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Biomedical subjects

E Cohen

Publications and source records attributed to E Cohen.

At least 55 records · Page 3Linked to original sources
PubMed2000

Acute hepatitis A: combination of the relapsing and the cholestatic forms, two rare variants.

Here we present an unusual case of a 23-year-old, otherwise healthy man who had a biphasic form of viral hepatitis A with a combination of two variants, the relapsing and cholestatic forms. One month after resolution of the first phase of acute hepatitis A, he was readmitted with jaundice and intense pruritus. During hospitalization, his serum bilirubin level increased to 50.2 mg/dL, with a slight increase in the other levels of liver enzymes. He was treated with ursodeoxycholic acid and later with corticosteroid therapy, resulting in resolution of symptoms and improvement of his liver function tests after 2 weeks. Medication therapy seems to be justified in markedly symptomatic patients with relapsing hepatitis.

Acute Disease↗
PubMed2000

Video-assisted thoracoscopic surgery.

Video-assisted thoracoscopic surgery is finding an ever-increasing role in the diagnosis and treatment of a wide range of thoracic disorders that previously required sternotomy or open thoracotomy. The potential advantages of video-assisted thoracoscopic surgery include less postoperative pain, fewer operative complications, shortened hospital stay and reduced costs. The following review examines the surgical and anesthetic considerations of video-assisted thoracoscopic surgery, with an emphasis on recently published articles.

Journal Article↗
PubMed2000

Bilateral idiopathic chondrolysis of the hip: a case report.

A case of bilateral idiopathic chondrolysis of the hip is presented. Chondrolysis is a process characterized by progressive necrosis of the hyaline cartilage of the acetabulum and femoral head, resulting in secondary joint space narrowing and stiffness. A 14-year-old boy was followed during a 2-year period, and the diagnostic values of the different imaging methods (radiography, magnetic resonance imaging [MRI], and bone scintigraphy) were evaluated. Scintigraphic evidence of marked periarticular uptake and premature fusion of the epiphysis of the greater trochanter was a reliable indicator of chondrolysis. Furthermore, the bone scan could precede other imaging methods (radiography and MRI) in the diagnosis of the progression of the pathologic process, status of the remodeling activity, and early involvement of an opposite joint. Given the high sensitivity of bone scans and the high specificity of radiographic and MRI examinations in the diagnosis of acute chondrolysis of the hip, all three methods are valuable and should be used as complementary diagnostic tools.

Adolescent↗
PubMed2000

Social phobia and the persistence of conduct problems.

Recent epidemiological studies suggest that both social anxiety and attention deficit hyperactivity disorder (ADHD) in childhood might predict levels of delinquent behavior in adolescence. The current study prospectively examines the influence of social phobia and ADHD symptom scale scores on the correlation in conduct disorder symptom scale scores over time. An epidemiologically selected sample of 776 young people living in Upstate New York received DSM-based psychiatric assessments in 1983, 1985, and 1992 using structured interviews. Correlations among conduct disorder scales over time were examined as a function of social phobia and ADHD ratings. Individuals with low scores on social phobia scales or high scores on ADHD scales exhibited the highest correlation in conduct disorder symptom scales over time. There was also a suggestion that low scores on social phobia scales predicted later risk for conduct disorder. Low scores on social phobia symptom scales or high scores on ADHD scales predict stronger across-time correlations in conduct disorder symptom scales. Various cognitive or biological factors might account for these moderating effects on conduct problems.

Adolescent↗
PubMed2000

[Ciguatera and peripheral neuropathy: a case report].

Ciguatera is the most frequently observed form of tropical fish poisoning. It appears as a syndrome associating general signs, gastrointestinal, cardiac and neurological problems. Peripheral and central nervous system signs may be observed. We report a case of a 60-year-old man who developed Ciguatera poisoning with diarrhea, facial paresthesia, myalgia, cramps and weakness. Physical examination revealed a motor distal deficit of the four limbs, myokymia and ataxia. EMG testing was in favor of an axonal neuropathy. Neurologic symptoms persisted for two months. This case illustrates a new pathophysiological mechanism of neuropathy: "axonal channelopathy. Abnormalities of peripheral nerve sodium and potassium channels result in clinical and electrophysiological manifestations unrelated to axonal degeneration or demyelinization. The ciguatoxin mainly acts on sodium channels. Prolonged sodium channel activation results in repetitive axon firing. Recently ciguatoxin was recently demonstrated to have a novel action, blocking the sodium channel leading to slowed nerve conduction and decreased motor and sensory action potential amplitudes.

Animals↗
PubMed2000

[Lysosome enzyme pseudodeficiency].

Inherited deficiency of lysosomal hydrolase often displays different clinical features. However, a greatly reduced enzyme activity may be observed in healthy individuals. This pseudo-deficiency concerns at least nine lysosomal hydrolases. When a deficiency has been proved, the presence of mutations known to cause pseudodeficiencies must be searched, above all in Tay-Sachs disease and metachromatic leukodystrophy.

