Search PubMed⌕ Search

Biomedical subjects

M Kessler

Publications and source records attributed to M Kessler.

At least 181 records · Page 10Linked to original sources
PubMed1995

[Connectology for treatment by peritoneal dialysis for chronic renal insufficiency].

With the exception of the simple Luer or Spike type systems all of the presently used CAPD devices have a system for intraluminal sterilization and/or an handling assist device. The sterilizing process can be chemical (antiseptics), physical (heat or ultraviolet (UV) light) or mechanical (flush effect). Studies comparing various peritoneal dialysis devices have led to results which diverge greatly, and are not always controlled. Synthesis of these studies shown that disconnect systems (DS) seemed to be not more effective against bacteriological contamination than the last generations of UV non-disconnect (NDS) systems. Efficacy of heat sterilization NDS must be confirmed. The choice of a NDS does not result only from a medical indication.

Humans↗
PubMed1995

Risk factors for bacterial infections in chronic haemodialysis adult patients: a multicentre prospective survey.

All adult patients from 13 dialysis centres were prospectively followed up for 6 months in an attempt to appraise the current risk factors for bacterial infections in stable chronically haemodialysed patients. Parameters recorded as potential risk factors for BI were age, gender, cause of renal failure, time elapsed since the start of dialysis, history of transplantation, recent surgical procedure, previous bacterial infection, current immunosuppressive or erythropoietin therapy, type of angioaccess device, and serum ferritin level. Six hundred and seven patients (mean age 56.5 years, range 18-85) were enrolled in the study. Mean time elapsed since the start of dialysis was 4.7 years. One hundred and eighteen patients had developed at least one bacterial infection during the study period whereas 489 had remained free of bacterial infection at the end of the follow-up. In multivariate analysis three parameters were found to be significant and independent risk factors for bacterial infection: previous history of bacterial infection (at least one versus no previous episode), type of angioaccess device (catheter versus native fistula), and elevated serum ferritin level (greater versus lower than 500 micrograms/l). These results support the evidence that impaired host defences in chronic haemodialysis patients may be secondary to the dialysis procedure and suggest that the incidence of bacterial infection in these patients may be further reduced by appropriate supportive therapy.

Adolescent↗
PubMed1995

[Diagnosis of the site and extent of breast carcinoma].

The value of X-ray-mammography, ultrasound, and MRI are compared with regard to their results in localization, differential diagnosis, and staging of carcinomas of the breast. For microcalcifications that are only imaged by mammography, X-ray is superior to the other imaging modalities and remains method of choice. Ultrasound is the most useful to differentiate cystic and solid lesions. The value of MRI is not yet proved sufficiently except in conservative and plastic surgery of breast carcinoma.

Biopsy↗
PubMed1995

Elevated body lead burden from drinking water in end-stage chronic renal failure.

Delta aminolaevulinic acid dehydratase (ALA-D) who assayed in 66 patients with end-stage renal failure who live in a region where there is a high risk of lead poisoning from drinking water (Vosges mountains). Sixty patients received dialysis and six underwent renal transplantation. Results were compared to those obtained in 366 control subjects with normal renal function hospitalized in a department of Internal Medicine and living in the same geographical area. The ALA-D level was significantly lower in dialysed patients (0.40 +/- 20) than in controls (0.57 +/- 0.31) (P = 0.0014). Transplant recipients had ALA-D levels comparable to subjects with normal renal function (0.59 +/- 0.37). In this high-risk population an EDTA test was performed in 74 subjects (with normal renal function and 17 dialysis patients in combination with haemofiltration for the latter patients. In the two study groups a negative correlation was found between ALA-D and the amount of lead chelated during the 24 h following administration of EDTA (r = -0.77 and -0.88 respectively). In subjects who live in an area of endemic lead poisoning, the incidence of elevated body lead burden from drinking water was similar in the group with normal renal function and in the group of dialysed patients (18.6 and 8.3% respectively). This study shows (i) that in dialysis patients, measurement of ALA-D represents an accurate screening test for lead overload, provided that the lower threshold of normal is lowered from 0.40 to 0.20, and (ii) that diagnosis and treatment are possible by administering EDTA in conjunction with haemofiltration or CAPD.

Aged↗
PubMed1995

[Diagnosis of tumors by needle aspiration cytology].

Fine needle aspiration cytology is considered an adequate method fulfilling the requirements for an early, minimal invasive, and simple to perform diagnostic technique for malignancies. Its establishment in human medicine is the basis for propagation of this method in veterinary medicine. This paper describes the technique of performing a fine needle aspiration and gives guidelines for the interpretation of cytologic samples. Indications, limitations and contraindications of aspiration cytology are discussed.

Animals↗
PubMed1994

A centrally active drug that modulates AMPA receptor gated currents.

Systemic administration of the drug 1-(1,3-benzodioxol-5-ylcarbonyl)-piperidine (1-BCP) has been reported to enhance monosynaptic responses in the hippocampus in vivo and to improve spatial and olfactory memory in rats. The drug's mechanism of action was investigated in the present study using membrane patches excised from cultured hippocampal slices. The decay time of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor mediated inward currents was greatly increased by 1-BCP in a concentration dependent and reversible fashion; peak current was also enhanced but to a lesser degree. In vitro slice experiments indicated that the drug has parallel effects on the field EPSP. It is concluded that 1-BCP is a centrally active modulator of the AMPA receptor.

