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Biomedical subjects

E Bernard

Publications and source records attributed to E Bernard.

At least 55 records · Page 3Linked to original sources
PubMed1998

Variability of cutaneous lymphatic flow rates in melanoma patients.

Preoperative lymphoscintigraphy was performed in 198 consecutive patients with cutaneous melanoma prior to their definitive surgical treatment. After intradermal injection of antimony sulphide colloid labelled with technetium-99m, lymphatic flow rates were measured in each patient and found to vary according to the location of the primary tumour. The fastest flow rates occurred from melanoma sites on the distal limbs, particularly the lower limbs. The slowest flow rates were from the head and neck region and the proximal limbs, especially the upper arms and shoulders. Lack of flow in the early dynamic images occurred most commonly for tumours on the upper arms and shoulders. These results can be used to optimize the timing of blue dye injection prior to surgery and may influence the sentinel node biopsy method to be used in individuals who show no early drainage.

Antimony↗
PubMed1997

Mapping of a second locus for familial hemiplegic migraine to 1q21-q23 and evidence of further heterogeneity.

Familial hemiplegic migraine (FHM) is an autosomal dominant variety of migraine with aura. We previously mapped an FHM gene on the short arm of chromosome 19. Mutations in this gene, recently shown to be the alpha1 subunit of a P/Q-type voltage-dependent calcium channel, CACNL1A4, are involved in approximately 50% of unselected FHM families and in all families where migraine attacks are associated with permanent cerebellar ataxia. As a first step toward the identification of other FHM genes, we conducted a genetic linkage analysis in one large French pedigree and showed significant linkage to two microsatellite markers D1S2635 (Zmax: 3.33 at theta = 0.05) and D1S2705 (Zmax: 3.64 at theta = 0.05), establishing the existence of a second locus for FHM (FHM2) on chromosome 1q21-q23. Analysis of six additional FHM families favored linkage to this locus in two of them; linkage was excluded in the last four families, indicating further heterogeneity. Chromosome 1-linked families differ from the ones linked to chromosome 19, because penetrance in those families is much lower, and in some of their members, epileptic seizures occur during severe migraine attacks.

Chromosome Mapping↗
PubMed1997

Importance of sebaceous glands in cutaneous penetration of an antiandrogen: target effect of liposomes.

The significance of the sebaceous gland pathway in the cutaneous permeation of an antiandrogen, 4-[3-(4-hydroxybutyl)-4,4-dimethyl -2,5-dioxo-1-imidazolidinyl]-2-(trifluoromethyl)benzonitrile (RU 58841), was studied with normal hairless rat skin and an induced scar hairless rat skin without sebaceous glands. RU 58841 was dissolved in an alcoholic solution and encapsulated in liposomes for comparison. After 24 h, the cumulative percentage of RU 58841 absorbed in vitro was 3-4-fold higher in the normal skin than in the scar skin; in the case of liposomes, the accumulation of the drug in the normal dermis was significantly higher than in the scar one. In the in vivo cutaneous distribution, the epidermis and dermis of the normal skin contained higher amounts of RU 58841 than the scar skin (ninefold with the solution and 16-fold with liposomes). An autoradiography study showed that with the solution, the drug was mainly localized in the stratum corneum/epidermis, and with the liposomes, the drug was mainly localized in the sebaceous glands. We concluded that the sebaceous glands constituted the main pathway for RU 58841. The alcoholic solution encouraged the localization of the drug into the stratum corneum, whereas liposomes targeted the sebaceous glands.

Androgen Antagonists↗
PubMed1997

Subarachnoid hemorrhage in the African-American population: a cooperative study.

The clinical outcome of patients following subarachnoid hemorrhage is complicated by delayed cerebral ischemia and contributing factors such as hypertension. To observe the impact of hypertension and delayed cerebral ischemia on the outcome of a predominantly African-American cohort following subarachnoid hemorrhage, both retrospective (n = 42) and prospective (n = 21) studies were conducted. In the total pool (n = 63), the mean age was 49.7 years (range: 17 to 80) with a preponderance of female patients (70%). Aneurysm formation was significant in the region of the posterior communicating artery. Of the patients reviewed, 73.8% had preexisting hypertension and 45.9% developed delayed cerebral ischemia. Approximately 89% of the patients who suffered from delayed cerebral ischemia had hypertension. Results failed to display any significant beneficial association between the use of the calcium channel blocker nimodipine and delayed cerebral ischemia. Use of the antifibrinolytic drug aminocaproic acid demonstrated a worse patient outcome. It is not recommended that aminocaproic acid be used in this population. Subsequently, due to the proportional occurrence of delayed cerebral ischemia in hypertensive patients following subarachnoid hemorrhage, it is suggested that prophylactic surgical management of unruptured intracranial aneurysms be considered in hypertensive patients. Further study is needed to discern the association between hypertension, delayed cerebral ischemia, and stroke in patients following subarachnoid hemorrhage.

