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Biomedical subjects

D Berger

Publications and source records attributed to D Berger.

At least 127 records · Page 7Linked to original sources
PubMed1991

Diagnosis of anterior cervical spinal epidural abscess by US and MRI in a newborn.

A 10-day-old girl who initially presented with fever developed over five days a complete paresis of both upper arms and swallowing difficulty. After emergency drainage of a retropharyngeal abscess, cervical US demonstrated a cervical anterior epidural mass compressing the cord. MRI confirmed the diagnosis of spinal epidural abscess secondary to C4-C5 spondylodiscitis. Surgical removal of the abscess was followed by complete disappearance of the neurologic symptoms after six months of follow-up. This is the first case of spinal epidural abscess in a newborn to be diagnosed by US and MRI preoperatively. The advantages of these non-invasive imaging modalities are discussed, and compared to myelography.

Abscess↗
PubMed1991

[Gravity suction drainage--an alternative to suction drainage in trauma surgery? A prospective randomized comparison in knee operations and hip joint alloarthroplasty?].

In two prospective randomized studies the common drainage system according to Redon was compared with the gravity system according to Robinson in 80 patients undergoing elective knee joint surgery and in 60 patients undergoing total hip replacement. By use of clinical criteria such as output volume and rate of hematomas in both groups no statistically significant difference could be established. However, there is a tendency to a lower hematoma rate in patients with knee joint operations and treated with the Robinson system. On the other hand after total hip replacement a tendency to lower hematoma rate was observed in the Redon group. These differences can be explained by the different output volumes after hip and knee joint operations. Probably the Robinson system cannot drain as much volume as the Redon system. A further explanation could be that after hip replacement an external compression cannot be sufficiently performed compared to the knee joint operations. Furthermore the remaining subfascial cavity after hip replacement should be drained with suction in order to reduce the extent of the cavity. This point of view is supported by the observation that the gravity system seems to be only an overflow one in clinical practice. The main advantage of the Robinson system is the significant lower pain score when removing the drainages and even when the drains are lying in situ. This advantage, however, is possibly a relative one, when the Redon drains are removed without suction. So the postulation that the Robinson system should be generally introduced in orthopedic surgery cannot be accepted. At the moment there are indications for both systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Ureterosigmoidostomy: a long-term follow-up of 15 patients with urinary diversion.

We reviewed 15 patients who underwent 16 ureterosigmoidostomies from 1975 to 1989. The underlying disease was bladder exstrophy in 13 patients. Urinary diversions have been performed according to Mathisen in 15 patients, one reoperation has been performed according to Coffey. Standard post-operative controls consist of physical examinations, capillary blood gas samples, intravenous pyelograms, inulin clearance measurements, 123I-hippuran scintigraphies and colonoscopies. Results concerning continence are judged very satisfactory in 80% of patients. 34% of patients presented with one or more episodes of unilateral or bilateral pyelonephritis. Intravenous pyelograms showed improved or unchanged urinary tract dilatation in 45% of kidneys and moderate and severe dilatation in 55%. Inulin clearance remained in normal range in 4 out of 6 patients followed. Renal function assessed by means of renal scintigraphy remained unchanged in 61% of kidneys, slightly decreased in 22% and severely in 17%. All patients are kept on a sodium-citrate therapy. Only one patient shows growth disturbances. Out of 9 patients followed with colonoscopy, none showed signs of malignancy.

Adolescent↗
PubMed1991

Demonstration of an interaction between transferrin and lipopolysaccharide--an in vitro study.

