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Biomedical subjects

M Robert

Publications and source records attributed to M Robert.

At least 55 records · Page 3Linked to original sources

Intraoperative enteroscopy for diagnosis of a bleeding jejunal lymphangioma.

A patient with recurrent gastrointestinal bleeding from a jejunal lymphangioma is described. Multiple preoperative diagnostic studies, including sonde enteroscopy, failed to reveal a bleeding source. A bleeding lymphangioma was subsequently detected by intraoperative enteroscopy of the small bowel. Intraoperative enteroscopy was a useful diagnostic technique in this patient with otherwise unexplained gastrointestinal bleeding.

Endoscopy, Gastrointestinal↗

Order parameter and interfacial tension of a colloid-polymer system

The order parameter and interfacial tension of a colloid-polymer system consisting of grafted silica particles in cyclohexane in the presence of the soluble polymer polydimethylsiloxane are determined experimentally in the entire liquid-liquid coexistence region, from the liquid-solid boundary to the critical point. The renormalized critical exponents of the order parameter and interfacial tension are found to be, respectively, beta(*)=0.371+/-0.026 and &mgr;(*)=1. 30+/-0.08, and are discussed in the light of theoretical predictions.

Journal Article↗

[Piezoelectric ESWL for ureteral calculi. Impact of topography and lithiasis measurements on therapeutic approaches and performance].

OBJECTIVE: To evaluate the influence of the site and dimensions of ureteric stones on the modalities and performances of in situ piezoelectric extracorporeal shockwave lithotripsy (ESWL). MATERIAL AND METHODS: A population of 385 patients with solitary radiopaque ureteric stones was analysed. The long axis of these stones (211 (55%) lumbar, 38 (10%) iliac and 136 (35%) pelvic stones) ranged from 5 to 21 mm (mean = 8.2 mm). The initial shock wave frequency was 4/s. Lumbar stones were treated in the dorsal supine position under diaz-analgesia and pelvic stones were treated in the ventral supine position without systematic sedation. The influence of wave frequency (1 versus 4/s) on the level of sedation and therapeutic performances was studied on 146 patients with lumbar (n = 92) or pelvic stones (n = 54). The results were evaluated after only one ESWL session and were analysed statistically by Student's test and Fisher test. RESULTS: The overall complete success rate was 74%. Iliac stones were characterized by significantly (p < 0.05) lower (61%) performances. The results were inversely proportional to the size of the stones, as the complete success rate was only 25% for stones > 12 mm. For lumbar stones, a lower frequency allowed a very significant reduction (p < 0.0001) of the level of sedation required without affecting the performance. For pelvic stones, a low frequency significantly (p < 0.05) limited the efficacy of ESWL, especially for stones > 8 mm (27% of complete successes). CONCLUSION: In situ piezoelectric ESWL allows effective management of most ureteric stones with of long axis between 5 and 10 mm. In the context of outpatient treatment, however, this approach requires modulation of the shock wave frequency according to the site of the stone. Another therapeutic approach, particularly endoscopy, should be considered for very large stones.

Adolescent↗

[Stretching the triceps surae muscle after 40 degrees C warming in patients with cerebral palsy].

