[Is oral chemotherapy an alternative to IV chemotherapy in aged patients?].
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Administration, Oral↗
Biomedical subjects
C Dupuis
Publications and source records attributed to C Dupuis.
[Herpetic meningitis in the child].
UNLABELLED: In children, viral meningitis is usually caused by Enteroviruses. Herpes simplex viruses (HSV) are known to be a cause of meningo-encephalitis. HSV-2 has been reported to cause recurrent meningitis (Mollaret's meningitis) in adults. CASE REPORT: We report the case of a three-year-old girl with HSV-1 meningitis, whose evolution with treatment by aciclovir was good. CONCLUSION: HSV-1 has rarely been reported as a cause of isolated aseptic meningitis in children. Primary phase of herpes simplex virus infection is not usually associated with neurologic complications.
Acyclovir↗
[From a single vertical scar to vertical mammaplasty. From Louis Dartigues (1869-1940) to Claude Lassus (1933)].
The cutaneous sequelae left by mammaplasties have always constituted a major problem as well for the patients as for the surgeons. Since the turn of the century and the birth of modern mammary corrections, surgeons have tried to reduce these scars, while avoiding the impairment of the vascularisation of the mammary gland, the nipple-areola complex and the skin. L. Dartigues proposed, in 1924, the use of a single subareolar vertical scar for the correction of limited mammary ptosis. F. Lötsch introduced, in 1923, the rudiments of the future vertical mammaplasty by associating a peri-areolar scar to the single vertical subareolar scar. In 1971, C. Lassus, who had become interested and had been using Lötsch's technique since 1964, abandoned the technique for a while, but returned to these basic technique of Lötsch which he modified over the years and made it applicable in 1980 to ptosed and most hypertrophied breasts. This article is also concerned with the historic evolution of the scars left by mammary corrections and with the mastopexy procedures.
Cicatrix↗
Paracrine effects of phosphorylated and excreted FGF1 by retinal pigmented epithelial cells.
We have recently shown that both inhibition of endogenous Fibroblast growth factor (FGF) synthesis in non dividing lens epithelial cells (Renaud et al. J. Biol. Chem 1996, 271: 2801-2811) and inhibition of secreted FGF1 in confluent quiescent retinal pigmented epithelial (RPE) cells (Guillonneau et al., Exp. Cell. Res. 1997, in press) induce rapid cell apoptosis. In addition, FGF2-stimulated release of endogenous FGF1 is associated with reduced apoptosis in RPE cells. We now show that a single addition of exogenous FGF2 to RPE cells induces after 4 days of culture, a great accumulation of FGF1 within the cells. Concomitantly we observe that FGF1 was released into the extracellular medium. Secreted FGF1 from RPE cells, purified from culture medium and added to either Go-arrested RPE or RMG cells at low plating density induced cell proliferation, whereas when it is added once to serum-depleted confluent RPE and RMG cells it prevented apoptosis. Both endogenous and secreted FGF1 are phosphorylated. In addition, FGF2 stimulated the production and release of phosphorylated FGF1 by RPE cells. We show that this secreted form of phosphorylated FGF1 binds to the high affinity tyrosine kinase receptors of RPE and RMG cells on retinal sections and to heparan sulfate proteoglycan in RPE cell extracellular matrix. In contrast to non-phosphorylated FGF1, phosphorylated secreted FGF1 was not degraded after internalization but accumulated within RPE and RMG cells, and is rapidly translocated to the nucleus suggesting a role in signal transduction and gene expression pathways. These results show that exogenous FGF2 activities might be mediated indirectly by phosphorylation and that secretion of FGF1 may function as a paracrine trophic factor for retinal cells.
Animals↗
FGF2-stimulated release of endogenous FGF1 is associated with reduced apoptosis in retinal pigmented epithelial cells.
