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Biomedical subjects

L Fournier

Publications and source records attributed to L Fournier.

At least 55 records · Page 3Linked to original sources
PubMed1993

K+ channel and alpha 2-adrenergic effects on glucose-induced Ca2+i surges: aberrant behavior in ob/ob mice.

Glucose-induced shifts in intracellular free Ca2+ concentration ([Ca2+]i) were quantitatively and temporally the same in ob/ob and +/+ beta-cells. In both, epinephrine promptly and protractedly inhibited the glucose-induced [Ca2+]i surge via a pertussis toxin-sensitive alpha 2-adrenergic mechanism that was reversible by potassium depolarization. When added before glucose, epinephrine blocked completely in the ob/ob beta-cells, but in the +/+ beta-cells it produced a delayed, reduced, and transient intracellular Ca2+ (Ca2+i) surge. Neither the ATP-sensitive K+ channel blocker tolbutamide nor the large-conductance Ca(2+)-activated K+ channel (Kmaxi) blocker charybdotoxin reversed the effect of epinephrine. Tetraethylammonium (TEA), a blocker of both the Kmaxi and the delayed-rectifier K+ channel, and forskolin attenuated the effect of epinephrine in +/+ but not in the ob/ob beta-cells. The data show that 1) alpha 2-adrenoreceptor activation decreases the glucose-stimulated Ca2+i surge in +/+ beta-cells primarily by activating a tolbutamide- and charybdotoxin-insensitive, TEA- and forskolin-sensitive K+ channel; 2) the hypersecretion of insulin in ob/ob beta-cells is not due to enhanced glucose-induced Ca2+ influx; and 3) the ob/ob beta-cells are aberrant with regard to alpha 2-adrenergic modulation.

Animals↗
PubMed1993

A comparison of mail and telephone interview strategies for mental health surveys.

The high cost of mental health surveys of the general population has sparked interest in less costly research methods. Two low-cost mental health survey strategies (mail and telephone) were compared in terms of cost, response rate and quality of data obtained. A total of 1,074 persons agreed to participate in the study as a sample, one-half by telephone and the other half by mail. They completed the Diagnostic Interview Schedule Self-Administered, a questionnaire designed to be self-administered, which was used to assess specific mental disorders and to evaluate risk factors. In addition, 239 respondents who were selected according to the presence or absence of specific diagnoses were reinterviewed face-to-face using the Diagnostic Interview Schedule as an external criterion. The telephone method yielded a better response rate (15% higher) and better control over answers (for example, less missing data). The mail strategy was less expensive and appeared to yield data of slightly better quality, particularly for respondents suffering from anxiety disorders.

Adolescent↗
PubMed1992

Serum squamous cell carcinoma antigen levels in invasive squamous vulvar cancer.

Squamous cell carcinoma (SCC) antigen levels were studied in 34 patients with primary (N = 27) or recurrent (N = 7) SCC of the vulva. In primary disease, the SCC antigen level was greater than 2.5 ng/ml in only four patients (15%). Elevated antigen levels ranged from 2.7-18.0 ng/ml. All of these patients had advanced disease by either clinical or surgical staging systems. Four of twelve patients with inguinal metastasis had elevated SCC antigen levels. In two of these patients the inguinal nodes were abnormal to palpation. No association of the SCC level and the degree of tumor differentiation was observed. SCC antigen levels were increased slightly (2.7-4.5 ng/ml) in three of six patients with locally recurrent disease. In one patient with distant recurrence the SCC antigen was 15.3 ng/ml. In both primary and recurrent disease all elevated SCC antigen levels decreased with effective therapy. Vulvar cancer is primarily a local disease that is easily assessed by physical examination. An effective tumor marker in vulvar cancer would benefit only the rare patient with distant but not local disease.

Antigens, Neoplasm↗
PubMed1992

Comparison of the properties of the ATP-sensitive K+ channels of pancreatic beta-cells of lean and obese (ob/ob) C57BL/6J mice.

Cultures of pancreatic islet cells from obese and lean mice of the C57BL/6J strain were established and their secretory response to glucose stimulation was measured. Insulin secretion (as % of total cellular insulin content) from the cells of the obese mouse cultures was significantly higher than from lean mouse cells. The properties of the glucose- and ATP-sensitive potassium channels present in these cultured beta-cells were compared using the cell-attached and the inside-out configurations of the patch-clamp technique. The channels of both types of mouse were indistinguishable in terms of conductance, ionic selectivity, kinetic behavior, voltage dependence or sensitivity to glucose, ATP and ADP. It is concluded that the depolarized state and the hypersecretory response of obese mouse beta-cells are not related to an altered behavior of their ATP-sensitive potassium channels.

