[A centennial--1866--The hypnology school of Nancy--1966--Sophrology in the dental office].
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France↗
Biomedical subjects
F Gay
Publications and source records attributed to F Gay.
Effects of AMI-25 on liver vessels and tumors on T1-weighted turbo-field-echo images: implications for tumor characterization.
This study was devoted to tumor differentiation in liver MR T1-weighted imaging with superparamagnetic iron oxide (SPIO). Twenty-one patients with 40 liver lesions were studied at 1.5 T. Before and at least 45 minutes after SPIO administration, turbo-field-echo (TFE) T1-weighted, TFE T1 x T2*-weighted (MXT), and fat-suppressed turbo-spin-echo T2-weighted images were acquired. A quantitative analysis was performed blindly. On TFE T1-weighted images, the signal enhancement was -33% +/- 12 for the liver, -24% +/- 2 for adenomas and focal nodular hyperplasia, +60% +/- 33 for the hemangiomas; metastases and cyst enhancement were not significant. After SPIO on TFE T1-weighted images, the hemangioma-to-liver signal ratio (149% +/- 18) was definitely higher than the mean metastasis-to-liver signal ratio (90% +/- 16). This T1-related differentiation ability lacked dramatically on TFE MXT images and, in one case, was reduced on post-SPIO TFE T1-weighted images by a long imaging delay after SPIO administration (2 hours).
Adult↗
Differentiation of Burkitt lymphoma cells by hexamethylenbisacetamide.
Hexamethylenbisacetamide (HMBA) can induce the Burkitt lymphoma Raji cells to enter the differentiation process as evidenced by the decrease of HLA-DR antigens. This event is preceded by a decrease of c-myc expression and of the phosphorylation of cellular proteins, due to either a decrease of tyrosine protein kinase activity or an increase of tyrosine phosphatase activity. These three events form a sequence and are part of the genetic program for differentiation and growth though they may not be causally related.
Acetamides↗
Does esophagectomy cure a resectable esophageal cancer?
During the years 1978-1990, 401 patients with esophageal cancer were evaluated for curative resection. A retrospective study was undertaken to estimate the efficacy of surgery and select criteria for long-term survival. After investigation, 187 patients (47%) underwent surgery. To evaluate the long-term results, 101 curative esophageal resections classified into stage I (11 patients), II (24 patients), and III, pathological TNM (66 patients), with at least 2 years' follow-up, were considered. Esophagogastrectomy was performed in 91% of the cases and gastric transposition was achieved in 96% of the patients. The anastomoses were intrathoracic (98%) and at the apex of the right thorax for tumors of the middle third of the esophagus. Staplers were used in 76% of sutures. Postoperative hospital mortality was 5.9%. Specific morbidity included strictures 11%, esophagitis 12%, and anastomotic leak 2%. Actuarial 5-year survival was 90.9% in stage I, 52.3% in stage II, and 17.7% in stage III. The overall 5-year survival rate was 34.2%, 64.8% for the N0 patients, and decreased to 17.7% when node involvement was observed. Five- to 8-year survival is also considered. It is concluded from this study that esophagectomy is actually the appropriate treatment in patients with nonmetastatic resectable carcinoma with an overall 34.2% 5-year survival. The operation can be performed with a low morbidity and mortality rate if done in experienced centers.
Adult↗
Sensitivity in vitro of Plasmodium falciparum to chloroquine and mefloquine in two regions of Benin.
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Animals↗
Isolation of Leishmania species from wild mammals in French Guiana.
Between 1981 and 1987, 486 wild mammals collected from 13 sites in French Guiana were examined for Leishmania. Eleven of 31 two-toed sloths, Choloepus didactylus, were infected, 4 of the isolates being identified as L. braziliensis guyanensis. This species was also found in 2 Didelphis marsupialis and 2 Proechimys sp. L. mexicana amazonensis was isolated from 3 Proechimys sp., 2 of which were P. cuvieri. The role of these mammals in the life cycles of the 2 anthropotropic species of Leishmania encountered in French Guiana is discussed.
Animals↗
Epidemiological aspects of human cutaneous leishmaniasis in French Guiana.
A follow-up study of 219 patients infected with parasitologically confirmed cutaneous leishmaniasis in French Guiana was made between 1981 and 1987. Cutaneous leishmaniasis appeared to be common in young male adults entering the forest for professional activities (84.2% of the cases). The lesions were generally of the classical ulcerative type. They were limited to the skin and preferentially located on the legs and forearms (20.7% and 19.8% respectively). Most of the cases (86.6%) represented primary infections, but 6.8% had a recurrent lesion at the site of an old, previously cured lesion.
Adolescent↗
Cloning of a fresh isolate of Plasmodium falciparum and drug sensitivity of the clones.
