Infections of the eyelid, lacrimal system, conjunctiva, and cornea.
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Bacterial Infections↗
Biomedical subjects
M Durand
Publications and source records attributed to M Durand.
[Intrapetrous cholesteatoma].
Intrapetrous cholesteatomas correspond to lesions extending beyond the classical limits of impairment at the level of the middle ear. This paper analyzes 31 cases of which only 2 are definitely primary, the other 29 probably being secondary. In 5 cases, a cholesteatoma had been previously removed by an open or semi-open technique. Such cholesteatomas, that are found at all ages (from 12 to 74), affect both sexes equally. They are easy to diagnose when the symptomatology combines a history of otitis, damage to facial motoricity, mixed deafness or anacusis and a tympanic aspect of cholesteatoma. They are much more difficult to diagnose in the absence of any facial deficit, of major deafness, and even more so if the tympanum is closed. CT-scanning and MRI now enable a precise study of the nature of the complaint and its extension. Surgical treatment requires full mastery of all the techniques of otoneurosurgery, the procedure depending very much upon the seat and extent of the intrapetrous cholesteatoma.
Adolescent↗
Comparison of dynamic and passive measurements of respiratory mechanics in ventilated newborn infants.
Pulmonary mechanics may differ in intubated and ventilated infants depending on whether they are measured by a dynamic or passive method. The objective of this study was to compare respiratory mechanics measured by a dynamic technique with those obtained by a single-breath occlusion technique in ventilated newborn infants. Thirty-one preterm and 15 term infants (mean +/- SD: gestational age, 29.3 +/- 2.3 and 39.5 +/- 1.4 weeks; birth weight, 1.2 +/- 0.5 and 3.4 +/- 0.4 kg; postnatal age, 12 +/- 13 and 5 +/- 4 days, respectively) were studied. Flows were measured through a pneumotachometer placed between the endotracheal tube and the ventilator circuit: tidal volume by integration of flow, and airway pressure directly with a pressure transducer. Airway occlusion was performed with a Neonatal Occlusion Valve (Bicore pulmonary monitor) at the end of inspiration, and the following relaxed exhalation was analyzed to give passive respiratory system compliance (Crs) and resistance (Rrs). These values were compared with dynamic respiratory system compliance (Cdyn) and dynamic expiratory resistance (Re) obtained with the PEDS system (P) within 1 hour, without an esophageal balloon and on the same ventilator settings. Dynamic respiratory system compliance and resistance measured with the PEDS and the Bicore systems did not differ significantly and were well correlated. Mean Cdyn (P) values in preterm and term infants were 77% and 77% of Crs; the equation of the regression line was Cdyn = 0.75 Crs + 0.02 and Cdyn = 0.78 Crs - 0.02; and standard error of the estimate (SEE) was 0.2 and 0.3 mL/cmH2O with a correlation coefficient (r) of 0.89 and 0.89 (P < 0.0001), respectively. The mean Re(P) values in preterm and term infants were 68% and 64% of Rrs, and the equation of the regression line was Re = 0.3 Rrs + 63 and Re = 0.5 Rrs + 20, with SEE of 25 and 20 cmH2O/L/sec, and r of 0.65 and 0.69 (P < 0.0001, P < 0.005), respectively. The two methods are non-invasive and were well tolerated. We conclude that passive and dynamic respiratory compliance and resistance measured in intubated infants are highly correlated, although the values measured by the passive technique are higher than those obtained by the dynamic technique.
Airway Resistance↗
Immunohistochemical determination of pS2 in invasive breast carcinomas: a study on 942 cases.
To assess the practical prognostic value of pS2, we evaluated its expression by immunohistochemistry in paraffin-embedded tissue from 942 previously untreated invasive ductal carcinomas (IDC) resected in our center between 1980 and 1986. Positive staining of tumor cells was found in 684 cases (73%), but most of the tumors contained only a small amount of positive cells. There was a negative correlation between pS2 and tumor size (p = 0.01) and histological grade (p < 0.0001), and a positive correlation between pS2 and hormonal receptor status (p < 0.001). With respect to overall survival, pS2 positivity was associated with a better prognosis for the whole group and the node-positive sub-group. However, in terms of relapse and metastasis, pS2 was not significant. Furthermore, in multivariate analysis including tumor size, nodal status, histological grade, ER status, PR status, chemotherapy, hormonal treatment, and pS2, the latter appears to be of no prognostic value.
