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Biomedical subjects

P Rousseau

Publications and source records attributed to P Rousseau.

At least 19 recordsLinked to original sources

Electrochemical impedance spectroscopy investigations of a microelectrode behavior in a thin-layer cell: Experimental and theoretical studies.

Electrochemical impedance spectroscopy experiments were performed on a microdisk electrode in a thin-layer cell using a scanning electrochemical microscope for controlling the cell geometry. Experimental data showed that when the thin-layer thickness diminished, an additional low-frequency response appeared. It was ascribed to the radial diffusion of the electroactive species and was strongly dependent on the thin-layer dimensions (both thickness and diameter). Moreover, the numerical simulation of the impedance diagrams by finite element method calculations confirmed this behavior. An equivalent circuit based on a Randles-type circuit was proposed. Thus, the diffusion was described by introducing two electrical elements: one for the spherical diffusion and the other for the radial contribution. A nonlinear Simplex algorithm was used, and this circuit was shown to fit the impedance diagrams with a good accuracy.

Journal Article↗

Adaptive correction of a tightly focused, high-intensity laser beam by use of a third-harmonic signal generated at an interface.

By using the third-harmonic signal generated at an air-dielectric interface, we demonstrate a novel way of correcting wavefront aberrations induced by high-numerical-aperture optics. The third harmonic is used as the input physical parameter of a genetic algorithm working in closed loop with a 37-actuator deformable mirror. This method is simple and reliable and can be used to correct aberrations of tightly focused beams, a regime where other methods have limitations. Improvement of the third-harmonic signal generated with an f/1.2 parabolic mirror by 1 order of magnitude is demonstrated.

Journal Article↗

[Gastric foreign body. Rare complication of nasogastric tube placing].

The use of an uncuffed endotracheal tube for the placement of nasogastric tubes during surgery is not a procedure free of any risk. We report a rare case of gastric foreign body secondary to this procedure. A 67-year-old patient who had underwent a coronary bypass for a three vessels disease two years before complained of postprandial epigastralgia lasting for a few months. The investigations reported a gastric ulcer associated with a tubular gastric foreign body. The endoscopic extraction found an endotracheal tube. It is a common habit in our institution to use this method when placing this tube through a nostril in order to ease the nasogastric tube insertion when it is difficult.

Aged↗

[Abbé-Mustardé's flap with lower lid transposition: three clinical cases].

The ideal solution first recommended is the use of Abbé-Mustardé's flap with lower lid transposition to rebuild the total loss of the upper eyelid. Every step of the surgical technique has been detailed to improve the result and keep the drawbacks under control. After having read articles on this subject, we describe three clinical cases, which enable us to compare with others surgical techniques that cannot rebuild all the levels of the eyelids and the edge of the eyelashes.

Basal Cell Carcinoma↗

Generation of 10(11) contrast 50 TW laser pulses.

We demonstrate what we believe to be the highest-contrast (10(11)), multiterawatt, chirped-pulse amplification (CPA) Ti:sapphire laser by applying the modified cross-polarized-wave (XPW) generation method. This method produces a contrast improvement of 3 orders of magnitude using microjoule input energy. Microjoule energy can be achieved by direct amplification without the complications of a double CPA system. The 10(11) contrast is sufficient for experiments on high-damage-threshold solid targets with focused intensities up to 10(22) W/cm(2).

Journal Article↗

The transpososome: control of transposition at the level of catalysis.

Studies of several transposable genetic elements have pinpointed the importance of the transpososome, a nucleoprotein complex involving the transposon ends and a transposon-encoded enzyme--the transposase--as a key in regulating transposition. Transpososomes provide a precise architecture within which the chemical reactions involved in transposon displacement occur. Data are accumulating that suggest they are dynamic and undergo staged conformational changes to accommodate different steps in the transposition pathway. This has been underpinned by recent results obtained particularly with Tn5, Tn10 and bacteriophage Mu.

Bacteriophage mu↗

Generation and characterization of the highest laser intensities (10(22) W/cm2).

We generated a record peak intensity of 0.7 x 10(22) W/cm2 by focusing a 45-TW laser beam with an f/0.6 off-axis paraboloid. The aberrations of the paraboloid and the low-energy reference laser beam were measured and corrected, and a focal spot size of 0.8 microm was achieved. It is shown that the peak intensity can be increased to 1.0 x 10(22) W/cm2 by correction of the wave front of a 45-TW beam relative to the reference beam. The phase and amplitude measurement provides for an efficient full characterization of the focal field.

Journal Article↗

Results of an unrelated transplant search strategy using partially HLA-mismatched cord blood as an immediate alternative to HLA-matched bone marrow.

