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Biomedical subjects

F Lefebvre

Publications and source records attributed to F Lefebvre.

At least 55 records · Page 3Linked to original sources

Prenatal diagnosis of Smith-Lemli-Opitz syndrome is possible by measurement of 7-dehydrocholesterol in amniotic fluid.

Amniocentesis was performed at 17.3 weeks in a pregnancy with severe intrauterine growth retardation. Cytogenetic studies on amniocytes were normal, 46,XX, and the pregnancy was continued. The diagnosis of Smith-Lemli-Opitz syndrome was suspected in the neonatal period and confirmed by the presence of 7-dehydrocholesterol (7-DHC) in the plasma (0.4 mmol/l, normal = not detectable) associated with a low total cholesterol concentration (0.4 mmol/l, normal = 2.56 +/- 0.23). Retrospective analysis of the amniotic fluid sample revealed an elevated level of 7-DHC (0.022 mmol/l; normal = undetectable). Therefore measurement of 7-DHC levels in amniotic fluid during the second trimester of pregnancy is useful for the prenatal diagnosis of Smith-Lemli-Opitz syndrome in families at risk and should be considered in cases of severe growth retardation of unknown aetiology for which amniotic fluid is available and in which a normal chromosomal pattern in amniocytes is present.

Adult↗

The effect of recombinant human basic fibroblast growth factor rhFGF-2 on human osteoblast in growth and phenotype expression.

This paper describes the studies of human recombinant basic fibroblast growth factor (rhFGF-2) for its effects on human osteoblast growth and phenotype expression. During a 24-h period of treatment, rhFGF-2 highly stimulated DNA synthesis in a dose-related fashion with a maximum stimulation of 150% for 1 ng/ml. On the other hand, rhFGF-2 decreases alkaline phosphatase activity, synthesis of type I collagen, and cumulative amount of osteocalcin. Moreover, rhFGF-2 provoked a threefold increase in the amount of intracellular cAMP. Scatchard plots show the presence of two classes of [125I] rhFGF-2 receptors. This data suggests that rhFGF-2 which stimulate cell replication may act indirectly as an anabolic agent and stimulate some of the phenotypic expression markers.

Adult↗

Nonoperative management of biliary tract fistulas after blunt abdominal trauma in a child.

Nonoperative treatment was carried out in a 12-year-old girl who presented with biliary fistulas after blunt abdominal trauma with hepatic injury. A computed tomography-guided percutaneous puncture showed biliary peritonitis and permitted the positioning of an efficient intraperitoneal drainage. Endoscopic retrograde cholangiography was very helpful for visualization and accurate localization of biliary injuries. This permitted positioning a nasobiliary drain to reduce intrabiliary pressure and to bypass a lesion of the common hepatic duct. This nonoperative management allowed healing of fistulas within 20 days, without bile duct stricture (noted on the follow-up intravenous cholangiogram 18 months later).

Abdominal Injuries↗

Beware of commercial human thrombins used to stimulate cultured endothelial cells.

In the field of in vitro biocompatibility testing, the investigation of cell response at the interface with a biomaterial is of great importance; there is a need for standard conditions and thus of well-defined and reliable sources of materials for an objective evaluation of cellular function. Thrombin is often used in vitro as a stimulating agent to check the specific functions of cultured endothelial cells. In the present work, and in order to select a thrombin of commercial origin, two criteria were borne in mind: purity towards the presence of the von Willebrand factor (vWF) and effectiveness towards vWF release by human umbilical venous endothelial cells (HUVEC) that have been submitted to four human commercial thrombins. We detected the presence of vWF in some thrombin solutions that have not yet been in contact with HUVEC. The different thrombins contained vWF antigen ranging from less than 0.1 mUnit per NIH unit of thrombin (from Diagnostica Stago and Sigma Chemical Co.) to 10-20 mUnit per NIH unit of Fibrindex thrombin (from Ortho Diagnostic Systems). Thus, if vWF is present in commercial thrombins, it contributes to and overestimates the vWF appearance in the media resulting from cell stimulation. Consequently, we fixed on thrombin from Diagnostica Stago for further studies involving HUVEC on biomaterials.

Biocompatible Materials↗

New artificial connective matrix made of fibrin monomers, elastin peptides and type I + III collagens: structural study, biocompatibility and use as tympanic membranes in rabbit.

Experiments leading to the conception and development of a new artificial connective matrix based on collagen-elastin-fibrin associations are presented. Preliminary evaluation of this biomaterial as an artificial tympanic membrane is described. Morphological evaluation was performed by histopathological and scanning electron microscopic studies. Biocompatibility was documented by subcutaneous implantation and experimental grafting in rabbits was performed with histopathological studies of the tympanic grafted membranes. The positive results obtained in this experimental study enable future studies in humans to be prepared.

Animals↗

New bioactivation mode for vascular prostheses made of Dacron polyester.

