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Biomedical subjects

J Libert

Publications and source records attributed to J Libert.

At least 19 recordsLinked to original sources
PubMed2003

CXCR4 expression in vitreoretinal membranes.

BACKGROUND/AIM: Proliferative vitreoretinopathy (PVR) and macular pucker (MP) vitreoretinal membranes are caused by abnormal cell migration. By their role in chemotactism, chemokine receptors represent good candidates to sustain this process. The authors thus investigated the expression of one of them, CXCR4, in these pathologies. METHODS: Three PVR and four MP membranes were surgically removed and processed for immunochemical studies with antibodies for CXCR4, cytokeratins or smooth muscle actin. RESULTS: CXCR4 expression was found in all membranes. There was no relation between severity of PVR or MP and presence of CXCR4. In addition, there was no difference in CXCR4 expression between MP and PVR. CONCLUSION: CXCR4 is expressed in PVR and MP. Further experiments are needed to test if CXCR4 and other chemokine receptors are implicated in vitreoretinal membrane formation.

Antibodies↗
PubMed2003

Vitrectomy and silicone oil in the treatment of acute endophthalmitis. Preliminary results.

PURPOSE: To evaluate the role of pars plana vitrectomy (PPV) and silicone oil injection in the treatment strategy of severe endophthalmitis. PATIENTS AND METHODS: This study analyses a retrospective case series of 34 patients with signs and symptoms of severe endophthalmitis with visual acuity limited to light perception. All underwent PPV with intraocular injection of antibiotics (IOAB), together with topical and oral antibiotics. In 10 patients (group 1), this treatment alone was sufficient to control infection. In 10 other patients (group 2) with the same initial treatment, a new vitrectomy was needed: 8 because of retinal detachment, 2 because of persistent infection. In 2 patients (group 3), initially treated with PPV and IOAB, a second vitrectomy with IOAB and silicone oil tamponade was needed to stop infection. In 12 patients (group 4), with the worse prognosis related to the severity of infection and/or to associated retinal necrosis, PPV, IOAB and silicone oil tamponade were conducted at first surgery. Final anatomic status and visual acuity were assessed to compare the effectiveness of these different treatments. RESULTS: In 22 patients (group 1, 2 and 3) treated initially without silicone oil, 12 patients (55%) needed further surgery, either for persistent infection or retinal detachment. Twelve patients (group 4) treated at first with silicone oil had a rapid control of the infectious process and better anatomical results with this procedure only. Final visual acuity was also better in the silicone oil groups (group 3 and 4) than in the non silicone groups (group 1 and 2). CONCLUSION: These results suggest that silicone oil tamponade might be beneficial in the treatment strategy of severe endophthalmitis.

Acute Disease↗
PubMed2001

[Chronic endophthalmitis].

Chronic endophthalmitis are intraocular infections, characterized by late onset and prolonged evolution. They are either of exogenous or endogenous origin and may be related to the penetration of "fastidious bacteria", mycoses or viruses. Diagnosis is based on specific techniques, including direct examination peroperatively, prolonged cultures on special medium and electron microscopic analysis. Treatment often combines diagnostic/therapeutic vitrectomy and intraocular injection of antibiotics. Their evolution is usually made of successive reactivations and explanting of the artificial lens is often necessary for a definitive remission in pseudophakic patients.

Chronic Disease↗
PubMed2000

[Methicillin-resistant Staphylococcus aureus nosocomial infections: epidemiology, prevention and antibiotic therapy].

Infections caused by methicillin-resistant Staphylococcus aureus strains are particularly representative of the various questions raised by nosocomial infection. The specific ecology of these strains, which is limited to care centers, gives evidence to their nosocomial origin. The mode of spread is mainly clonal by cross-transmission, which emphasizes the importance both of individual hygiene measures and procedures for spread control. Both the incidence and percentage of methicillin-resistant strains are tracers of choice for the local status as regards the risk of nosocomial infection. Multiresistance of most methicillin-resistant Staphylococcus aureus strains causes therapeutical difficulties, emphasizing the importance of controlling spread of glycopeptide-resistant strains.

Cross Infection↗
PubMed2000

ADCON-L hydrogel as a vitreous substitute: preliminary results.

The ideal vitreous substitute has still to be found. This report concerns the preliminary results of a translucent hydrogel, ADCON-L, used successfully in neurosurgery. We have used this hydrogel as a vitreous substitute in the right eye of New-Zealand albino rabbits following vitrectomy. The follow-up period was four weeks and the evaluation was followed by biomicroscopy, indirect ophthalmoscopy, and electroretinography. The results obtained suggest a potential retinotoxicity of this hydrogel as shown by the statistically significant reduction of the mean B-wave amplitude at day 14 (p < 0.05) and day 28 (p < 0.005), as well as an important postoperative inflammatory reaction. Another transparent formulation of the same molecule is currently under investigation.

Animals↗
PubMed1997

[Impact of anti-retroviral treatment with protease inhibitors on the evolution of cytomegalovirus retinitis in the patient carrying acquired immunodeficiency syndrome].