A freshly isolated strain of Plasmodium falciparum was cloned by limited dilution using a co-culture of infected erythrocytes on monolayers of functionally active rodent hepatocytes. 15 clones were isolated, and the anti-malarial activity of chloroquine, quinine, mefloquine and halofantrine against the clones, the original isolate, and a culture-adapted isolate was determined using a 48 h radioisotope microdilution method. The multiplication rates of all clones and the culture-adapted isolate were estimated by counting the number of parasitized cells on Giemsa-stained thin smears. Variations found in drug sensitivity and multiplication rate of different clones provided strong evidence of heterogeneity of a single strain parasite population. No morphological variation was detected by light microscopy. The use of a hepatocyte feeder layer improved the adaptation of cloned parasites to continuous culture conditions and thus enabled us to clone directly a fresh isolate, without losing clones during the culture-adaptation process.
Animals↗
Primary culture of human lung microvessel endothelial cells: a useful in vitro model for studying Plasmodium falciparum-infected erythrocyte cytoadherence.
In the past, several cell lines have been used as in vitro models for studying cytoadherence, which refers to the specific binding of Plasmodium falciparum-parasitized red blood cells (PRBC) to host endothelium of microvessels. These models include: (a) human cells, including human umbilical vein endothelial cells (HUVEC), C32 amelanotic melanoma cells and monocytes; (b) non-human cells transfected with human genes, including COS and CHO cells; and (c) purified candidate receptor molecules. However, endothelial cells from malaria target organs are rarely investigated. In this study, we describe the efficient isolation and characterization of human lung endothelial cells (HLEC). This is the first in vitro study of P. falciparum PRBC cytoadherence to human lung endothelium, one of the target organs during severe malaria. The endothelial nature of the HLEC lines was confirmed by the presence of the von Willebrand factor, anti-human platelet endothelial adhesion molecule-1 and E-selectin antigens as specific endothelial markers. After exposure of HLEC to human cytokines, FACScan analysis indicated the coexpression of PRBC receptors CD36, intercellular adhesion molecule-1 (ICAM-1), E-selectin and vascular cell adhesion molecule-1 (VCAM-1). The laboratory-adapted P. falciparum strains adhered specifically in vitro to these HLEC. The binding of PRBC could be inhibited with variable efficiency by various monoclonal antibodies (anti-CD36 > anti-ICAM-1 > anti-VCAM-1 > anti-E-selectin). Target organ specific cell lines such as HLEC expressing a variety of potential P. falciparum PRBC cytoadherence receptors may provide in vitro systems for studying the pathophysiology of severe malaria and identifying new therapeutic agents designed to directly block adhesive events involved in severe malaria.
Animals↗
Direct acridine orange fluorescence examination of blood slides compared to current techniques for malaria diagnosis.
The renewed interest in the use of fluorochromes for malaria diagnosis prompted us to evaluate the acridine orange fluorescence technique on blood slides, and to compare it with established techniques using thick and thin blood films and the QBC malaria test, using the Giemsa-stained thick film technique as our standard method for comparison. We compared 123 positively diagnosed cases and 120 negative cases. For primary samples (day 0), the sensitivity of the thin blood film fluorescence acridine orange technique (AO) was 96.4%, and its specificity was 95.1%. In cases of imported malaria, with a prevalence rate of 16.2%, the positive predictive value was 79.2% and the negative predictive value 99.3%. Sensitivity of AO was significantly higher than that of Giemsa-stained thin blood films for parasitaemias < 5000/microL. The potential of AO for species diagnosis of Plasmodium was 85.2%, using Giemsa-stained thin films as the reference technique. Where QBC imposes a cost limitation, especially in developing countries, despite its high performance, the AO diagnostic technique is a valuable alternative, because of its simplicity, almost negligible cost, and its diagnostic reliability. The method may also have potential value in the diagnosis of other microbiological diseases.
Acridine Orange↗
Percutaneous endoscopic gastrostomy.
From March 87 to March 92, fifty eight patients were referred to our department for percutaneous endoscopic gastrostomy (PEG). The modality of the feeding tube insertion is described. The most common indications for placement were neurologic disorders in 62% of the cases (n = 36) and malignant diseases in 32% (n = 19). The success rate of the technique was 98.3% (n = 57). No procedure-related mortality was observed. A low rate of major complication (1.7%) and minor complication (10.5%) was noted. Feeding tubes were removed in 21% of patients (n = 12); none of them with malignant disease. Survival curve analysis demonstrated that 50% of patients died within 3 months of PEG placement. Such results raise questions about the selection of patients undergoing PEG. Our experience of patients undergoing PEG. Our experience suggests that PEG is easy and safe, even in debilitated patients, having an acceptable life expectancy.
Central Nervous System Diseases↗
Endoscopic treatment of esophagogastric varices.
We report our current management of variceal bleeding with endoscopic sclerotherapy. We emphasize the importance of resuscitation and of recording at time zero and within the first 72 hours clinical and laboratory indicators, as these influence the management of these patients. Primary sclerotherapy using Histoacryl for active bleeding and Ethoxysclerol for recent bleeding should be performed as soon as the patient is stable hemodynamically. As we have identified factors related to the severity of hemorrhage and of liver failure degree which can predict early failure of sclerotherapy, patients presenting with these findings should be, in the future, referred quickly toward alternative therapies among which non-surgical intrahepatic shunt appears a promising modality.
Cyanoacrylates↗
Treatment of peptic ulcer severe bleeding.
