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Biomedical subjects

P Labrune

Publications and source records attributed to P Labrune.

At least 91 records · Page 5Linked to original sources

Single-strand conformation polymorphism for detection of mutations and base substitutions in phenylketonuria.

In the past few years, more than 20 different mutations have been reported in hyperphenylalaninemias. In southwestern Europe and Mediterranean countries, however, the mutant genotypes reported account for only a fraction (27%) of all mutant alleles at the phenylalanine hydroxylase (PAH) locus, and most of the mutations causing the disease remain unknown. In order to develop a strategy for rapid detection of mutation-containing exons, we applied the single-strand conformation-polymorphism (SSCP) technique to exons 3, 5, 7, and 12 of the PAH gene. We observed five abnormal patterns of migration in mutant PAH genes, and we consistently found base substitutions in the corresponding exons, with no false-positive results. By this procedure, two novel putative mutations were detected in the seventh exon of the PAH gene, (A259V and Y277D) and we were able to demonstrate that the delta I94, R158Q, R408W, and E280K mutations were easily detectable by the SSCP technique. This procedure is therefore of particular interest for rapid detection of mutation-containing exons and for determination of further genotype-phenotype correlations in hyperphenylalaninemias.

Base Sequence↗

Gunn rats: a reproducible experimental model to compare the different methods of measurements of bilirubin serum concentration and to evaluate the risk of bilirubin encephalopathy.

Three groups of Gunn rats were studied: group 1 was perfused with bilirubin solution alone, group 2 was perfused with bilirubin and albumin solutions simultaneously, group 3 was perfused with bilirubin solution for 30 min then bilirubin and albumin solutions for the following 10 min. Our results indicate that (1) Gunn rats are a reliable experimental model to study the risk of bilirubin encephalopathy, (2) unbound bilirubin can enter the brain when albumin binding capacity is reduced, (3) and bilirubin binding capacity of serum for unbound unconjugated serum bilirubin is a better criterion than total serum bilirubin and erythrocyte bilirubin to evaluate the risk of kernicterus. This model could also be used to study variations of permeability of the blood-brain-barrier and influences of drugs on bilirubin metabolism.

Animals↗

Unusual cerebral manifestations in hereditary fructose intolerance.

Five children with hereditary fructose intolerance developed symptoms of neurological impairment. In three of them, neurological involvement was related to the acute hepatic toxicity of fructose (hypoglycemia, abnormal coagulation, cardiovascular collapse); in the other two, such a relationship could not be demonstrated. Neurological impairment is not classic in hereditary fructose intolerance, but its occurrence in the acute phase of the disease is possible and does not constitute an argument against the diagnosis.

Brain Diseases, Metabolic↗

Familial hypermethioninemia partially responsive to dietary restriction.

Hypermethioninemia and absolute methionine intolerance were observed in three siblings. These patients had several peculiar clinical features comprising failure to thrive, mental and motor retardation, facial dysmorphy with abnormal hair and teeth, and myocardiopathy. Hepatic S-adenosylhomocysteine hydrolase activity was decreased by 80% in the three children. These clinical and biochemical features differ from those of hypermethioninemias previously described, and thus represent a new form of inherited disorder of methionine metabolism. Whether S-adenosylhomocysteine hydrolase deficiency is primary or secondary to an unknown metabolic defect remains to be determined.

Adenosylhomocysteinase↗

[Sclerosing cholangitis revealing histiocytosis X].

The case of a 3 year-old boy who presented isolated cholestasis as the initial symptom of histiocytosis X is described. Other symptoms occurred later on. Despite treatment (corticosteroid and Vinblastin), the disease continued to progress and the child died at the age of 4 1/2 years with HIV infection (contaminated blood product) and tuberculosis.

Child, Preschool↗

Crigler-Najjar type II disease inheritance: a family study.