The performance of vascular prostheses, especially those of small calibre, still presents several problems. The use of polyesters such as the well-known poly(ethylene terephthalate) (Dacron) and, more recently, poly(tetrafluoroethylene) and polyurethanes provides a marked improvement. We have developed a process to increase the efficiency of such prostheses, using the ability of the Dacron polyester to be covalently modified by proteins under mild chemical conditions. The biomaterial is obtained from the particular interaction of elastin-solubilized peptides with type I + III collagens under very precise conditions. We have obtained an irreversible covalent bonding on Dacron. These biological conditions and the addition of connective proteins and glycosaminoglycans conferred on the resulting material a composition and a three-dimensional structure equivalent to the subendothelium, providing bioactive properties suitable for the development of a vascular prosthesis.

Biocompatible Materials↗

A fractal approach to the segmentation of microcalcifications in digital mammograms.

This paper presents a computerized method for the automated segmentation of individual microcalcifications in a region of interest (ROI) known to contain a cluster in digital mammograms. Mammographic parenchyma caj be accurately modeled with the fractal approach, but not areas with microcalcifications. The digitized image is divided into 16 x 16-pixel overlapping windows and those accurately modeled by the fractal model are eliminated. The next steps include local thresholding of the ROIs using an iterative method, the elimination of some of the artifacts and identification of the clustered microcalcifications using a clustering algorithm. The evaluation was performed on 81 simulated clusters superimposed on normal mammographic backgrounds and on a representative database of 408 real mammograms. Microcalcification locations were identified by two radiologists independently. These locations were compared to those found by the computer algorithm. An average of 59% of the simulated microcalcifications and 69% of the microcalcifications common to both radiologists were detected. The algorithm described provides a fully automated method for the segmentation of individual microcalcifications in an area of the mammogram known to contain a cluster.

Biopsy↗

An optimized parsing algorithm well suited to RNA folding.

The application of stochastic context-free grammars to the determination of RNA foldings allows a simple description of the sub-class of sought secondary structures, but it needs efficient parsing algorithms. The more classic thermodynamic model of folding, popularized by Zuker under the framework of dynamic programming algorithms, allows an easy computation of foldings but its use is delicate when constraints have to be introduced on sought secondary structures. We show here that S-attribute grammars unify these two models and we introduce a parsing algorithm whose efficiency enables us to handle problems until then too difficult or too large to deal with. As a matter of fact, our algorithm is as efficient as a standard dynamic programming one when applied to the thermodynamic model (yet it offers a greater flexibility for the expression of constraints) and it is faster and saves more space than other parsing algorithms used so far for stochastic grammars.

Algorithms↗

[Treatment of hip dislocations and subluxations by Petit's splints].

PURPOSE OF THE STUDY: The management of DDH in infants less than one year old is not yet definite. Many ambulant therapeutic methods are described and Pavlik's harness is widely employed. The use of Petit's splints is less well known and we report our experience with 169 cases. MATERIAL AND METHOD: Between 1973 and 1991, Petit's splints were used in 112 cases, following abduction cushions in 55 cases and after Pavlik's harness in 2 cases. 103 hips were dislocated but reducible. This permitted progressive abduction of the hips in order to obtain the reduction of the dislocation and to ensure stabilization by retraction of the slack articular capsule. RESULTS: Only 8 dislocations (4,7 per cent) couldn't be reduced by this procedure and necessitated another treatment. Hips were normal after 5 years of follow up in 118 cases and there were 43 residual dysplasias. 6 post reductional avascular necrosis (3,7 per cent) were recorded as a complication of this method among which only one was a serlous from. DISCUSSION: This ambulatory method for treatment of congenital hip dislocation seems to be forsaken by many authors. Nevertheless its effectiveness has been demonstrated with a complication rate lower than with Pavlik's harness procedure.

Female↗

A simulation model of clustered breast microcalcifications.

A simulation model of clustered microcalcifications superimposed on normal mammographic backgrounds has been developed and evaluated. A cluster is described according to its size, the number of microcalcifications it contains, and their density. A microcalcification is defined on the basis of its size, shape, location within the cluster, its contrast, and the distribution of the gray-level values between pixels that belong to it. Gray-level parameters are dependent on the surrounding tissue, which is also slightly modified. The main dependencies between the parameters are taken into account. All the parameters are randomly sampled using distribution laws determined from the statistical analysis of 408 real clusters containing a total of 8611 microcalcifications. Some statistical characteristics depend on the structural mammographic pattern on which the cluster is superimposed. The evaluation of the simulation model, performed by two radiologists on a test set of 100 real and simulated clusters, did not reveal any statistically significant difference between the simulated clusters and the real ones. This method provides clusters of microcalcifications with well-defined characteristics and can be used to evaluate the accuracy of computerized detection methods.

Biophysical Phenomena↗

[Congenital clubfoot. Analysis of 260 cases followed from birth].