Transferrin is reported to be a major lipopolysaccharide binding protein of human plasma, at least in vitro. By use of the limulus-amebocyte-lysate test the influence of transferrin on endotoxicity was studied. In the absence of any other protein human iron-free transferrin was able to strongly enhance endotoxicity in a concentration-dependent manner. Similar results were obtained when transferrin was added to primarily heat-inactivated plasma. Even in this assay the endotoxin recovery increased when transferrin was exogenously added. On the other hand, transferrin inhibited endotoxicity when inactivation of the plasma samples was performed after the addition of endotoxin and transferrin. These results lead to the conclusion that transferrin in fact interacts with lipopolysaccharide in a biologically important manner. In order to achieve neutralization of endotoxin, however, other plasma constituents are needed. The hypothetical function of transferrin is possibly a disaggregation of lipopolysaccharide micelles, following the interaction between the two molecules. The present data should justify further studies in order to clarify a possible benefit of the substitution of transferrin during gram-negative sepsis.

Blood Physiological Phenomena↗
PubMed1991

[Intraductal carcinomas in situ. Retrospective study of 21 cases and review of the literature].

In situ canalicular carcinomas are defined as malignant, galactophoric epithelial cells, do not invade the basal membrane. The author saw 21 cases of in situ canalicular carcinomas which were treated surgically at the University Hospital of Rennes. It is possible from these cases to include certain themes: there is a pathology of an early carcinoma of the breast which will go on growing. It concerns patients in the menopausal age who 1 in 3 have a family history of neoplasia. Medical examination is important because in 1 out 2 cases leads to complimentary examinations which help to make the diagnosis. Mammography is essential because it leads to the diagnosis of a finding of suspicious microcalcifications as well as arranges an outline. The histology will indicate what the therapy should be. Comedocarcinomas (cellular proliferation with central necrosis) has to be considered as separate from other better differentiated types (solid, cribriform, papillary and clinging carcinomas). In fact comedocarcinomas often have a poor prognosis and the factors are: the size, the mitotic activity, the poor cellular differentiation, perigalactoriphic reaction, and stromal and multi centre micro-invasion. Treatment has to be adapted to features of this pathology. Mastectomy which used to be routine in these cases because of the high incidence of multiple centres, are to be reserved for cases with a poor prognosis. At present conservative treatment is being evaluated, but it seems logical to recommend it in non-invasive cancers with a good prognosis when a large lumpectomy followed up by radiotherapy to the whole breast can be used, particularly because this form of treatment is now given to invasive tumours. It is very important to follow-up these patients regularly and for a long time, clinically and with mammography if conservative treatment is carried out, in any case when the opposite breast is at risk. Conclusion. Now that treatments have become varied the improvement in prognosis will depend on early diagnosis. This means that mammography screening will proceed to an increasing number of non-invasive cancers of the breast that are discovered, and to a need to work out acceptable and effective treatment for these cancers.

Adult↗
PubMed1991

[Primary pure carcinoid tumor of the breast: a case report. Review of the literature].

The authors present a case of primary pure carcinoid tumour of the breast and point out how rare it is and how they made their diagnosis mainly by histology. A review of the literature makes it possible to assess the prognosis which should be good and they also describe the anatomo-pathological findings in these tumours. Finally these tumours show a strange histogenesis which if it is understood makes it possible to understand certain processes of cellular differentiation in breast tissue.

Aged↗
PubMed1991

[Salpingitis and bacteriology].

Salpingitis remains a public health problem due to their direct cost (hospitalization) and indirect cost (sequelae) and they also confront the clinician with questions concerning the bacteriological diagnosis. It is necessary to multiply the samples taken in order to obtain a series of arguments to attribute the origin of the salpingitis to an organism, if a single organism is involved. The reliability of these examinations depends on the site and the care with which they are carried out as well as on the quality of the transportation and culture media. The convergence of these data leads to the prescription of appropriate antibiotics.

Adolescent↗
PubMed1991

[Scarred uterus. Results and selection of patients for vaginal delivery. Apropos of 884 cases].

