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Biomedical subjects

J Bernheim

Publications and source records attributed to J Bernheim.

At least 199 records · Page 11Linked to original sources
PubMed1988

Sclerosing peritonitis. Possible early diagnosis by computerized tomography of the abdomen.

Sclerosing peritonitis (SP) has come to be recognized as a serious complication of peritoneal dialysis (PD). However, diagnosis is often established at a late stage of the disease and at laparotomy. The use of computerized tomography (CT) of the abdomen in 2 patients, clinically suspected of suffering from SP, revealed loculated ascites, adherent bowel loops, bowel lumenal narrowing, and thickening of the peritoneal membrane. Such radiological changes in patients on PD seem highly consistent with a diagnosis of SP. We feel that CT of the abdomen may help in attaining an early, correct, and noninvasive diagnosis of SP. We recommend that CT of the abdomen be performed in any patient on chronic PD who has clinical manifestations suggestive of SP. Early diagnosis of SP can lead to early cessation of PD and hopeful recovery of the peritoneal membranes and space.

Female↗
PubMed1988

Single dose pharmacokinetics of cetirizine in young and elderly volunteers.

The pharmacokinetics of the H1-receptor antagonist cetirizine were studied from 0 to 48 h after a single oral intake of 10 mg in 10 elderly volunteers (60 to 90 years) and in 10 young healthy volunteers (21 to 29 years). In young healthy volunteers about 60% of an oral dose of cetirizine was excreted in the urine in unchanged form. Mean plasma concentrations were slightly higher in the elderly subjects. Cmax (362 ng/ml), Tmax (1.30 h), terminal half-life (11.8 h) and AUC infinity (4316 ng.h/ml) in the elderly subjects were somewhat higher than in the young subjects (Cmax: 337 ng/ml, Tmax: 1.12 h, terminal half-life: 10.6 h, AUC: 3721 ng.h/ml), but the difference was not significant. The mean cumulative urinary excretion at 32 h was significantly lower in the elderly subjects. It is concluded that the slight differences in pharmacokinetics of cetirizine between young and elderly subjects after single oral intake can be attributed to the decreased renal clearance in the elderly.

Administration, Oral↗
PubMed1987

Rapidly progressive glomerulonephritis (crescentic glomerulonephritis) in the course of type I idiopathic membranoproliferative glomerulonephritis.

Membranoproliferative glomerulonephritis is a chronic glomerulopathy with a generally progressive course toward end-stage renal disease and a high recurrence rate in renal allografts. Described herein is the appearance of rapidly progressive glomerulonephritis (crescentic glomerulonephritis) in the course of type I membranoproliferative glomerulonephritis. This transition occurred within 6 weeks, documented histologically by an initial and subsequent renal biopsy. No recurrence of the disease was noted in a living donor graft 18 months posttransplantation.

Adolescent↗
PubMed1987

5-Azacytidine and 5-aza-2'-deoxycytidine behave as different antineoplastic agents in B16 melanoma.

The antiproliferative effects of 5-azacytidine (acaCyd) and 5-aza-2'-deoxycytidine (azadCyd) were studied in murine B16 melanoma and a series of B16 melanoma derived mutant strains with selective resistances to the respective drugs. The in vitro cytotoxicities of azaCyd and azadCyd on B16 wild type, expressed in terms of IC50 values, were found to be 5 microM and 0.2 microM, respectively. The in vitro cytotoxicity of both drugs was dependent on the duration of exposure. Uridine and cytidine were able to reverse the in vitro cytotoxicity of azaCyd, but not of azadCyd. Conversely, 2'-deoxycytidine was able to reverse the cytotoxic effect of azadCyd but not of azaCyd. Thymidine and 2'-deoxyuridine had no detectable effects on the in vitro cytotoxicity of either azaCyd or azadCyd. B16 melanoma mutant strains that were selected for resistance to azaCyd showed no cross-resistance to azadCyd, cytosine arabinoside or the fluorinated pyrimidine analogues FUrd, FCyd, FdUrd and FdCyd. Mutant strains that were selected for resistance to azadCyd showed no cross-resistance to azaCyd or fluorinated pyrimidine analogs, but only to cytosine arabinoside. The combined data suggest that azaCyd and azadCyd follow different routes of intracellular metabolic activation and exert their cytotoxic activity via different intracellular targets.

Animals↗
PubMed1987

Effects of sodium loading on the renal synthesis of prostanoids in the rat.

