Biomedical subjects
C Henry
Publications and source records attributed to C Henry.
A new approach to the evaluation of liver graft function by nuclear magnetic resonance spectroscopy. A comparative study between Euro-Collins and University of Wisconsin solutions.
The incidence of primary dysfunction or non-function of liver grafts still occurs at an unacceptable rate and the identification of new markers of graft viability and metabolic capacity is essential. Proton nuclear magnetic resonance (H NMR) spectroscopy has previously shown potential in the evaluation of renal allograft dysfunction after ischaemia reperfusion. The aim of this study was to compare liver graft function in a rat isolated perfused liver model after 24 hours of preservation in either Euro-Collins (EC) or University of Wisconsin (UW) solutions. Livers were reperfused for 90 min with a modified Krebs-Henseleit medium. Functional parameters measured were: pressure and resistances, bile and transaminase production. The production of lactate, pyruvate, citrate and succinate, beta-hydroxybutyrate and aceto-acetate was measured by H NMR. There was a significant difference in both haemodynamics and bile production in favour of the UW group. The transaminases were similar in the two groups. Measurements of citrate, succinate and ketone bodies by H NMR were all higher in the UW group. These markers indicate better metabolic function of these grafts during reperfusion. In conclusion, discriminating different hepatic metabolic pathways is possible and easy by H NMR and can be used to assess both the preservation quality of liver grafts and their functional recovery.
[A rare cause of acute abdominal pain: mesenteric heterotopic pancreas complicated by acute pancreatitis].
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The experience of oncology nursing: a novice staff nurse reports.
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[Manic-depressive disease. Diagnosis, evolution, treatment].
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The Saccharomyces cerevisiae protein YJR043C (Pol32) interacts with the catalytic subunit of DNA polymerase alpha and is required for cell cycle progression in G2/M.
We have analysed the YJR043c gene of Saccharomyces cerevisiae, previously identified by systematic sequencing. The deletion mutant (yjr043cdelta) shows slow growth at low temperature (15 degrees C), while at 30 degrees C and 37 degrees C the growth rate of mutant cells is only moderately affected. At permissive and nonpermissive temperatures, mutant cells were larger and showed a high proportion of large-budded cells with a single duplicated nucleus at or beyond the bud neck and a short spindle. This phenotype was even more striking at low temperature, the mutant cells becoming dumbbell shaped. All these phenotypes suggest a role for YJR043C in cell cycle progression in G2/M phase. In two-hybrid assays, the YJR043c gene product specifically interacted with Pol1, the catalytic subunit of DNA polymerase alpha. The pol1-1 /yjr043cdelta double mutant showed a more severe growth defect than the pol1-1 single mutant at permissive temperature. Centromeric plasmid loss rate elevated in yjr043cdelta. Analysis of the sequence upstream of the YJR043c ORF revealed the presence of an MluI motif (ACGCGT), a sequence associated with many genes involved in DNA replication in budding yeast. The cell cycle phenotype of the yjr043cdelta mutant, the evidence for genetic interaction with Pol1, the presence of an MluI motif upstream and the elevated rate of CEN plasmid loss in mutants all support a function for YJR043C in DNA replication.
[Laparoscopic cholecystectomy in acute cholecystitis].
PURPOSE: To determine the feasibility, operative risk and patients' benefit of laparoscopy in emergency cholecystectomy for acute calculous cholecystitis. PATIENTS AND METHODS: From January 1991 to December 1998, 234 patients with acute calculous cholecystitis were operated on by emergency laparoscopic cholecystectomy. There were 131 women and 103 men (mean age: 57 years), (Asa 2: 48%, Asa 3: 10%). In seven patients, choledocolithiasis was detected by endoscopic ultrasonography and preoperatively treated by endoscopic sphincterotomy. The mean delay between in-hospital admission and cholecystectomy was 20 hours (2-160). Cholecystectomy was performed with primary approach of Calot's triangle. Intraoperative cholangiography, selectively performed (n = 70), detected choledocolithiasis in three patients. RESULTS: The mean duration of surgery was 149 minutes (62-313). The conversion rate was 13% and decreased through the years. The postoperative complication rate was 18%. Eight patients (3.4%) had an abdominal complication. One patient (0.4%) died of bile peritonitis after intraoperative undetected main bile duct injury. The mean postoperative hospital stay was 6.04 days. It was 3.5 days only, very old patients and those with severe associated disease being excluded. CONCLUSION: Laparoscopy appears to be a good approach for emergency cholecystectomy in patients with acute calculous cholecystitis.