PURPOSE OF THE STUDY: Equinus in patients with cerebral palsy results from at least two factors: excessive contracture of the triceps surae and muscle retraction. Tendon surgery and progressive lengthening techniques using plaster walking boots can provide variable improvement in retraction. We compared the effect of this technique when applied with or without prior 40 degrees C warming in the same patients. We also assessed the efficacy of this treatment method in terms or degree of retraction, patient age, puberty maturity, and sex. MATERIALS AND METHODS: This series included 70 muscles in 52 patients with cerebral palsy aged 2 years 11 months to 21 years (mean 8 years 3 months). Common features in these patients were: - equinus mainly explained by triceps retraction, - no history of prior surgery on the triceps tendon, - knee flexion less than 15 degrees in the upright position, - easily reduced lateral deformation of the foot, - absence of mediotarsal dislocation, - triceps stretching could be achieved without triggering unacceptably intense contracture. The retraction of the triceps surae was measured from the maximal passive dorsal flexion angle of the foot, before and after applying each stretching boot. The difference between these measurements gave the gain obtained with the plaster boot. Protocol R- (stretching with plaster boot) consisted in a series of slow stretchings for 10 minutes before making the boot which was worn 7 days. Recurrent retraction in these same patients warranted another treatment within a delay of 3 to 17 months (mean delay 8.7 months). The same treatment then followed protocol R+ where the stretching was preceded by immersion of the segment in a 40 degrees C water bath for 10 minutes. RESULTS: Mean gain obtained with protocol R+ (warming) was 6.8 degrees knee extended and 7.1 degrees knee flexed. These differences were highly significant in both cases (p <0.0001). We had no failures with protocol R+ while with protocol R- (stretching without warming) the gain was nil or less than 5 degrees for 29 muscles knee extended and for 32 muscles, knee flexed. The gain was not related to age, sex or puberty maturity. It was not related to the angle of dorsal flexion of the foot prior to stretching. DISCUSSION: Our findings demonstrate that when the conditions allowing prolonged stretching of the triceps surae are present, prior warming at 40 degrees C for 10 minutes leads to an improvement in muscle lengthening in all patients, even in those for whom prior treatment had been unsuccessful without warming. This observation would indicate that the mechanisms allowing greater lengthening are present in all patients with cerebral palsy but that they cannot be triggered due to abnormal muscle viscosity related to distal vasomotor disorders frequently observed in this condition. Further research is needed to detail this point.

Adolescent↗

High-affinity antibodies from hen's-egg yolks against human mannose-6-phosphate/insulin-like growth-factor-II receptor (M6P/IGFII-R): characterization and potential use in clinical cancer studies.

The mannose-6-phosphate/insulin-like growth-factor-II receptor (M6P/IGFII-R) involved in trafficking of newly synthesized lysosomal enzymes, degradation of IGFII and activation of TGFbetaI, was suggested as being coded by a tumor-suppressor gene. No specific antibodies are currently available for clinical studies. Since M6P/IGFII-R is a highly conserved protein in mammals, we immunized chicken with human M6P/IGFII-R. Up to 200 mg of specific IgY from weekly pooled egg yolk was extracted by the polyethylene glycol procedure. Chicken IgY antibodies specifically recognized the human and bovine 270-kDa M6P/IGFII-R but not the 46-kDa M6P-R, as documented by immunoprecipitation and immunobloting. Using biosensor analysis, IgY antibodies were shown to bind M6P/IGFII-R with high affinity (K(D) = 7.5 x 10(-9) M). A solid-phase competitive ELISA using bovine M6P/IGFII-R coated on 96-well microplates, allowed us to titrate the M6P/IGFII-R in human sera at a sensitivity of 300 ng/ml. The M6P/IGFII-R was stained by immunoperoxidase in breast- and ovarian-cancer cell lines (T47D, MDA-MB231, MCF7 and BG1) and in frozen breast-cancer tissues, showing predominant localization in the trans-Golgi network. Staining specificity was shown with irrelevant IgY and by extinction with antigen excess. Quantitative immunohistochemical analysis of frozen sections from 40 invasive breast carcinomas indicated varying levels (from 5 to 400 units) of the M6P/IGFII-R protein which were not correlated with tumor size, histological grade and estrogen receptor or progesterone receptor. There was a trend (p = 0.08) between lymph-node invasiveness and low receptor level. Moreover, the M6P/IGFII-R level was significantly lower in cancer cells than in normal cells in 10 out of the 21 tumors in which the peritumoral normal glands could be quantified in parallel. These 2 last results agree with the hypothesis of a tumor-suppressor gene for this receptor and suggest more basic and clinical studies to prove it.

Animals↗

Retaliatory cuckoos and the evolution of host resistance to brood parasites.