Adult↗
The prognostic value of c-erbB2 in primary breast carcinomas: a study on 942 cases.
To assess the practical prognostic value of c-erbB2, we performed a study on 942 invasive ductal carcinomas treated with primary surgery between 1980 and 1986 in our center. We evaluated its expression by immunohistochemistry in paraffin-embedded tissue using a polyclonal antipeptide antibody. Of 942 tumors, 229 (24%) showed a positive membrane staining. We observed a significant association between c-erbB2 and Scarff-Bloom-Richardson grading (p < 0.0001) and a negative correlation between c-erbB2 and both estrogen and progesterone receptors (p < 0.0001). In our analysis, with respect to overall survival (OS), relapse-free survival (RFS), and metastasis-free survival (MFS), c-erbB2 was statistically significant (p < or = 0.0001) for the whole group and the node-positive subgroup. In multivariate analysis, c-erbB2 appeared to be an independent variable for RFS and MFS in the node-negative group. However, in our hands, c-erbB2 had a poor prognostic value in comparison with the classical prognostic variables such as histological grade, nodal status (N), hormonal receptor status (estrogen and progesterone receptors), and tumor size, and it did not supersede the classical parameters.
Adult↗
Prognostic value of p53 in breast invasive ductal carcinoma: an immunohistochemical study on 942 cases.
P53 immunohistochemical detection using DO7 antibody on 942 cases of previously untreated breast invasive ductal carcinoma (IDC) with a median follow up of 117.9 months (89 to 160) was performed. Three hundred and three (32%) tumors were positive. All positive tumors were taken into account, positivity ranging from 1 to 100% of tumoral cells. The Chi square test showed significant negative correlation between p53 positivity and age (p = 0.01), estrogen receptor status (p < 0.0001), and progesterone receptor status (p = 0.0005), and significant positive correlation with tumor grade according to the Scarff, Bloom and Richardson system (SBR Grade) (p < 0.0001). There was no significant association with tumor size or nodal status. Concerning the univariate analysis, in the whole group and node-positive group (n = 544) p53 positivity was highly significant for overall survival (OS) (p < 0.0001 and p = 0.0003), disease-free interval (DFI) (p = 0.0001 and p = 0.0005), and metastasis-free interval (MFI) (p < 0.0001 and p = 0.0003). In the node-negative group (n = 398), p53 was significant with respect to OS (p = 0.01) and DFI (p = 0.04). P53 positivity came out as an independent prognostic parameter in the multivariate analysis in the whole group and the node-positive group, though of minor significance compared to axillary lymph node status, SBR grade, progesterone receptor status and tumor size.
Adult↗
[Prediction of respiratory complications after surgery of the abdominal aorta].
The most frequent type of complication in patients undergoing aortic surgery is respiratory. Preoperative lung function (PFT) and arterial blood gas measurement (ABG) are often carried out to assess the risk more precisely. The aim of the present retrospective study was to determine which value of lung function test could identify patients who developed such complications. "Receiver Operating Characteristic" (ROC) curves and the area beneath the curve for the diagnosis of respiratory complications were calculated for each variable of PFT and ABG. The greatest Youden index for each variable was chosen as indicative pulmonary function criterion of increased risk of pulmonary complications. One hundred and ninety-five patients (age: 65 +/- 10 years) were included. Respiratory complications occurred in 15% of patients. Respiratory complications increased from 12% if the vital capacity (VC) was > or = 77% of the predicted value to 35% if the VC was < 77% (P = 0.002), and from 10% if the FEV1 was > 76% to 34% if the FEV1 was > or = 76% (P = 0.0005). A decreased PaO2 or increased PaCO2 was not correlated with an increased incidence of respiratory complications. Length of stay in ICU or in hospital were increased when VC or FEV1 were low. Frequency of pulmonary complications was 9% in patients without PFT abnormalities, 16% in patients with either diminished VC or FEV1 and 35% in patients with both lowered VC and FEV1. However, all the areas under the ROC curves were < 0.7 and the sensitivity of the different variables was low. It is concluded that routine preoperative PFT and ABG cannot predict respiratory complications after abdominal aortic surgery.
Aged↗
Development of scales to measure perceived physical education class climate: a cross-national project.
