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C Lefèvre

Publications and source records attributed to C Lefèvre.

At least 19 recordsLinked to original sources
PubMed2006

[Compound tissue reconstruction of the forearm in emergency. About 17 clinical cases].

The authors report a serial of 17 patients with complex trauma of the forearm treated in emergency by means of compound tissue reconstruction. Every patient present a cutaneous defect associated with multiple lesions or defects of the subjacent tissues. The management consisted of a large debridement with excision of all contuse tissues, a stable osteosynthesis witch permit an early mobilization of the hand and fingers, a revascularization of the hand by a by-pass procedure or a vascular bridge free flap, reconstruction of the muscles, tendons, and the nerves at the same time as possible, a coverage of the tissues by free flaps or forearm pedicle flaps and a physiotherapy by a specialized team undertaken immediately after surgery. The functional results have been evaluated satisfying in the whole serial. The authors conclude that the compound tissue reconstruction of the forearm in emergency with an early physiotherapy permits an optimal functional recovery within short period. It authorizes a rapid socioprofessional return of these patients with complex trauma of the forearm.

Adolescent↗
PubMed2004

[Vascularized fibular transplant for avascular necrosis of the femoral head: 16 cases].

PURPOSE OF THE STUDY: We report our experience with vascularized fibular transplant using the technique described by Urbaniak for the treatment of avascular necrosis of the femoral head. MATERIAL AND METHODS: Sixteen patients, mean age 39 years 4 months at surgery, were evaluated at mean 3 years 6 months follow-up (minimum 15 months). Mean pain score (analog visual scale) was 6.25/10. Mean Postel-Merle-d'Aubigné (PMA) function score was 12. The Ficat classification was grade 2A (n=9) or grade 2B (n=7). RESULTS: There were no cases of infection or migration of the fibula. The only complication at the donor site was one case of paresia of the long extensor of the hallux which resolved spontaneously. There were five failures which required a hip prosthesis (31%). Three failures occurred early during the first 18 months. Two were late. These patients had grade 2B (n=4) or grade 2A (n=1) necrosis. At last follow-up, eleven hips had not required prosthetic revision (69%). The pain score improved in 81% of patients: mean score=2.3. Nine patients were satisfied or very satisfied (81%). Among these eleven hips, function was good or excellent in eight (72%). Walking distance was improved in nine patients, unchanged in one and worse in one. Joint motion improved in nine patients, was unchanged in one and decreased in one. Nine patients resumed their full-time job. Mean sick leave was 13.3 months. Radiographically, only two of the initial Ficat grade 2A hips remained at this stage. Likewise only one of the three hips initially rated grade 2B remained at this stage. Overall radiographic results were: failure (n=5), worsening (n=9), stabilization and no improvement (n=2). Among the nine 2A hips, one was converted to a total hip prosthesis and five femoral heads remained spheric. Among the seven 2B hips, four were converted to a total hip prosthesis and two femoral heads collapsed. DISCUSSION: At mean follow-up (3.5 years), 69% of the hips had not required total hip arthroplasty. The grade 2A hips did better but the small sample size did not allow statistical comparison. There was a clear discordance between the clinical presentation and the radiographic findings among the hips which were not treated with a prosthesis: good function score, maintained occupational and daily life activities contrasting with unfavorable radiographic evolution. Results could be improved by detailed quantification of the lesion using 3D imaging and by associating intraoperative navigation.

Adult↗
PubMed2001

Mutations in CGI-58, the gene encoding a new protein of the esterase/lipase/thioesterase subfamily, in Chanarin-Dorfman syndrome.

Chanarin-Dorfman syndrome (CDS) is a rare autosomal recessive form of nonbullous congenital ichthyosiform erythroderma (NCIE) that is characterized by the presence of intracellular lipid droplets in most tissues. We previously localized a gene for a subset of NCIE to chromosome 3 (designated "the NCIE2 locus"), in six families. Lipid droplets were found in five of these six families, suggesting a diagnosis of CDS. Four additional families selected on the basis of a confirmed diagnosis of CDS also showed linkage to the NCIE2 locus. Linkage-disequilibrium analysis of these families, all from the Mediterranean basin, allowed us to refine the NCIE2 locus to an approximately 1.3-Mb region. Candidate genes from the interval were screened, and eight distinct mutations in the recently identified CGI-58 gene were found in 13 patients from these nine families. The spectrum of gene variants included insertion, deletion, splice-site, and point mutations. The CGI-58 protein belongs to a large family of proteins characterized by an alpha/beta hydrolase fold. CGI-58 contains three sequence motifs that correspond to a catalytic triad found in the esterase/lipase/thioesterase subfamily. Interestingly, CGI-58 differs from other members of the esterase/lipase/thioesterase subfamily in that its putative catalytic triad contains an asparagine in place of the usual serine residue.

