Biomedical subjects

A Michel

Publications and source records attributed to A Michel.

At least 19 recordsLinked to original sources

PubMed2002

The transsexual: what about the future?

Since the 1950s, sexual surgical reassignments have been frequently carried out. As this surgical therapeutic procedure is controversial, it seems important to explore the actual consequences of such an intervention and objectively evaluate its relevance. In this context, we have carried out a review of the literature. After looking at the methodological limitations of follow-up studies, the psychological, sexual, social, and professional futures of the individuals subject to a transsexual operation are presented. Finally, prognostic aspects are considered. In the literature, follow-up studies tend to show that surgical transformations have positive consequences for the subjects. In the majority of cases, transsexuals are very satisfied with their intervention and any difficulties experienced are often temporary and disappear within a year after the surgical transformation. Studies show that there is less than 1% of regrets, and a little more than 1% of suicides among operated subjects. The empirical research does not confirm the opinion that suicide is strongly associated with surgical transformation.

Female↗

PubMed2002

Conditioned hyperkinesia induced by cocaine in mice is dose-dependent but not correlated with the unconditioned response or the contextually-sensitized response.

The aims of the study were to test whether drug dose is positively related to the magnitude of the conditioned response following sensitization to the behavioural effects of cocaine and to investigate the relationship between the conditioned response and cocaine-induced sensitization. Male mice (C57BL/6J) were first injected over seven successive days with either saline or cocaine at 2.5, 5, 10 or 20 mg/kg s.c., in the testing room. On the test day, 24 h after the last injection, mice from all conditions were challenged with saline in the testing room to test for conditioned cocaine effects. Mice were video-recorded and various behaviours were later scored using a time-sampling technique. Cocaine-elicited orofacial stereotypy was significantly sensitized at the two highest doses and dose-dependently conditioned at the three highest doses. Cocaine-increased locomotion was sensitized at the three highest doses and significantly conditioned at 10 and 20mg/kg. Cocaine-increased sniffing did not change over pretreatment at any dose, and was conditioned only at 10 mg/kg. Cocaine-decreased immobility also did not change over pretreatment at any dose, but was conditioned at 10 and 20mg/kg. Concomitantly, rearing was reduced by cocaine at 10 and 20mg/kg, without sensitization being induced, and it was reduced under saline challenge after 5 mg/kg cocaine, while cocaine-decreased grooming was sensitized at the three highest doses and conditioned at 10 and 20 mg/kg cocaine. There was a positive relation between the size of the conditioned response for orofacial stereotypy and the magnitude of the unconditioned stimulus (the doses), a result conforming to the Pavlovian account of the placebo effect. This could also be concluded from considering the behaviour patterns as components of a unique placebo effect (hyperkinetic syndrome), since orofacial stereotypy, very apparent at 20 mg/kg cocaine, interfered at that dose with the full-blown expression of locomotion and sniffing, both yielding (approximately) inverted U-shaped dose-effect curves. However, no correlation was found between the magnitude of the conditioned response and the amplitude of sensitization (the difference between the initial unconditioned non-sensitized response and the last unconditioned sensitized response), a finding which indicates that conditioned responding does not participate in the generation of the sensitized effects, contrary to the 'excitatory conditioning model of contextual sensitization'.

Animals↗

PubMed2002

Comparisons of two groups of sex-change applicants based on the MMPI.

Out of 29 men asking for a sex-change, 16 reported clinical anamnesis criteria for transsexualism according to the DSM-III-R, a more restrictive diagnosis than the DSM-IV gender dysphoria diagnosis. In addition, all the subjects had taken an MMPI which, of course, did not contribute to the transsexualism diagnosis but which served to describe their personalities. The 16 subjects diagnosed as transsexual and the 13 who did not qualify for this diagnosis were compared on the basis of personality variables measured by the MMPI. Certain differences became evident. The transsexuals systematically complied to cultural stereotypes of femininity without any uneasiness, whereas the nontranssexuals could be subdivided into two groups, those with a vague sense of ill-being linked to a pronounced feminine identity or those with only a slight feminine identity and who showed no particular difficulties.