1. The production of prostaglandin (PG) E2, F2 alpha and thromboxane B2 (TXB2) by isolated glomeruli, cortical tubular suspensions and medullary and papillary slices was measured in normal Long-Evans rats 4, 8 and 14 days after starting on oral Na+ load and the results were compared with those of rats on a normal Na+ intake. 2. In glomeruli, PGE2 decreased at days 4 and 8, and returned to normal at 14 days. PGF2 alpha decreased only at day 4 and TXB2 decreased in all Na+-loaded animals. In cortical suspensions, a transient decrease of PGE2 was observed at day 4. In medullary slices, PGE2 and TXB2 decreased in all experimental periods. In contrast, in papillae, a significant increase of PGE2 was observed with Na+ loading at day 8, but PGF2 alpha and TXB2 did not change consistently. 3. Similar changes were observed in rats with hypothalamic diabetes insipidus (DI rats) Na+ loaded for 4 days, as compared with DI rats on a normal Na+ intake. 4. The results suggest that prostanoids participate in the renal adaptation to an increased Na+ intake, and that this response is relatively independent of the presence of antidiuretic hormone.

Animals↗
PubMed1987

Increased drainage volume in intermittent peritoneal dialysis using a two-bag, low hydrostatic pressure drainage system.

Adequate drainage volume (DV) is a prerequisite for long-term success of intermittent peritoneal dialysis (IPD). Ultrafiltration (UF) is basically determined by the interplay of two major forces: a driving osmotic force created by a hyperosmolar dialysate solution versus an opposing force--the intraperitoneal hydrostatic pressure. Conventional drainage procedures (CS) are capable of achieving a fluid volume of 3 L per bag. We found that this intrabag volume corresponds to an intrabag hydrostatic pressure of 60 cm water. Because this drainage system is closed, the intrabag hydrostatic pressure reflects intraperitoneal hydrostatic pressure. A low-pressure system (LPS) was devised to evaluate the possible influence on DV of reducing HP. Our results show that such LPS does indeed significantly improve DV, using a decreased number of exchanges. The residual volume and its glucose concentration (in a 1.5-g/dl exchange) were measured with CS. When followed by an 4.25-g/dl exchange, an 11% reduction in glucose concentration was evident. Thus, the osmotic driving force may also be impaired by incomplete drainage. To obtain maximal DV during IPD, a LPS should be used. This could be achieved by using 2 L dialysate in 3-L bags.

Aged↗
PubMed1987

Spectral analysis of fluctuations in heart rate: an objective evaluation of autonomic nervous control in chronic renal failure.

A quantitative, noninvasive method of assessing autonomic control, based on the spectral analysis of beat-to-beat fluctuations in heart rate (HR), was applied to patients with chronic renal failure (RF). Since the power spectrum of HR fluctuations measures the dynamic nervous control of HR, it can be used to quantitate a normal control system as opposed to a disturbed or depressed system. Indeed, in RF patients, a strong reduction in the HR power spectrum was observed in all frequency ranges, both sympathetically and parasympathetically mediated. A similar depression in autonomic control was demonstrated in patients on hemodialysis or peritoneal dialysis. RF patients not yet undergoing dialysis show a lesser degree of depression. Spectral analysis of HR fluctuations in RF patients makes it possible to quantitate autonomic dysfunction and to reliably measure its development as a function of time, and requires only a 10-min standard electrocardiogram recording.

Adult↗
PubMed1987

Total parathyroidectomy with autotransplantation in haemodialysed patients with secondary hyperparathyroidism--should it be abandoned?

The development of secondary hyperparathyroidism is almost universal in patients with end-stage renal disease. Medical management frequently fails and in such circumstances parathyroidectomy becomes a necessity. Total parathyroidectomy with autotransplantation of parathyroid tissue into the patient's forearm has been advocated as the surgical procedure of choice. In a previous publication we reported our experience with this technique in six haemodialysed patients. We now extend our follow-up to 19 patients over an observation period ranging from 6 to 66 months. Five of these patients required graft removal because of recurrent secondary hyperparathyroidism. Despite total graft removal, two patients had clinical and laboratory evidence of persistent hyperparathyroidism. Histology of the removed graft tissue demonstrated severe hyperplasia as well as invasion of adjacent muscle, adipose tissue, and vascular channels by parathyroid cells. This raises the possibility of local and distant metastatic spread of parathyroid tissue resulting in hyperparathyroidism. We suggest that parathyroid autotransplantation is potentially hazardous and should in fact be abandoned.

Female↗
PubMed1986

[Routine use of 6-month antitubercular treatment in 300 patients].