1-Acylglycerol-3-Phosphate O-Acyltransferase↗
PubMed2001

Mutations in the gene encoding SLURP-1 in Mal de Meleda.

Mal de Meleda (MDM) is a rare autosomal recessive skin disorder, characterized by transgressive palmoplantar keratoderma (PPK), keratotic skin lesions, perioral erythema, brachydactyly and nail abnormalities. We report the refinement of our previously described interval of MDM on chromosome 8qter, and the identification of mutations in affected individuals in the ARS (component B) gene, encoding a protein named SLURP-1, for secreted Ly-6/uPAR related protein 1. This protein is a member of the Ly-6/uPAR superfamily, in which most members have been localized in a cluster on chromosome 8q24.3. The amino acid composition of SLURP-1 is homologous to that of toxins such as frog cytotoxin and snake venom neurotoxins and cardiotoxins. Three different homozygous mutations (a deletion, a nonsense and a splice site mutation) were detected in 19 families of Algerian and Croatian origin, suggesting founder effects. Moreover, one of the common haplotypes presenting the same mutation was shared by families from both populations. Secreted and receptor proteins of the Ly-6/uPAR superfamily have been implicated in transmembrane signal transduction, cell activation and cell adhesion. This is the first instance of a secreted protein being involved in a PPK.

Amino Acid Sequence↗
PubMed2001

Novel point mutations, deletions, and polymorphisms in the cathepsin C gene in nine families from Europe and North Africa with Papillon-Lefèvre syndrome.

Papillon-Lefèvre syndrome is an autosomal recessive disorder characterized by palmoplantar keratoderma, periodontitis, and premature loss of dentition. Mutations in the CTSC gene that encodes cathepsin C have been described in families affected with Papillon--Lefèvre syndrome. Cathepsin C is the least understood of the lysosomal cysteine proteases; it has been reported to participate in both intracellular and extracellular cleavage of proteins and activation of serine proteases in immune and inflammatory cells. We report here eight new mutations in Papillon-Lefèvre syndrome families: four deletions and four point mutations, including a missense mutation in the propeptide chain that could help elucidate structure-function relationships in this protein. We also found that the 458C > T mutation, first reported in two families by Hart et al (2000c), was a neutral polymorphism in our families, as suggested by Allende et al (Cathepsin C gene: first compound heterozygous patient with Papillon--Lefèvre syndrome and novel symptomless mutation. Hum Mutat 17:152-153, 2001).

Africa, Northern↗
PubMed2000

[Rehabilitation of the first dorsal interosseous muscle by transfer of the extensor pollicis brevis tendon].

Weakness of the pinch grip between index finger and thumb, in ulnar nerve palsy, leads to severe loss of hand function. The first dorsal interosseous plays a major rôle as it abducts and flexes the index finger at its base and stabilizes the MP joint of this finger. Replacement of this muscle is therefore important. The authors report the results of eight clinical cases of replacement of the first dorsal interosseous by extensor pollicis brevis. They obtained good improvement of hand function, in terms of objective and subjective results, in all cases.

Adolescent↗
PubMed1999

First paleoparasitological analysis of a midden in the Aleutian Islands (Alaska): results and limits.

Excavations on Buldir Island, Aleutian Islands, Alaska, have revealed the remains of several features dated between the 13th and 17th centuries A.D. Soil from an open-air workshop, represented by 2 excavated pits, and a structure built of whale bones were sampled for evidence of parasites and microfloristic remains. Two groups of helminth eggs (Diphyllobothrium and Ankylostomidae) were identified in samples from the open-air pits; microfloristical remains were found in all samples. This is the first paleoparasitological analysis conducted on an Aleutian midden.

Alaska↗
PubMed1998

Determination of ivabradine and its N-demethylated metabolite in human plasma and urine, and in rat and dog plasma by a validated high-performance liquid chromatographic method with fluorescence detection.

A sensitive and selective high-performance liquid chromatographic method with native detection of fluorescence was developed and validated for the quantitation of ivabradine and its N-demethylated metabolite in plasma (rat, dog, human) and human urine. The procedure involves the use of an analogue as internal standard, solid-phase extraction on cyano cartridges, separation on a Nova-Pak C8 column and fluorescence detection. Calibration curves are linear in the concentration ranges from 0.5 to 100 ng/ml in plasma and 2.0 to 500 ng/ml in urine with a limit of quantitation set at 0.5 and 2.0 ng/ml in plasma and urine, respectively. The analysis of plasma and urine samples (spiked with the analytes at low, medium and high concentrations of the calibration range) demonstrates that both analytes can be measured with precision and accuracy within acceptable limits. Quality controls spiked with analyte concentrations up to 10000 ng/ml can also be analysed with excellent precision and accuracy after dilution of the samples. The parent drug and its metabolite are stable in plasma and urine after short-term storage (24 h at room temperature and after three freeze-thaw cycles) as well as after long-term storage at -20 degrees C (at least 6 months in animal plasma and 12 months in human plasma and urine). The method has been used to quantify both compounds in plasma and urine samples from clinical and non-clinical studies with ivabradine.