Adolescent↗

PubMed2002

An Anesthesia Information Management System (AIMS) as a tool for controlling resource management of operating rooms.

OBJECTIVES: In our department, we have been using an Anesthesia Information Management System (AIMS) for five years. In this study, we tested to what extent data extracted from the AIMS could be suitable for the supervision and time-management of operating rooms. METHODS: From 1995 to 1999, all relevant data from 103,264 anesthetic procedures were routinely recorded online with the automatic anesthesia record keeping system NarkoData. The program is designed to record patient related time data, such as the beginning of anesthesia or surgical procedure, on a graphical anesthesia record sheet. The total number of minutes of surgery and anesthesia for each surgical subspecialty per hour/day and day of the year was calculated for each of the more than 40 ORs, amounting to a total of 112 workstations. RESULTS: It was possible to analyze the usage and the utilization of ORs at the hospital for each day of the year since 1997. In addition, annual and monthly evaluations are made available. It is possible to scrutinize data of OR usage from different points of view: queries on the usage of an individual OR, the usage of ORs on certain days or the usage of ORs by a certain surgical subspecialty may be formulated. These data has been used repeatedly in our hospital for decision making in OR management and planning. CONCLUSIONS: In assessing the results of our study, it should be considered that the system used is not a specialized OR management tool. Despite these restrictions, the system contains data which can be used for an exact and relevant presentation of OR utilization.

Anesthesiology↗

PubMed2002

Medical Imaging Informatics and Medical Informatics: opportunities and constraints. Findings from the IMIA yearbook of Medical Informatics 2002.

OBJECTIVES: The Yearbook of Medical Informatics is published annually by the International Medical Informatics Association (IMIA) and contains a selection of recent excellent papers on medical informatics research (http://www.yearbook.uni-hd.de). The 2002 Yearbook of Medical Informatics took as its theme the topic of Medical Imaging Informatics. In this paper, we will summarize the contributions of medical informatics researchers to the development of medical imaging informatics, discuss challenges and opportunities of imaging informatics, and present the lessons learned from the IMIA Yearbook 2002. RESULTS AND CONCLUSIONS: Medical informatics researchers have contributed to the development of medical imaging methods and systems since the inception of this field approximately 40 years ago. The Yearbook presents selected papers and reviews on this important topic. In addition, as usual, the Yearbook 2002 also contains a variety of papers and reviews on other subjects relevant to medical informatics, such as Bioinformatics, Computer-supported education, Health and clinical management, Health information systems, Knowledge processing and decision support, Patient records, and Signal processing.

Computer-Assisted Instruction↗

PubMed2001

Genetic identification of Saccharomyces bayanus var. uvarum, a cider-fermenting yeast.

Twenty-one Saccharomyces strains isolated from a cider process were analysed in terms of karyotypes, Y' S. cerevisiae sequence occurrence, rDNA structure and cross-fertility with species tester strains. A strong predominance of S. bayanus var. uvarum G. Naumov was found (18 strains vs. three S. cerevisiae). Among the S. bayanus var. uvarum, only three strains proved to contain species-specific Y' S. cerevisiae sequences.

Beverages↗

PubMed2001

KUB3 amplification and overexpression in human gliomas.

