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Biomedical subjects

D Herman

Publications and source records attributed to D Herman.

At least 73 records · Page 4Linked to original sources

Comparison of conidial and mycelial allergens of Alternaria alternata.

Alternaria allergens, separated by SDS polyacrylamide gel electrophoresis and transferred onto a nitrocellulose membrane, were identified using sera from Alternaria-allergic patients. 30 Alternaria components of spore and mycelium, ranging in molecular weight from more than 150 to 12 kD, bound IgE antibodies. 15 were detected by more than 25% of the sera and only 4 (85, 56, 42, 31 kD) by more than 50% of the sera. Among these four major allergens, the 56-kD component was present mostly in the spore extract, the 85- and 42-kD fractions in the mycelium extract and the 31-kD in both extracts. The 31-kD component showed the highest IgE binding and the highest frequency of binding (95% with mycelium extract and 79% with spore extract). It was composed of two subunits.

Allergens↗

[Surgical treatment of saddle nose, our experience apropos of 19 cases].

19 patients presenting with saddle deformity of the nose were operated upon between 1981 and 1988. Either a bony or a cartilagenous autograft has been employed according to the nature of the deformity. The mean follow-up was two and a half year. The results confirm the high rehability of cartilagenous grafts in the treatment of partial deformities. Treatment of total saddle deformities proved to be less satisfactory with spontaneous resorption of two grafts out of six, one of which was a homologue bony graft from the bank.

Bone Transplantation↗

[Pneumatocele caused by ballistic injury of the anterior stage of the skull base, a case report].

The authors present a case of intracerebral expansive pneumatocele following a ethmoido-sphenoidal fracture by a bullet. The case presented is exceptional, as the bullet went through the brain case without injuring the neurological structure. The patient is operated on through the low paralateronasal approach, by filling the ethmoid and the sphenoid with autologous bone material. This surgical treatment makes closure of the fistula and disappearance of the pneumatocele possible, however, not enough time has gone by for making other judgments. This approach, which has a much lower morbidity rate than the approach of the anterior stage through craniectomy, is effective for fractures of the sphenoid and the posterior ethmoid.

Adult↗

[Role of the free forearm flap in reconstruction after total circular pharyngolaryngectomy. Review of the literature and a case report].

Methods of surgical repair after total pharyngo-laryngectomy have considerably improved since the introduction of micro-surgical techniques. The use of free autografts for reconstruction of the pharynx is now preferred in most centers to the use of musculo-cutaneous flaps. The free forearm flaps appears to be particularly suitable for this type of repair. The authors report on their experience in performing this procedure with one of their patients. The results of this technique in major published series are then compared with those achieved with similar procedures employing free jejunal interposition grafts.

Female↗

[Cervicofacial actinomycosis. Apropos of 2 atypical locations].

Cervico-facial actinomycosis is a chronic bacterial disease caused by actinomycetes. The diagnosis may be made on the specific anatomo-pathological appearance of the granulomas and be confirmed by anaerobic culture of the germs. The authors report two atypical cases: the first is a case of a thyroglossal pseudocyst, the second that of adenoidal vegetations in an adult. Treatment with Penicillin G or V for six weeks produced a favourable response. The various clinical forms of the condition described in the literature, should encourage the physician to include bacteriological testing for actinomycetes among his investigations.

Actinomycosis, Cervicofacial↗

[Is protective therapy possible in occupational asthma? Role of immunotherapy].

Specific immunotherapy (ITS) can be a preventative measure for occupational allergy when allergens cannot be fully eliminated. Many allergens provoke IgE-mediated reactions, but when they are haptens and the physiopathology is complex, then the value of ITS is restricted. However, with common allergens whose density increases with occupation, such as house dust and house dust mites for domestic employees, pollens for florists and animal epithelia for breeders, then ITS is effective. On the other hand, when the allergen is specific for the job, of which there are two well documented examples in bakers asthma from wheat flour and laboratory worker's asthma to small laboratory animals there are disparate results. Overall, there is only a modest place for ITS in the treatment of professional asthma, because of the lack of purified, well-standardised extracts.