Motivational research in the classroom has adopted a social cognitive perspective but has mainly been restricted to the study of individual achievement cognitions. In addition to this, there is a need to study and assess the perception children have of the class climate. Using social cognitive theory as a base, this research reports the development of class climate scales in French and English for use in physical education classes. Psychometric development with the French scale was shown to be satisfactory, including adequate factorial structure assessed by exploratory and confirmatory factor analysis (CFA), and good internal and test-retest reliability. A parallel English scale demonstrated a less adequate fit to the proposed model when using CFA, but shortened scales assessing just mastery and performance dimensions of climate were shown to predict important motivational measures in a structural equation modelling analysis.
Adolescent↗
[Allografts in otology. Potential risk of prion contamination. Current status of knowledge and legislation].
The potential risk of prion contamination has led the government authorities to stop the use of dura mater allografts of human origin. The aim of this work was to determine the potential risk for implantation of allografts in otology and to review the current reglementation. Although Creutzfeldt-Jakob's disease has not been reported to be transmitted by these allografts and despite the apparently rigorous decontamination methods used by the manufacturers which meet the most severe international recommendations, it is apparently necessary to stop implantation for the time being. This decision has resulted from the lack of a precise directive from the governmental authorities and the uncertainty about prion transmission and the reel effect of inactivation procedures.
France↗
Effects of early dexamethasone therapy on pulmonary mechanics and chronic lung disease in very low birth weight infants: a randomized, controlled trial.
OBJECTIVE: To determine the changes in pulmonary mechanics before and during early dexamethasone therapy, and to evaluate the effect of dexamethasone on the duration of mechanical ventilation in very low birth weight (VLBW) ventilator-dependent infants at risk for chronic lung disease (CLD). METHODS: A prospective randomized trial was conducted. Forty-three patients (birth weight 600 to 1500 g, gestational age 24 to 32 weeks) who failed to be weaned from the respirator at 7 to 14 days of age were enrolled; 23 infants received a 7-day course of dexamethasone (0.5 mg/kg/day intravenously for 3 days, 0.25 mg/kg/day for 3 days, and 0.1 mg/kg/day for 1 day), and 20 patients were in the control group. At similar mean airway pressure (MAP) and fractional inspired oxygen concentration (FiO2), respiratory system mechanics were measured before and on days 2, 5, and 7 of the study. Airway pressure, flow and tidal volume (VT) were recorded and only mechanical breaths were analyzed. Respiratory compliance (Crs) and respiratory resistance (Rrs) were calculated by two factor least mean square analysis. RESULTS: Eighty-three percent of infants in the dexamethasone group and 90% in the control group received surfactant in the first 24 hours of life. There was a significant increase in Crs and VT in the dexamethasone group as compared with the control group (P < .001). No major changes in Rrs were observed. Dexamethasone therapy significantly decreased FiO2 and MAP P < .001) and facilitated successful weaning from mechanical ventilation. In addition to a shorter duration of mechanical ventilation (P < .01), the occurrence of CLD (FiO2 > 0.21 at 36 weeks of corrected gestational age, chest radiograph changes) was significantly decreased in the dexamethasone group (P < .01). Except for a transient increase in blood pressure and serum glucose, there were no significant differences in infection rates, intraventricular hemorrhage, or retinopathy of prematurity. Thirteen patients in the control group received dexamethasone at a later age. CONCLUSIONS: Our findings indicate that: 1) early dexamethasone therapy in VLBW infants markedly improves respiratory compliance and tidal volume, reduces FiO2 and MAP requirements, and facilitates extubation in these infants; 2) early dexamethasone therapy reduces the duration of mechanical ventilation and decreases CLD (at 28 days and 36 weeks) in a population of VLBW infants largely treated with surfactant.
Chronic Disease↗
Los Angeles County-University of Southern California Medical Center clinical pathology case conference: extreme hypermagnesemia in a neonate.
A preterm male infant born at 33 weeks of gestation developed respiratory depression and apnea at approximately 20 h after birth. Laboratory tests indicated severe hypermagnesemia, acidosis, and hypercalcemia. Cord blood and maternal blood concentrations of magnesium were normal. The effects and possible causes of hypermagnesemia are reviewed. The infant recovered with treatment, although the etiology of his hypermagnesemia remains unknown.
Acidosis↗
Neonatal pulmonary mechanics and oxygenation after prophylactic amnioinfusion in labor: a randomized clinical trial.
