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Biomedical subjects

M David

Publications and source records attributed to M David.

At least 415 records · Page 23Linked to original sources
PubMed1990

[Pelvic arteriovenous fistula after ligation of the spermatic cord].

The authors report the case of a 40 year old man undergoing left orchiectomy for Leydig cell tumour. Eight months later, the patient presented with a thrill in the left femoral triangle which angiography revealed to be due to a voluminous pelvic arteriovenous fistula arising at the expense of the left hypogastric artery, especially the arteries supplying the external genitalia. Surgical repair of the arteriovenous fistula was performed without prior embolisation. This haemorrhagic surgery was facilitated by the use of a blood recovery apparatus. The immediate postoperative course was uneventful and follow-up angiography one year later showed perfect stability of the result. This case offers an occasion to recall the risks of fistula during massive ligation of arteriovenous pedicles even in the case of small pedicles which should be treated with the same preventive approach as for the renal or splenic pedicle, i.e. separate ligation of the arterial and the venous element.

Adult↗
PubMed1990

[Pulmonary metastasis with left intra-atrial extension of liposarcoma. Apropos of a case].

The direct extension of a neoplastic thrombus of the pulmonary veins into the left atrium is extremely rare. The authors report the case of a pulmonary metastasis from a liposarcoma of the thigh extending into the pulmonary veins and prolapsing into the left atrium. The patient was successfully treated by tumorectomy under cardiopulmonary bypass then by left upper lobectomy.

Adult↗
PubMed1990

[Incomplete androgen insensitivity syndrome. Difficulties of diagnosis and management].

A familial form of incomplete androgen insensitivity syndrome (AIS) is reported. The index case was first seen at 9 months of age for ambiguous genitalia. Diagnosis of AIS, suspected but first discarded on the basis of an androgen sensitivity test, was finally made at puberty on the discordance between poor virilization and elevated levels of both testosterone and LH, a florid gynecomastia, and the exclusion of any enzymatic defect in testosterone biosynthesis of 5 alpha-reductase deficiency. Androgen receptors in public skin were within the limits of normal for total number, with normal affinity. Familial occurrence included 2 first cousins born 7 and 10 years later, a maternal grand-uncle with similar ambiguous genitalia, and a maternal uncle with the gynecomastia-preserved fertility syndrome. This case report illustrates the heterogeneity of AIS in a given family and the difficulty of and early positive diagnosis in a newborn presenting with sexual ambiguity.

Body Height↗
PubMed1990

[Relay chemotherapy using continuous perfusion of cisplatin and fluoro-uracil in advanced cancer of the breast. Analysis of a series of 50 cases].

Fifty patients with advanced breast cancer (21 undergoing first and second stage palliative treatment: group 1, and 29 undergoing stage three or more: group 2), were included in a phase II trial with administration of a combination relay chemotherapy consisting of cisplatin (100 mg/m2/day) and fluorouracil (1,000 mg/m2/day), in continuous perfusion during 4 days, in cycles of five days repeated every three weeks (mean duration: 12 weeks). Toxicity was frequent and severe (a total of 17 treatments discontinued, and five deaths, 3 in group 1, 2 in group 2). The main manifestations of intolerance were threefold: haematological and leucopenia, in almost half of the patients, including 2 severe with 1 case of infectious complication and 4 thrombopenias requiring discontinuation of the treatment, including 2 with a severe haemorrhagic syndrome; cardiovascular, with three deaths due to heart failure; renal, most of the time laboratory tests disorders with 1 clinical syndrome. An objective response of more than fifty p. cent was obtained in five patients in group 1 (29.4%) and 3 patients in group 2 (11.1%); it lasted an average of 6.5 months and varied according to the locations: nodes (43%), liver (40%), pleuro-pulmonary (22%). Responses were obtained (13%) for lesions which resisted to previous chemotherapy. Five patients (14%) presented a functional improvement. The survival (mean = 4.8 months) was correlated, in group 1, to initial life conditions (p = 0.01) and was longer in group 1 for menopausal patients who had well tolerated the treatment (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Interleukin-6 is the major regulator of acute phase protein synthesis in adult human hepatocytes.