Asthma↗

[The course of acquired C 1 esterase inhibitor deficiency in lymphoproliferative syndrome].

Acquired deficiency in C1 esterase inhibitor (C1 INH) was first described by Caldwell in 1972. Since that date, about 30 cases have been reported, in most cases during proliferative lymphocyte B syndromes. The acquired C1 INH deficiency can provoke episodes of angioneurotic edema as in hereditary AE. The complement profile differs, notably by the usual sudden fall in C1. Documented data suggest consumption of complement and therefore of C1 INH. The present case is the first reported of an acquired C1 INH deficiency during a cold hemagglutinin disease. The activation of complement by the classical pathway appears provoked by tumoral cells rather than a humoral factor, as suggested by the efficacy of anti-tumoral therapy in contrast to plasmapheresis in the present case. A possible mechanism for the C1 INH deficiency is discussed.

Anemia, Hemolytic, Autoimmune↗

[Seasonal changes in specific IgE: the acarid Dermatophagoides pteronyssinus].

The authors have studied monthly the titres of specific IgE to Dermatophagoides pteronyssinus, by Phadebas RAST, in 8435 measurements, spread over 4 years. Significant seasonal and monthly variations were seen every year with a maximum level in the autumn or the beginning of winter, with a second peak at the end of winter in 3 years of the 4. There was no close superposition of pattern form one year to another. The domestic relative humidity had a significant effect on the seasonal variation with a mean shift of 2 months that could be explained by the length of the biological cycle of the mites. These data compare with those of the literature (sampling of mites in bedding, longitudinal studies...).

Acari↗

Validity of clinic-based nutritional surveillance for prevalence estimation of undernutrition.

Few studies have been performed to assess the validity of clinic-based nutritional surveillance systems. We compared estimates of the prevalence of underweight (low weight-for-age) obtained from the clinic-based Swaziland surveillance system with estimates obtained from the 1983 National Nutrition Status Survey of Rural Swaziland. The age-adjusted prevalence of underweight among first-time clinic attenders (10.0%) was very similar to that estimated by the national survey (9.4%). However, the prevalence of underweight among children attending two or more times in a year was less than half that of first attenders (4.4%). The regional differences in the prevalence of underweight found in the national survey were not detected by the surveillance system. Surveillance data are useful in describing the nutritional status of children from clinics within the surveillance system. However, surveillance data, particularly from re-attenders, will not necessarily provide a valid estimate of nutritional status within the general population or of differences between regions.

Age Factors↗

[Interstitial lymphoid pneumonia and polyadenopathies in patients infected with the LAV/HTLV III virus].

Seven patients of Haitian and Central African origin were investigated for interstitial pneumonitis and unexplained chronic lymphadenopathy. A study of broncho-alveolar lavage fluid showed no opportunistic micro-organisms and disclosed a high alveolar lymphocyte count with more than 80% T8+ cells. In 3 patients, open lung biopsy showed lymphoid interstitial pneumonitis. Follicular hyperplasia was a constant finding in lymph nodes. Benign lymphocytic infiltration was found in other organs of all patients, associated with polyclonal hyperimmunoglobulinaemia, low peripheral T4+ cell count and LAV-Ig G antibodies.

Acquired Immunodeficiency Syndrome↗

[Role of thoracic x-ray computed tomography in the pretherapeutic evaluation of bronchial cancer. A prospective study of 60 patients].

The value of computerized tomography (CT) was compared with that of conventional exploratory methods (standard radiology, bronchial tomography and endoscopy) in 60 patients with non-anaplastic bronchial cancer evaluated preoperatively. After CT examination thoracotomy was avoided in 14 (23%) patients with local or distal extension. CT proved more sensitive than conventional methods in the assessment of pleural and/or parietal extension, and of direct or lymph-node mediastinal invasion (67% vs 33%, 50% vs 33%, 64% vs 45% respectively). Similar results (75%) were obtained in cases with hilar lymph-node involvement. However, caution must be exerted before excluding thoracotomy, since CT may give false-positive results.

Adult↗

A prospective study of detorubicin in malignant mesothelioma.