Hydrodynamics optimization in butterfly swimming: position, drag coefficient and performance.
A kinematic study allowed to define the three most propulsive positions during a butterfly swimming cycle, which were: the end of the external sweep, the end of the internal sweep and the end of thrust. These instantaneous positions were different for the ex-world champion Pankratov when compared to another swimmer. Using manikins and a drag-measuring device, we showed that the end of the internal sweep induced the highest drag values and that Pankratov may reduce energy expenditure by taking up a particular position during the end of the swimming cycle. These results point out the relations between swimming movements, passive drag and swimmers' performance.
Is sensitization to Alternaria alternata a risk factor for severe asthma? A population-based study.
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Temperament in bipolar illness: impact on prognosis.
OBJECTIVE: The present study was designed to investigate the relations between temperament and outcome in bipolar illness. METHODS: Seventy-two patients presenting with bipolar type I disorder were recruited from consecutive admissions and evaluated when euthymic. The criteria developed by Akiskal and Mallya (Criteria for the 'soft' bipolar spectrum: treatment implications. Psychopharmacol. Bull. 1987;23:68-73) were used to assess both depressive (DT) and hyperthymic temperaments (HT) in a dimensional approach. RESULTS: Multiple regression analysis showed that a higher DT score or a lower HT score were significantly associated with a greater number of episodes. Furthermore, a higher DT score was strongly associated with a higher percentage of major depressive episodes. Conversely, a higher HT score was associated with a trend to manic rather than depressive episodes. Suicide attempts appeared more frequent in the history of patients presenting with higher DT scores. CONCLUSIONS: Our findings strengthen the hypothesis that temperament is one of the main variables accounting for some features in the clinical evolution of bipolar disorder such as polarity of episodes. Furthermore, these findings are consistent with the hypothesis of a trait-state continuum between personality and affective episodes.
Lidocaine and bupivacaine exert differential effects on whole blood coagulation.
STUDY OBJECTIVES: To compare bupivacaine to lidocaine's effects on blood clotting at two concentrations, and to characterize and determine relative effects of two equianalgesic bupivacaine and lidocaine concentrations. DESIGN: Prospective, dual-controlled, whole blood equal volume admixture thrombelastographic (TEG) study. SETTING: University of Pennsylvania Medical Center operating rooms. PATIENTS: 20 ASA physical status I and II patients' blood comprised control groups and anesthetic groups. INTERVENTIONS: Analysis of whole blood clotting used six TEG channels for untreated and saline controls and four final concentrations (1.0% lidocaine, 0.5% lidocaine, 0.25% bupivacaine, and 0.125% bupivacaine) of local anesthetics. Saline control and the local anesthetic-treated specimens underwent 8.3% hemodilution. MEASUREMENTS AND MAIN RESULTS: Blood was studied. Saline control or four anesthetic solutions (30 microliters) were added in random order two 5 TEG cuvettes. Whole blood (330 microliters) was mixed ex vivo at 37 degrees C. A sixth channel with untreated whole blood (360 microliters) acted as an undiluted control. Data for four TEG parameters [reaction time (r), angle (alpha), maximum amplitude (MA), and percent decrease in TEG amplitude from MA 30 minutes after MA acquisition (Lysis 30)] for undiluted control and saline volumetric controls were compared to each other using Student's t-test for paired observations. Lidocaine and bupivacaine groups' TEGs were compared to the paired saline control analysis of variance for repeated measures. A p-value less than 0.05 was considered significant. There was no difference between whole blood and saline control TEGs. All local anesthetics produced significant hypocoagulable changes from control. Angle alpha and MA were significantly decreased in all local anesthetic groups. Ther time was prolonged only in the high lidocaine-treated blood. Lysis was a feature of the low lidocaine and bupivacaine solutions. Equianalgesic lidocaine produced more profound hypocoagulable effects than did bupivacaine. CONCLUSIONS: Lidocaine and bupivacaine both significantly impaired TEG coagulation in a concentration-dependent manner. Lidocaine was significantly more hypocoagulable than bupivacaine at two similarly analgesic concentrations.
