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Biomedical subjects

J M Ebran

Publications and source records attributed to J M Ebran.

At least 19 recordsLinked to original sources
PubMed2003

Description of microangiopathy in children with type 1 diabetes mellitus: a 19-year retrospective study.

BACKGROUND: The aim of the study was to estimate the outcome of patients with type 1 diabetes followed in a university hospital in the paediatric department and then in the adult diabetic department for at least 10 years. METHODS: We made a retrospective analysis of 50 patients (28 women and 22 men) with type 1 diabetes with disease duration of 19 +/- 6 years and analysed whether retinopathy and nephropathy had progressed, had remained unchanged or had improved or normalised. RESULTS: The mean age of diabetes onset was 8 +/- 4 years (1-16). Ketoacidosis revealed diabetes in 36% of the children. Mean HbA(1c) was 8.6 +/- 1.8%, and was over 8.5% in 34% of the patients. The mean age at onset of puberty (Tanner stage II) was 12 +/- 1 years in girls and 13 +/- 1 years in boys. Mean HbA(1c) was 7.9 +/- 1.2% during the year before onset of puberty and 8.7 +/- 1.1% in the following 3 years, corresponding to a 10% pubertal increase in HbA(1c). Retinopathy was seen in 50% of the patients at a mean age of 22 +/- 5 years, 15 +/- 6 years after onset of diabetes. Mean HbA(1c) was 9.7 +/- 1.6% in patients with proliferative retinopathy, 9.0 +/- 1.5% in patients with non proliferative retinopathy, and 8.1 +/- 1.3% in those without (p=0.02, proliferative versus no retinopathy, p > 0.05 non proliferative versus no retinopathy). Microalbuminuria was diagnosed in 26% of the patients. Mean HbA(1c) was 9.3 +/- 2.1% in patients with microalbuminuria versus 8.1 +/- 1.3% in those with normoalbuminuria (p=0.02). CONCLUSIONS: Glycemic control was similar in patients with non proliferative retinopathy and those without. Proliferative retinopathy and nephropathy were both related to the level of glycemic control.

Adolescent↗
PubMed2002

Proliferative retinopathy in patients with type 1 diabetes of less than 5 years' duration.

The position statement about diabetic retinopathy postulates that at least 3-5 years of duration of diabetes are needed for the retinopathy to occur, and initial retinal examination should be performed within 3-5 years after the initial diagnosis. We report here the case of a 18 year-old type 1 diabetic woman with a proliferative retinopathy discovered 2 years after the onset of a clinical diabetes. The hypothesis of a Latent Autoimmun Diabetes in Adults (LADA) could not be excluded and we propose, particularly in this context, to detect a diabetic retinopathy at the onset of diabetes.

Adolescent↗
PubMed2002

[The reconstruction of the lacrimal pathway in the common canaliculus surgery].

We describe a new technique for restoring lacrimal pathway anatomy in common canaliculus surgery. Fourteen patients (4 men and 10 women), with a mean age of 59 +/- 19 years, suffering from chronic epiphora caused by common canaliculus stenosis were operated on (18 procedures: 14 unilateral, 4 bilateral). We used a modified Dupuy-Dutemps technique. The anterior face of the lacrimal sac was cut as a flap, which was secured with the posterior nasal mucosal flap for the posterior anastomosis plane. The common canaliculus stenosis and the external face of the lacrimal sac were excised guided by the operating microscope so as to put in place a bicanalicular device, which was left for 6 months. The anterior plane of anastomosis was made of a Goretex((R)) patch or PTFE((R)) (Polytetrafluoroethylene((R))) placed under the deep face of the orbicularis muscle. The procedure was successful in 15 of the 18 cases (success rate: 83.3%). Among the three failures, two were due to the early loss of the bicanalicular stent and one to anastomosis fibrosis. This technique made it possible to restore lacrimal pathway anatomy, which was severely modified by the dacryocystorhinostomy procedure and to protect the anastomosis from fibrosis by the surrounding tissues. Biomaterials such as Goretex((R)) and PTFE((R)) are valuable tools for this technique. In common canaliculus stenosis, restoring the lacrimal pathway with biomaterials such as Goretex((R)) or PTFE((R)) improves the functional results.

