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Biomedical subjects

A Arnaud

Publications and source records attributed to A Arnaud.

At least 91 records · Page 5Linked to original sources
PubMed1991

[Cancer of the rectum in elderly patients over the age of seventy-five years. Results of the surgical treatment].

The authors reviewed 122 rectal cancers observed over a period of 14 years in patients over the age of 75 years. Sixty-eight patients underwent extensive rectal resection, 17 were treated by local excision, and 28 only underwent a colostomy. Eight patients were excluded for surgery. The analysis of all of these groups showed that perioperative mortality was greater for large resections than for local resections, but with a lower recurrence rate and a higher survival at 3 years. Survival at 5 years after large resections was very close to the natural life expectancy for people of the same age. Moreover, survival was the quality of more comfortable than after local excision, and operative mortality was generally due to organ failure rather than to age itself. Radical surgery does not have to be systematically refused for very old patients, but he discussed in terms of the patients general status.

Actuarial Analysis↗
PubMed1990

Impact of smoking, physical training and weight reduction on FVII, PAI-1 and hemostatic markers in sedentary men.

The variations of FVII, PAI-1, TAT complexes, fibrinopeptide A, D-Dimers and beta thromboglobulin plasma levels were studied on 30 sedentary men, smokers and non-smokers, who were admitted to a 6 months' program of physical training and smoking cessation. After 3 months of intervention, sustained physical training was associated with the decrease of FVII and PAI-1 levels. Mild exercise performed during a second 3-month period could maintain normal FVII and PAI-1 activities but participants who stopped the training increased their FVII and PAI-1 plasma levels. FVII was not influenced by smoking habits. Smoking cessation seemed to slightly potentiate the decrease of PAI-1 levels associated with mild exercise. Overweight, FVII and PAI-1 levels were correlated and the weight reduction induced by training was related to the changes in the factors. In smokers, physical exercise was associated with a significant increase of hemostatic markers. This exercise-induced variation disappeared after 3 months of intervention in participants who stopped smoking and reappeared in those who smoked again after 6 months of intervention. This finding was not influenced by the physical training program.

Antithrombin III↗
PubMed1990

Impaired fibrinolytic capacity in patients with inflammatory bowel disease.

The venous occlusion test was applied to 17 patients with inflammatory bowel disease (IBD; 7 cases of Crohn's disease, 10 cases of ulcerative colitis). Results were compared to those obtained in 20 healthy matched control subjects. Patients with IBD had significantly decreased t-PA Ag release (p less than 0.001) and had no significant vWF Ag release. Residual PAI activity was evidenced after venous stasis in the IBD group but not in the control group. Hypofibrinolysis was more important in patients with an evolutive IBD than in patients with IBD in remission. Impaired systemic fibrinolytic capacity might contribute to an increased risk for thromboembolic complications and to the pathogenesis of inflammatory bowel disease.

Adult↗
PubMed1990

[Diagnosis and treatment of hydatid cyst of the liver].

Hydatid cyst of the liver is not uncommon in France. Its various symptoms often include pain, but chance discovery is not exceptional. The diagnosis is helped by two paraclinical examinations, ultrasonography and computerized tomography, which have become indispensable as they provide invaluable information on the precise location and anatomical rapports of the cyst and on possible complications. Laboratory tests are useful for the diagnosis and post-operative follow-up of these cysts. For the time being at least, treatment is purely surgical. Percutaneous needle aspiration and drainage have not yet proved to be totally innocuous, and medicinal treatments seem to be helpful only in cases with intraperitoneal rupture. The choice of the operative technique--essentially a more or less complete cystectomy--has an impact on surgical results: the operative mortality is usually low (2 to 5 p. 100), but the morbidity, mainly due to biliary tract complications of the cysts, remains as high as 30 p. 100.

Echinococcosis, Hepatic↗
PubMed1990

Purification and properties of a malolactic enzyme from Leuconostoc oenos ATCC 23278.

The malolactic enzyme of Leuconostoc oenos ATCC 23278 was purified 136fold. The molecular weight was estimated at 132,000 when determined by gel filtration. The enzyme contained two identical subunits (Mw = 66,000 using sodium dodecyl sulfate gel electrophoresis). The malolactic enzyme catalyzes the NAD(+)- and Mn(+)-dependent reaction L-malate----L-lactate + CO2. The apparent Km values for malic acid, NAD+, and Mn2+ were 17 mM, 0.044 mM, and 0.017 mM, respectively. The optimal pH and the optimal temperature for activity were 5.0, and 37 degrees C, respectively and the isoelectric point was pH 4.30. L-lactate and ethanol were non-competitive inhibitors, whereas succinate, citrate, and D-tartrate showed competitive type inhibitions.