The authors present their results as far as successful vaginal delivery (in 39.9% of cases) carried out in 884 cases with a scar in the uterus. They also give the morbidity and maternal and fetal mortality as well as those that developed a rupture of the uterus. No mother died in their series and there was no fetal death that could be ascribed to a complete rupture or a uterine dehiscence. Both fetal and maternal mortality was considerably higher when the trial of scar failed or when a Caesarean section was carried out prophylactically, as compared with the results from vaginal delivery. 2.17% of all the 884 patients with a uterine scar had a complete or incomplete rupture of the scar. Finally the describe their criteria for selecting patients for attempts at vaginal delivery and they show that it is necessary to test the ability of the fetus to pass through the pelvis after looking very carefully at the partogram made for the previous Caesarean operation. In this way they were able to use a trial of labour in slightly contracted pelves or where the fetus was big in such a manner as to obtain a vaginal delivery in, respectively, 68 and 72% of cases.

Birth Weight↗
PubMed1990

Correlation between endotoxin-neutralizing capacity of human plasma as tested by the limulus-amebocyte-lysate-test and plasma protein levels.

In the present study the endotoxin-neutralizing capacity of human plasma obtained from healthy volunteers was determined by use of the limulus-amebocyte-lysate test. The extent of the endotoxin-neutralizing capacity which showed a very broad variation was correlated to the plasma levels of some proteins which are believed to contribute to endotoxin transport and detoxification. The plasma levels of alpha 2-macroglobulin and transferrin, the major transport proteins, as well as the levels of IgG, IgA and IgM and apoprotein A were not significantly correlated to the neutralizing capacity. Only the apoprotein B, the major apoprotein of the low density lipoprotein fraction shows a significant correlation. Together with previously published results it should be concluded that low density lipoproteins are involved in the endogenous endotoxin-neutralizing reaction occurring in human plasma, at least when high doses of endotoxin are administered. Nevertheless the endotoxin-neutralizing reaction seems to be a very complex multistep process.

Apolipoproteins A↗
PubMed1990

An analysis of neural spike-train distributions: determinants of the response of visual cortex neurons to changes in orientation and spatial frequency.

A previously unexploited method of examining neural spike-trains was applied to data obtained from cells in the visual cortex. Distributions of interspike intervals recorded extracellularly from cat visual cortex under four conditions were analyzed. Stimuli were gratings differing in orientation and spatial frequency. The probability density function of first passage time for a random walk with drift process, which is defined by its barrier height and drift coefficient, was used to characterize the generating process of axonal discharge under resting and stimulus conditions. Drift coefficient and barrier height were derived from the sample mean and standard deviation of the measured inter-spike intervals. For cells with simple receptive fields, variations in the drift coefficient were produced by changes in orientation and spatial frequency. Variations in barrier height were produced only by changes in orientation of the stimulus.

Animals↗
PubMed1990

Influence of human transferrin and group-specific protein on endotoxicity in vitro.

The present study concerns the endotoxin neutralizing activity of human iron-free transferrin, and group-specific protein also called Gc-globulin. Iron-free transferrin was used because former studies showed that the endotoxin binding capacity is restricted to apotransferrin. The endotoxin neutralizing activity of the different protein preparations was tested by use of the limulus-amebocyte-lysate test after solubilizing in an isotonic electrolyte buffer at pH 7.0. Surprisingly, in the presence of transferrin the limulus test detected about 200% and 150%, respectively, of the endotoxin content measurable in the presence of human albumin or without any protein. The addition of Gc-globulin leads to a loss of endotoxin of about 40%.

Albumins↗
PubMed1990

[Possibilities for assessing unilateral functional disorders of the upper urinary tract in infants with urethral valves].

Upper urinary tract function was evaluated in 15 infants in whom urethral valves were diagnosed. One baby died at 16 days of age and was not completely investigated. In 4, the valves did not have untoward effect on the bladder and the upper urinary tract. In 10 others, function was evaluated using the Hodson index, creatinine, PAH, inuline clearance and renal I123-Hippuran scintigraphy with measurement of the accumulation indices. The various examination procedures were of value in providing precise evaluation of the renal performances at diagnosis as well as in prognosis and follow-up of the function of each kidney.

Creatinine↗
PubMed1990

Portal vein thrombosis of the adolescent: indications for autologous internal jugular vein interposition meso-caval shunt.

