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Biomedical subjects

A Gilbert

Publications and source records attributed to A Gilbert.

At least 91 records · Page 5Linked to original sources
PubMed1990

Reduction of plasma cholesterol levels in normal men on an American Heart Association Step 1 diet or a Step 1 diet with added monounsaturated fat.

The design of diets to achieve optimal changes in plasma lipid levels is controversial. In a randomized, double-blind trial involving 36 healthy young men, we evaluated the effects on plasma lipid levels of both an American Heart Association Step 1 diet (in which 30 percent of the total calories were consumed as fat: 10 percent saturated, 10 percent monounsaturated, and 10 percent polyunsaturated fats, with 250 mg of cholesterol per day) and a monounsaturated fat-enriched Step 1 diet (with 38 percent of the calories consumed as fat: 10 percent saturated, 18 percent monounsaturated, and 10 percent polyunsaturated fats, with 250 mg of cholesterol per day). The effects of these diets were then compared with those of an average American diet, in which 38 percent of the total calories were consumed as fat: 18 percent saturated, 10 percent monounsaturated, and 10 percent polyunsaturated fats, with 500 mg of cholesterol per day. The men consumed the average American diet for 10 weeks before random assignment to one of the two Step 1 diets or to continuation of the average diet for an additional 10 weeks. Caloric intake was adjusted to maintain a constant body weight. As compared with the mean (+/- SD) change in the plasma total cholesterol level in the group that followed the average American diet throughout the study (-0.05 +/- 0.36 mmol per liter), there were statistically significant reductions (P less than 0.025) in the plasma total cholesterol level in the group on the Step 1 diet (-0.37 +/- 0.27 mmol per liter) and in the group on the monounsaturated fat-enriched Step 1 diet (-0.46 +/- 0.36 mmol per liter). There were parallel reductions in the plasma low-density lipoprotein cholesterol levels in these two groups. Neither the plasma triglyceride levels nor the high-density lipoprotein cholesterol concentrations changed significantly with any diet. We conclude that enrichment of the Step 1 diet with monounsaturated fat does not alter the beneficial effects of the Step 1 diet on plasma lipid concentrations.

Adult↗
PubMed1990

The acute phase protein response in mice does not show tolerance to recurrent sterile inflammation.

The response of acute phase proteins to repeated inflammatory stimuli was studied in BALB/c mice and Hylyne Dutch rabbits. Inflammation was produced by subcutaneous injections of turpentine/arachis oil twice weekly for three and a half weeks. Serum amyloid-P component (SAP) levels in the mice showed no significant decrease in the level of response following each injection and the pattern of response was the same in mice previously rendered tolerant to endotoxin. Haptoglobin levels in the rabbits also responded equally to repeated injections in two animals and showed a declining response in a third animal which became unwell during the experiment. The ability of experimental animals to continue to respond fully to repeated inflammatory stimuli supports the suggestion that the subnormal responses seen in certain chronic inflammatory conditions may reflect an underlying defect in the acute phase response rather than an adaptive change following chronic inflammation.

Acute-Phase Proteins↗
PubMed1990

Thumb duplication: surgical treatment and analysis of sequels.

Between 1978 and 1988, 50 thumb duplications were operated upon at either the orthopedic department of Hôpital Trousseau (Paris) or at l'Institut Français de la Main (Paris). Following Wassel's classification, we observed a large incidence of types IV, II and VII (in that order). There was a 30% incidence of associated anomalies. The average age at operation was 15 months. We were able to review 30 patients (31 thumbs) with a mean follow-up of 30.9 months. We divided our series into two groups depending on the operative protocol. Group A: 19 patients (20 thumbs), operated on between 1978 and 1982 and reviewed at 33 months on average. Group B: 11 patients (11 hands) operated on between 1983 and 1988 and reviewed with a mean follow-up of 28.5 months. All of the children were evaluated following Wassel's and Tuch's criteria. In groupe A, only five thumbs could be considered normal, or near normal upon this reexamination. All the others were affected by various sequels, which were essentially esthetic. Only two thumbs had a functional deficit, due to instability of the MP joint in one case, and stiffness of the two joints of the thumb in the other. These poor objective results were, however, not shared by the children and their parents, since 16 of them declared themselves satisfied with the appearance and the function of the thumb. 6 patients required further surgery with an average of 2.5 operations per patient. These secondary operations gave imperfect results: out of 6 such patients, we obtained 3 fair results, and three remained poor. This relatively high proportion of sequels in our patients in group A led us to change our treatment protocol in 1983. Our revised attitude was to treat all deformities at once, and especially axial deviation with a corrective osteotomy if soft tissue surgery alone did not afford perfect realignment of the thumb. Thus, among the 11 reviewed patients of group B, 6 results could be considered to be good, 4 suffered from slight sequels, and one patient required a secondary surgery (tenolysis of the extensor apparatus) to correct an inadequate active extension of the IP joint. This result was functionally good on review. The optimal age for operation is between 12 and 18 months. Il seems to us that bad results are apparent early, after 6 to 12 months, because they are mainly due to inadequate treatment. Conversely, good short-term results seem to persist with growth, but there is an overall paucity of studies in this field.

Classification↗
PubMed1990

Traumatic brachial plexus palsy in children.