Cerebroside-Sulfatase↗
PubMed1999

Outcomes at 1 year and economic implications of platelet glycoprotein IIb/IIIa blockade in patients undergoing coronary stenting: results from a multicentre randomised trial. EPISTENT Investigators. Evaluation of Platelet IIb/IIIa Inhibitor for Stenting.

BACKGROUND: We assessed in a randomised trial the long-term outcomes for potent adjunctive antiplatelet therapy given at the time of coronary stenting. METHODS: In 63 hospitals in the USA and Canada, 2399 patients were randomly assigned stenting with abciximab, stenting with placebo, or balloon angioplasty with abciximab. Standard adjunctive therapy with aspirin, ticlopidine, and heparin was used. The major outcomes of death and myocardial infarction were assessed at 1-year follow-up by intention to treat. We also investigated the 1-year cost-effectiveness of combined stenting and abciximab therapy. FINDINGS: At 1-year follow-up, eight (1.0%) of 794 patients in the stent plus abciximab group had died, compared with 19 (2.4%) of 809 in the stent plus placebo group (hazard ratio 0.43 [95% CI 0.19-0.97], p=0.037). The combined endpoint of death or large myocardial infarction occurred in 42 (5.3%) and 89 (11.0%), respectively (0.46 [0.32-0.67], p<0.001). By multivariate modelling, the factors independently associated with improved survival were assignment to stenting with abciximab (p=0.027) and greater preprocedural stenosis (p=0.002); those associated with worse survival were age greater than 70 years (p<0.001), previous heart failure (p=0.001), diabetes treated with insulin (p=0.02), and postprocedural occlusion (p<0.001). Relative to stenting plus placebo and balloon angioplasty plus abciximab, the incremental 1-year costs of stenting plus abciximab were US$581 and $932. The corresponding cost-effectiveness ratios were US$5291 and $6213 per added life-year. INTERPRETATION: Coronary stenting with abciximab, compared with stenting alone or balloon angioplasty with abciximab, is associated with improved survival and is an economically attractive therapy by conventional standards.

Abciximab↗
PubMed1999

[Eales disease with neurologic manifestation: differential diagnosis of multiple sclerosis. Report of two cases].

BACKGROUND: Eales disease is a condition associating recurrent vitreous and retinal hemorrhage related to retinal periphlebitis. This ophthalmological disease is sometimes associated with central nervous system manifestations. CASE REPORT: Two patients with Eales disease of the retina developed a progressively worsening neurological deficit several years later. DISCUSSION: Evidence of multifocal anomalies of the white matter initially suggested a possible association of Earles disease with multiple sclerosis. Pathology findings enable formal differentiation of these two entities. Earles disease with neurological manifestations remains an uncommon condition and constitutes a differential diagnosis of multiple sclerosis.

Adult↗
PubMed1999

Phenotype of adults with the 22q11 deletion syndrome: A review.

22q11 deletion syndrome (22qDS) is due to microdeletions of chromosome region 22q11.2. Little is known about the phenotype of adults. We reviewed available case reports of adults (age >/=18 years) with 22qDS and compared the prevalence of key findings to those reported in a large European survey of 22qDS (497 children and 61 adults) [Ryan et al., 1997: J. Med. Genet. 34:798-804]. Fifty-five studies reported on 126 adults (83 women, 40 men, 3 unknown sex), mean age 29.6 years (SD = 8.7 years). Compared with the European survey, adults with 22qDS reviewed had a lower rate of CHD, 30% versus 75%; chi(2) = 88.65, df = 1, P < 0.0001, but higher rates of identified palate anomalies, 88% versus 15%; chi(2) = 37.45, df = 1, P < 0.0001, and learning difficulties, 94% versus 79%; chi(2) = 12.13, df = 1, P = < 0.0008. The most common finding reported was minor facial anomalies. Few reports provided details of minor physical anomalies. Psychiatric conditions were more prevalent, 36% versus 18%; chi(2)= 5.71, df = 1, P < 0.02, than in the survey: 60% of reviewed adults were transmitting parents (72% mothers) ascertained following diagnosis of affected offspring. They had lower rates of CHD, cleft palate, and psychiatric disorders but similar rates of learning disabilities, and other palate and facial anomalies compared with adults ascertained by other methods. The results suggest that learning disabilities and facial and palate anomalies may be key findings in 22qDS adults, but that ascertainment is a key factor in the observed phenotype. Comprehensive studies of adults with 22qDS identified independently of familial transmission are necessary to further delineate the phenotype of adults and to determine the natural history of the syndrome.

Abnormalities, Multiple↗
PubMed1999

Automated multi-residue isolation of fluoroquinolone antimicrobials from fortified and incurred chicken liver using on-line microdialysis and high-performance liquid chromatography with programmable fluorescence detection.