Chromatography, Gel↗
PubMed1990

Pirarubicin phase II study in untreated metastatic small-cell lung carcinoma. A cooperative study of the Groupe Français de Pneumo-Cancérologie (GFPC).

Pirarubicin (THP) (Roger Bellon Laboratory, France) is a new anthracycline under clinical development. In order to assess the efficacy and toxicity of the drug in small-cell lung carcinoma (SCLC), we have undertaken this trial in front-line therapy in patients with metastatic disease, PS less than 3 and at least one evaluable lesion. Responses were assessed after two cycles of THP (60 mg/m2 i.v. bolus every 3-4 weeks) and a further cross over to VP16 + CDDP (three cycles) was systematic whatever the response to THP. This crossover was performed after only one cycle in case of obvious progression. From June 1988 to April 1990, 32 patients were enrolled: 6 were ineligible (4 non-SCLC, 2 M0), 26 patients were fully evaluable for THP and 18 patients for VP16-CDDP. The characteristics of the patients were as follows: mean age 57.4 years (38-71); T4: 54%; T3: 27%; T2: 19%; N3: 62%; N2: 35%; No: 4%. The efficacy was as follows 1 complete response and 2 partial responses (confirmed by endoscopy); 12 patients received only one cycle because of obvious progression; the overall response rate is 12% (95% confidence interval 0-24%). The patient who had complete response after pirarubicin remained in CR after VP16-CDDP, whereas the 2 patients who had partial response achieved CR for one and PR for the other; among the 15 who did not respond 1 CR and 7 PR were observed. The only significant toxicity of THP was granulopenia without infection. THP seems to be an effective anthracycline in SCLC, and the study is continuing. A response could be reached in 50% of the nonresponders with standard therapy and 10 of 24 patients (42%) finally responded. Therefore, this schedule for testing new drugs in metastatic SCLC appears ethically acceptable.

Adult↗
PubMed1990

Comparison of Berodual and salbutamol in asthma: a multicenter evaluation.

A 2-month study was carried out to compare the efficacy and safety of Berodual (B) (Boehringer Ingelheim) and salbutamol (S) in asthma. B is a combined agent with 20 micrograms of ipratropium bromide and 50 micrograms of fenoterol in each metered aerosol puff. Each puff of S contained 100 micrograms of drug. 196 patients were included in the study and received 4 x 2 puffs a day of either B or S. FEV1 and FVC were measured every month, and peak expiratory flow rate (PEFR) 4 times a day, i.e. morning and evening before and after administration of drug. Improvement of PEFR was the same in the two groups. No tachyphylaxis occurred. No difference was observed between the two drugs with regard to heart and respiratory rate, dyspnea and blood pressure. Tremor seemed less frequent with B but this difference was not statistically significant. B achieved the same effects as S though containing less beta-2-agonist agent.

Aerosols↗
PubMed1990

Value of ELISA using A60 antigen in the diagnosis of active pulmonary tuberculosis.

This investigation was undertaken to assess the effectiveness of an enzyme-linked immunosorbent assay (ELISA) using A60 antigen in ascertaining diagnosis in hospitalized patients suspected to have pulmonary tuberculosis (TB) but with negative sputum stains. Cultures were performed to confirm active or inactive disease. IgG and IgM antibody activity was determined by adding a 1:100 dilution of serum to plates coated with A60 antigen. After addition of peroxidase-conjugated antihuman IgG or IgM and color development, optical density (OD) was determined. A total of 83 patients was studied, taking into account their current disease status and prior history. Using as a cutoff value the mean value +/- 2 SD measured in the negative culture, no TB history group, that is, OD = 0.50 for IgG measurements and 0.43 for IgM measurements, the sensitivity, specificity, and positive predictive value of IgG measurements were equal to 48, 71, and 50%, respectively. Using IgM measurements, these parameters were equal to 76, 98, and 95%, respectively. Combining the results of IgG and IgM measurements, sensitivity, specificity, and positive predictive value were equal to 68, 100, and 100%, respectively. Thus, the ELISA described here can greatly facilitate the diagnosis of TB in patients with negative smears.

Antigens, Bacterial↗
PubMed1990

[Chemotherapy with high-dose cisplatin in brain metastasis of lung cancers].

CDDP is one of the most active single drugs in non small cell lung carcinoma. High doses of 200 mg/m2 are well tolerated when fractionated doses are used over a period of 5 d. Twenty-four consecutive patients (male, age range 38-70 y) with brain metastasis of lung carcinoma were included in this study. The total dose of CDDP - 200 mg/m2 - was divided into 5 equal daily fractions, infused over 6 h. Parenteral hydratation commenced the night before therapy. Efficiency was assessed by means of CT scan 15-30 d after the last course of chemotherapy. Complete response was achieved if no lesion was found on the CT scan; partial deafness 2 cases, renal toxicity 1 case, severe myelotoxicity 2 cases. Efficiency: failure was observed in 17 cases, objective responses in 7 cases (2 cases without injection contrast in the tumor, 3 partial regressions, 2 complete regressions). Thirty per cent of patients in this study exhibited an objective response with low toxicity. CDDP seems to be very useful in cerebral metastasis of lung carcinoma.