The three monokines interleukin-1 beta (IL-1 beta), tumor necrosis factor alpha (TNF alpha), and interleukin-6 (IL-6) modulate acute phase plasma protein synthesis in adult human hepatocytes. Only IL-6 stimulates the synthesis of the full spectrum of acute phase proteins as seen in inflammatory states in humans, i.e. synthesis and secretion of C-reactive protein, serum amyloid A, fibrinogen, alpha 1-antitrypsin, alpha 1-antichymotrypsin and haptoglobin are increased while albumin, transferrin and fibronectin are decreased. IL-1 beta as well as TNF alpha, although having a moderate effect on the positive acute phase proteins and inhibiting the synthesis of fibrinogen, albumin and transferrin, fail to induce serum amyloid A and C-reactive protein. These data suggest that IL-6 plays the key role in the regulation of acute phase protein synthesis in human hepatocytes.

Acute-Phase Proteins↗
PubMed1989

fixK, a gene homologous with fnr and crp from Escherichia coli, regulates nitrogen fixation genes both positively and negatively in Rhizobium meliloti.

Nitrogen fixation genes are shown to undergo a complex positive and negative regulation in Rhizobium meliloti. Activation of fixN by fixLJ is shown to require a third regulatory gene, fixK. As fixK is activated by fixLJ, we propose a cascade model for fixN regulation such that fixLJ activates fixN via fixK. In addition fixK negatively regulates expression of the nif-specific activator nifA as well as its own expression by autoregulation. Thus nifA and fixK are subject to a mixed regulation, positive (by fixLJ) and negative (by fixK). The sequence of fixK shows homology with the Escherichia coli regulators fnr and crp, which makes fixK the third characterized member of this family of prokaryotic regulators.

Amino Acid Sequence↗
PubMed1989

Phospholipid content and fatty acid composition of human heart.

Phospholipid content and fatty acid composition of human heart were determined on 36 biopsy specimens collected during open heart surgery. The main phospholipid classes, phosphatidylcholine (PC), phosphatidylethanolamine (PE), diphosphatidylglycerol (DPG), and sphingomyelin (SPH) were separated by HPLC, quantified, and converted to fatty acid methyl esters which were chromatographed on capillary GLC columns. Sex and age (mainly 40-70) of patients had no significant influence on the relative distribution of phospholipid classes and only a slight effect on fatty acid composition. Incorporation of trans 18:1 in phospholipid classes was low. cis and trans octadecenoic isomers seemed to be selectively incorporated, the delta 9 and delta 11 cis or trans isomers being predominant. Human and rat data were compared, and some species differences were noticed. In human PC, palmitic acid is higher and stearic acid much lower than in rat PC. Saturated dimethyl acetals (16:0 and 18:0) in PC and PE were greater for humans. Incorporation of 20:4 n-6 in human PE is higher than in rat PE.

Adolescent↗
PubMed1989

17 alpha-ethinylestradiol decreases production and release of prostacyclin in cultured human umbilical vein endothelial cells.

Human umbilical vein endothelial cells (HUVEC) were incubated with the estrogen 17 alpha-Ethinylestradiol (30 ng/ml) in order to examine its regulating influence on synthesis and release of prostacyclin (PGI2). ATP (1 mg/ml) was used to stimulate PGI2-production through the purine receptors. We demonstrated that this level of estrogen decreases PGI2-synthesis by 11% and PGI2-release by 32% within 300 sec. Longer incubation times (48 hrs) resulted in the same inhibitory effect. Intracellular ATP content and methyl-3H-thymidine uptake demonstrated that the decrease of prostacyclin-concentration is not caused by reduced viability of the cells but by a direct inhibitory effect on prostacyclin synthesis and release.

Adenosine Triphosphate↗
PubMed1989

Palmoplantar psoriasis: experience with 8-methoxypsoralen soaks plus ultraviolet A with the use of a high-output metal halide device.

The use of 8-methoxypsoralen water soaks plus ultraviolet A was evaluated retrospectively in 11 patients with moderate to severe palmoplantar psoriasis that had been resistant to previous topical therapies. Patients received twice- or thrice-weekly 30-minute hand and/or foot soaks in 8-methoxypsoralen, 2.5 mg/L, followed by UVA irradiation. The condition of one patient cleared completely, and seven showed good improvement. The range of treatments required for maximal improvement was 14 to 43 with a mean of 28. The range of maximum UVA dosage per treatment was 3.5 to 17.5 joules/cm2, and the range of cumulative UVA required for maximal improvement was 45 to 388 joules/cm2 with a mean of 165 joules/cm2. The mean serum level of 8-methoxypsoralen 60 minutes after completion of hand and foot soaks was 2.5 +/- 0.5 ng/ml compared with 95.75 +/- 10.43 ng/ml after oral 8-methoxypsoralen, 0.5 mg/kg. In our experience this treatment has been a safe and relatively effective form of therapy for resistant palmoplantar psoriasis.