OBJECTIVE: Amnioinfusion has been reported to improve the perinatal outcome of pregnancies complicated by decreased amniotic fluid volume, but detailed information on its possible adverse effects on neonatal pulmonary mechanics and oxygenation is not available. STUDY DESIGN: We evaluated 42 infants with birth weights of 2600 to 4320 g and gestational ages of 36 to 44 weeks, who were born to mothers enrolled in a prospective, randomized trial of amnioinfusion for oligohydramnios in labor. Maternal entry criteria were gestational age 36 weeks or older, estimated fetal weight more than 2500 g, oligohydramnios defined as an amniotic fluid index of 5 cm or less, and a normal fetal heart rate pattern. Evaluation of pulmonary mechanics and oxygen saturation (SaO2) was done with the infants breathing room air between birth and day 3 of life. Transpulmonary pressure, flow, and tidal volume were recorded simultaneously, and pulmonary resistance and lung compliance were calculated. SaO2 was measured for 30 minutes with the Nellcor N-200 oximeter and IBM computer oximetry software. RESULTS: Evaluation of the data revealed no significant difference between the two groups for tidal volume, lung compliance, pulmonary resistance, or work of breathing. There were no differences between the two groups in the number of desaturation episodes or in percent of desaturations to less than 90%, 85%, or 80% SaO2. CONCLUSION: Prior studies have shown amnioinfusion to improve perinatal outcome. Our findings demonstrate that amnioinfusion for oligohydramnios in labor does not adversely affect neonatal pulmonary mechanics or oxygenation.
Amnion↗
Energy expenditure and cardiorespiratory responses at the transition between walking and running.
We investigated whether the spontaneous transition between walking and running during moving with increasing speed corresponds to the speed at which walking becomes less economical than running. Seven active male subjects [mean age, 23.7 (SEM 0.7) years, mean maximal oxygen uptake (VO2max), 57.5 (SEM 3.3) ml.kg-1.min-1, mean ventilatory threshold (VTh), 37.5 (SEM3) ml.kg-1.min-1] participated in this study. Each subject performed four exercise tests separated by 1-week intervals: test 1, VO2max and VTh were determined; test 2, the speed at which the transition between walking and running spontaneously occurs (ST) during increasing speed (increases of 0.5 km.h-1 every 4 min from 5 km.h-1) was determined; test 3, the subjects were constrained to walk for 4 min at ST, at ST +/- 0.5 km.h-1 and at ST +/- 1 km.h-1; and test 4, the subjects were constrained to run for 4 min at ST, at ST +/- 0.5 km.h-1 and at ST +/- 1 km.h-1. During exercise oxygen uptake (VO2), heart rate (HR), ventilation (VE), ventilatory equivalents for oxygen and carbon dioxide (VE/VO2, VE/VCO2), respiratory exchange ratio (R), stride length (SL), and stride frequency (SF) were measured.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Interaction of Hoechst 33258 with a DNA triple helix.
The interaction of Hoechst 33258 molecule, a minor groove binding drug, with T-A-T triple helix and A-T double helix was studied using circular dichroism spectroscopy and thermal denaturation. The triple helix consisted of an oligonucleotide (dA)12-x-(dT)12-x-(dT)12, where x is a hexa-ethylene glycol chain bridged between the 3' phosphate of one strand and the 5' phosphate of the following strand. This oligonucleotide is able to fold back on itself to form a very stable triplex. Circular dichroism spectroscopy demonstrates that Hoechst 33258 can bind to the triple helical structure. Spectral analysis shows that the bound drug exhibits a conformation and an environment slightly different in double-stranded and in triple-stranded structure. The affinity to the triple stranded structure is found smaller than to the double stranded one. Thermal denaturation experiments demonstrate that Hoechst 33258 destabilizes the triplex whereas it stabilizes the duplex.
Bisbenzimidazole↗
Berenil complexation with a nucleic acid triple helix.