6-Cyano-7-nitroquinoxaline-2,3-dione↗
PubMed1994

[Epidemiology and results of organ grafts].

Using the complete, multicentric Registry of organ transplantation in France, from 1970 to 1992, including 26,485 transplantations (kidney, heart, heart-lungs, lungs, liver), we studied four statistical parametres: 1. movement on the waiting list; 2. mean waiting time; 3. actuarial survival of the graft for the kidney, heart and liver; 4. number of recipients surviving with a functioning graft as of 31 December 1992. Patients awaiting a kidney transplant comprise a group that differs epidemiologically from the others on the basis of the length of the waiting list, entering and existing flux, and for the mortality rate of patients waiting for a graft. Similarly, the actuarial survival profile is different for the first year in kidney transplant recipients compared to the others.

France↗
PubMed1994

Stimulation of NMDA receptors activates calpain in cultured hippocampal slices.

The hypothesis that intense stimulation of NMDA receptors activates calpain was tested in long-term cultures of hippocampus. Slices prepared from 10-day-old rats were maintained for periods of up to 6 weeks and then assayed for a stable breakdown product that results from the proteolysis of spectrin by calpain. The breakdown product increased dramatically during the first 24 h after tissue preparation and then decreased to a low level that remained unchanged for weeks. NMDA caused a 2- to 3-fold increase in breakdown product that rose linearly with time (5-30 min) and was blocked by the receptor antagonist MK-801. The effect of NMDA was the same throughout the culture period and was dependent upon the concentration of extracellular calcium with no effect at 2 mM and maximal effect at 4 mM calcium. These results indicate that rapid activation of calpain occurs in undamaged hippocampal neurons following stimulation of NMDA receptors.

Animals↗
PubMed1994

Kainate binding to the AMPA receptor in rat brain.

Displacement of [3H]AMPA and [3H]CNQX by kainate was measured in membranes and solubilized fractions from rat brain. In soluble fractions, plots of [3H]AMPA and [3H]CNQX binding displaced by kainate resulted in one-site fits with Ki values in the range of 1-3 microM. In membranes, plots of [3H]AMPA binding displaced by kainate resulted in graphs which were better fit by two-site regression analysis than by a one-site fit. The Ki value for the high-affinity component of these two-site fits was 3-9 microM and the low-affinity component Ki was in the range of 70-120 microM; similar values were determined for kainate displacement of [3H]CNQX. The presence of thiocyanate ions had no effect on kainate displacement of [3H]CNQX. Since the affinity for kainate of the presumed synaptic AMPA receptor is in the range of EC50 values for kainate determined from physiological studies, these data contribute further evidence for the idea that kainate binding to synaptic AMPA receptors may be responsible for many of kainate's physiological effects.

6-Cyano-7-nitroquinoxaline-2,3-dione↗
PubMed1994

[Mesangial IgA deposits nephropathy].

Idiopathic IgA nephropathy of Berger's disease is characterized by prominent and diffuse IgA deposits in the mesangium. In many countries, it is the most common type of primary chronic glomerulonephritis. Typically, it is revealed by recurrent episodes of gross hematuria in association with ENT infection, but it can progress insidiously with microscopic hematuria and proteinuria. Serum IgA levels are increased in about 50% of cases. IgA nephropathy is not a minor condition: 20% of patients develop end-stage chronic renal failure 10 years after diagnosis and 50% after 20 years. IgA nephropathy can recur in a transplanted kidney suggesting that this disease is a systemic disorder although it has a remarkable tropism for the kidney. Even though many points remain to be elucidated, its pathogenesis appears to be linked to a genetic factor responsible for a lymphocyte dysfunction and an acquired environmental factor such as penetration of an antigen via the mucosa which may give rise to an excessive and inappropriate IgA immune response with the deposition of IgA in the mesangium and the development of progressive renal alterations. No treatment has been shown to be effective but tonsillectomy advised in case of a recurrent tonsillar focal infection is most often accompanied by a decrease in the incidence of gross hematuria. Corticosteroid therapy can be of benefit in cases involving a nephrotic syndrome associated with minimal glomerular lesions. In all cases, control of possible hypertension is of value in slowing the progression of this disease.

Adolescent↗
PubMed1994

Renal transplantation in patients over sixty years of age.

The aim of this study was to analyze whether old age affects the outcome of renal transplantation. Data were presented on all 337 renal allografts performed from January 1, 1987 to November 30, 1992 in the department of Nephrology and Urology, University Hospital of Nancy. Of these, 32 (9.5%) were performed in patients over 60 years old at the time of transplantation (mean duration of follow-up 22.3 +/- 17.1 months). No significant difference was noted in patient and graft survivals between the two groups at 36 months (respectively 83.8% and 76.1% in elderly patients; 96% and 82.8% in younger recipients). In the older group, all grafts were lost due to death (2/5) or nephrectomy (3/5) with a functional transplant (3/5) whereas chronic rejection accounted for the majority of graft loss in the younger group (23/43, p < 0.05). Episodes of acute rejection occurred with a very low incidence in elderly patients (15.6%). Infections were infrequent in this group and did not represent serious complications. Functional rehabilitation and quality of life were as good in elderly as in younger recipients. These results suggest that renal transplantation is an acceptable form of treatment for patients older than 60 years with end-stage renal disease in the absence of obvious contraindication.

Adult↗