Over a 2-year period, all patients with incipient tuberculosis seen in a hospital unit were given a 6-month treatment consisting of rifampicine, isoniazide, pyrazinamide and ethambutol. A retrospective study of these 300 patients showed that the treatment was effective, with no failure if taken for more than 2 months. Relapses were rare when the drugs were taken regularly, the responsible M. tuberculosis strain was sensitive, and there was no associated malignancy (present in 1.4% of the cases). The drugs were moderately well tolerated, and treatment had to be modified because of side-effects in 4.6% of the patients. It also appeared that 57% of the patients fully complied with the prescription, and 16% were lost sight of by the hospital unit. Treatment was altered in 36% of the cases, but in 16% changes were introduced by private doctors for reasons which retrospectively proved to be without medical grounds. It is concluded that this 6-month chemotherapeutic regimen was effective in more than 98% of the cases, and that the main problem in management of tuberculosis is the patient's compliance with treatment.

Adolescent↗
PubMed1986

NADH-dependent prostaglandin E2-9-ketoreductase activity and prostaglandin synthesis in the Brattleboro rat kidney: effects of the antidiuretic hormone.

The activity of prostaglandin (PG)E2-9-ketoreductase (9KR), an enzyme catalyzing the conversion of PGE2 to PGF2 alpha, was significantly increased in glomerular and cortical homogenates of diabetes insipidus (DI) rats, as compared to normal Long Evans (LE) rats, and did not change with ADH treatment. Medullary 9KR was similar in the three groups and papillary 9KR was increased, but not significantly, in both groups of DI rats. Km values for PGE2 and NADH were compared in the various compartments of the kidney. Levels of 9KR were not correlated with the PGE/PGF ratio in urine or supernatants. The synthesis of PGE2 and PGF2 alpha by isolated glomeruli was increased in DI rats. This was not reversed by ADH treatment, PGE2 synthesis increasing even further, especially in the presence of arachidonic acid. In contrast, medullary slices produced significantly less PGs in DI than in LE rats and returned to normal with ADH treatment. Papillary slices produced similar quantities of prostaglandins in all groups. The results do not support the concept that the alterations in PG synthesis observed in DI rat are related only to changes in 9KR activity, but do not exclude the possibility that the enzyme participates in the regulation of PG biosynthesis.

Animals↗
PubMed1986

Leiomyoma of the anal canal: report of two cases.

Leiomyoma of the rectum and anal canal is an unusual clinical entity. Generally, it does not produce any clinical signs and in most cases it is discovered incidentally in the course of routine rectal examination. The clinical presentation, diagnosis, and surgical treatment are described in two presented cases of anal canal leiomyoma.

Aged↗
PubMed1986

Structural and metabolic changes characterizing the aging of various cartilages in mice.

It is well documented that various organs and tissues in the body show a differential, non-homogeneous pattern of development and aging. The present study evaluates some of the morphological and metabolic changes characterizing the aging of different types of cartilages in normal male mice. Representatives of hyaline, fibrous, articular and elastic types of cartilage were obtained from animals ranging from 1 week to 1 year of age. Our determinations included the following: total body and organ weights, proteins and DNA concentrations, [3H]leucine and [35S]sulfate uptake. The biochemical assays were accompanied by morphological examinations of corresponding tissue specimens. This investigation clearly indicates that the growth and maturational activities of the various cartilages examined attained their completion at a very early stage of life (1-3 months postnatally). Thereafter, a phase of steady state prevails, followed by a gradual but continuous decline in the various metabolic activities. The morphological findings illustrate the nature of the age-related structural changes. The present findings indicate that a skeletal tissue such as cartilages of various types, tends to age early during the lifespan of the animal.

Aging↗
PubMed1986

Sodium intake as a determinant of urinary prostaglandin excretion. Studies in the Brattleboro rat.

In order to investigate the effects of changes in sodium (Na) balance on the renal production of prostaglandins (PG) E2 and F2 alpha in the absence of antidiuretic hormone (ADH), studies were performed in Brattleboro rats, without endogenous ADH, and in heterozygote Long Evans rats which served as controls. All rats received a diet virtually devoid of Na, with distilled water ad libitum, and Na intake was modified by adding different quantities of Na to the drinking water. Three groups were studied for each strain: normal Na intake, low Na intake and Na loading. At the end of a 14 day diet period, urinary PGE2 and PGF2 alpha were measured by radioimmunoassay in collections obtained for three consecutive days. In the Na depleted animals, both PGE2 and PGF2 alpha decreased. The PGE2/PGF2 alpha ratio (E/F ratio) was unchanged. In contrast, Na loading induced a significant decrease of PGE2 but PGF2 alpha increased, though not significantly. The E/F ratio was significantly decreased. The results were qualitatively similar in the presence or absence of ADH, but the Brattleboro rats, overall, excreted less PGs than controls. The results suggest that changes in Na balance are major factors influencing urinary PG excretion. These substances probably play a role in the modifications of Na handling by the kidney in different balance states.