We present a dynamic model of the evolution of host resistance to avian brood parasites, when the latter can retaliate against hosts that reject parasitic eggs. In a verbal model, Zahavi (1979, American Naturalist, 113, 157-159) suggested that retaliatory cuckoos might prevent the evolution of host resistance by reducing the reproductive success of rejecter hosts (i.e. by destroying their eggs or nestlings). Here we develop a model based on the association between the great spotted cuckoo, Clamator glandarius, and its main host, the European magpie, Pica pica, because this is the only system that has provided supportive evidence, to date, for the existence of retaliatory behaviour. Our aims were (1) to derive the conditions for invasion of the retaliation strategy in a nonretaliatory parasite population and (2) to investigate the consequences of retaliation for the evolution of host defence. If we assume a cost of discrimination for rejecter hosts in the absence of parasitism, and a cost paid by a retaliator for monitoring nests, our model shows cyclical dynamics. There is no evolutionarily stable strategy, and populations of both hosts and parasites will cycle indefinitely, the period of the cycles depending on mutation and/or migration rate. A stable polymorphism of acceptors and rejecters occurs only when parasites are nonretaliators. The spread of retaliator parasites drives rejecter hosts to extinction. Copyright 1999 The Association for the Study of Animal Behaviour.

Journal Article↗

Semenogelin I: a coagulum forming, multifunctional seminal vesicle protein.

Human seminal plasma spontaneously coagulates after ejaculation. The major component of this coagulum is semenogelin 1, a 52-kDa protein expressed exclusively in the seminal vesicles. Recently, a sperm motility inhibitor has been found to be identical to semenogelin I, suggesting that it may also be a physiological sperm motility inhibitor. The protein is rapidly cleaved after ejaculation by the chymotrypsin-like prostatic protease prostate-specific antigen, resulting in liquefaction of the semen coagulum and the progressive release of motile spermatozoa. Some of the cleavage products of Sg I may also have various biological functions. While the semenogelin I protein is unique to human and higher primates, it has recently been shown to belong to a gene family having a similar gene structure but encoding widely differing proteins. The recently elucidated characteristics of the semenogelin I gene as well as the biochemical and functional properties of the encoded protein are reviewed, and an attempt is made to integrate the various findings into a model for semen coagulation, sperm immobilization and potential other functions.

Amino Acid Sequence↗

Interference of magnetic resonance imaging contrast agents with the serum calcium measurement technique using colorimetric reagents.

A possible interaction between either linear (Gd-DTPA-BMA and Gd-DTPA) or macrocyclic (Gd-DOTA) gadolinium complexes used as magnetic resonance imaging (MRI) contrast agents and colorimetric technique reagents for the measurement of serum calcium was evaluated on human serum pools, and its mechanism was investigated by means of UV spectrometry and electro-spray ionization mass spectrometry (ESI-MS). The highest concentration tested was 2.5 mM (corresponding to a putative strictly intravascular distribution of the compound) and the lowest dose was 0.2 mM (i.e. about two elimination half lives). Serum calcium was dosed in duplicate by conventional colorimetric techniques involving o-cresol-phthalein complexone (OCP) or methylthymol blue (MTB) as reagents. No interference was detected when mixing Gd DOTA with serum, whatever the concentration. Gd DTPA (2.5 mM) did not interfere with the colorimetric technique either. Conversely, the Gd DTPA-BMA solution induced a concentration-related variation in apparent calcium levels. In the UV experiments, solutions of 2.5 mM MRI contrast media were mixed with OCP or MTB and UV absorption spectra were recorded between 400 and 800 nm. For Gd-DOTA/OCP and Gd-DOTA/MTB, no significant variations in the absorbance were detected. However, in the presence of Gd DTPA BMA, the absorbance of OCP and MTB showed substantial and immediate variations over time. The ESI-MS studies showed a complete displacement of Gd3+ ion in the case of Gd-DTPA BMA. In the presence of OCP, we observed the disappearance of Gd-DTPA BMA and the formation of the free ligand DTPA BMA and a new complex Gd OCP with an original stoichiometry of 2/2. Such a phenomenon did not occur in the case of Gd DOTA and Gd DTPA. The decomplexation of Gd-DTPA BMA in the presence of OCP can probably be explained by the weaker thermodynamic stability of Gd-DTPA BMA compared to that of Gd-DOTA and Gd DTPA.