Both inhibition of endogenous fibroblast growth factor (FGF) synthesis on nondividing lens epithelial cells and inhibition of secreted FGF1 in confluent quiescent retinal pigmented epithelial (RPE) cells induce rapid cell apoptosis (Renaud et al., 1996, J. Biol. Chem., 271, 2801-2811). In addition several studies demonstrate that exogenous FGF2 can promote retinal cell survival in vitro and in vivo. To determine the possible relationship between exogenous FGF2, endogenous FGF1, and cell survival, we examined the protective effect of a single dose of exogenous FGF2 on long-term culture of quiescent RPE cells after serum withdrawal. After 4 days of culture, a dramatic and sustained upregulation of FGF1 protein expression occurs specifically in response to exogenous FGF2. After addition of FGF2 (20 ng/ml), RPE cells express fourfold more FGF1 after Day 7 than after Day 1 of culture. This phenomenon is FGF2 dose-dependent. In contrast, neither serum nor FGF2 have an effect on total endogenous FGF2 expression. In addition, in response to exogenous FGF2, FGF1 is secreted in significant amounts into the extracellular medium at a rate comparable to FGF1 accumulation within the cell. Furthermore, in the absence of serum, significant increase in cell death occurs on Day 6 of culture, whereas addition of exogenous FGF2 induces a twofold decrease of RPE cell apoptosis. In the presence of exogenous FGF2, addition of a specific anti-FGF1 neutralizing antibody induces a rapid apoptosis of RPE cell cultures. Thus, we speculate that exogenous FGF2 may indirectly prolong cell survival by increasing synthesis and secretion of endogenous FGF1 and that endogenous FGF1, directly in response to exogenous FGF2, may function as an autocrine trophic factor in RPE cells.
Animals↗
Functional evidence for NO-synthase activation by substance P through a mechanism not involving classical tachykinin receptors in guinea-pig ileum in vitro.
1. This study tested the hypothesis that a nitric oxide synthase (NOS) was activated in guinea-pig ileum in vitro in response to substance P (SP), and attempted to characterize the tachykinin receptor involved in this activation by the use of selective receptor agonists and antagonists. 2. Strips of guinea-pig ileum (8 x 2 mm) were superfused (Krebs, 37 degrees C, 2 ml min-1) with: (i) tachykinin receptor agonists: SP, GR 73,632 (NK1), GR 64,349 (NK2), senktide (NK3), and neuropeptide (NP) gamma; (ii) tachykinin receptor antagonists: CP 99,994 (NK1), SR 48,968 (NK2), SR 142,801 (NK3); (iii) nerve-related agents: carbachol (CCh), atropine, tetrodotoxin (TTX), hexamethonium; (iv) NOS inhibitors: N omega-nitro-L-arginine-methyl-ester (L-NAME), N omega-monomethyl-L-arginine (L-NMMA) and aminoguanidine (AG); (v) NO-related agents, L-arginine (L-Arg), D-arginine (D-Arg), sodium nitroprusside (NaNP) and methaemoglobin. Muscle contractility was recorded isometrically and quantified as integrated area of activity. 3. SP, tachykinin receptor agonists and NP gamma (10 pM to 10 microM), produced concentration-dependent contractions of ileal strips, with EC50s in the nanomolar range, and maximal responses (Emax) attained at 0.1 microM for SP and 1 microM for the other agonists. The Emax response to SP equalled that to KCl (60 mM) taken as a 100% control (99.3% [93.0-105.7]; mean and 95% CI; n = 12); a comparable Emax contraction was obtained with the other tachykinin receptor agonists (1 microM) as well as with CCh (1 microM). 4. Under baseline conditions, L-NAME (1 microM), L-NMMA (1 microM) and AG (1 microM), failed to contract the muscle strip. In contrast, when superfused for 3 min, 10 min after SP (0.1 microM), they induced a transient contraction of the strip (e.g. for 1 microM L-NAME: 50 to 70 s duration; amplitude 73 +/- 12%, n = 24). 5. The NOS inhibitor-induced contractile response was not obtained after KCl (60 mM), GR 73,632, GR 64,349, senktide or CCh (all up to 1 microM). In contrast, this contractile response was obtained after NP gamma (1 microM). 6. Blockade of tachykinin NK1, NK2 and NK3 receptors by continuous superfusion of CP 99,994, SR 48,968 and SR 142,801 (1 microM) respectively, starting 5 min before SP, did not modify the response to L-NAME, superfused 10 min after SP (0.1 microM). The contractile response to L-NAME (1 microM) was blocked by atropine (1 microM), superfused either before or after SP. In contrast, it persisted after TTX or hexamethonium (1 microM) superfused in the same conditions. 7. The amplitude of NOS inhibitor-induced contraction (1 microM) was dependent on the concentration of priming SP (1 pM to 1 microM). In contrast, the contractile response to NOS inhibitors (1 nM to 10 microM) of the ileum strip primed with SP (0.1 microM) was not concentration-related. 8. L-NAME-induced contraction was prevented by continuous superfusion of L-Arg (1 microM), but not D-Arg (1 microM). In addition, the NO donor, sodium nitroprusside (1 microM) and the NO scavenger, methaemoglobin (10 micrograms ml-1), both prevented the contractile response to L-NAME. 9. In summary, SP and to a lesser extent NP gamma, exert a permissive action allowing contractile stimulating effects of L-NAME, L-NMMA and AG, in guinea-pig ileum in vitro, by a mechanism which apparently does not involve tachykinin NK1, NK2 and NK3 receptors. This action is likely to result from the activation of a NO-synthase by SP in the vicinity of intestinal myocytes. Thus, L-NAME, L-NMMA or AG, by blocking this SP-induced NO production, unveiled a smooth muscle contraction which involves a cholinoceptor (atropine-sensitive) mechanism.