Gene amplification is known to occur frequently in human glioma. Recently we reported cloning of a novel gene termed glioma-amplified sequence 16 (GAS16) by microdissection-mediated cDNA capture. In this article, we demonstrate that GAS16 results from an alternative splicing process of the Ku70 binding protein 3 (KUB3) that is essential for DNA double-strand break repair. The alternative splice product was found in glioblastoma and in normal fetal brain. We determined the amplification frequency of KUB3 in glioma with different grading. We analyzed a total of 102 glioma primary tumors and found KUB3 to be amplified in 12/82 (14%) glioblastomas, 4/13 anaplastic astrocytomas (30%), and 2/4 astrocytomas, but in none of three pilocytic astrocytomas. Northern blot analysis of glioblastoma shows a strong correlation between KUB3 amplification and overexpression. Amplification of KUB3 appears to be independent of other genetic changes frequently associated with the development of gliomas, including EGFR amplification, LOH of TP53, and LOH of chromosome 10. The KUB3 amplification and overexpression may interfere with the function of KUB3 in the DNA-PK complex involved in the maintenance of genome stability and reduction of mutation frequency.

Alternative Splicing↗

PubMed2001

[Is prolonged ambulatory physical therapy after anterior cruciate ligament-plasty indicated? Comparison of costs and benefits].

Thirty-five patients were prospectively examined on average 5.9 and 11.1 months after reconstruction of the anterior cruciate ligament. Eighteen patients were treated postoperatively with a regular physiotherapy (PT) program 2-3 times per week for 30 min, 17 patients with a special, extended, and supervised rehabilitation program 3-5 times per week for 2.5 h. Criteria for exclusion from this study were previous operation or fractures of the affected knee. The bases for the evaluation of the clinical results were the clinical examination, the Lysholm and Tegner scores, KT 1000, angular reproducibility according to Barrett (proprioception), and the figure-of-eight hop test. It appeared that patients treated with extended ambulatory physiotherapy (EAP) gained a significantly higher degree of functionality in the Lysholm score after 5.9 months (p < 0.02) and the Tegner score after 11.1 months (p < 0.05) than patients treated with regular physiotherapy. Patients treated with EAP also displayed better results in the proprioceptive capability test with an angular deviation of 5.8 degrees after 5.9 months compared to 11 degrees in patients receiving regular PT. After 11.1 months, there were no differences in proprioceptive capability between the two groups. Although the EAP patients were faster in the figure-of-eight hop test (0.39 s difference compared to 0.58 s in the PT patients), the results were not statistically significant. In KT 1000 ventral tibial instability was on average 21% lower in the PT patients than in the EAP patients. After 11.1 months, both groups exhibited the same median value of 3 mm. Furthermore, EAP patients were able to return to work after 36.7 days on average, a 35% shorter period than in the case of PT patients (55 days), also of statistical significance (p < 0.02). To conclude, the primarily higher costs of this intensive rehabilitation program are justified by the better functional outcome linked with an earlier return to work.

Adult↗

PubMed2001

Imidazo[1,2-a]quinoxalines: synthesis and cyclic nucleotide phosphodiesterase inhibitory activity.

A group of imidazo[1,2-a]quinoxalines have been synthesised from quinoxaline by condensation of an appropriate haloester or intramolecular cyclisation of a keto moiety on an intracyclic nitrogen atom. The reactivity of the heterocycle was explored through diverse reactions such as electrophilic substitution, lithiation and halogen-metal exchange to give access to a new series of derivatives. Confirmation of their structure was mainly performed by NMR, after careful assignment of the signals in comparison to previous attributions made on the parent imidazo[1,2-a]quinoxaline and discussion of available data in the literature. The cyclic nucleotide phosphodiesterase inhibitor activity of some of these derivatives has been assessed on isoenzymes type III and type lV. Compound 15, 4-(methylamino)imidazo[1,2-a]quinoxaline-2-carbonitrile, exhibited potent relaxant activity on smooth muscle, with a potency similar to the one measured with SCA 40, its structural analogue in the imidazo[1,2-a]pyrazine series.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗

PubMed2001

Stable expression of human 5alpha-reductase type II in COS1 cells due to chromosomal gene integration: a novel tool for inhibitor identification.

