent inhibitory capacity on endothelial and A549 cells against MPO toxicity or excessive production of ROS during anoxia/reoxygenation. On cell-free systems, CAZ had unique 1O2–scavenging activity; and less effect on ferryl species. CAZ exerts its antioxidant effect by chelating activity. Conclusions: Overall results indicate that: 1) CAZ protects endothelial cells against MPO toxicity but also A549 cells towards the effect of anoxia/reoxygenation; 2) CAZ protects α2M and 3) acts as efficient inhibitor of lipid peroxidation of linoleate and hydroxyl radical and as singlet oxygen-scavengers. Antioxidant properties of CAZ might be relevant in clinical situations where excessive activation of leukocytes is known and in anoxia/reoxygenation model cause an increased production of ROS. [less ▲]

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See detailOrgan donation after physician-assisted death
Detry, Olivier ULg; Laureys, Steven ULg; Faymonville, Marie ULg et al

in Transplant International (2008), 21(9), 915

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See detailEffect of intravenous lidocaine on the depth of propofol anesthesia assessed by the bispectral index (BIS)
Delangh, Virginie; Hans, Grégory ULg; Kaba, Abdourahmane ULg et al

in Acta Anaesthesiologica Belgica (2008, June 14), 59(3), 206

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See detailIntravenous lidocaine reduces propofol requirement during propofol - remifentanil anaesthesia for thyroid surgery
Charlier, Vanessa ULg; Lauwick, Séverine ULg; Hans, Grégory ULg et al

in Acta Anaesthesiologica Belgica (2008, June 14), 59(3), 204

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See detailDiselenide Derivative, Potential Successor of Ebselen with High Antioxidant Activity: Assessment on in vitro Models
Mareque-Faez, Juan; Deby, Carol; Lamy, Maurice ULg et al

in Resource-Full Chemistry (2008, May 24)

Oxidative stress plays a key role in several pathophysiological events, including the attack of DNA, cell membrane damage and signaling pathways disruption. The harmful effect of oxidant stress has been ... [more ▼]

Oxidative stress plays a key role in several pathophysiological events, including the attack of DNA, cell membrane damage and signaling pathways disruption. The harmful effect of oxidant stress has been attributed to a high production of reactive oxygen species (ROS) followed by a depletion of antioxidant enzymes, glutathione peroxidase (GPx), a mammalian selenoenzyme which functions as a catalytic antioxidant, has been described to protect various organisms against oxidative stress. In the past two decades, the design of small weight molecules such as ebselen (PZ 51, 2-phenyl-1,2-benzoisoselenazol-3(2H)-one), has renewed the interest of synthetic analogues able to mimic the GPx activity. From four in vitro in vitro models, we previously showed that ebselen and some of its analogues (compounds 1, 2, 3 and 4) not only behaved at various degrees as GPx-like mimics but also as antioxidants especially for diselenide derivative (3). The present study deals with the antioxidant effect of diselenide derivative (3) versus ebselen on cellular model and the enzyme myeloperoxidase (MPO) activity using the in vitro systems. Derivative (3) has been chosen because of its interesting antioxidant profile in cell-free systems. [less ▲]

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See detailThe Effect of Clonidine Infusion on Distribution of Regional Cerebral Blood Flow in Volunteers
Bonhomme, Vincent ULg; Maquet, Pierre ULg; Phillips, Christophe ULg et al

in Anesthesia and Analgesia (2008), 106(3), 899-909

BACKGROUND: Through their action on the locus coeruleus, alpha2-adrenoceptor agonists induce rapidly reversible sedation while partially preserving cognitive brain functions. Our goal in this ... [more ▼]

BACKGROUND: Through their action on the locus coeruleus, alpha2-adrenoceptor agonists induce rapidly reversible sedation while partially preserving cognitive brain functions. Our goal in this observational study was to map brain regions whose activity is modified by clonidine infusion so as to better understand its loci of action, especially in relation to sedation. METHODS: Six ASA I-II right-handed volunteers were recruited. Electroencephalogram (EEG) was monitored continuously. After a baseline H2(15)O activation scan, clonidine infusion was started at a rate ranging from 6 to 10 microg x kg(-1) x h(-1). A sequence of 11 similar scans was then performed at 8 min intervals. Plasma clonidine concentration was measured. Using statistical parametric mapping, we sought linear correlations between normalized regional cerebral blood flow (rCBF), an indicator of regional brain activity, and plasma clonidine concentration or spindle EEG activity. RESULTS: Clonidine induced clinical sedation and EEG patterns (spindles) comparable to early stage nonrapid eye movement sleep. A significant negative linear correlation between clonidine concentration and rCBF or spindle activity was observed in the thalamus, prefrontal, orbital and parietal association cortex, posterior cingulate cortex, and precuneus. CONCLUSIONS: The EEG patterns and decreases in rCBF of specific brain regions observed during clonidine-induced sedation are similar to those of early stage nonrapid eye movement sleep. Patterns of deactivated brain regions are also comparable to those observed during general anesthesia or vegetative state, reinforcing the hypothesis that alterations in the activity of a common network occur during these modified conscious states. [less ▲]

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See detailSafety of Fully Automatic External Defibrillation by Untrained Lay Rescuers in the Presence of a Bystander
Hosmans, Tony; Maquoi, Isabelle ULg; Vogels, Catherine et al

in Resuscitation (2008), 77(2), 216-219

OBJECTIVE: Automated external defibrillators (AEDs) are becoming increasingly available in public places to be used by citizens in case of cardiac arrest. Most AEDs are semi-automatic (SAEDs), but some ... [more ▼]