Bromthymol Blue↗

Harmful effects of UVA on the structure and barrier function of engineered human cutaneous tissues.

PURPOSE: To investigate the effects of a single UVA exposure on engineered human cutaneous tissues. MATERIALS AND METHODS: Skin equivalents (SE) were obtained by culturing keratinocytes on fibroblast-populated collagen gels; epidermal equivalents (EE) were obtained by seeding keratinocytes on non-populated collagen gels. After maturation and differentiation of the epidermis, SE and EE were exposed to 50 or 100 J/cm2 UVA. Structural damage and total epidermal lipids were analysed and diffusion of radioactive oestradiol was monitored 24 and 72h post-irradiation. RESULTS: Twenty-four hours after UVA irradiation, a disorganization of the living epidermis is observed. UVA also significantly reduced the skin barrier function and led to an increase in phospholipid and in a decrease of ceramide levels. However, both the structure and the barrier function of SE were recovered 72 h post-irradiation, thereby suggesting that an intrinsic repair process might exist within the irradiated SE. CONCLUSION: This study provides a strong evidence that UVA radiation alters both the epidermal and dermal structures, the synthesis of epidermal lipids, and the permeability of the human skin.

Cells, Cultured↗

Piezoelectric lithotripsy of ureteral stones: influence of shockwave frequency on sedation and therapeutic efficiency.

OBJECTIVE: The aim of this randomized study was to assess the relation between shockwave frequency, sedation, and efficiency in piezoelectric extracorporeal shockwave lithotripsy (SWL) for ureteral calculi. METHODS: A random sample of 114 patients aged between 15 and 74 (mean 45) years were treated at the shockwave frequencies of 1 (N = 57) or 4 (N = 57) per second using the EDAP LT 02 lithotripter at maximum energy. The stones' largest diameter ranged from 5 to 18 mm (mean 7.6 mm). Lower ureteral stones were treated with the patient in the prone position and upper ureteral stones in supine position. The duration of SWL sessions and stone measurements were statistically similar for patients treated at low and high frequencies. The levels of required sedation (none, intramuscular analgesia, intravenous sedation-analgesia) and stone-free rates after one session were analyzed by Student's t-test or Fisher's exact test. RESULTS: Sedation did not differ statistically with SWL frequency for mid and lower ureteral calculi. However, the use of intravenous sedation-analgesia was less common for patients with upper ureteral stones treated at low rather than high frequency (19% and 100%, respectively; P < 0.0001). The success rate was significantly lower (P = 0.04) for lower ureteral calculi treated at low v high frequency (65 % and 89%, respectively) but was not statistically affected by frequency for upper ureteral stones. CONCLUSION: We recommend high frequency for piezoelectric SWL of lower ureteral calculi, especially for stones with a maximum diameter > or =8 mm. On the other hand, low-frequency SWL appears to be suitable for the treatment of upper ureteral stones.

Adolescent↗

Direct percutaneous approach to the upper pole of the kidney: MRI anatomy with assessment of the visceral risk.

PURPOSE: In an attempt to determine the visceral risk secondary to a direct percutaneous puncture of the upper renal calix, the anatomic relations of the upper pole of the kidney were studied by magnetic resonance imaging. METHODS: Examination was performed on 25 normal volunteers placed successively in the right and left prone oblique position. The kidney axis and minimal distances from the cutaneous plane at the level of the upper and lower poles were measured. Axial and tangential simulated percutaneous approaches to the upper renal calix were compared in term of risk of damage to the pulmonary, splenic, and hepatic parenchyma. RESULTS: The transversal anteversion angle was statistically comparable for right and left kidneys, but the sagittal anteversion angle was significantly higher for right kidneys (p = 0.05). The minimal distance from the cutaneous plane was statistically comparable for the upper and lower poles. The lower pole was significantly deeper for left than right kidneys (p = 0.01). The visceral risk was statistically comparable for left and right kidneys and was significantly higher in case of an approach in the axis of the upper renal calix or through the 10th intercostal space compared to a puncture via the l1th space (p = 0.0001). CONCLUSION: A percutaneous puncture of the upper pole of the kidney above the 11th rib increases the risk of visceral damage. Preoperative evaluation, with the aid of CT scan or MRI, of the risk of pulmonary, splenic, or hepatic injury could be carried out in these cases.