The interaction of berenil molecule, a minor groove binding drug, with T-A-T triple helix and A-T double helix was studied using circular dichroism spectroscopy and thermal denaturation. The triple helix was made by an oligonucleotide (dA)12-X-(dT)12-X-(dT)12, where x is a hexaethylene glycol chain bridged between the 3' phosphate of one strand and the 5' phosphate of the following strand. This oligonucleotide is able to fold back on itself to form a very stable triplex. Circular dichroism spectroscopy demonstrates that berenil can bind to the triple helical structure. Spectral analysis shows that in the same ionic strength the drug bound to a double-stranded structure exhibits a conformation and an environment close to those observed in triple-stranded structure. The influence of the ionic strength on the interaction between the berenil molecule and the 36-mer is clearly demonstrated. We showed that when no NaCl salt is added in the buffer the triplex form of (dA)12-X-(dT)12-X-(dT)12 is stabilized by berenil whereas it is destabilized slightly by the dye when NaCl concentration is 1 M.
Base Sequence↗
Phase I study of retelliptine dihydrochloride (SR 95325 B) using a single two-hour intravenous infusion schedule.
Retelliptine dihydrochloride (SR 95325 B, NSC D-626717-W) is an ellipticine derivative having a very high level of antitumor activity in resistant murine solid tumor models. We studied in a Phase I trial escalating doses of retelliptine using a single 2-hour IV infusion schedule. Data from other Phase I studies allowed a starting dose of 80 mg/m2 and a rapid dose escalation. Included were 15 patients (M/F = 13/2) with a median age of 55 (range: 17-72). There were 22 courses delivered at the following dose levels: 80, 180, 700, 900, 1,200, and 1,500 mg/m2. Primary tumor types were kidney (6 patients), colon (3 patients), pancreas (2 patients), and others (4 patients). Mild dose-related visual troubles (blurring, accommodation troubles, oculomotor paresis) occurred in 9/11 patients starting from 700 mg/m2. Asymptomatic EKG anomalies, including significant prolongation of PR and QRS intervals occurred at 1500 mg/m2 (in 3/3 patients) marking the maximum tolerated dose. Both visual and EKG anomalies were spontaneously reversible few minutes to few hours after the end of infusion. Other possible drug-related toxicity occurred sporadically such as somnolence, bronchospasm, dry mouth, and vomiting (2 patients each). There were no significant laboratory anomalies. Neither drug-related deaths nor objective complete or partial responses were observed. The recommended dose for Phase II trial using the 2-hour intravenous infusion schedule is 1,200 mg/m2.
Adolescent↗
Competition between reductive acetogenesis and methanogenesis in the pig large-intestinal flora.
Washed bacterial suspensions obtained from the pig hindgut were incubated under 13CO2 in a buffer containing NaH13CO3 and carbohydrates. Incorporation of 13C into short chain fatty acids was assayed by quantitative nuclear magnetic resonance. The effects of different levels of H2 added to the gas phase (0, 20 and 80% v/v) and of the specific methanogenesis inhibitor 2-bromoethane-sulphonic acid (BES) were determined. In control incubations increasing the concentration of H2 markedly increased methane production. Single- and double-labelled acetate and butyrate were formed in all incubations. In the absence of BES, increasing H2 significantly increased the incorporation of 13CO2 into butyrate and the proportion of double-labelled acetate in total labelled acetate. The addition of BES proved to be very successful as a methane inhibitor and greatly enhanced the amount of mono- and double-labelled acetate, especially at the highest H2 partial pressure. The results suggest that methanogenesis inhibited both routes of reductive acetogenesis, i.e. the homoacetate fermentation of hexose (represented for the most part by single labelling) and the synthesis of acetate from external CO2 and H2 (represented mostly by double labelling). A highly significant interaction between BES and H2 concentration was observed. At the highest pH2 BES increased the proportion of labelled acetate in total acetate from 17.1% for the control to 50.9%. It was concluded that although acetogenesis and methanogenesis can occur simultaneously in the pig hindgut, reductive acetogenesis may become a significant pathway of acetate formation in the absence of methanogenesis.
Acetates↗
Susceptibility of multiresistant serotype 012 Pseudomonas aeruginosa to fosfomycin in combination with other antibiotics.
Serotype 012 represented 15% of 244 isolates of Pseudomonas aeruginosa isolated in the hospital over a 2 year-period and most isolates of this serotype were resistant to multiple antibiotics. Combination experiments showed that fosfomycin and amikacin together were active against 92% of 012 isolates. It is recommended that serotyping be used systematically to identify 012 strains rapidly and fosfomycin/amikacin be considered as a presumptive antipseudomonal therapy in 012 infections.
4-Quinolones↗