OBJECTIVE: Automated external defibrillators (AEDs) are becoming increasingly available in public places to be used by citizens in case of cardiac arrest. Most AEDs are semi-automatic (SAEDs), but some are fully automatic (FAEDs) and there is ongoing debate and concern that they may lead to inadvertent shocks to rescuers or bystanders because the timing of the shock is not controlled by the rescuer. We therefore compared the behaviour of untrained citizens using an FAED or an SAED in a simulated cardiac arrest scenario. DESIGN AND PARTICIPANTS: One hundred and seventy-six laypeople were randomised to use an FAED or an SAED (Lifepak CR+, Medtronic, Redmond, USA) in a simulated cardiac arrest scenario on a manikin (Ambu, Denmark) where a bystander was touching the victim's upper arm. Each rescuer's performance was recorded on video and analysed afterwards using a modified Cardiff Score. The rescuer or the bystander was considered unsafe if either of them touched the victim during shock delivery. RESULTS: Eleven cases could not be analysed because of technical problems. Fifteen participants violated the protocol making further analysis impossible. Of the remaining 150 participants, 68 used the FAED and 82 used the SAED. The rescuers were safe in 97/150 (65%) cases, without a difference between FAED and SAED. The bystander was safe in 25/68 (37%) cases in the FAED group versus 19/82 (23%) in the SAED group (p=0.07). Combined safety of both rescuer and bystander was observed in 23/68 (34%) cases in the FAED group versus 15/82 (18%) in the SAED group (p=0.03). CONCLUSIONS: Safety was not compromised when untrained lay rescuers used an FAED compared with an SAED. The observation of overall safer behaviour by FAED users in the presence of bystanders may be related to the additional instructions provided by the FAED, and the reduced interaction of the rescuer with the bystander when using the SAED. [less ▲]

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See detailAnalgésie par blocs nerveux périphériques continus dans le cadre des soins de plaies cutanées
Lecoq, Jean-Pierre; Jacquemin, Denise ULg; Lamy, Maurice ULg et al

in Revue Médicale de Liège (2008), 63(1), 3-16

We present the case of a patient with a circumferential venous ulcer at the level of the calf. She is hospitalized for surgical treatment by continuous aspiration dressing and coverage with skin graft ... [more ▼]

We present the case of a patient with a circumferential venous ulcer at the level of the calf. She is hospitalized for surgical treatment by continuous aspiration dressing and coverage with skin graft. This patient presents a history of chronic pain, on which classical medications have few effects and are accompanied by side effects. After discussion with the patient, a double continuous peripheral nervous block (femoral and sciatic nerve) is set up to improve the tolerance to wound dressing. This technique presents favorable antalgic results. The indications and the different techniques of block performance (by electrostimulation or echo-guided) are described. The infectious risks related to the presence of catheter near cutaneous wounds are clarified according to recent data of literature. The relevance of these techniques in correlation with the development of chronic pain and on the trophicity of the wounds are also discussed. [less ▲]

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See detailPerception of pain in the minimally conscious state with PET activation: an observational study.
Boly, Mélanie ULg; Faymonville, Marie-Elisabeth ULg; Schnakers, Caroline et al

in Lancet Neurology (2008), 7(11), 1013-20

BACKGROUND: Patients in a minimally conscious state (MCS) show restricted self or environment awareness but are unable to communicate consistently and reliably. Therefore, better understanding of cerebral ... [more ▼]

BACKGROUND: Patients in a minimally conscious state (MCS) show restricted self or environment awareness but are unable to communicate consistently and reliably. Therefore, better understanding of cerebral noxious processing in these patients is of clinical, therapeutic, and ethical relevance. METHODS: We studied brain activation induced by bilateral electrical stimulation of the median nerve in five patients in MCS (aged 18-74 years) compared with 15 controls (19-64 years) and 15 patients (19-75 years) in a persistent vegetative state (PVS) with (15)O-radiolabelled water PET. By way of psychophysiological interaction analysis, we also investigated the functional connectivity of the primary somatosensory cortex (S1) in patients and controls. Patients in MCS were scanned 57 (SD 33) days after admission, and patients in PVS 36 (9) days after admission. Stimulation intensities were 8.6 (SD 6.7) mA in patients in MCS, 7.4 (5.9) mA in controls, and 14.2 (8.7) mA in patients in PVS. Significant results were thresholded at p values of less than 0.05 and corrected for multiple comparisons. FINDINGS: In patients in MCS and in controls, noxious stimulation activated the thalamus, S1, and the secondary somatosensory or insular, frontoparietal, and anterior cingulate cortices (known as the pain matrix). No area was less activated in the patients in MCS than in the controls. All areas of the cortical pain matrix showed greater activation in patients in MCS than in those in PVS. Finally, in contrast with patients in PVS, those in MCS had preserved functional connectivity between S1 and a widespread cortical network that includes the frontoparietal associative cortices. INTERPRETATION: Cerebral correlates of pain processing are found in a similar network in controls and patients in MCS but are much more widespread than in patients in PVS. These findings might be objective evidence of a potential pain perception capacity in patients in MCS, which supports the idea that these patients need analgesic treatment. [less ▲]

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See detailGuidelines for the transfusion of red cells
Baele, Philippe; Muylle, L.; Noens, L. et al

in Acta Clinica Belgica (2008), 63(5), 301-312

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