We have reviewed 25 children with traumatic brachial plexus palsy during the last fifteen years. Motor vehicle injury was responsible for 17 of these cases. Associated lesions were noted in 68%. All lesions were supraclavicular, including C5-C6 in 5 cases, C5-C7 in 5 cases and C5-T1 in 13 cases. Precise data was not available for two patients. Root avulsion was noted in 63% of our patients. Neurotization was performed in eight of the sixteen patients who had surgical repair. Tendon transfers were performed in 9 patients, 5 of which have had a previous surgical plexus repair. Elbow flexion was restored in all but one, and protective sensation of the hand in 40% of the patients undergoing plexus surgery. We conclude that surgery should be performed on children who have no evidence of nerve regeneration three months following traumatic brachial plexus palsy.

Adolescent↗
PubMed1990

[Immune response during experimental periodontitis in mice].

Four groups of mice, each of a different genotype, were orally inoculated with Actinomyces viscosus. The resulting periodontal bone loss was monitored and the isotype specific anti-A. viscosus serum humoral immune responses measured by ELISA. Maximum periodontal bone loss occurred in all genotypes with inoculation of 1.6 x 107 colony forming units of A. viscosus. IgG and IgM isotype levels increased with inoculation of 1.6 x 107 colony forming units of A. viscosus in three of the four groups, indicating that IgA may be important in producing periodontal bone loss.

Actinomyces↗
PubMed1990

[Current treatment of malformations of the hand].

Since 1976, the author has operated over 700 congenital malformations of the hand. This treatment was modified in several ways: 1) The age of the patients has become younger, treatment sometimes beginning before one year of age (syndactyly, radial clubhand). 2) A number of techniques, such as the removal of a supernumerary thumb or pollicization, have become much more complex and standardized, thus greatly improving the outcome. 3) Other malformations (aplasia of the fingers), which were left untreated before, can now be treated by growing bone grafts or the transfer of toes.

Follow-Up Studies↗
PubMed1989

Increased muscle regeneration after repair of divided motor nerve with neuronotrophic factors containing glue.

Neuronotrophic factors (NTFs) directed to spinal cord motor neurons were collected in rats within silicone nerve regeneration chambers according to LONGO et al. (1983b). Unilateral addition of NTFs to the fibrin glue used for the repair of divided sciatic nerves improved locally nerve regeneration without affecting the controlateral side. Nerve regeneration was assessed by weight gain of the reinnervated muscles and by radioactive labelling of the acid-soluble phosphate fractions of both nerve Schwann cells and reinnervated muscle cells. Fast gastrocnemius and slow soleus muscles, the motor nerve of which had been repaired with added NTFs, were significantly heavier (21 and 28%) than their controlateral controls, and the metabolic dedifferentiation attendant on post-division nerve repair was less marked. It is suggested that this experimental nerve regeneration model is suitable to test potential nerve-active agents in vivo, under conditions close to the usual clinical setting, with, as ultimate goal, the improvement of the end-results of microsurgical repair of peripheral nerve in man.

Animals↗
PubMed1989

[Repair of cutaneous tissue loss of the arm. Development of the principles and technics].

Few sectors of reconstructive surgery have evolved as quickly over the past few years as the use of skin flaps, especially those used to cover losses of substance in the upper limb. This development is due to the increasing concern of surgeons about: 1) ensuring selective coverage of higher quality (the teguments used for the hand must be supple, thin and sensitive); 2) having reliable techniques; 3) reducing operating times and the duration of treatment.

Arm↗
PubMed1988

[The cubital flap].

The authors describe a flap with a pedicle derived from the dorsal branch of the ulnar artery. The ulnar artery gives rise to the dorsal ulnar artery 2 to 5 cm before the pisiform. This artery passes under the flexor carpi ulnaris muscle, accompanied by the dorsal branch of the ulnar nerve. It supplies an area 10 to 20 cm long by 5 to 9 cm wide on the ulnar side of the forearm and it also supplies the skin lying over the last three metacarpals on the dorsum of the hand and the Vth abductor. This artery also sends a branch to flexor carpi ulnaris and to the pisiform. It is now possible to trace a large flap in the forearm without interrupting the arterial axis. Large defects of the dorsum of the hand, wrist, thenar and hypothenar eminences can be covered by this pedicle or island flap. This artery is remarkably constant. Five clinical cases are presented.

Adult↗
PubMed1988

[The ulnar flap].

A new skin or fascial flap is described, based on the dorsal ulnar artery. In hundred fresh cadaveric forearms this vessel was constant with a diameter of 1 to 1.3 mm, passing dorsally from the ulnar artery deep to the flexor carpi ulnaris muscle. It supplies the skin and the fascia in the distal two thirds of the ulnar side of the forearm (length from 9 to 20 cm; width 1.5 to 10 cm). A flap based on this vessel can cover defects of the dorsal and palmar aspects of the hand and wrist, the thenar and the hypothenar eminence. It can be used as a fascial flap to avoid fibrosis around the median nerve and the tendons. The authors show the anatomy and some clinical cases.

Adult↗
PubMed1988

Tendon transfers for shoulder paralysis in children.

The treatment of shoulder paralysis in children is discussed and a new classification system is presented. The importance of treating contracture before considering tendon transfers is emphasized, especially for internal rotation contracture where subscapularis release alone results in the return of active external rotation is 47 per cent of patients. Specific transfers for external rotation, internal rotation and abduction are discussed.

Child, Preschool↗