Adenosine Diphosphate↗
PubMed1992

Why discrepancies exist between structured diagnostic interviews and clinicians' diagnoses.

The authors employed empirical methods to study the causes of discrepancies between clinicians' and epidemiologists' diagnoses of "cases" from the general population within the homogeneous DSM-III/DIS system. Four interviewers conducted 139 interviews using the DIS, while psychiatrists completed a DSM-III checklist, after which they could then ask any questions they wanted. All kappas exceeded 0.58. Meetings were subsequently organized with all participating psychiatrists in order to point out reasons for discrepancies between DIS diagnoses and clinical judgement. The authors came to the following conclusions: (1) DSM-III ambiguities led to discrepancies, especially when reference periods were not specified. (2) Discrepancies arose when cases were difficult: symptoms pertaining to different diagnoses or multiple diagnoses and the fact that clinicians could use volunteered comments, while interviewers were obliged to keep strictly to the schedule, contributed to discrepancies. (3) Other approaches, such as CIDI for anxiety and DISSA for depression, could improve DIS performances.

Anxiety Disorders↗
PubMed1992

Index of pulmonary expansion: a new method to estimate lung hypoplasia in congenital diaphragmatic hernia.

In order to find a simple method for assessing the degree of lung hypoplasia in congenital diaphragmatic hernia (CDH), we measured an index of pulmonary expansion (V/P: expiratory tidal volume over inspiratory pressure) in 23 pulmonary normal and 16 CDH neonates. We also measured V/P in 9 newborn lambs, 6 with experimentally induced CDH and 3 controls, and compared V/P values with fractional lung masses (FLM: lung weight over body weight). In animals, the correlation between V/P and FLM was significant (P less than .05), whereas there was a very significant inverse correlation between pulmonary interstitial emphysema found at postmortem and FLM (P less than .01). These findings suggest that V/P could be an indicator of lung hypoplasia and, therefore, of sensitivity to barotrauma. In neonates with CDH, this index could be useful to make comparisons between series and to separate infants who cannot be ventilated at usual pressures without significant barotrauma.

Animals↗
PubMed1992

Antibiotic-impregnated plaster of Paris beads. Trials with teicoplanin.

Teicoplanin-impregnated plaster of Paris beads were made and in vitro release properties were studied. Teicoplanin was released in an initial massive dose, with a rapid decline during the first three days, followed by a slowly declining prolonged release up to 30 days. The release tested by diffusion in gelose and high-performance liquid chromatography was found to be 21.4% and 28.2%, respectively, of the amount theoretically present in the beads. Plaster of Paris is a resorbable, nontoxic biomaterial that has already been used to fill dead spaces in bone and deliver antibiotics in the treatment of chronic osteomyelitis. The addition of teicoplanin, a new antistaphylococcal agent with low known bacterial resistance, is a promising alternative. Follow-up tests in vivo, simulating local conditions of the osteomyelitic bone, are necessary to prove efficacy.

Anti-Bacterial Agents↗
PubMed1992

[Duplex ultrasonography in the diagnosis of deep vein thrombosis of the legs. Agreement between two operators].

