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Biomedical subjects

A Karim

Publications and source records attributed to A Karim.

At least 37 records · Page 2Linked to original sources
PubMed2003

[Steinert myotonic dystrophy and blepharoptosis surgery: 9 case reports].

UNLABELLED: Steinert myopathic dystrophy is a generalized, hereditary disease with bone, muscular, heart and ocular involvement. PATIENTS AND METHODS: This is a retrospective study of nine patients with significant blepharoptosis due to Steinert disease, who were treated at the Adolphe de Rothschild Ophthalmology Foundation over a period of 5 years. Ptosis was symmetric and major in all cases with poor levator excursion. Severity criteria were an absence of the Bell phenomenon and diminished orbicularis tone. A frontalis suspension was performed in eight cases with intentional undercorrection. The outcome was favorable in all cases, 2 with a slight overcorrection underwent a second operation DISCUSSION: conclusion: Surgical treatment of ptosis in Steinert disease is difficult because of a risk of lagophthalmic, keratopathy due to the severity of the disease, an absence of the Bell phenomenon and ophthalmoplegia. This surgery must be undertaken with caution, most often using a frontalis suspension. Undercorrection must be systematic, with the single goal of freeing the pupil in the primary position.

Adult↗
PubMed2003

[Uveitis in children: about 20 cases].

INTRODUCTION: Uveitis in children is rare: 3%-8% of all cases. It requires the same diagnostic and etiological processes as uveitis in adults, with additional difficulties at examination and a sometimes insidious progression. MATERIAL AND METHODS: Retrospective study of 20 cases of childhood uveitis from 1995 to 2000. All patients received an ophthalmologic examination and an etiological search, with specific and/or symptomatic treatment and follow-up lasting from 6 months to 5 years. RESULTS: The 20 children presenting uveitis were 4-16 years old, with etiologies as follows: 8 cases of Behçet's disease, 2 cases of Vogt-Koyanagi-Harada's disease, 1 case of sarcoidosis, 1 case of uveitis associated with coeliac disease, 1 case of toxoplasmosis, 1 case of sympathetic ophthalmia, 1 case of uveitis with streptococcal infection, 3 cases of ocular toxocarosis, and 2 cases with unknown etiology. Treatment based on the etiological findings was started in the cases of toxoplasmosis and uveitis from streptococcal infection. The others were treated with high- and then digressive-doses of corticosteroids. ANALYSIS: We have noted the high incidence of Behçet's disease in our series. Progression was marked by frequent recurrence for one case of Vogt-Koyanagi-Harada's syndrome and one case of toxoplasmosis. This study also revealed a few cases of complicated cataract. DISCUSSION: Clinical characteristics, diagnosis, and treatment of uveitis in children are discussed.

Adolescent↗
PubMed2003

[Choroidal granuloma revealing tuberculosis. A case report].

BACKGROUND: The incidence of tuberculosis is still high in developing countries and a steady increase in new cases has been observed in industrial countries within the past decade. Among other reasons, the growing number of immunodeficient patients and migration from developing to industrial countries are both contributing factors. OBSERVATION: A 70-year-old female patient presented with a marked decrease in visual acuity of the left eye. There was no history of tuberculosis. Funduscopy of the left eye revealed a choroidal tumor with multiple choroidal lesions, mostly located at the posterior pole, and adjacent serous retinal detachment. Ultrasonography showed a solid elevated mass; magnetic resonance imaging showed the tumor with posterior extension. Because of blindness in this eye and the presence of posterior extension, the eye was subsequently enucleated. Intraoperative observation found caseum necrosis through scleral breaking. The histological study confirmed choroidal tuberculoma. The patient developed pulmonary tuberculosis 15 days after surgery. The outcome was favorable after antibiotic treatment. DISCUSSION: Confirming the diagnosis of tuberculous uveitis is often difficult. The differential diagnosis includes other granulomatous ocular inflammations. The detection of Mycobacterium tuberculosis and the clinical course make this diagnosis the most likely one. CONCLUSION: Choroidal granuloma is a rare and atypical location of tuberculosis. This case showed the diagnostic difficulties when there is no history of tuberculosis.

Aged↗
PubMed2003

[Emergency treatment of post-traumatic orbital emphysema: a case report].

PURPOSE: Orbital emphysema is a common complication of orbital wall fractures (50% of blow-out fractures). It is generally a benign and self-limited condition. However, it may compromise retinal and optic nerve vascularization and therefore requires rapid management. PATIENT AND METHOD: We report a case of traumatic orbital emphysema resulting in ischemic optic neuritis. The orbital emphysema was drained using a 25-gauge needle mounted on a syringe filled with normal saline, with the plunger removed, and guided by air bubble eruption. RESULTS: Vision was promptly recovered following drainage of the orbital emphysema. CONCLUSION: The development of orbital emphysema after an orbital fracture is a consequence of a forceful expiratory effort raising intranasal pressure. It must be drained, as described, in cases of vascular compression.