Inhibitors of human 5alpha-reductase type II are promising drug candidates for the treatment of benign prostatic hyperplasia which is associated with high prostatic DHT levels. In this study we describe the evaluation of potential inhibitors in a new cell assay. First a plasmid (pRcCMV-5alphaII) for the expression of human 5alpha-reductase type II was constructed by the use of the vector pRcCMV and transfected into the African green monkey fibroblast-like cell line COS1. By selection with G418 sulfate, ten COS1 single cell clones were obtained of which three stably exhibited high 5alpha-reductase activity. One single cell clone (COS1-5alphaIIST) was selected for further investigations. By Southern blot analysis, fluorescence in situ hybridization (FISH) and comparative PCR experiments it turned out that the expression plasmid pRcCMV-5alphaII has been integrated into the chromosome, resulting in a long-term stable expression of the foreign 5alpha-reductase gene. The newly established cell line was used for testing novel compounds on their inhibitory effect on human 5alpha-reductase type II. Using this whole cell assay, inhibitors with IC(50) values in the nanomolar range could be identified.

Androstenedione↗

PubMed2001

The spectrum of vascular lesions in the mammary skin, including angiosarcoma, after breast conservation treatment for breast cancer.

BACKGROUND: With the general acceptance of lumpectomy, axillary staging, and radiotherapy as local treatment for infiltrating breast cancer, an appreciation is evolving for the spectrum of vascular lesions that occur in the mammary skin after this treatment. Most of these lesions develop within the prior radiation field after breast conservation treatment. STUDY DESIGN: A retrospective chart and slide review was conducted, consisting of five patients with cutaneous vascular lesions after breast conservation treatment for infiltrating breast cancer. RESULTS: The latent time interval from definitive treatment of breast cancer to the clinical recognition of vascular lesions ranged from 5 to 11 years. Two patients did not have either arm or breast edema, two patients had breast edema, and the fifth patient had arm edema. Lesions arising in the irradiated mammary skin included extensive lymphangiectasia (one), atypical vascular lesions (two), and cutaneous angiosarcoma (four). CONCLUSIONS: Atypical vascular lesions at the skin margins of mastectomy may be predictive of recurrence after resection of angiosarcoma. Excision of skin from the entire radiation field may be necessary to secure local control of the chest wall in patients with cutaneous angiosarcoma after therapeutic breast radiotherapy.

Aged↗

PubMed2001

Evaluation of the suitability of a patient data management system for ICUs on a general ward.

The development of the ICUData patient data management system (PDMS) for intensive care units (ICU), by IMESO GmbH, Hüttenberg, Germany, was based on the assumption that processes and therapies at ICU are the most complex with the highest data density compared with those in other wards. Based on experience with the system and on a survey conducted among users at our pain clinic, we evaluated whether the concept of the present software architecture, which sufficiently reproduces processes and data at an ICU, is suitable as a PDMS for general wards. The highly modular and client-centric approach of the PDMS is founded on a message-based communications architecture (HL7). In the beginning of the year 2000, the system was implemented at the pain management clinic (12 beds) of our hospital. To assess its user friendliness, we conducted a survey of medical staff (n=14). From April 1st 2000 to August 31st 2000, all clinical and administrative data of 658 patients at the pain management clinic were recorded with the PDMS. From the start, all users had access to data and information of other connected data management systems of the hospital (e.g. patient administrative data, patient clinical data). Staff members found the system mostly useful, clearly presented, practical, and easy to learn and use. Users were relatively satisfied with stability and performance of the program but mentioned having only limited knowledge of the program's features. The need for external support during a computer crash was rated negatively. Despite the need for further usage training and improved program performance, the software architecture described seems to be a promising starting point for the construction of a PDMS for general wards.

Attitude of Health Personnel↗

PubMed2001

PHF3 expression is frequently reduced in glioma.