Endoscopic sclerotherapy is now the treatment of first choice for oesophageal varices. However, in spite of its efficiency and safety, recurrent bleeding remains possible and oesophageal sclerosis does not cure other potentially incapacitating symptoms related to portal hypertension. This report describes four adolescents with prehepatic hypertension for whom sclerotherapy was inadequate. They were treated successfully by an autologous internal jugular vein interposition mesocaval shunt. This operation is safe, decompresses the whole splanchnic territory and obviates the need for long term endoscopic surveillance.

Adolescent↗
PubMed1990

[Significance of blood uric acid determination. Review of the literature].

Determination of the blood uric acid levels is still a weak indicator in the evaluation of the prognosis of fetal distress when compared with materno and feto-placental vascular tests. Its diagnostic and prognostic value in case of maternal gravidic nephropathy could be improved by a specific uricase titration and initial determination at the beginning of the 2nd trimester. Elevated uric acid levels would therefore be undeniably helpful in selecting the form of treatment.

Female↗
PubMed1989

Energetics of diphtheria toxin membrane insertion and translocation: calorimetric characterization of the acid pH induced transition.

The pH and temperature stabilities of diphtheria toxin and its fragments have been studied by high-sensitivity differential scanning calorimetry. These studies demonstrate that the pH-induced conformational transition associated with the mechanism of membrane insertion and translocation of the toxin involves a massive unfolding of the toxin molecule. At physiological temperatures (37 degrees C), this process is centered at pH 4.7 at low ionic strength and at pH 5.4 in the presence of 0.2 M NaCl. At pH 8, the thermal unfolding of the nucleotide-bound toxin is centered at 58.2 degrees C whereas that of the nucleotide-free toxin is centered at 51.8 degrees C, indicating that nucleotide binding (ApUp) stabilizes the native conformation of the toxin. The unfolding profile of the toxin is consistent with two transitions most likely corresponding to the A fragment (Tm = 54.5 degrees C) and the B fragment (Tm = 58.4 degrees C), as inferred from experiments using the isolated A fragment. These two transitions are not independent, judging from the fact that the isolated A fragment unfolds at much lower temperatures (Tm = 44.2 degrees C) and that the B fragment is insoluble in aqueous solutions when separated from the A fragment. Interfragment association contributes an extra -2.6 kcal/mol to the free energy of stabilization of the A fragment. Whereas the unfolding of the entire toxin is irreversible, the unfolding of the A fragment is a reversible process. These findings provide a thermodynamic basis for the refolding of the A fragment after reexposure to neutral pH immediately following translocation across the lysosomal membrane.

Calorimetry, Differential Scanning↗
PubMed1989

Chloroquine as a hyperthermia potentiator.

The antimalarial agent chloroquine (CQ) inhibits DNA and RNA polymerase and interferes with lysosomal function. We sought to determine if these properties make chloroquine effective as a hyperthermia sensitizer. B16F10 melanoma cells were treated for 180 min at 37 or 41 degrees C with 0.005 mM CQ, 0.01 mM CQ, 0.05 mM CQ, or 0.1 mM CQ and colony formation evaluated at 7 days. CQ was cytotoxic at 37 or 41 degrees C in a dose-dependent fashion. A significant increase in cytotoxicity was seen with 0.5 and 0.1 mM CQ at 41 degrees C compared to 37 degrees C (P less than 0.01). The influence of treatment time on CQ cytotoxicity was examined by treating cells with 0.05 mM CQ at 37 or 41 degrees C for 30-min intervals from 30 to 180 min. Increasing length of exposure to CQ increased cytotoxicity at both 37 and 41 degrees C. For each interval studied treatment at 41 degrees C significantly decreased colony formation compared to treatment at 37 degrees C (P less than 0.01). Complete cell kill was achieved after 180 min of 41 degrees C treatment compared to 80% cell kill at 37 degrees C. We conclude that in this model CQ is an effective potentiator of hyperthermia.

Cell Survival↗