Prothrombin 20210G/A mutation in two patients with mesenteric ischemia.
Primary cases of splanchnic vein thrombosis are now less common since a systematic screening for hypercoagulability is performed. In 1996, a sequence variation in the 3'-untranslated region of the prothrombin gene (F.II 20210G/A mutation) has been linked to a threefold increased risk for venous thrombosis. The role of this thrombophilic disorder is not documented in patients with thrombosis of the splanchnic veins. This report presents two patients with a mesenteric ischemia associated with a heterozygous state for the F.II 20210G/A mutation. The first patient developed an ischemic colitis and the second one an ischemic necrosis of the terminal ileum related to a thrombosis of the superior mesenteric vein. In both cases, another thrombotic risk factor was associated: either a general prothrombic state (primary antiphospholipid syndrome) or a focal factor (abnormal hemodynamic conditions related to a liver cirrhosis). It has recently been proposed that several conditions need to be combined for deep vein thrombosis to develop. Screening for the combination of multiple underlying prothrombotic conditions thus appears justified in patients with splanchnic thrombosis. The role of the F.II 20210G/A mutation as a predisposing factor for thrombosis of the digestive vessels should be considered and needs further investigation.
Evidence-based guidelines for the management of genital chlamydial infection in general practice. (Leicestershire Chlamydia Guidelines Group).
BACKGROUND: Valid clinical guidelines can be effective in improving patient care. Genital Chlamydia trachomatis infection is the commonest curable sexually transmitted disease (STD) in England and Wales and is an important cause of pelvic inflammatory disease (PID), tubal infertility and ectopic pregnancy. No published guidelines exist on managing genital chlamydial infection in British general practice. OBJECTIVE: We aimed to develop valid guidelines for the management of genital chlamydial infection for use in British general practice. METHODS: A district-wide postal questionnaire survey was used to document current clinical practice. A critical review of the evidence concerning the management of genital chlamydial infection as it relates to British general practice was performed. The information gained from the critical review and survey was used to develop evidence-based guidelines within a multidisciplinary guideline recommendation group. RESULTS: The guidelines covered the diagnosis, investigation, drug treatment and referral of adult male and female patients with genital chlamydial infection in general practice. CONCLUSION: Valid guidelines for the management of genital chlamydial infection have been developed for use in British general practice. Appropriate dissemination and implementation of the guidelines should lead to earlier detection and treatment of men and women with chlamydial infection and thereby reduce the incidence of PID, tubal infertility and ectopic pregnancy in women.
Management of MDR-TB in resource-poor countries.
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Adjuvant therapy for melanoma in dogs: results of randomized clinical trials using surgery, liposome-encapsulated muramyl tripeptide, and granulocyte macrophage colony-stimulating factor.