Anti-Inflammatory Agents↗
PubMed2002

[Vogt-Koyanagi-Harada syndrome in children].

INTRODUCTION: Uveitis in children accounts for 5% to 10% of all uveitis cases. Some causes such as Vogt-Koyanagi-Harada syndrome rarely affect young children. We report two cases. CASE REPORT: No.1: A 9-year-old girl was followed up for severe and chronic total uveitis. General fundus depigmentation with several white and yellowish rounded lesions in peripheral fundus suggested the diagnosis of Vogt-Koyanagi-Harada, which was confirmed by the development of areas of vitiligo in the lumbar region. The patient was treated with a bolus of corticosteroid therapy. No. 2: A 12-year-old girl had bilateral uveopapillitis and the clinical initial examination and laboratory evaluation failed to provide a diagnosis. The patient was also treated with a bolus of corticosteroid therapy and then high-dose oral prednisone. After several months, the patient's examination showed a sunset glow fundus with several white and yellowish rounded lesions in peripheral fundus. DISCUSSION: Vogt-Koyanagi-Harada syndrome rarely affects young children, so the diagnosis may be difficult if the extraocular manifestations are not present. The bolus of corticosteroid therapy and cytotoxic agents may be necessary and the prognosis may be poor in severe cases.

Adrenal Cortex Hormones↗
PubMed2002

[Childhood Behçet's disease: clinical and evolutive aspects. About 13 cases].

INTRODUCTION: Behçet's disease is a systemic vasculitis which rarely occurs in childhood. The aim of this study was to evaluate clinical characteristics and outcome of Behçet's disease in Moroccan children. MATERIAL AND METHODS: A retrospective study of 13 cases of children, 10 males and 3 females with Behçet's disease followed up between 1990 and 1998. The diagnosis of Behçet's disease was based on the criteria of the international study group for Behçet's disease. All patients were studied by a complete clinical, ophthalmological and laboratory staging and treated with appropriate therapy. RESULTS: The mean age at diagnosis of Behçet's disease was 13.9 years. Familial forms were found in 30.7% of cases. Oral aphtae were noted in all cases while genital ulcers were present in 76% of cases. Cutaneous lesions were found in only 1 case and 53.8% of children had a pathergy test. Articular involvement was found in 30.7%, neurological features in 46% and vascular manifestations in 38.4%. Only one case of intestinal involvement was noted. Ocular features (76%) were bilateral in all cases and were dominated by panuveitis complicated by macular edema ant retinal vasculitis. CONCLUSION: Behçet's disease seems to have particular characteristics in childhood. Familial forms, articular and digestive manifestations appear to be more frequent in early stages of Behçet's disease in children. Neurological and vascular involvement with panuveitis seems more frequent in the older children.

Adolescent↗
PubMed2001

Possible levofloxacin-induced acute hepatocellular injury in a patient with chronic obstructive lung disease.

Levofloxacin is one of the most commonly prescribed antibiotics for both inpatient and outpatient care of respiratory tract infection. It is generally well tolerated, and it has an excellent safety profile. We report a case of severe acute liver toxicity that apparently complicated intravenous administration of levofloxacin, which resolved after discontinuation of the drug.

Acute Disease↗
PubMed2001

Plasmid-mediated extended-spectrum beta-lactamase (CTX-M-3 like) from India and gene association with insertion sequence ISEcp1.

Six non-clonally related enterobacterial isolates producing a same extended-spectrum beta-lactamase CTX-M-15 were isolated in 1999 from patients hospitalized in a New Delhi hospital. CTX-M-15 differed from CTX-M-3 by an asparagine to glycine substitution in position ABL238. Its gene was located on large plasmids varying in size. In each case, a same insertion sequence ISEcp1 was identified upstream of the 5' end of bla(CTX-M-15). Typical -35 and -10 promoter sequences of Enterobacteriaceae were identified in the 3' end of ISEcp1. The location of ISEcp1 upstream of plasmid-mediated CTX-M-type beta-lactamase genes may contribute to their spread or/and their expression.

Amino Acid Sequence↗
PubMed2001

Two atropisomers of tricarbonyl[eta6-6-chloro-3-(3-chloro-2-methylphenyl)-2,4,8-trimethyl-1,2,3,4-tetrahydro-2,4-dibora-1,3-diazanaphthlene]-chromium(0).

The structures of two atropisomers of the title compound, [Cr(C16H18B2Cl2N2)(CO)3], are reported. For both compounds, the Cr(CO)3 moiety is bound to the C6 aromatic ring of the molecule; the existence of atropisomers resulting from the non-equivalence of both faces of the C6 aromatic ring is a consequence of the 3-chloro-2-methylphenyl ring being nearly perpendicular to the mean plane of the 2,4-dibora-1,3-diazanaphthalene ring. The orientation of the Cr(CO)3 tripod relative to the C6 aromatic ring is such that it is nearly eclipsed in one isomer (2.4 degrees rotation from being eclipsed with C--N, C--Cl and C--H) and slightly twisted (16.2 degrees ) from an eclipsed conformation in the other.