Animals↗
PubMed1998

Arterial and neural relations at the posterior and lateral aspects of the medullo-spinal junction.

The authors report the results of a series of 59 microdissections of the region of the foramen magnum. These dissections were made under the strict conditions of a surgical approach using an operating microscope. The major anatomic structures of the medullo-spinal junction are arranged mainly at its lateral aspect. The customary surgical approaches to the posterior cranial fossa give ready access to the cerebello- and latero-medullary cisterns. The description of the neurovascular structures contained therein assumes a particular importance because of the relative frequency of lesions developing at this level. This study deals particularly with the vertebral a. (VA), the inferior posterior cerebellar a. (IPCA), the cranial nn. IX (glossopharyngeal n.), X (vagus n.), XIc and XIs (cranial and spinal accessory n.) and XII (hypoglossal n.). The anatomy of this posterior and lateral region is characterised by the contrast between the relatively uniform course of the VA and the variable course of the IPCA, a true guideline whose very irregular arrangement accounts for the diversity of its relations with the last four cranial nn.

Cadaver↗
PubMed1998

[Static and dynamic changes of the cervical spine after laminectomy for cervical spondylotic myelopathy].

PURPOSE OF THE STUDY: Extensive cervical laminectomy has been widely used in the treatment of progressive myelopathies secondary to stenotic conditions. Complications of this procedure such as spinal instability, accelerated spondylotic changes, postoperative spinal deformity and constriction of the dura mater by extradural scar tissue formation have been recognized. However, the frequency of these complications is probably overestimated and their consequences on the clinical outcome remain unknown. The purpose of this report was to describe the incidence and consequences of cervical spinal deformity and instability after multilevel laminectomy in adult patients with myelopathy caused by cervical spondylosis and to determine the usefulness of preoperative dynamic films in the prevention of postoperative destabilization. MATERIALS AND METHODS: 30 patients older than 30 years who underwent a laminectomy of more than 3 levels without fusion for myelopathy secondary to cervical spondylosis were reviewed retrospectively with an average follow-up of 5 years. Functional results were evaluated according to the Japanese Orthopaedic Association scoring system. Lateral views in neutral position, in flexion and in extension of the preoperative cervical roentgenograms were analyzed in comparison with the last follow-up one in order to identify the changes in the curvature of the cervical column, in the range of motion of the neck, in the intervertebral angular mobility and antero-posterior displacement of the vertebral bodies, and finally to identify the incidence of spinal instability. RESULTS: 18 patients (31 per cent) developed postoperative changes in cervical spine curvature. 15 patients (25 per cent) had one or more destabilized levels. Deformities of the cervical spine occurring after surgery do not appear to cause any symptom or neurologic abnormalities. Destabilization required repeat surgery in 3 patients. All the levels found destabilized on the postoperative films were hypermobile on the preoperative dynamic radiographs. A preoperative olisthesis without hypermobility was not a risk factor for postoperative destabilization. CONCLUSION: The use of preoperative dynamic radiographs should improve the selection of patients undergoing laminectomy for the treatment of multilevel cervical cord compression. Dynamic X-rays may also reinforce the need for possible adjunctive procedures such as fusion and instrumentation, in order to prevent a postoperative destabilization. A preoperative olisthesis with a hypermobility in sagittal or horizontal planes must be fused and instrumented.

Aged↗
PubMed1997

Detection of herpes simplex DNA in semen and menstrual blood of individuals attending an infertility clinic.

OBJECTIVE: To determine a possible link between herpes simplex virus 1 (HSV) and infertility. METHOD: A specifically designed polymerase chain reaction with nested primers, was developed and used to test for HSV in 153 men and 20 women attending an infertility clinic. RESULTS: HSV DNA was detected in 37 (24%) out of 153 semen samples and in 11 (55%) out of 20 menstrual blood samples. However, HSV DNA (0%) was not detected in the semen of 16 males with children. A significant association between the evidence for infertility and an HSV positive test was observed in men (Fisher's exact test, p = 0.024), and a stronger effect was found in females after failed in vitro fertilization (Fisher's exact test p = 0.0086). CONCLUSION: This is the first report of the detection of herpes simplex virus DNA in semen and menstrual blood. Encouraging preliminary results justify antiviral therapy in case of a positive test.

Acyclovir↗
PubMed1996

Collective epidemic models.