Adult↗

Piezoelectric shockwave lithotripsy of urinary calculi: comparative study of stone depth in kidney and ureter treatments.

PURPOSE: The aim of this prospective study was to assess the relation between stone depth and the efficiency of piezoelectric extracorporeal shockwave lithotripsy (SWL). PATIENTS AND METHODS: A total of 150 patients presenting with 25 pelvic, 75 caliceal, and 25 upper and 25 lower ureteral calculi were treated using the EDAP LT02 lithotripter. All of the stones were easy to localize with sonographic and radiographic systems, and their largest diameter ranged from 4 to 25 mm (mean 8.5 mm). Renal and upper ureteral calculi were treated with the patient in the supine position and lower ureteral stones in prone position. On the basis of a meticulous stone localization and focusing, depth measurements were carried out under real-time ultrasonic guidance, the minimal distance between the cutaneous plane and the focal point being recorded only for definitely localized calculi. RESULTS: Ureteral calculi were significantly deeper than renal stones (p < 0.0001), but the distance from the cutaneous plane was statistically similar for upper and lower ureteral calculi. Stone depth was statistically affected by body mass index (BMI), patients with a BMI >25 having significantly deeper renal and ureteral calculi than subjects with a BMI < or =25 (p < 0.00001 and 0.01, respectively). Renal stones resisting SWL were significantly deeper than successfully treated calculi (p < 0.03). At the level of the ureter, the success rate after one SWL session was 85% for stones with a depth < or =110 mm and 57% for deeper stones, the difference being significant (p < 0.05). CONCLUSION: Stone depth has a significant influence on treatment outcome after piezoelectric SWL for both renal and ureteral calculi. We recommend particular attention be given to corpulent patients presenting with ureteral stones.

Adult↗

Phase transitions of colloid-polymer systems in two dimensions.

Phase transitions of systems consisting of colloidal particles and non-adsorbing polymer in a solvent are studied theoretically in two dimensions. The colloids are modeled as hard spheres and the polymer as an ideal gas. The imbalance in osmotic pressure induced by the depletion effect gives rise to an effective attraction tail for the colloid-colloid interaction. For a monodisperse polymer, liquid-liquid separation is predicted to occur for appropriate colloid concentrations when the ratio s of the radius of gyration of the polymer to the radius of the colloidal particle is greater than 0.31, while solid-liquid separation is predicted to occur for all colloid concentrations when s is smaller than 0.31. Polydispersity of polymer is found to increase the extent of liquid-liquid coexistence, and when the average s is smaller than 0.31, and for appropriate colloid concentrations, liquid-liquid coexistence occurs provided the polymer size distribution is broad enough. Partitioning and size distribution of polymer in coexisting phases are also predicted.

Journal Article↗

[Posterior urethral polyps in children. A case report].

Posterior urethral polyps are rare. A case is reported in a 7-year-old boy presenting with pain and burning micturition. Ultrasound and cystography revealed the diagnosis by showing a round solid structure in the bladder neck. Cystoscopy confirmed the diagnosis by showing its implantation base at the summit of the verumontanum. The polyp was removed by endoscopic resection and histological examination of the resection specimen showed a fibrous polyp. A brief review of the clinical features, diagnostic methods, natural history and treatment of this benign tumour is presented.

Child↗

[Scrotal pseudoabscess revealing congenital diverticulum of the anterior urethra in children].

The authors report a case of infected congenital diverticulum of the anterior urethra in a 6-week-old infant. This diverticulum presented clinically in the form of a scrotal abscess. Retrograde cystourethrography established the diagnosis. Two-stage treatment was preferred because of the infection: aspiration of the diverticulum and antibiotics, subsequently followed by surgical repair with resection of the diverticulum and immediate urethral reconstruction. The immediate postoperative course was marked by demonstration of hypertrophic pylori stenosis, which had not been previously investigated despite the presence of symptoms predating the diverticulum (repeated vomiting at the age of one month). Treatment was surgical. A brief review of diverticula of the anterior urethra is presented, defining the aetiological factors as well as the diagnostic and therapeutic features.