Isolation of the quinolones, sarafloxacin (SAR), oxolinic acid (OXA), and flumequine (FMQ), from fortified chicken liver tissues, and SAR incurred chicken liver tissues was achieved by combined liquid-liquid extraction and aqueous on-line microdialysis using the automated trace enrichment of dialysates (ASTED) system. Analysis of tissue isolates after ASTED clean-up was performed using reversed-phase HPLC and programmable fluorescence detection. Overall recoveries of SAR, OXA and FMQ from samples fortified over a concentrations range of 1-100 ppb were 94, 97 and 87% with overall inter-assay variability of 4.2, 4.1 and 3.6%, respectively. Chicken liver samples incurred with SAR at three concentration levels also were tested by the ASTED method. The method exhibited high peak resolution (3.4-4.2 on average), a high signal-to-noise ratio, and demonstrated good precision. The ASTED-HPLC method overall had a lower limit of detection (LOD) of 0.2 ppb, and a limit of quantitation (LOQ) of 1 ppb.

Animals↗
PubMed1999

Determination of sarafloxacin residues in fortified and incurred eggs using on-line microdialysis and HPLC/programmable fluorescence detection.

Isolation of sarafloxacin (SAR) from fortified and incurred chicken eggs was done by a combination of liquid-liquid extraction and aqueous on-line microdialysis performed on an automated trace enrichment of dialysates (ASTED) system. The ASTED system coupled a sample cleanup procedure with HPLC and programmable fluorescence detection. Overall recoveries of 87-102% for SAR were obtained from samples fortified over a range of 1-100 ng/g. The relative standard deviation values ranged from 22 to 26% for samples fortified between 1 and 5 ng/g and from 2 to 12% for samples fortified between 10 and 100 ng/g. The limits of detection and quantitation were 0.2 and 1 ng/g, respectively. Eggs containing incurred SAR, which were collected over a 3-day dosing period and for 5 consecutive days thereafter, also were analyzed by using this technique. Because the method is automated, 35 samples can be processed within a 24-h period, which enables large data sets to be acquired over a short time period.

Animals↗
PubMed1999

HIV-1 Vpr-chloramphenicol acetyltransferase fusion proteins: sequence requirement for virion incorporation and analysis of antiviral effect.

The human immunodeficiency virus type 1 Vpr is a virion-associated protein that is incorporated in trans into viral particles, presumably via an interaction with the p6 domain of the Gag polyprotein precursor. Recently, several studies demonstrated that Vpr fusion proteins could be used as intravirion inactivating agents. In this study, we compared different Vpr-chloramphenicol acetyltransferase (CAT) fusion proteins for their virion incorporation ability and their effect on the infectivity of HIV viruses. Our deletion analysis indicates that both the N-terminal alpha-helical domain and the leucine/isoleucine-rich (LR) domain located in the middle region of Vpr are required for optimal virion incorporation of Vpr-CAT fusion proteins. The C-terminal basic region, associated with Vpr's ability to mediate cell cycle arrest in G2, was not required for virion incorporation, thus allowing the development of Vpr-based chimeric proteins devoid of any effect on cell growth. The fusion of Vpr at the N- or C-terminus of CAT targeted with equal efficiency the chimeric protein into virions. While the virion incorporation of most Vpr-CAT fusion proteins tested in this study was dependent on the presence of an intact p6 domain, fusion proteins containing only the N-terminal alpha-helical domain of Vpr (amino acid 1 to 42) were incorporated into virions in a p6-independent manner. Virion incorporation of Vpr-CAT fusion proteins was shown to decrease viral infectivity. Moreover, the insertion of HIV protease-cleavage sites between Vpr and CAT not only efficiently delivered and released the cleaved CAT product into HIV viral particles, but also greatly potentiated the inhibition of progeny virion infectivity. Overall, our study: (1) defines the Vpr sequence requirement and configuration necessary for the specific and optimal incorporation of Vpr fusion protein into HIV particles; (2) shows that Vpr fusion proteins have the ability to suppress HIV infectivity by targeting multiple steps of viral morphogenesis.

Amino Acid Sequence↗
PubMed1999

Lung separation in the patient with a difficult airway.

During video-assisted thoracoscopy the lungs should be well collapsed to allow the surgeon an optimal view of the surgical field. The use of 'difficult tubes' such as the double lumen tube or Univent cannot be avoided despite the presence of a difficult airway. If it is only possible to place a single lumen tube, a tube exchanger can be used to switch to a double lumen tube or a Univent tube. Alternatively, a Fogarty embolectomy catheter can be passed down the single lumen tube as an independant bronchial blocker. The Bullard and the Wu laryngoscopes and the laryngeal airway mask can further assist in establishing an airway. Finally, depending on the extent and the length of the procedure, an airway, initially not classified as difficult, may become difficult and postoperative planning is a must.

Editorial↗