Spontaneous canine oral melanoma (COM) is a highly metastatic cancer, resistant to chemotherapy, and can serve as a model for cancer immunotherapy. Liposome-encapsulated muramyl tripeptide-phosphatidylethanolamine (L-MTP-PE) can activate the tumoricidal activity of the monocyte-macrophage system following i.v. injection. The objective of these studies was to evaluate the therapeutic effectiveness of L-MTP-PE administered alone and combined with recombinant canine granulocyte macrophage colony-stimulating factor (rcGM-CSF) in dogs undergoing surgery for oral melanoma. Ninety-eight dogs with histologically confirmed, clinically staged, oral melanoma were entered into two randomized, double-blind, surgical adjuvant trials. In trial 1, 50 dogs were stratified based on clinical stage and randomized to once a week L-MTP-PE or lipid equivalent (control). When all of the clinical stages were combined, no difference in disease-free survival or in survival time (ST) were detected. However, within stage I, dogs receiving L-MTP-PE had a significant increase in ST compared with control, with 80% of the dogs treated with L-MTP-PE still alive at >2 years. Within each stage II and stage III, there was no difference detected between the treatment groups. In trial 2, 48 dogs were stratified on the basis of clinical stage and extent of surgery (simple resection or radical excision), treated with L-MTP-PE two times a week, and randomized to rcGM-CSF or saline (placebo) given s.c. daily for 9 weeks. Within each stage and when all of the stages were combined, there was no difference between the treatment groups. In both studies, stage I COM is associated with a better prognosis. No effect on survival was observed with regard to tumor location in the oral cavity, sex, type/extent of surgery, or age. In a subset of dogs tested, pulmonary alveolar macrophage cytotoxicity was enhanced with combined rcGM-CSF and L-MTP-PE but not in dogs treated with L-MTP-PE alone. The present study indicates that after surgery, L-MTP-PE administered alone or combined with rcGM-CSF showed no significant antitumor activity in treating advanced stage COM. In early stage COM, L-MTP-PE was shown to result in a prolongation of ST. Furthermore, this study provides additional rationale for the use of the dog model for human malignant melanoma.
Genomic organization, 5'-flanking region and chromosomal localization of the human glutathione transferase A4 gene.
We have isolated and characterized a human glutathione transferase A4 (hGSTA4) subunit gene from a yeast artificial chromosome containing several other glutathione transferase alpha genes and pseudogenes. The homodimeric protein hGSTA4-4, is involved in the detoxification of 4-hydroxynonenal and other reactive electrophiles produced by oxidative metabolism, and may have a significant role in protecting intracellular components from oxidative damage. The hGSTA4 gene spans nearly 18 kb, contains seven exons, maps onto chromosome 6p12, and lies in close proximity to the 7SK small nuclear RNA gene in a head-to-tail orientation. The intron/exon borders conform to the standard rules, an open reading frame is present beginning at position 154 in exon 2, and the stop codon is at position 822 in exon 7. The transcription initiation site has been determined by primer extension analysis and is located 135 bp upstream of intron 1. Isolation and sequencing of the hGSTA4 gene 5'-flanking region revealed it to be devoid of TATA or CCAAT boxes but it does contain an initiator element overlapping the transcription start site, a GC box and putative binding sites for transcription factors AP1, STAT, GATA1 and NF-kappaB. Reverse transcription-PCR analysis revealed that hGSTA4 mRNA was present in all the tissues tested, although in low amounts, suggesting that this subunit may be ubiquitously expressed.
Cloning of STK13, a third human protein kinase related to Drosophila aurora and budding yeast Ipl1 that maps on chromosome 19q13.3-ter.
This report describes the identification of a cDNA encoding STK13, a third human protein kinase related to the Drosophila Aurora and the budding yeast Ipl1 kinases. After screening of a human placental cDNA library with a Xenopus laevis cDNA encoding the pEg2 protein kinase and 5' RACE on testis mRNA, a full-length cDNA was isolated. The chromosomal localization of STK13 on 19q13.3-ter between the markers D19S210 and D19S218 was established by a combination of somatic cell and radiation hybrid panel PCR screening. The localization of STK13 on human chromosome 19 was confirmed by fluorescence in situ hybridization (FISH) using a genomic clone containing STK13 as a probe.
Serotonin transporter gene polymorphisms in patients with unipolar or bipolar depression.
To explore the involvement of serotonin transporter (5HTT) in mood disorder, we studied two polymorphisms of the 5HTT gene (a variable number of tandem repeats in the second intron (VNTR) and a 44 bp insertion/deletion in the 5HTT linked polymorphic region (5-HTTLPR)) in a sample of unipolar and bipolar patients and controls. Homozygosity for the short variant of the 5-HTTLPR was significantly more frequent in bipolar patients than in controls (chi2 = 4.68, d.f. = 1, P = 0.03) whereas there was no difference between bipolar patients and controls for allele distribution, suggesting a recessive effect. The interaction between the two markers suggests that the two polymorphisms probably have independent effects to determine the susceptibility to affective disorder. Further studies are required to identify the precise phenotype associated with 5HTT polymorphisms in depressed patients.