Journal Article↗
PubMed2001

Combinatorial study of surface pattern formation in thin block copolymer films.

Surface pattern formation in diblock copolymer films is investigated as a function of film thickness h and molecular mass M. Smooth films are observed for certain h ranges centered about multiples of the lamellar thickness L0, and we attribute this effect to an increase in the surface chain density with h in the outer brushlike copolymer layer. We also observe apparently stable labyrinthine surface patterns for other h ranges, and the average size of these patterns is found to scale as lambda approximately L0(-2.5). Hole and island patterns occur for h ranges between those of the labyrinthine patterns and the smooth regions, and their size similarly decreases with L0 and M.

Journal Article↗
PubMed2001

Tissue factor pathway inhibitor does not influence inflammatory pathways during human endotoxemia.

Activation of coagulation induces a proinflammatory response in in vitro and animal experiments. Inhibition of the tissue factor-dependent pathway of coagulation inhibits cytokine release and prevents death in gram-negative sepsis models in primates. This study investigated the influence of blocking the coagulation system by tissue factor pathway inhibitor (TFPI) on endotoxin-induced inflammatory responses in healthy humans. Eight men were studied in a double-blind, randomized, placebo-controlled cross-over study. They received a bolus intravenous injection of 4 ng/kg of endotoxin, followed by a 6-h continuous infusion of either TFPI (0.2 mg/kg/h after a bolus of 0.05 mg/kg) or placebo. Endotoxin induced-activation of coagulation was prevented completely by TFPI. In contrast, TFPI did not influence leukocyte activation, chemokine release, endothelial cell activation, or the acute phase response. Thus, complete prevention of coagulation activation by TFPI does not influence activation of inflammatory pathways during human endotoxemia.

Acute-Phase Reaction↗
PubMed2001

A novel MVMp-based vector system specifically designed to reduce the risk of replication-competent virus generation by homologous recombination.

Recent work highlights the potential usefulness of MVM-based vectors as selective vehicles for cancer gene therapy (Dupont et al, Gene Therapy, 2000; 7: 790-796). To implement this strategy, however, it is necessary to develop optimized methods for producing high-titer, helper-free parvovirus stocks. Recombinants of MVMp (rMVMp) are currently generated by transiently co-transfecting permissive cell lines with a plasmid carrying the vector genome and a helper plasmid expressing the capsid genes (replaced with a foreign gene in the vector genome). The resulting stocks, however, are always heavily contaminated with replication-competent viruses (RCV), which precludes their use in vivo and particularly in gene therapy. In the present work we have developed a second-generation MVMp-based vector system specifically designed to reduce the probability of RCV generation by homologous recombination. We have constructed a new MVMp-based vector and a new helper genome with minimal sequence overlap and have used the degeneracy of the genetic code to further decrease vector-helper homology. In this system, the left homologous region was almost completely eliminated and the right sequence overlap was reduced to 74 nt with only 61% homology. We were thus able to substantially reduce ( approximately 200 x), but not completely eliminate, generation of contaminating viruses in medium-scale rMVMp preparations. Since the remaining sequence homology between the new vector and helper genomes is weak, our results suggest that contaminating viruses in this system are generated by nonhomologous recombination. It is important to note, unlike the autonomously replicating helper viruses produced from the first-generation vector/helper genomes, the contaminating viruses arising from the new packaging system cannot initiate secondary infection rounds (so they are not 'replication-competent viruses'). Our findings have important implications for the design of new MVMp-based vectors and for the construction of trans-complementing packaging cell lines.

Animals↗
PubMed2001

Interstitial pneumonitis in a patient treated with alpha-interferon and ribavirin for hepatitis C infection.

Hepatitis C is a common infection with worldwide prevalence. It has a variable course and can lead to chronic hepatitis, cirrhosis and hepatocellular carcinoma. Until recently alpha-interferon (IFN-alpha) was the only effective treatment available. Combination therapy with IFN-alpha and ribavirin has been found to be more efficacious than IFN-alpha alone. Various side effects have been ascribed to interferon, such as arthralgias, myalgias, fatigue, and gastrointestinal and neuropsychiatric symptoms. Interstitial pneumonitis is a rare but known complication of IFN-alpha when given at a high dosage of 6 to 10 million units per day. Ribavirin is associated with dose-dependent hemolytic anemia, cough, dyspnea, rash, depression, and dyspepsia, although a potential role in interferon-induced interstitial pneumonitis has not been described. We describe a patient with an excellent clinical response of chronic hepatitis C to combination therapy with IFN-alpha at a dosage of 3 million units per day and ribavirin. The patient developed interstitial pneumonitis that resolved after discontinuation of IFN-alpha and ribavirin. Given that interstitial pneumonitis has previously been reported with high-dose IFN-alpha, this case suggests that this complication may occur with lower dosages of IFN-alpha, although a potential role for ribavirin in this disorder at present remains speculative.

Antiviral Agents↗