INTRODUCTION: This study is a critical analysis of the results in a homogeneous series of 260 cases of congenital clubfoot followed from birth. MATERIAL AND METHODS: This series of congenital club feet was divided in 2 groups: the stiff forms (144 cases) and the supple forms (116 cases). Daily physical therapy and Denis Brown's splints were begun from the first examination. This method did not allow full correction of deformations in 213 cases. A posterior medial surgical release was performed. Its importance depended on the criteria of radio-clinical analysis before surgery. 46 feet were operated twice. RESULTS: Follow up averaged 7 years. 39 per cent of patients had completed growth, only 18 per cent of feet were not operated. With the surgical treatment, the results were ""very good'' and ""good'' in 75.1 per cent of cases, according to an analysis using Seringe's criteria. 21 per cent were operated again, on an average between 3 and 8 years, with poorer results than at first surgery. DISCUSSION: The quality of the results depends on the quality of the functional treatment. Poor control of equinism with Denis-Brown splints can be corrected by using Seringe's articulated splints or by a series of plaster casts. CONCLUSION: Many technical factors influence the results. The quality of post-operative contention is stressed.

Child, Preschool↗

Endothelial cell compatibility testing of three different Pellethanes.

There is a need for viable small diameter vascular grafts, the luminal surface of which could be seeded by endothelial cells (ECs) to prevent thrombosis. In order to select candidates for EC seeding before implantation, the in vitro cytocompatibility of three different Pellethanes (polyetherurethanes) using human ECs was investigated. The methodology included two stages depending on either direct contact between cells and materials or contact between cells and material extracts, obtained under standardized conditions. By the latter method, we observed a cytotoxic effect on cell growth with 2363-55 D Pellethane extract at a 50% (v/v) concentration in the nutrient medium, likely provoked by leachables and correlated with the lowest levels of tPA, PAI1, and vWF antigens in the supernatants. By the former method, we studied EC attachment and growth. Morphology was studied by classical means and completed by scintigraphy and microautoradiography after 111Indium-labeling of the EC monolayer. Differentiation was determined by the release of vWF antigen and measurement of vWF activity (multimeric organization) after human thrombin stimulation. Despite an inhibition of proliferation for both 55 D and 75 D types (compared to the control), a functional monolayer of ECs was obtained on 75 D. Pellethane 75 D could be the best support for in vitro endothelization.

Blood Vessel Prosthesis↗

Ex vivo leucocyte adhesion and protein adsorption on TiN.

Titanium nitride (TiN) is regarded as a potential biomaterial for blood-contact applications. Its in vitro haemocompatibility has been evaluated already and gave promising results. The purpose of this study was to continue studying its 'biological' behaviour through an ex vivo evaluation. The material was a physical vapour deposition elaborated TiN coating and the phenomena observed were leucocyte adhesion and albumin and fibrinogen adsorption. These ex vivo results were compared with in vitro results obtained previously. Two reference medical grade silicone elastomer and three TiN arterio-arterial extra-corporeal circuits were tested. No leucocyte was retained by TiN, as in in vitro experiments; the ex vivo fibrinogen adsorbed quantity was higher and albumin adsorption was about the same in in vitro and in ex vivo situations. TiN can be considered as a suitable blood-contacting material.

Adsorption↗

New artificial connective matrix-like structure made of elastin solubilized peptides and collagens: elaboration, biochemical and structural properties.

Several improvements of the basic reaction between elastin peptides and type III collagen, specially the addition of heparan sulphate proteoglycans, are presented. The consequent elaboration of either cell culture support or membranes are described and illustrated by scanning electron microscopy. The material produced possesses composition, very well organized lamellar structure and some properties quite close to natural membranes such as subendothelial tissue.

Biocompatible Materials↗

New artificial connective matrix-like structure: thrombogenicity and use as endothelial cell culture support.

The recently described artificial connective matrix made of elastin solubilized peptides, type I+III collagens and connective proteins is shown to have structural and biological properties very close to the natural arterial subendothelium: the capacity to promote endothelial cell cultures maintaining their phenotype expression and its non-thrombogenicity. This new bioactive composite material could be used to replace arteries.

Biocompatible Materials↗

Cytocompatibility study of NHLBI primary reference materials using human endothelial cells.

Four different materials, low density polyethylene (LDPE), polydimethylsiloxane (PDMS), polyvinylcholoride (PVC) and cellulose, were selected by the Devices and Technology Branch of the National Heart Lung and Blood Institute (NHLBI) as primary reference materials for blood contacting. Among the wide variety of tests proposed to assess hemocompatibility of short-term blood contacting catheters, it was desirable to rule out whether these materials could release toxics for vascular cells of the physiological environment. Thus, the cytocompatibility of these materials have been checked towards human umbilical vein endothelial cells: the method used avoids direct contact between cells and materials but evaluates the effect of possible toxic substances leached from materials. These substances were obtained under defined conditions according to a standard. The results show that the extracts of cellulose and LDPE provoke an important cytotoxic effect on the endothelial cell cultures, while the extracts of PDMS and PVC allow the obtention of endothelial cell lining of the reference surface, with a correct global metabolic activity and the intracellular presence of von Willebrand factor.

Biocompatible Materials↗

A new biodegradable elastin-fibrin material; its use in urological, digestive and cardiovascular surgery.

A new original artificial connective matrix mainly made of elastin and fibrin-like product is used to reinforce damaged tissues and to close and restore a loss of substance in several domains of surgery: all sites in the digestive system and urinary tract; besides, it can substitute for the pericardium in iterative heart operations. In all cases, the original tissue is restored ad integrum while the biodegradable material disappears completely, without any complications.

Animals↗