Animals↗
[Pubertal development after pediatric heart transplantation].
Twenty-one children and adolescents underwent orthotopic cardiac transplantation at the Hôpital Sainte-Justine between July 1984 and June 1993. Of those patients, 16 (4 girls and 12 boys) who survived more than one year after the procedure were followed prospectively for documentation of onset and progression of puberty. The immunosuppressive therapy included cyclosporine, azathioprine and prednisone. Subjects were evaluated at 6 month intervals for the study of: pubertal development according to staging by the method of Marshall and Tanner and hormonal profile (FSH, LH, testosterone, DHEAS). Despite a stagnation of pubertal signs before surgery, puberty carried on and progressed normally postoperatively. The urinary levels of gonadotropins rose to adequate levels for age. Testosterone levels in boys were related to the progression of secondary sexual characteristics. Levels of DHEAS were drastically reduced, most likely because of the supraphysiological doses of oral glucocorticoids. Our results indicate that after pediatric heart transplantation, puberty progresses normally at adolescence.
Adolescent↗
Safety, tolerability, and pharmacokinetic actions of diltiazem in pediatric liver transplant recipients on cyclosporine.
Thirty-two children who had undergone liver transplantation were paired according to their posttransplantation duration, renal function, and diagnoses when possible and randomized either to continue nifedipine (NIF group) or switch to diltiazem (DIL group), in addition to continuing their usual immunosuppressive medications. The cases were followed prospectively regarding diltiazem tolerance, cyclosporine dose requirements, effect on cyclosporine kinetics, diltiazem kinetics, as well as effect on renal function. Diltiazem was well tolerated at a dose of 3 mg to 6.4 mg/kg/day (max 180 mg/day) with infrequent self-limited mild side effects. Cyclosporine daily dose was reduced by a mean of 36.7% and 38.3% at 3 and 6 months, respectively, in the DIL group to achieve target trough cyclosporine levels without modifying liver function. No significant difference in renal function was observed after 3 to 6 months in either group based on blood urea nitrogen and creatinine levels and glomerular filtration rate by the DTPA method. Diltiazem appears to be well tolerated in children and allows for substantial dose reductions of CSA without apparent effects on liver graft function.
Adolescent↗
[Scimitar syndrome with anatomical or functional absence of the right pulmonary artery. Apropos of 4 cases].
BACKGROUND: Scimitar syndrome is characterized by an anomalous pulmonary vein draining into the inferior vena cava and visible roentgenographically as a crescentic shadow of vascular density along the right border of the cardiac silhouette. The aim of this study is to report four cases associated with anatomical or functional absence of the right pulmonary artery. CASE REPORTS: Diagnosis of scimitar syndrome had been made in 4 patients aged 3, 10, 23 and 33 years. Pulmonary scintigraphy and/or CT scan detected the scimitar syndrome and the type of pulmonary and systemic vascularization. In all cases, the vascularization of the right lung did not originate from the pulmonary artery trunk but was supplied by systemic vessels arising from the abdominal aorta. The right pulmonary artery was vascularized a retro, against the stream, by the systemic vessels (two cases); alternatively, circulation into the right pulmonary artery resulted directly from the systemic vessels, this pulmonary artery being anatomically absent (two cases). Pulmonary arterial pressures were normal in all four cases and functional tolerance was good in three cases; repeated and severe hemoptysis required right pneumonectomy in the last patient. CONCLUSIONS: These four cases are compared to six other similar cases in the literature. Elegant and non invasive methods are now disposable to detect such a syndrome and to assess the type of pulmonary vascularization.
Child↗
Bacterial pericarditis in infancy and childhood.