Up to now cytomegalovirus retinitis (CMVR) recurrence in AIDS patients was considered to be very high, even on maintenance therapy. Protease inhibitors (PI) are antiretroviral molecules which, with more efficacity than reverse transcriptase inhibitors, decrease viral charge and increase CD4's count aswell as survival. We analysed the impact of PI on CMVR evolution in a retrospective review of 18 patients with CMVR on maintenance therapy and PI treatment. In a first group, 13 patients started PI some time after CMVR diagnosis (median CD4 = 9/mm3). A second group of 5 patients developed CMVR (median CD4 = 63/mm3) after initiation of PI. In the first group, incidence of CMVR recurrences/1000 patients days was 6,45 (2323 patients days of follow-up (PDFU) before starting PI and 3,44 (4066 PDFU) after starting PI. In this group, during the follow-up's period of CD4's count inferior to 75/mm3, incidence of CMVR is 6,84/1000 patients days and becomes 0,86/1000 patients days during the follow-up's period of CD4's count superior to 75/mm3. In the second group, incidence of CMVR was 0/1000 patients days (1972 PDFU). In summary, incidence of CMVR decreases with PI's treatment. Interruption of CMVR maintenance therapy could be considered in patients with CD4's count higher than 75/mm3.

Adult↗
PubMed1997

[The Baerveldt implant in refractory glaucoma: clinial results].

25 Baerveldt glaucoma implants were placed in 22 patients, between 1992 and 1997. The indications were: 14 cases of neovascular glaucoma, 4 congenital glaucomas, 3 glaucomas due to intraocular silicone oil and 4 various glaucomas. The mean preoperative intraocular pressure was 46 mmHg (26-77) on a mean of 2.1 glaucoma medications. The postoperative mean intraocular pressure was 17 mmHg (5-50) on a mean of 0.5 glaucoma medications with a mean follow-up of 16 months (1 week-48 months). The final intraocular pressure was less than or equal to 20 mmHg in 20 of the 25 eyes. The final visual acuity improved or remained the same in 10 of the 25 cases and worsened in 11 cases (4 cases undetermined). The most frequently observed complications were: hyphema, choroidal effusion and corneal edema. Our results, in terms of intraocular pressure control, with the Baerveldt implant in patients with complicated glaucomas appear to be satisfactory. The use of this implant could be extended.

Adolescent↗
PubMed1996

[Intravenous corticosteroid megadose treatment in ocular Behçet disease].

Ocular Behçet's disease is characterized by a very poor visual prognosis. Twelve patients which had a maintenance treatment with immunosuppressors received 30 intravenous i.v. bolus of corticoids for uncontrolled severe retinal vasculitis (macular edema 58% of cases) and papillitis (100% of cases) (1 bolus treatment = 0.5-2 g of i.v. methylprednisolone once a day, for 3 days). In addition, oral immunosuppression was moderately increased in order to prevent further recurrences. Tolerance was good in all cases. Visual acuity (VA) remained stable or improved after one month in 87% of cases following the bolus treatment. In 92%, the VA remained stable or improved for a mean follow-up of 6 years. These good results suggest that intravenous bolus of steroids is a safe and efficient therapy which may prevent further decrease of the visual acuity and may reduce the side effects of the immunosuppressive treatment needed to control severe posterior uveitis in Behçet's disease.

Adult↗
PubMed1995

[Progressive non-inflammatory lesions of the vitreous and intermediate uveitis].

A 77 year old man presented with a decreased vision, quite anterior segments, vitreous haze (++) (cells and flare) OD > OS, snow banks and snow balls at the inferior pars plana, suggesting an intermediate uveitis. Two subTenon injections of steroids were performed on the right eye, with improvement of his right visual acuity from 5 to 10/10. Cells and snow balls disappeared but the vitreous became more fluffy and more organized. Investigations did not demonstrate any systemic disease. The vitreous haze progressed bilaterally and failed to respond to systemic steroids. A year later, visual acuity was limited to hand movements (OD) and remained at 9/10 (OS). The vitreous haze + (OD) and ++ (OS) was extremely fluffy and moderately organized without inflammatory cells. Vitrectomy was performed in both eyes. Non inflammatory fibro-cellular membranes in a dense collagenous network with amorphous precipitates were observed in electron microscopy. One year later, he developed a systemic B-cell lymphoma. This unusual case illustrates the possible evolution of intermediate uveitis in a secondary PVR-like progressive non inflammatory vitreous haze with a particular increase of the amount of collagen fibrils and amorphous precipitates responsible for the fluffy aspect of the vitreous failing to respond to steroids.

Aged↗
PubMed1994

[Surgical approach to diabetic retinopathy].

Progress in instrumentation and techniques may prevent from blindness patients affected with severe diabetic retinopathy. Surgery stabilizes the situation in 20% of the cases and improves vision in 70%. In 10% of the cases, however, treatment is undertaken too late and the eye may be lost. Although great improvements have been realized, early detection and screening for diabetic retinopathy, as well as adequate laser therapy, are of prime importance to save vision of diabetic patients.

Blindness↗