Aminocaproates↗
PubMed1997

Pediatric nuclear oncology.

Nuclear medicine plays an important and increasing role in the management of childhood malignancy. This is particularly true in the solid tumours of childhood. It is also helpful in the management of the complications of cancer treatment such as the infections which often accompany immune suppression in oncology patients. Scintigraphy is a complementary investigation to other radiological techniques and adds the functional dimension to anatomical investigations such as CT, MRI and ultrasound. Scintigraphy is used in the initial diagnosis, staging, assessment of tumour response to treatment, detection of recurrence and the diagnosis of complications. In selected malignancies radionuclides are also used in treatment. This review discusses the technical considerations relating to children and the specific techniques relating to pediatric oncology. Specific tumours and the various applications of radionuclides are discussed in particular lymphoma, primary bone tumours, soft tissue sarcomas, neuroblastoma, Iangerhan's cell histiocytosis, Wilms' tumour, brain tumours and leukemia. Uncommon tumours are also discussed and how radionuclides are useful in the investigation of various complications which occur in oncology patients.

Child↗
PubMed1996

The lumbar and femoral bone mineral densities in a normal female Puerto Rican population.

The aim of this study was to establish the reference values of the bone mineral density (BMD) of the lumbar spine and the proximal femur in a normal adult female Puerto Rican population. In the selection of the population, exclusion criteria included diseases, use of drugs and toxic habits (smoking and alcoholism) known to affect bone and mineral metabolism. The study population comprised 131 healthy females, ages 20 to 69 years. Spinal radiographs were taken of women age 60 or more to exclude spinal defects or artifacts. The bone mineral densities were measured using the dual energy X Ray absorptiometer (DEXA, Hologic model 1000). The peak BMD was found in the lumbar spine at the age 30 to 39 years and at the age 20 to 29 years in the femoral neck, trochanter and Ward's triangle. The decrease in BMD from peak values to those at age 60 to 69 years were 18% for the lumbar spine, 16.3% for the femoral neck, 30.1% for the Ward's triangle and 12.4% for the trochanter. The major fall in the BMD was related to the menopause and compares with that of other series. There was no statistical difference from Hologic reference values in a mixed population of the USA.

Absorptiometry, Photon↗
PubMed1996

[Subcutaneous cysticercosis].

INTRODUCTION: The case of a patient originated from Angola who presented subcutaneous and neurologic cysticercosis is reported. OBSERVATION: The patient was referred for the etiological diagnosis of recurrent seizures. The diagnosis was made by histologic examination of a subcutaneous lesion. COMMENTS: We review the clinical characteristics of subcutaneous cysticercosis. The association of subcutaneous nodules and signs of central nervous involvement occurring in a patient originating from an area where cysticercosis is endemic, must be suspected of cysticercosis.

Adult↗
PubMed1995

[Persistent diarrhea in HIV infected patients: role of Enterocytozoon bieneusi].

OBJECTIVES: To determine the epidemiologic, clinical and aetiologic features of chronic diarrhoea in patients with human immunodeficiency virus (HIV) infection. METHODS: Between January 1992 and April 1993, all HIV positive patients with chronic diarrhoea were enrolled in a prospective study. There were 46 patients in the study group including 33 (22 homosexuals) in stage C according to the 1993 Centers for Disease Control classification. RESULTS: Thirty-four pathogenic agents were isolated in 26 of the patients (57%). Enterocytozoon bieneusi was the most frequently found pathogen (11 patients, 24%) followed by Cryptosporidium sp (8 patients). Enterocytozoon bieneusi was found in association with other pathogens in 7 patients. All patients with microsporidiosis were in stage C (p = 0.04) and had a longer duration of diarrhoea (19.6 vs 9.8 weeks, p = 0.03), greater weight loss (9.6 vs 2.1 kg, p = 0.0003) and a lower Karnofsky index (48% vs 67%, p = 0.01). Prophylaxy with dapsone or pyrimethamine during the 3 months prior to inclusion had been more frequent (p = 0.04 and p = 0.05 respectively) in patients without microsporidiosis. CONCLUSION: Microsporidiosis should be suspected as a probable cause of chronic diarrhoea in HIV positive patients with a CD4 count < 100/mm3. Multiple infections may be a factor leading to treatment failure. Microsporidiosis seems to be linked to homosexual intercourse.