The authors report on a cooperative study of 43 cases of bacterial pericarditis observed in children. This disorder was suspected in patients with septicemia who developed symptoms and signs of pericarditis (precordial pain, muffled heart sounds, pericardial friction rub, cardiomegaly). Early diagnosis of this condition is now facilitated by echocardiography. A combination of medical and surgical treatments (appropriate antibiotic therapy after culture and sensitivity tests and early pericardial drainage) led to complete recovery in almost all of the cases (42 of 43). After long-term follow-up, no cases of constrictive pericarditis were observed.
Adolescent↗
The "horseshoe" lung: six new cases.
Six cases of horseshoe lung have been found in a group of 147 scimitar syndrome cases collected in a cooperative multicenter study. These cases were associated either with the severe infantile or with the benign adult form of the scimitar syndrome. The aim of this paper is to describe the clinical and imaging signs as well as the prognosis of 6 new cases of horseshoe lung in association with scimitar syndrome. The authors conclude (1) that the diagnosis of horseshoe lung may be strongly suspected on standard chest radiographs and confirmed by thoracic CT scan; (2) that the prognosis of scimitar syndrome does not seem to be worse when associated with horseshoe lung.
Adolescent↗
Horseshoe lung and scimitar syndrome in an asymptomatic child.
The authors describe a case of scimitar syndrome in a 7-year-old asymptomatic boy in whom CT scan showed a horseshoe lung. Thus, although this association is traditionally considered severe and a cause of early death, it can be compatible with a normal life.
Child↗
[Scimitar syndrome complicated by stenosis of the right pulmonary vein. Apropos of 4 cases].
The authors report 4 cases of the scimitar syndrome with pulmonary hypertension by stenosis of an abnormally draining right pulmonary vein and they also review the literature. All cases were symptomatic from infancy. The diagnosis was confirmed by catheterisation which showed a significant pressure gradient between the right pulmonary vein and the inferior vena cava, and by angiography which demonstrated the stenosis. None of the treatments proposed (interventional catheterisation with dilatation and eventual implantation of a stent, surgery with treatment of the stenosis and reimplantation of the right pulmonary vein in the left atrium, or pneumonectomy) were satisfactory. However, it is possible that earlier treatment could be effective as changes in the pulmonary vascular bed seem to occur very early in these patients.
Catheterization↗
[Natural history and prognostic factors in primary endocardial fibroelastosis in infants].
Over a 33 year period, 127 patients under 2 years of age with dilated cardiomyopathies and appearances compatible with the diagnosis of primary endocardial fibroelastosis were admitted to the paediatric cardiac unit of the CHRU of Lille. The average follow-up was 8.9 +/- 6.7 years. Ninety-four children (74%) were cured, 16 (13%) had persistent cardiomegaly and/or left ventricular dysfunction on echocardiographic examination, and only 17 (13%) patients died (10 in the year following their initial hospital admission including 5 in the first week). The outcome of patients was not related to age at diagnosis, sex, cardiothoracic index, initial shortening fraction of the left ventricle or the period at which the patients were seen for the first time. On the other hand, the presence of a family history of cardiomyopathy was associated with a significantly worse prognosis. A recurrence of symptoms was the factor most closely correlated with a bad prognosis: 12 of the 19 patients (63%) with this evolution died, and 4 others (21%) had persistent myocardial dysfunction at the end of the study. These recurrences were often observed after premature withdrawal or after use of ineffective dosages of digitalis. In the authors' experience, dilated cardiomyopathy in neonates with clinical features of primary endocardial fibroelastosis is associated with a relatively high number of cures. Prolonged treatment with high doses of digitalis seems a determining prognostic factor.(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiomyopathy, Dilated↗
[Calcification and healing of infectious myocardial pseudoaneurysms. Apropos of 2 cases].
The authors present two cases of infectious myocardial pseudo-aneurysms: the first was secondary to an intracardiac foreign body with mitral valve endocarditis; the second to septicaemia of urinary origin. Both cases progressed to calcification of the pseudo-aneurysm which appeared to be a mode of healing. Reviewed 20 and 19 years respectively after the initial episode, both patients have normal cardiac appearances apart from the residual myocardial calcification.
Aneurysm, Infected↗
Cyclosporine kinetics in pediatric liver transplant recipients: impact of dose fractionation on true glomerular filtration rate.
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Azathioprine↗
[The ups and downs of Williams-Beuren syndrome].
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Abnormalities, Multiple↗
J. G. Hierzel: a lip-switch flap in 1756.
After reviewing the historical aspects of the various lip-switch flaps, the authors draw attention to the existence of a report of a lip-switch flap performed in Sweden in 1756 by J.G.Hierzel.
History, 18th Century↗