Glioblastoma is the most frequent brain tumor and accounts for approximately 50--60% of all astrocytic tumors. Many chromosome alterations have been described in glioblastoma, but only for a few alterations were the genes identified and linked to genetic pathways in glioblastoma development. To contribute to the identification of novel genes involved in glioblastoma development we used a combined immunological and molecular screening approach. Here we report the identification and expression analysis of a novel gene from human chromosome 6q12 that is considered to be the third member of a family of PHD finger containing genes and is termed PHF3. PHF3 is ubiquitously expressed in normal tissues including brain, but its expression is significantly reduced or lost in glioblastoma, glioblastoma cell lines, anaplastic astrocytomas and astrocytomas. The PHF3 protein sequence contains several protein motifs frequently found in transcription factors. One of those motifs is a PHD finger, also termed LAP motif and known to bind large portions of DNA. Another region of the protein revealed a high homology to the transcription factor TFIIS, especially to a region that is necessary for the Polymerase II binding properties of TFIIS. Combining these results, PHF3 is a novel member of a large class of regulatory proteins containing a LAP motif, and loss of its expression in glioblastoma may contribute to glioma development.

Adult↗

PubMed2001

A psycho-endocrinological overview of transsexualism.

The technical possibility of surgical sex change has opened up a debate concerning the legitimacy and utility of carrying out such an intervention at the request of the transsexual. Diagnostic, psychological, medical and ethical arguments have been brought forth, both for and against. Nonetheless, anatomical transformation by surgical means has currently become a practice as the frequency of serious gender identity disorders is constantly progressing. After a brief introduction, the present paper will consider typological, aetiological and epidemiological aspects of transsexualism. Treatment of the sex change applicant is then defined and discussed in terms of psychological, psychiatric, endocrinological and surgical aspects. Finally, the question of post-operation follow-up will be examined.

Endocrinology↗

PubMed2001

Tracing movement of African buffalo in southern Africa.

Genetic characterisation of two pathogens, namely foot and mouth disease (FMD) virus and Mycobacterium bovis, isolated from African buffalo (Syncerus caffer) in southern Africa was used to determine the origin of buffalo in situations where the source of infection was obscure. By determining the phylogenetic relatedness of various FMD virus isolates using partial sequencing of the main antigenic determinant, VP1, the origin of buffalo moved illegally to the non-endemic region of South Africa was traced to the Kruger National Park (KNP) where FMD is endemic in the buffalo population. Comparative analysis of the 'genetic fingerprints' of bovine tuberculosis isolates from buffalo and cattle has aided in tracing the original source of infection of buffalo populations in the KNP. Furthermore, these analyses have assisted in tracing the origin of infected animals that have been moved to other parts of South Africa.

Africa, Southern↗

PubMed2001

Influence of the method of data collection on the documentation of blood-pressure readings with an Anesthesia Information Management System (AIMS).

The influence of methods for record keeping on the documentation of vital signs was assessed for the Anesthesia Information Management System (AIMS) NarkoData. We compared manually entered blood-pressure readings with automatically collected data. These data were stored in a data-base and subsequently evaluated and analyzed. The data sets were split into two groups, "manual" and "automatic". We evaluated the effect of automatic data collection on the incidence of corrected data, data validity and data variation. Blood-pressure readings of 37,726 data sets were analyzed. We could assess that the method of documentation did influence the data quality. It could not be assessed whether the incorrectness of data during automatic data gathering was caused by artefacts or by the anesthesiologist.

Anesthesiology↗

PubMed2001

The epidemiology of tuberculosis in free-ranging African buffalo (Syncerus caffer) in the Kruger National Park, South Africa.