AIDS-Related Opportunistic Infections↗
PubMed1995

Growth monitoring: the role of community health volunteers.

A community volunteer programme was initiated in rural Jamaica in May 1990. The main aim of the programme was to monitor the growth of children less than 36 months of age through community health volunteers (CHVs) and improve their nutritional status. At the end of the second year the programme was evaluated to determine its effectiveness. The results of the evaluation indicated that almost all (95.6%) of the children were covered by the CHVs. In addition the participation rate was high (78.5%). However, only 50% of the children were adequately covered. Nonetheless, 81% of them gained adequate weight. Indeed, malnutrition levels declined by 34.5%. The annual cost per child per year for the total programme was fairly moderate (US$14.5) with growth monitoring accounting for nearly half (42.7). The results suggest that CHVs can play an important role in primary health care programmes in developing countries.

Adult↗
PubMed1995

Diaspirin crosslinked hemoglobin (DCLHb) attenuates bacterial translocation in rats.

Intestinal barrier function is compromised following severe hemorrhage which may allow bacterial translocation (BT) to occur and subsequently initiate a systemic response leading to multiple system organ failure (MSOF). This study compared BT following hemorrhage and resuscitation with lactated Ringer's solution (LR) or diaspirin crosslinked hemoglobin solution (DCLHb). Rats (250-350 grams) were hemorrhaged to a base deficit of 15 +/- 2 mmol/L and immediately resuscitated with either 3:1 LR or 1:1 DCLHb based on shed blood volume. Four hours following resuscitation, the mesenteric lymph node complex was harvested, homogenized and plated onto MacConkey and Columbia CNA agar culture media. Facultative anaerobic and obligate aerobic bacteria were identified 48 hours later in 11/22 (50%) LR-treated rats and in 4/21 (19%) DCLHb-treated rats (p < or = 0.05). Following resuscitation, base excess (BE) and central venous oxygen saturation (SvO2) were not only restored to baseline but were significantly greater (p < or = 0.05) in DCLHb-treated rats than in LR-treated rats. In a separate group of rats subjected to the same hemorrhage and resuscitation protocol, mean arterial pressure in DCLHb-treated rats, but not LR-treated rats, was restored to baseline by 15 minutes and remained at or above baseline for up to 4 hrs. Twenty-four hour survival was 50% in LR-treated rats and 77% in DCLHb-treated rats (p > 0.05). These data suggest that DCLHb is superior to LR in restoring tissue oxygen delivery, as judged by BE and SvO2. Furthermore, since DCLHb restores oxygen delivery and attenuates BT, early resuscitation with DCLHb may limit gut ischemia and subsequent gut barrier failure and hence prevent the development of sepsis, MSOF and subsequent death.

Animals↗
PubMed1995

[Elastase-type endopeptidase of fibroblasts. Effect of metalloprotease inhibitors].

Human skin fibroblasts produce in culture an elastase-type metalloendopeptidase which can hydrolyze synthetic elastase-substrate as Suc ala3 pNA and degrade also elastic fibers when injected in the dermis or deposited on cryostat-skin sections [3-8]. Here we describe further characterization of this enzyme activity using metallo-enzyme inhibitors as well as specific inhibitors of known Zn-endopeptidases such as angiotensin converting enzyme and enkephalinase. Among the metal complexing agents tested only EDTA and o-phenanthrolin could inhibit the elastase-type activity of fibroblasts, other known metal complexing substances capable of reacting with Zn (2,2' dipyridyl, diethyl dithiocarbamate and other metal chelators) were ineffective as was also lisinopril, an ACE-inhibitor [13]. Phosphoramidon and retrothiorphan, specific enkephalinase inhibitors [12] did strongly inhibit the elastase type activity of human skin fibroblasts (IC50 10(-8) M). Ethanol at conc-s used to dissolve organic, water insoluble inhibitors (50-100 microliters/ml) strongly inhibited the enzyme. It appears that the metal prosthetic group of fibroblast elastase (presumably, Zn) is not directly accessible to several of the low M. Wt complexing agents. The efficiency of enkephalinase inhibitors suggest a possible relationship between this enzyme and fibroblast-elastase.

Adult↗