Abscess↗

[Management of cleft lip and/or palate diagnosed in utero].

OBJECTIVE OF THE STUDY: To assess the usefulness of fetal karyotyping in the management of facial cleft lip with or without cleft palate diagnosed during pregnancy and to determine which etiologic and prognosis criteria are helpful to consider for prenatal counselling. MATERIAL AND METHODS: Retrospective study on 35 cases of facial cleft lip and/or palate prenatally diagnosed by ultrasound examination and managed in our fetal medicine unit from 1 January 1989 to 31 December 1996. Complete follow-up was obtained for all fetuses. RESULTS: In our series, the mean gestational age at diagnosis was 25 weeks. In 43% of the cases, additional sonographic anomalies were also recognized. These associated anomalies were more frequent when amniotic fluid quantity was abnormal. Fetal chromosomal determination was conducted in 2/3 of fetuses and numeric or structural abnormalities were found in 20% not related to the cleft size or type (lip and/or palate). All fetuses with isolated facial cleft were chromosomally normal. We report 4 midline clefts, all of them were associated with additional sonographic findings and 3 were part of an holoprosencephaly. CONCLUSION: Prenatal diagnosis of cleft lip and/or palate must draw attention to associated sonographic anomalies especially when amniotic fluid quantity is abnormal. Chromosomal karyotyping is not necessary when facial clefting is isolated except in cases diagnosed early in pregnancy. Midline clefts must draw attention on cerebral midline integrity.

Abnormalities, Multiple↗

[Urogenital amyloidosis: clinico-pathological study of 8 cases].

Amyloidosis of the genito-urinary tract is uncommon. We report 8 cases, often misdiagnosed as a neoplastic process (6/8). Amyloidosis was localized in the bladder (3 cases), in the ureter (1 case) and in the prostate and/or seminal vesicles (4 cases). The amyloid protein was characterized in 7 cases by immunohistochemistry. Among the bladder and ureter amyloidosis, 2 cases were classified as AL lambda amyloidosis and one case as AA amyloidosis in a patient with long history of chronic arthritis. In the fourth case, the deposits could not be identified. Nevertheless an AL amyloidosis might be suggested. Two cases of prostate and/or seminal vesicles amyloidosis were stained with an anti-B2M antibody, in hemodialyzed patients. The 2 others, positive with the anti-Transthyretina antibody, were classified as senile amyloidosis. This small series illustrated the heterogeneous pathogenic types of amyloidosis in the urogenital tract and emphasized the interest of immunohistochemistry to identify the chemical composition of these deposits.

Adult↗

Inactivation of tumor suppressor p53 by mot-2, a hsp70 family member.

The mortalin genes, mot-1 and mot-2, are hsp70 family members that were originally cloned from normal and immortal murine cells, respectively. Their proteins differ by only two amino acid residues but exhibit different subcellular localizations, arise from two distinct genes, and have contrasting biological activities. We report here that the two proteins also differ in their interactions with the tumor suppressor protein p53. The pancytosolic mot-1 protein in normal cells did not show colocalization with p53; in contrast, nonpancytosolic mot-2 and p53 overlapped significantly in immortal cells. Transfection of mot-2 but not mot-1 resulted in the repression of p53-mediated transactivation in p53-responsive reporter assays. Inactivation of p53 by mot-2 was supported by the down-regulation of p53-responsive genes p21(WAF-1) and mdm-2 in mot-2-transfected cells only. Furthermore, NIH 3T3 cells transfected with expression plasmid encoding green fluorescent protein-tagged mot-2 but not mot-1 showed an abrogation of nuclear translocation of wild-type p53. These results demonstrate a novel mechanism of p53 inactivation by mot-2 protein.

3T3 Cells↗