The presence of bovine tuberculosis (Mycobacterium bovis) in the Kruger National Park (KNP) was determined for the first time in 1990. It was diagnosed in an African buffalo (Syncerus caffer) bull, which was found recumbent and in an emaciated and moribund state near the south-western boundary fence. This prompted an investigation into the bovine tuberculosis (BTB) status of the KNP, with emphasis on its epidemiological determinants and risk factors. This report documents the findings of surveys that were conducted from 1990 to 1996. It was found that BTB had entered the KNP ecosystem relatively recently (+/- 1960), and has found favourable circumstances for survival and propagation in a fully susceptible and immunologically naive buffalo population. Indications are that it entered the KNP from across the southern river boundary, where the presence of infected domestic cattle herds had been documented. From there the infection spread through the southern buffalo population and is currently spreading in a northward direction. It was estimated that this northward spread took place at a rate of about 6 km per year; the prospect being that, if this rate of spread is maintained, the entire KNP may be affected in less than 30 years from now. Spillover from buffalo had already occurred in species such as chacma baboon (Papio ursinus), lion (Panthera leo), cheetah (Acinonyx jubatus), kudu (Tragelaphus strepsiceros) and leopard (Panthera pardus). Although there is no indication yet that these species act as maintenance hosts, the possibility is raised that these, or an as yet overlooked species, might assume such a role in future. In the KNP, BTB manifests itself as a chronic and predominantly subclinical disease in buffalo. It may take years for clinical signs to develop, and then only at a terminal stage, when emaciation is a constant feature. It is suspected that the time from infection to death is variable and dependent on the animal's immune response, which can be weakened by such factors as stress, old age or droughts. It was found that, in the interim, buffalo have a normal reproductive life. On necropsy, buffalo show almost exclusively lung and upper respiratory tract involvement, pointing to an aerogenous mode of transmission. Histologically, little sign of encapsulation of lesions was detected, which suggests that they are exceptionally susceptible to BTB and that most lesions are open and infectious and progressive, leading ultimately to death of the individual. Evidence also indicates that BTB is progressive within the herd context (92% being the highest prevalence rate thus far determined in a buffalo herd) as well as progressive within the KNP buffalo population (the implication being that virtually all buffalo herds in the KNP will eventually be infected). Preliminary data suggest a positive correlation between disease prevalence and mortality, with potential mortality reaching up to 10% in buffalo herds having BTB prevalence rates of 50 % and higher. Only the future will tell what the effect of the disease on the population dynamics of buffalo will be.

Animals↗

PubMed2000

Permanent cerebral hypoperfusion: 'preconditioning-like' effects on rat energy metabolism towards acute systemic hypotension.

Chronic cerebrovascular disorders are often complicated by additional temporary ischaemic insults, resulting in substantial deterioration of brain energy metabolism. In the present study, chronic limitations of oxygen supply were induced in Wistar rats by 2 weeks of permanent bilateral common carotid artery occlusion (2-vo) to initiate a 'preconditioning-like' effect that protects rat brain energy metabolism against further acute systemic hypotension (15 min). Haemodynamic parameters, arterial blood gases and body temperature were monitored. Energy metabolites were determined in rat parietotemporal cerebral cortex: adenosine 5'-triphosphate (ATP), adenosine 5'-diphosphate (ADP), adenosine 5'-monophosphate (AMP), phosphocreatine (PCr), and adenosine by the high-pressure liquid chromatography (HPLC) technique and lactate spectrophotometrically. After 2 weeks, permanent 2-vo led to a significant decrease in the concentrations of cortical tissue ATP and PCr, from 3.06+/-0.48 to 2. 09+/-0.28 and from 4.27+/-0.63 to 3.35+/-0.41 micromol/g, respectively. These changes were associated with a two-fold increase in AMP and adenosine. Acute systemic hypotension alone (non-preconditioning) reduced ATP and PCr drastically, to 0.97+/-0. 51 and 1.76+/-1.23 micromol/g. Tissue concentrations of lactate, AMP, and adenosine were markedly increased, three- to five-fold, in 'non-preconditioned' brain tissue. In contrast, after 2 weeks of 2-vo acute hypotension did not significantly alter the cortical energy state any further. The effects of preconditioning on tissue ATP and PCr were most pronounced at 5 min and 48 h after reperfusion. In conclusion, permanent 2-vo seems to activate compensatory mechanisms, which effectively protect the rat's cortical energy metabolism against an additional ischaemic attack ('preconditioning-like' effect).

Acute Disease↗