Animals↗
PubMed1986

Effect of angiotensin II on prostanoid synthesis in isolated rat glomeruli.

The influence of angiotensin II (ANG II) on the synthesis of glomerular prostanoids is controversial, possibly because of the different methodologies employed. In order to assess this inter-relationship isolated rat glomeruli were incubated with and without shaking. The use of shaking during incubation significantly increased the amounts of prostanoid synthesized, most probably because of continuous non-specific activation of phospholipase (PLA2) activity. After preincubation in a non-shaking bath, ANG II was added for a second incubation period. A marked increase of prostaglandin (PG) E2, and, to lesser degree, of thromboxane (TX) B2 was noted, with no change on PGF2 alpha synthesis. These results show (a) that preincubation without shaking, by lowering the non-specific activation of the PLA2 activity, may unmask, in vitro, specific peptide stimulation, and (b) that ANG II, stimulating principally PGE2 synthesis, may modify the vasoactive status of the glomerular vasculature.

Angiotensin II↗
PubMed1986

Renal prostaglandins E2 and F2 alpha throughout normal human pregnancy.

Twenty-five normal pregnant women were studied sequentially at 4-week intervals, beginning from weeks 8-16 until delivery. In eighteen women the study was repeated 6 weeks after delivery. The 24-h urinary excretion of PGE2 and PGF2 alpha, plasma renin activity (PRA), plasma aldosterone and fractional excretion of sodium (FENa) were measured at each visit. PGE2 and PGF2 alpha increased progressively throughout pregnancy (867 +/- 81 and 1048 +/- 94 ng 24 h-1 respectively, before week 15 and 1581 +/- 175 and 2625 +/- 305 ng 24 h-1, respectively, after week 35) and returned to normal values 6 weeks after delivery (748 +/- 107 and 1503 +/- 165 ng 24 h-1, respectively). PRA and aldosterone increased in a similar fashion, but values of prostaglandins did not correlate with those of PRA or aldosterone. PGE2 correlated directly with FENa but this correlation was weak. These results may suggest that tubulo-interstitial prostaglandins play a role in the regulation of sodium homeostasis during pregnancy.

Adult↗
PubMed1986

Long-term survival in bronchogenic carcinoma with a solitary metastasis.

Partial resection of a huge anaplastic large cell carcinoma of the upper lobe of the right lung was performed in a 47-year-old patient in order to relieve symptoms of pulmonary hypertrophic osteoarthropathy. Several months later a solitary metastasis was noted in the muscles of the right forearm. The metastasis was resected and the forearm irradiated. The patient was further treated with injections of autologous tumour cell vaccine and BCG. Today, 7 years later, the patient is alive, without any signs of neoplastic disease.

Carcinoma, Small Cell↗
PubMed1986

[Assessment of the quality of life of cancer patients. The preliminary applications to advanced bronchial cancers].

So far there is no good evidence that chemotherapy improves survival in non small cell lung cancer. Reports of randomized trials testing chemotherapy versus supportive treatment alone are very few. In recent years, more and more emphasis has been put on the quality of life for cancer patients. Subjective tests such as Anamnestic comparative self Assessment (A.C.S.A. test, Dr. Bernheim) were designed as well as objective ones, using different types of self evaluation. However very few studies have been focused on this aspect in patients with non small cell lung cancer. Therefore the G.E.T.C.B. (Groupe d'Etude et de Traitement des Cancers Bronchiques) decided to initiate a cooperative randomized trial (02 CB 84) in metastatic epidermoid and large cell bronchus carcinoma, in order to test the potential benefit from chemotherapy in these tumors and how it affects the quality of live. In this trial, C.O.P.A.C. combination (Cyclophosphamide, Vincristine, Cis-Platinum, Adriamycin and CCNU) is randomized versus no chemotherapy. The quality of life is assessed monthly on the one hand by a modified A.C.S.A. test performed by a physician and on the other hand by a question list given to the patient. This question list attempts to evaluate the impact of disease as a reference point. Finally protocol 02 CB 84 (activated in 05/84) may give information about the effect of chemotherapy on both survival and quality of life.

Antineoplastic Combined Chemotherapy Protocols↗