Adult↗
PubMed1989

Psoriasis therapy: comparative studies with a hydrocolloid dressing, plastic film occlusion, and triamcinolone acetonide cream.

The efficacy of a new hydrocolloid dressing occlusion, alone or with 0.1% triamcinolone cream, was compared with triamcinolone acetonide alone or under plastic film occlusion in the treatment of localized plaque-type psoriasis. Thirty-eight patients were randomly assigned to one of four bilateral, paired-comparison treatment groups. Patients underwent 3 weeks of treatment, after which they were followed up for an additional week. After 3 weeks hydrocolloid occlusion with triamcinolone acetonide yielded a significantly better response than the cream alone or the hydrocolloid dressing alone, but the new dressing was comparable to a plastic film occlusive dressing of triamcinolone acetonide. After discontinuation of treatment, however, the sites that had been treated with hydrocolloid-occluded triamcinolone acetonide retained the better results. Topical steroids under hydrocolloid occlusive dressing may be a useful alternative to steroids alone for treatment of localized recalcitrant psoriasis.

Administration, Topical↗
PubMed1989

Keratosis lichenoides chronica with prominent telangiectasia: response to etretinate.

A 65-year-old man with a chronic pruritic lichenoid eruption with telangiectasia is presented. Histologic findings consisted of a lichenoid reaction with many dilated dermal capillaries. Treatment with oral etretinate resulted in considerable improvement. We believe that our patient had a vascular variant of keratosis lichenoides chronica.

Aged↗
PubMed1989

The ADONIS experiment.

The background to the setting up and implementation of the ADONIS project is described. Ways in which ADONIS might benefit both document supply centres and smaller organizations such as biomedical libraries are suggested. Particular attention is paid to economic considerations.

Commerce↗
PubMed1989

Prenatal treatment in congenital adrenal hyperplasia due to 21-hydroxylase deficiency: up-date 88 of the French multicentric study.

A multicentric study of prenatal treatment of congenital adrenal hyperplasia (CAH) resulting from 21-hydroxylase deficiency in 43 pregnancies at risk for CAH is presented. The mothers were given dexamethasone per os, 0.5 mg either 12-hourly or 8-hourly. From the analysis of the results obtained in the present study and review of the literature, it would appear that the first condition for successful prevention of female virilization in utero (a total of 6 cases) is to start treatment as early as possible, no later than the 7th week. The dose of dexamethasone should be related to maternal size: 20 micrograms/kg/day (in 2 or 3 fractioned) doses would seem to be both efficient and safe. Adrenal suppression of both maternal and fetal adrenal function should be controlled by appropriate hormonal determinations. Finally, the advantages of early prenatal diagnosis or no prenatal diagnosis are discussed.

Adrenal Hyperplasia, Congenital↗
PubMed1989

The usefulness of immunofluorescent tests in pemphigus patients in clinical remission.

Direct and indirect immunofluorescent studies (DIF, IIF) were performed on 24 pemphigus vulgaris patients who were in a state of clinical remission. The tests were repeated after an interval of 6 months. All the patients were on maintenance therapy with oral prednisone. The DIF in eight patients showed negative results among whom seven remained negative. Six patients out of 24 showed weakly positive fluorescence and ten patients showed strong positive fluorescence. The IIF was negative in 17 patients and positive in seven patients who also showed positive DIF. During a follow-up period of 20 months, one of eight patients with negative DIF relapsed compared with two of six patients with weak positive DIF and five of 10 patients with strong DIF. Five patients with strong DIF for IgG also had C3, of whom three relapsed, compared with five of 19 patients who were negative for C3. Four of seven patients with positive IIF relapsed compared with four of 17 with negative IIF. It is suggested that repeated DIF tests in pemphigus patients, who are in clinical remission, may serve as an indicator for the immunological activity and be of help in the management of these cases.

Adult↗