Adenocarcinoma↗
PubMed1990

[The bronchodilator effect of aerosol beta-2-mimetic and anticholinergic agents in patients with chronic bronchitis].

The aim of this study was to compare the effects of beta-2 stimulant adrenergic bronchodilators, salbutamol (S) and atropinic bronchodilators, oxitropium bromide (O). The drugs were administered by aerosol, alone or in combination. 20 patients with stable chronic bronchitis were randomised into two groups G1 and G2 and respiratory function tests were done on each group in two sequences, S1 and S2 with 24 hours between. The sequence S1 consisted of three spirometric measurements; an initial control measurement (C) preceding the inhalation of two puffs of 100 mcg of S with a repeat spirometry 15 minutes later followed by the inhalation of two puffs of 100 mcg of O followed by a final spirometry 45 minutes later, one hour after beginning the test. The protocol S2 was similar but the order of drugs was reversed (O then S). The subjects were subjected successively to regimes S1 and S2 for group 1 and inversely for group 2 according to the standard procedure for a crossover trial. The forced expired volume (FEV1) was expected as a percentage of the predicted values and absolute values. Thus only the first dose of inhaled bronchodilator increased slightly but significantly the FEV1. In effect, the administration of the second product led to no supplementary bronchodilator effect. The patients were classified as responders or non-responders for different thresholds of improvement of FEV1 of 10, 15 and 20%. The number of non-responders to the 2 classes of drugs was much greater when the threshold of improvement was raised to 20%. Some patients responded to bronchodilators, others uniquely to one of the two products and finally some to neither. Without reversibility tests it is not possible to predict the response to atropine from the response to beta-2-mimetics.

Aerosols↗
PubMed1990

[Wegener's granulomatosis. Contribution of computed tomography and nuclear magnetic imaging].

Amongst the endothoracic forms of Wegener's granulomatosis, tracheal, bronchial and above all mediastinal localisations are unusual. Such a case having a bad outcome is reported here. Computed Tomography (TDM) was used to assess the extend of pulmonary parenchymal involvement. Magnetic Resonance Imaging (MRI) was superior to TDM for showing transmural infiltration of the tracheal and the origin of main bronchi.

Bronchial Diseases↗
PubMed1989

Purification and properties of the beta-glucosidase from a nitrile hydratase-producing Brevibacterium sp. strain R312.

Besides its nitrile hydratase and wide spectrum amidase activities, the Brevibacterium sp. R312 strain also possesses a constitutive beta-glucosidase. Its optimum pH is 6. The enzyme was purified by fractionation precipitation with ammonium sulfate followed by chromatographic elutions on Q-Sepharose Fast Flow, Sephadex G-200 and Phenyl Superose. The resulting purification was 1960 folds for a 6% yield. The molecular weight of this enzyme was estimated at 180,000. It contains two identical sub-units. The pI is 5.5. This enzyme has a strong affinity for aryl-beta-glycosides:pNPG, prunassine; it could also degrade linamarine. It is inhibited by p-chloromercuribenzoate, delta-gluconolactone and glucose.

Brevibacterium↗
PubMed1989

Endo-rectal repair of rectocele.

Rectocele may cause colorectal symptoms particularly difficulty in evacuation. It is readily identified on clinical examination of the perineum but the pathophysiological abnormality can easily be defined by defaecography. Between 1984 and 1988 we have operated on 16 patients who presented with difficulty in evacuation associated with rectocele. We have used a simple endo-anal repair aimed to restore a firm recto-vaginal septum. Excellent functional results were obtained in 11 patients, 4 were considerably improved and one patient had a poor result.

Adult↗
PubMed1989

[Chronic postoperative rectal fistulae. Treatment by transanal colo-anal anastomosis. Apropos of 4 cases].

In a few cases, the postoperative rectal fistulas progress towards chronicity despite correct treatment and left iliac derivation. In 4 cases of such fistulas (3 females and 1 male, mean age 46 years), developed after rectal surgery and persisting for 2 to 16 months in young subjects, in good general condition and with a good long-term prognosis, we performed rectal resection with transanal colo-anal anastomosis according to the Parks technique. This procedure led to healing of the course of the fistulas, then closure of the derivation anus in the 4 patients. The functional results proved to be satisfactory, following short-term rehabilitation with biofeedback. After discussing the other surgical possibilities, the authors estimate that such a radical cure must be decided upon without delay, in case of chronic rectal fistula.

Adult↗