A number of models have been proposed to describe the spread of infectious diseases of the S-I-R type. Most of them account for variable infectivity levels, and very few incorporate variable susceptibility levels. In the present work, a new epidemic model, called a collective model, is constructed that combines both variabilities in a general way. It is then established how to determine the exact distribution of the final state and the severity of the epidemic when the infection process stops.

Communicable Diseases↗
PubMed1996

[Therapeutic possibilities of the lateral supra-malleolar flap and its variations. Apropos of 6 clinical cases].

The distally based lateral supramalleolaire flap with a retrograde blood flow on the perforating branch of the peroneal artery is a good flap to treat loss of skin involving the ankle, the region behind the Achilles tendon, and the foot. Based on the results of an anatomical study, the authors describe a modification of this flap which can be raised on the infero-lateral collateral artery, with an anterograde blood flow. In fact, clinical experience of six cases shows that vascular pedicle component (perforating branch of the peroneal artery, infero-lateral collateral artery) and blood flow (anterograde, retrograde) can be calculated according to the regional vascular network, arc of rotation and the type of flap. Because of the many possible combinations, it can be considered to be a flap with variable vascular pedicle raised "à la carte". However, according to our clinical cases, the anterograde blood flow does not seem to have resolved the problems of venous congestion of this flap.

Adult↗
PubMed1995

Internal motions of apo-neocarzinostatin as studied by 13C NMR methine relaxation at natural abundance.

Dynamics of the backbone and some side chains of apo-neocarzinostatin, a 10.7 kDa carrier protein, have been studied from 13C relaxation rates R1, R2 and steady-state 13C-(1H) NOEs, measured at natural abundance. Relaxation data were obtained for 79 nonoverlapping C alpha resonances and for 11 threonine C beta single resonances. Except for three C alpha relaxation rates, all data were analysed from a simple two-parameter spectral density function using the model-free approach of Lipari and Szabo. The corresponding C-H fragments exhibit fast (tau e < 40 ps) restricted libration motions (S2 = 0.73 to 0.95). Global examination of the microdynamical parameters S2 and tau e along the amino acid sequence gives no immediate correlation with structural elements. However, different trends for the three loops involved in the binding site are revealed. The beta-ribbon comprising residues 37 to 47 is spatially restricted, with relatively large tau e values in its hairpin region. The other beta-ribbon (residues 72 to 87) and the large disordered loop ranging between residues 97-107 experience small-amplitude motions on a much faster (picosecond) time scale. The two N-terminal residues, Ala1 and Ala2, and the C-terminal residue Asn113, exhibit an additional slow motion on a subnanosecond time scale (400-500 ps). Similarly, the relaxation data for eight threonine side-chain C beta must be interpreted in terms of a three-parameter spectral density function. They exhibit slower motions, on the nanosecond time scale (500-3000 ps). Three threonine (Thr65, Thr68, Thr81) side chains do not display a slow component, but an exchange contribution to the observed transverse relaxation rate R2 could no be excluded at these sites. The microdynamical parameter (S2, tau e and R2ex) or (S(slow)2, S(fast)2 and tauslow) were obtained from a straightforward solution of the equations describing the relaxation data. They were calculated assuming an overall isotropic rotational correlation time tau c for the protein of 5.7 ns, determined using standard procedures from R2/R1 ratios. However, it is shown that the product (1-S2) x tau e is nearly independent of tau c for residues not exhibiting slow motions on the nanosecond time scale. In addition, this parameter very closely follows the heteronuclear NOEs, which therefore could be good indices for local fast motions on the picosecond time scale.

Apoproteins↗
PubMed1994

A fast word search algorithm for the representation of sequence similarity in genomic DNA.

Representation of sequence similarity by dot matrix plots is a method widely used for comparing biological sequences. The user is presented with an overall view of similarity between two sequences. Computation of this plot has been reconsidered here. An improvement is proposed through the preprocessing of the data into an automation recognizing the word structure of a sequence. The main advantage of this approach is to systematically eliminate the repetitions during word comparison. Simple heuristics are also considered to greatly speed up pattern matching. As a result, large sequences are handled very efficiently. This is illustrated by a comparison of large genomic DNA. The algorithm has been implemented in an interactive application on a microcomputer.

Algorithms↗
PubMed1994

The "anatomic" view of the suprarenals in medical imaging.

Based on coordinates derived from three series of anatomic sections, the authors propose a view for tomographic investigation, applicable in MRI and ultrasound, which reconstructs the ideal image of the suprarenal gland in its quadrilateral as described by Testut. This "anatomic" view is 45 degrees vertical and oblique, intermediate between the sagittal and frontal views, which it can advantageously replace. A new aspect of suprarenal tomography, recalling the image of a triskele, is described in the context of this view.

Adrenal Glands↗