Between January 1981 and December 1983, a prospective therapeutic trial of detorubicin (14-diethoxyacetoxy-daunorubicin [DTR]) was conducted in 40 patients with histologically proven malignant mesothelioma (MM). DTR was given intravenously at 40 mg/m2 on days 1, 2, and 3 for five 21-day cycles, then 40 mg/m2 once every 21 days. Thirty-five patients (32 with pleural MM, 3 with peritoneal MM) were eligible. The overall median survival from onset of chemotherapy was 17 months. Complete relief from chest pain was observed in 8 of 15 cases (53%). Of 21 patients with measurable disease, there were 2 complete responses (10%) and 7 partial responses (33%). Median duration of response was 30 weeks. Congestive cardiac failure developed in two patients after 1100 and 1600 mg/m2 of DTR, respectively. Hematologic toxicity was moderate. This study demonstrates that DTR is effective against MM.

Adult↗

Convergence of sensory inputs in somatosensory cortex: interactions from separate afferent sources.

Intracellular recording techniques were used to test for cross-modality and topographic convergence among inputs to area 3a of cerebral cortex. Recordings were made within the projection area of group I afferent fibers of the deep radial nerve in barbiturate-anesthetized cats. Epsps were evoked in 90% of neurons (81/90) by electrical stimulation of more than one nerve of the contralateral forelimb. The deep radial nerve evoked the shortest latency epsps within this region of cortex and the only ones likely to be mediated by a monosynaptic thalamocortical pathway. However, the epsps evoked from other forelimb nerves (of deep or cutaneous origin) had mean latencies only a few milliseconds (1.3-3.0 ms) longer. Furthermore, there were a variety of interactions among inputs from separate afferent sources. The observed interactions included spatial facilitation, occlusion and afferent inhibition. The consequence of these interactions was that neuronal responses were shaped by combinations of effects from different topographic regions of the forelimb or of different modalities. The findings are interpreted as indicating a sharing of neurons among pathways to cortical neurons from separate afferent sources. Interactions between ascending pathways by way of such shared neurons may contribute to the modulation or plasticity of somatosensory responsiveness during behavior or after deafferentation.

Animals↗

Responses of cat motor cortex neurons to cortico-cortical and somatosensory inputs.

Intracellular techniques were used to investigate a cortico-cortical path from sensory cortex to motor cortex of cats. Cortico-cortical epsps were evoked in motor cortex neurons by microstimulation of area 3a. Epsps with latencies between 1.2 and 2.4 ms were identified as monosynaptic. These short latency cortico-cortical effects were recorded in layers II through VI of the motor cortex. Neurons with monosynaptic cortico-cortical epsps also received excitatory inputs from forelimb nerves, usually from both muscle and cutaneous afferent fibers. The epsps evoked from forelimb nerves in motor cortex neurons were preceded by neural activity in somatosensory cortex. Time delays between arrival of inputs in sensory cortex and in motor cortex were compared to the latencies of cortico-cortical epsps in the same motor cortex neurons. It was apparent that the timing was appropriate for the identified cortico-cortical path to have relayed some sensory inputs to motor cortex.

Animals↗

Lymphoid interstitial pneumonitis in acquired immunodeficiency syndrome-related complex.

Three patients had a typical clinical, functional, and histologic pattern of lymphoid interstitial pneumonitis (LIP). All 3 also had a marked follicular and interfollicular hyperplasia of peripheral lymph nodes. A benign lymphocytic infiltration was seen in the kidneys in 2 patients, in the liver of 1 of these, and in the nasopharynx and the bone marrow in another. This LIP, associated with other diffuse benign lymphocytic infiltrates, could be part of AIDS-related manifestations. The patients originated from central Africa (2 patients) and Haiti (1 patient) where AIDS is endemic. They had several immune abnormalities frequently observed in AIDS such as a polyclonal hyperimmunoglobulinemia and, in the 2 patients studied, a decreased number of T4 lymphocytes and an inverted T4/T8 blood lymphocyte ratio. All 3 patients had serum antibodies to human T-cell leukemia viruses.

Acquired Immunodeficiency Syndrome↗