The success of a defined management policy op peptic ulcer haemorrhage which incorporates endoscopic therapeutic intervention depends on the early identification of a high risk group of patients and a high risk group of ulcers. The high risk group of patients consists of those likely to experience further bleeding on the basis of clinical prognostic indicators: shock and severe anaemia on admission and the pattern of bleeding; or tolerate rebleeding and emergency surgery poorly: patients over 60 years and those with associated disease. UGI endoscopy should be performed early (within 6-12 hours) in this group in order to identify the bleeding point and provide prognostic information regarding the risk of further haemorrhage. Peptic ulcers with major stigmata of recent bleeding (spurting or non-bleeding visible vessel) have high risk of rebleeding, the risk is even greater when major stigmata of recent haemorrhage (SRH) are associated with shock on admission. Patients with such ulcers should be monitored intensively and receive endoscopic haemostatic treatment in order to terminate active haemorrhage or prevent rebleeding thereby avoiding the need for emergency surgery with its attendant morbidity and mortality. Patients with ulcers with minor or no SRH have a very low risk of rebleeding and don't require intensive monitoring or endoscopic treatment and can be discharged from hospital early. Ulcers which cannot be completely characterized have an intermediate risk of rebleeding and should be managed as high risk lesions. Secondary to the anatomy of the visible vessel any haemostatic endoscopic treatment should be applied around, but avoiding, the sentinel clot. Well-designed randomized controlled trials of endoscopic haemostatic treatment of peptic ulcer haemorrhage in which stratification of risk was based on the SRH, have demonstrated for non-bleeding vessel a significant reduction in rebleeding and in emergency surgery, for spurting bleeding benefit was found only for the rebleeding risk. No advantage was demonstrated in each group of patients in term of mortality. Such studies also demonstrate the superiority of the Nd:YAG laser over the Argon laser. Perforation is a rare complication of Nd:YAG laser photocoagulation (less than 1%). Precipitation or aggravation of arterial haemorrhage during treatment of a visible vessel, as a result of a direct hit, is a more frequent complication (0-29%). Further laser treatment is successful in terminating 75% of these induced bleeds, the remainder requiring surgery. Preinjection of the ulcer with adrenaline does not appear to prevent this complication.(ABSTRACT TRUNCATED AT 400 WORDS)
Gastroscopy↗
Operative colonoscopic endoscopy.
There are several conditions where operative colonoscopy is useful. Acute colonic pseudo-obstruction or Ogilvie's syndrome is characterized by a acute distension of the colon. Although medical management may be sufficient in many cases, endoscopic decompression must be performed when colonic distension is greater than 12 cm. Insertion of decompression tube to avoid rapid recurrence seems to be adequate. In case of massive lower intestinal hemorrhage, colonoscopy seems to be more accurate than mesenteric angiography. Such endoscopic examination requires an experienced endoscopist. Colonoscopic polypectomy has become the standard method for removal of colonic polyps. Factors influencing the rate of complications have been studied. While the number of complications was very low, we have observed that all the major hemorrhages were immediate when the blended current was used, but delayed when the pure coagulation current was applied. Endoscopic laser photocavitation is a valuable palliative method treating rectal adenocarcinoma in well selected patients. Indeed, if the patients survive sufficiently long after initial therapy, it becomes increasingly difficult to achieve persistent palliation with laser therapy.
Adenocarcinoma↗
Report of chloroquine resistance malaria in Niger.
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Adult↗
[Resistance of Plasmodium falciparum to mefloquine in Sierra Leone and Kenya].
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Adult↗
[Recording of the his bundle potential at the surface of the thorax in healthy volunteers. Application to the study of propranolol].
New analogic-digital technology contributions to standard electrocardiography may allow to record the his bundle potential from the body surface. The aim of this work has been to study the validity of this method by its application to estimate the dromotropic effect of propranolol in healthy volunteers. His bundle potential from body surface was recorded in 19 out of 26 enrolled subjects. The negative dromotropic effect of propranolol (40 mg orally) was observed in only 10 volunteers. The direction of the PR and PH interval changes was used to estimate sensibility (0.9) and specificity (0.89) of this method. There was also a significant correlation (0.89 less than p 0.05) between PR and PH interval changes. This new non-invasive method could be used in clinical pharmacology but the subjects must be preselected.
Adult↗
How effective is enteroscopy?
The small bowel can be successfully investigated by enteroscopy techniques. Several types of enteroscopes with different technical characteristics have been developed. In this paper we explain the respective advantages and disadvantages of the different techniques. Results of several series using these two enteroscopes are summarized and commented. The review of different series make clear that enteroscopes, especially those including an operating channel represent an attractive alternative diagnostic tool to angiography and small bowel barium studies in patients presenting obscure digestive bleeding. The series reviewed in this paper confirm the high diagnostic efficacy of this type of endoscopy. Most of the lesions found are arteriovenous malformations especially in the elderly. Small bowel tumours are more likely to be found in younger patients. New indications for enteroscopy should be evaluated carefully. Obscure digestive bleeding represents the main indication of enteroscopy. However clinical situations suggesting Crohn's disease or malabsorption syndromes may be effectively evaluated by this special endoscopic technique.
Angiodysplasia↗