The inheritance of Crigler-Najjar type II disease is still contested. Autosomal dominant transmission with incomplete penetrance and autosomal recessive transmission have been proposed. We had the opportunity to study the hepatic activity of bilirubin uridinediphosphate glucuronyltransferase in parents whose first child had been affected by Crigler-Najjar type II disease. The demonstration of reduced activity of glucuronidation in the liver of both parents suggests autosomal recessive inheritance. The second infant of this couple was affected by the same disease and was treated with success by phenobarbital.

Bilirubin↗

Human immunodeficiency virus-associated thrombocytopenia in infants.

Severe thrombocytopenia was the initial manifestation of human immunodeficiency virus infections in 5 infants under 15 months of age. In only 2/5 cases maternal seropositivity was previously known while in the other 3 it was discovered after onset of the infants' thrombocytopenia. One infant died, due to intracranial hemorrhage, and the other 4 developed to disease stage IV. Human immunodeficiency virus infection must be considered in the diagnosis of thrombocytopenia.

Child, Preschool↗

[Intermittent intracranial hypertension revealing a tumor of the cervical spine].

A 6 year-old girl was admitted with symptoms of increased intracranial pressure. These manifestations spontaneously disappeared, then recurred a few days later, leading to the discovery of hydrocephalus with increased protein concentration in the cerebrospinal fluid. A cervical spine tumor was diagnosed by magnetic nuclear resonance examination. The patient was successfully operated on for a benign astrocytoma. In the absence of a cerebral tumor, cervical spinal tumors should be looked for when recurring symptoms of intracranial hypertension occur in a child.

Astrocytoma↗

[Evaluation of diagnostic and therapeutic methods in hyperinsulinism in newborn infants and infants. Apropos of a retrospective study of 26 cases].

This report concerns 26 cases of hyperinsulinism in neonates and infants. Clinically, the syndrome beginning in the neonatal period seems to differ by several aspects from the disease with a later onset: diagnostic difficulties, treatment modalities and long term prognosis. Insulinemia determined when the patient presents with hypoglycemia is often (75 to 80% of cases) normal. The diagnosis of hyperinsulinism has to be based on the clinical characteristics of hypoglycemia (timing of the episodes, response to glucagon) and on specific biological data (C-peptide, plasma ketone bodies and branched-chain amino acids at the time of hypoglycemia induced by fasting). The pathogenesis of hyperinsulinism is still poorly understood and has several etiologies.

Evaluation Studies as Topic↗

[Determination of blood level of muscle enzymes in glycogenoses with liver involvement: a diagnostic criterion].

Serum muscle enzyme activity assays were routinely performed in 36 patients with glycogen storage diseases (15 types 1a and 1b, 12 type III, and 9 types VI and IX). Creatine phosphokinase serum activity was increased only in type III. Glutamate-pyruvate transaminase, aldolase and lactate dehydrogenase serum activities were increased in all the forms of glycogen storage disease studied. Muscle involvement may at least partly explain the increased serum enzyme activities in type III.

Alanine Transaminase↗

[Long-term course of hepatic glycogenosis. A retrospective study of 76 cases].

In order to study the long term outcome of hepatic glycogen storage diseases, a national retrospective inquiry gathered 76 patients older than 12 years. In adolescents and adults, hypoglycemia, failure to thrive, pubertal delay, hepatomegaly and metabolic disturbances are major in type I, intermediary in type III and mild in type "VI+IX". Spontaneous improvement of these symptoms is noted in older patients. Beside these classical signs, anemia, high blood pressure, renal failure and persistent hypercholesterolemia were reported in some type I glycogen storage disease and bad school and professional results in type III. The knowledge of these complications should lead to a better management of these patients.

Adolescent↗

[Wilson's disease with liver copper in normal concentration].

The cases of 2 children with Wilson's disease revealed by persistent hypertransaminasemia are reported. Blood ceruloplasmin concentration was low but the liver content of copper was lower than usually seen in presymptomatic forms of the disease. The apparently low liver copper concentration could be explained by an unusually important steatosis.

Child↗