The operator-dependent nature of venous Duplex-ultrasonography diagnosis of deep venous thrombosis (DVT) of the leg is the principal reproach applied to it and a reason for delaying use. The aim of the present study was to evaluate concordance between two operators, with rigorous application of the same methodology of exploration of the venous axes. The study included 82 patients under hospital care, randomly selected from among those referred for the first Duplex-ultrasonography examination for DVT, and having accepted to undergo 2 consecutive explorations, one by each of the two operators. The two operators evaluated independently, for the 19 venous axes of the legs: 1: the interpretability of the examination, 2: the differential diagnosis between: absence of thrombus, presence of thrombus, nonconclusive examination, and 3: the score for the DVT extension. Evaluation of concordance of diagnosis was by Cohen's kappa coefficient, calculated on the positive diagnosis of DVT and the site of the most proximal thrombus. Extension scores were compared by calculation of the coefficient of correlation "r". Interpretability rates were 92% and 91% respectively for the two operators, 35 DVT being diagnosed in 27 patients by operator A and 36 DVT in 27 patients by operator B. The kappa coefficient for diagnosis of DVT with localization in the affected leg was 0.90 [0.81-0.98]. It was 0.89 [0.73-1] for proximal lesions, 0.86 [0.74-0.97] for the lower leg level, and 0.79 for localization of the proximal extremity of the thrombus. Extension scores evaluated by the two operators were 2.88 and 3.14 respectively, with a coefficient of correlation between the extension scores of 0.96. The 5 diagnostic divergences concerned the lower leg level; the 2 localization discordances concerned: the frontier zones leg-lower popliteal, lower femoral-upper popliteal. Good concordance between results of the two operators using Duplex-ultrasonography exploration was obtained even though the majority of the DVT were in the calf, a region known to be explored with difficulty. Overcoming the operator-dependent character of Duplex-ultrasonography by a rigorous exploratory methodology could make it the future reference examination for the diagnosis of DVT.

Female↗
PubMed1992

[Malaria in the Dunkerque hospital center from December 1979 to December 1990].

Seventy-one cases of malaria were diagnosed in the hospital of Dunkerque from 1979 to 1990. Forty-five patients have been infected in the Comores islands. Among the 24 other imported cases, 17 (71%) have been contaminated in Western or Central Africa. One case of congenital malaria and one of malaria acquired by blood transfusion are also reported. Plasmodium falciparum was detected in 84.5% of the patients. The four human species were found among the Comorians. Two cases with abnormal forms of Plasmodium vivax were observed.

Adolescent↗
PubMed1991

[Spontaneous and instrumental perforations of the thoracic esophagus (non-neoplastic, non-caustic). Apropos of 20 cases].

The authors present twenty cases of spontaneous or instrumental perforation of the thoracic esophagus (neoplastic and caustic perforations excluded). The delay before treatment was less than 24 hours in only one case. Mortality rate was 15%, concerning three patients (three cases of Boerhaave's syndrome) treated by T tube drainage. The contribution of exclusion using stapling technique should increase the indications of direct suture, which remains elective treatment. Esophagectomy retains its indications for perforations with pathologic esophagus or late diagnosis.

Adult↗
PubMed1990

The DISSA: an abridged self-administered version of the DIS. Approach by episode.

The Epidemiological Catchment Area (ECA) program is a major step in psychiatric epidemiology because it uses a structured interview: the Diagnostic Interview Schedule (DIS). This gives psychiatric diagnoses in different diagnostic systems and can be administered by lay interviewers. However many surveys on health-related topics cannot give the time needed to administer the DIS and train the personnel to use such a complex schedule as the DIS. The DISSA is a self-administered abridged form of the DIS and represents an effort to produce a short and simple instrument for three types of diagnoses: major depressive disorder, all anxiety disorders (generalized anxiety, phobias, panic) and alcohol disorders. In this paper we describe the DISSA and give preliminary evidence about its efficiency. This will be done by comparing DISSA results with clinicians judgments, the DIS and a checklist derived from HSC. The DISSA functions in a manner similar to its parent instrument but achieves this in a shorter and less costly mode. Actually the approach by episode used for assessing depression seems to work better than the DIS. Comparisons with the checklist show a clear superiority of the DISSA for depression, alcohol and anxiety disorders but not for generalized anxiety.

Humans↗
PubMed1990

Bacterial translocation in colorectal cancers.

Bacterial translocation, the passage of viable indigenous bacteria from the gastrointestinal tract to the mesenteric lymph nodes and other internal organs, has been poorly studied in man to date. Pericolonic lymph nodes, liver, portal blood, and peritoneum specimens were harvested before antibiotics were administered during 20 operations for colorectal cancer and compared with those obtained in 20 operations for non colorectal conditions. Bacterial translocation, defined as the presence of intestinal bacteria in at least one of the specimens, was found in 13 patients (65 percent) in the colorectal cancer group as compared to 6 (30 percent) in the control group (p less than 0.05). The increased incidence of bacterial translocation in colorectal cancers was mainly due to the presence of bacteria in the pericolonic lymph nodes adjacent to the cancer. These findings suggest that intestinal bacteria translocate from the bowel lumen in a high proportion of patients with colorectal cancer and further stress the need for prophylactic antibiotics in colorectal cancer surgery.

Adenocarcinoma↗