Female↗
PubMed1992

[Scintigraphy of the lacrimal ducts. Value of the lateral incidence in postoperative period].

Lacrimal scintillography, a simple, non traumatic, and physiological method, has been for a long time an useful exploration in the study excretory pathology. It allows an accurate diagnosis especially in the case of functional stenosis and, due to its ability to indicate the exact seat of obstruction, this technique is able to determine the surgical treatment required. This study underlines the contribution of lacrimal scintillography in the control of surgical anastomosis permeability, because of a modification in the initial technique: the use of scintillography in employing the lateral view rather than the front view, usually used, permits a better visualisation of the new surgically created excretory passage, particularly in the posterior area of nasal fossae.

Aged↗
PubMed1990

[Scintigraphy of the lacrimal ducts: the value of the lateral view in the postoperative period].

Lacrimal scintillography, a simple, non traumatic, and physiological method, has been for a long time an useful exploration in the study of lacrimal excretory pathology. It allows an accurate diagnosis especially in the case of functional stenosis and, due to its ability to indicate the exact seat of obstruction, this technique is able to determine the surgical treatment required. This study underlines the contribution of lacrimal scintillography in the control of surgical anastomosis permeability, because of a modification in the initial technique: the use of scintillography in employing the lateral view rather than the front view, usually used, permits a better visualisation of the new surgically created excretory passage, particularly in the posterior area of nasal fossae.

Aged↗
PubMed1988

[Chronic alcohol-tobacco poisoning: towards an early detection of optic neuropathy].

Forty-two patients (33 men, 9 women) with normal visual acuity admitted to an alcoholism rehabilitation programme were evaluated for colour vision using the automatized Fransworth-Munsell test (ChromopsR) and for central visual field using Friedmann's analyser. An early colour blindness without axis, i.e. a lack of colour discrimination, was often found. At the same time, in the more intoxications perimetric defects appeared in the 30 degrees area first centrally, then followed by arcuate superior scotomas.

Adult↗
PubMed1985

[Congenital ectropion of the iris epithelium and glaucoma].

Two cases of unilateral ectropion uveae with ipsilateral juvenile glaucoma are reported including one with ipsilateral ptosis. This rare, non progressive anomaly, is characterized by the presence of iris pigment epithelium on the anterior surface of iris stroma, quite often associated with neurofibromatosis, ipsilateral ptosis or Rieger's syndrome. Congenital or juvenile glaucoma is almost systematically associated with the condition and must be evaluated and treated. Pathogeny of the anomaly has to be interpreted keeping in mind the concept of neurocristopathy, i.e. developmental anomalies of neural crest origin tissues.

Anterior Chamber↗
PubMed1985

[Gonioretraction using argon laser].

Argon laser trabeculoplasty (ALT) has recently become one of the most popular procedures in the treatment of chronic open angle glaucoma. Although ALT is quite efficient, its mode of action is far from understood and the rate of complications or side effects is not negligible. In 1981 we began exploring a different procedure that we have called argon laser gonioretraction (ALG) with reference to the Cairns surgical goniospasis. While the corneo-scleral trabeculum is the target for argon laser beams in ALT, in ALG the beams are directed toward the ciliary band in an attempt to get the scar to pull the scleral spur backwards and stretch the trabeculum. The procedure may also act through the uveal trabeculum. The procedure was first utilized from 1981 to 1983 in 43 chronic open angle glaucoma eyes with: 1/ a high rate of success in decreasing the intraocular pressure on a long term basis, 2/ an acceptable rate of complications. 18 months after laser surgery, intraocular pressure was fully controlled without any medical treatment in 19 cases (44%). 18 additional cases (42%) were controlled with the help of less medical treatment than before. In 4 cases (8%) the failure was complete including one case with significant prolonged and non-responsive post-op hypertension which has induced a slight alteration of the visual field. One case was lost to follow-up. Supposed advantages of ALG over ALT are: integrity of the corneo-scleral trabeculum is maintained, goniosynechiae are more peripheral, and there is less propensity to induce proliferation of endothelial cells.

Adult↗
PubMed1984

[Intracorneal suture. A simple procedure for the correction of astigmatism after cataract operation].

A simple surgical procedure to cure post cataract-surgery astigmatism is reported. Corneo-corneal (sometimes corneo-scleral), 9-0 polyamide monofilament sutures are put in radially at the end (or at the two ends) of the flattest meridian to increase its curvature and therefore its refractive power. 14 eyes were treated by this procedure, 11 of them for an "against the rule" astigmatism (1st group) and the 3 others for a "with the rule" astigmatism (2nd group). No corneal incision or resection is performed before suturing. Surgery has been efficient in all cases. As compared to a mean pre-op against the rule astigmatism of 6.55 +/- 2.20 diopters, the post-op residual astigmatism was no more than 3.16 +/- 1.94, 2.66 +/- 1.17, 2.69 +/- 1.33 and 2.80 +/- 1.74 diopters, respectively 8 days, 3 months, 6 months, 12 months after the surgery. The average axis of the effect of the surgery was almost perpendicular to the initial axis of the astigmatism. The visual acuity also improved but was dependent on other factors in addition to the refractive surgery. The results were stable from 3 months after surgery and remained unchanged in those cases where the follow-up period was 18 months or more. No significative complications have been observed and side effects have been negligible. In our opinion, the results that we have obtained open the way to the intracorneal suture, without any section of the cornea, as a potential treatment for excessive astigmatism.

Aged↗
PubMed1983

[Routine monitoring of patients treated with synthetic antimalarials].

Routine tests of visual acuity, and ocular fundus, angiography, and ERG examinations should be conducted regularly in patients receiving synthetic antimalarial drugs. Toxicity of these compounds is a current problem as 8 out of 81 patients being treated presented symptoms associated with ERG changes or macular lesions, and reduced visual acuity in some cases. There was a lack of correlation between ERG effects and the onset of macular disorders: one patient had marked macular changes and a normal ERG while another had a normal fundus and visual acuity but abolished ERG activity. Identical doses do not always produce the same effect and toxic symptoms have developed after a dosage ranging from 86 to 760 g. This suggests the existence of individual hypersensitivity.

Aged↗
PubMed1983

[Modifications in blood zinc and lead concentrations and ALA-dehydratase activity in optic neuropathy from alcohol and tobacco abuse].

Plasma red blood cell and total blood zinc levels were significantly decreased in 52 consecutives cases of bilateral, retrobulbar, axial optic neuropathy caused by chronic abuse of ordinary wine and/or beer and/or hard beverages and cigarette smoking principally in men in their forties [plasma zinc: 746 mg/l +/- 179 (n = 52), control 907 mg/l +/- 127; red blood cell zinc: 10,218 mg/l +/- 1,327 (n = 10), control 12,244 mg/l +/- 1,307; total blood zinc: 4,849 mg/l +/- 1,069 (n = 51), control 5,831 mg/l +/- 644]. In contrast, blood lead levels were increased in these cases - blood lead: 344 mg/l +/- 101 (n = 30), control 193 mg/l +/- 94. Activity of red blood cell delta-amino-levulinic acid dehydratase (ALA-dehydratase), a zinc dependent enzyme, was decreased [red blood cell ALA-dehydratase; 18,8 IU/l +/- 2,2 (n = 13), control 44,8 IU/l +/- 3,3]. Plasma magnesium was slightly decreased while serum copper was not significantly modified. Possible ophthalmological implication of these findings are discussed.

Alcoholism↗
PubMed1983

[Therapeutic affect of zinc sulfate on central scotoma due to optic neuropathy of alcohol and tobacco abuse].

The oral administration of 400 mg/day for one month of zinc sulphate, when compared with placebo, provoked normal plasma zinc level in treated patients, principally men in their forties, with bilateral, retrobulbar, axial, optic neuropathy related to excessive smoking and consumption of ordinary wine and/or beer and/or spirits. Treatment significantly improved visual capacity (measured with Friedmann analyser) of the central scotoma area (5 degrees).

Alcoholism↗