Cord blood (CB) is an alternative to other sources of stem cells for transplantation. However, the impact of including CB in the initial strategy of unrelated graft search in a cohort of patients has been the object of limited analysis. Here, we report the results of such a strategy in 91 consecutive children. Absence of mismatch was required for adult donors, and up to two mismatches were allowed for CB grafts, with a nucleated cell dose over 2.5 x 10(7) cells/kg. A graft was found for 84 of the 85 children who remained available for a 3-month search. In all, 64 patients were transplanted, 36 with CB and 28 with bone marrow (BM). Primary graft failure, acute grade II-IV and extensive chronic graft-versus-host disease occurred in five, five and zero CB, and in three, one and two BM patients, respectively. The 3-year survival was 59% in CB and 57% in BM patients. Accepting CB as a source of stem cells offers a graft to almost every child in need of an unrelated transplantation, with a probability of survival similar to that of unrelated BM transplantation.

Adult↗

[Entrapment of the long head of the biceps: the "hourglass biceps". Another cause of pain and locking of the shoulder].

PURPOSE OF THE STUDY: We describe a mechanical condition affecting the long head of the biceps tendon (LHBT) causing potentially unrecognized entrapment within the joint and subsequent pain and locking. This is caused by a hypertrophic intra-articular portion of the tendon that is unable to slide into the bicipital groove during elevation of the arm. MATERIALS AND METHODS: Twenty one patients were identified, during open (14 cases) or arthroscopic (7 cases) surgery, with a so called "hourglass biceps" i.e., hypertrophic intraarticular portion of the LHBT and incarceration of the tendon during elevation. All cases occurred in conjunction with a rotator cuff rupture except one who had a partial deep tear. All patients were treated by excision of the biceps, after tenodesis or bipolar tenotomy, and appropriate treatment of the concomitant lesions. RESULTS: All patients presented with anterior shoulder pain and loss of passive elevation averaging 10-20 degrees. A dynamic intraoperative test involving forward elevation with the elbow extended demonstrated entrapment of the tendon within the joint in each case. This test creates a characteristic "buckling" of the tendon and "squeezing" of the tendon between the humeral head and the glenoid ("hourglass test"). Excision of the tendon allowed immediate restoration of complete elevation. Mean Constant score increased from 38 points to 76 points postoperatively. DISCUSSION: The "hourglass biceps" is caused by a hypertrophic intraarticular portion of the tendon that is unable to slide into the bicipital groove during elevation of the arm. Loss of 10-20 degrees of passive elevation, bicipital groove tenderness, and radiographic findings of a hypertrophied tendon can aid in diagnosis. The "hourglass biceps" should not be misdiagnosed for a frozen shoulder. Definitive diagnosis is made at surgery with the "hourglass test": incarceration and squeezing of the tendon within the joint during forward elevation of the arm with the elbow extended. Simple tenotomy cannot resolve this mechanical block. Either tenotomy with excision of the intraarticular portion of the LHBT or tenodesis must be performed. The "Hourglass" biceps is an addition to the familiar pathologies of the long head of the biceps tendon (tenosynovitis, prerupture, rupture, instability), and should be considered in any case of chronic anterior shoulder pain associated with a loss of shoulder elevation.

Aged↗

A target specificity switch in IS911 transposition: the role of the OrfA protein.

The role played by insertion sequence IS911 proteins, OrfA and OrfAB, in the choice of a target for insertion was studied. IS911 transposition occurs in several steps: synapsis of the two transposon ends (IRR and IRL); formation of a figure-of-eight intermediate where both ends are joined by a single-strand bridge; resolution into a circular form carrying an IRR-IRL junction; and insertion into a DNA target. In vivo, with OrfAB alone, an IS911-based transposon integrated with high probability next to an IS911 end located on the target plasmid. OrfA greatly reduced the proportion of these events. This was confirmed in vitro using a transposon with a preformed IRR-IRL junction to examine the final insertion step. Addition of OrfA resulted in a large increase in insertion frequency and greatly increased the proportion of non-targeted insertions. The intermolecular reaction leading to targeted insertion may resemble the intramolecular reaction involving figure-of-eight molecules, which leads to the formation of circles. OrfA could, therefore, be considered as a molecular switch modulating the site-specific recombination activity of OrfAB and facilitating dispersion of the insertion sequence (IS) to 'non-homologous' target sites.

Biopolymers↗

HLA-G protein processing and transport to the cell surface.

Data are presented on the intracellular trafficking of HLA-G protein, taking the unique features of this non-classical molecule into consideration: the existence of seven isoforms resulting from alternative splicing (HLA-G1 to G7), and reduced tail length compared with HLA class I antigens. Biochemical studies and analysis of viral strategies for escaping the host immune system led to the demonstration that (i) both the membrane-bound (HLA-G1) and the soluble (HLA-G5) forms of the molecule require peptide association for cell surface expression, using TAP-dependent or TAP-independent pathways; (ii) peptide loading onto the HLA-G protein plays a critical role in controlling the quality of the molecule reaching the cell surface; (iii) surface expression of truncated HLA-G molecules is possible, and (iv) HLA-G expression may be restricted to soluble HLA-G5. These data reveal that HLA-G presents specific cell trafficking pathways and strongly support the contention that the primary function of HLA-G is as of an inhibitor ligand for immune-competent cells.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Billie Belle.

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Death↗

Ethical and legal issues in palliative care.

As palliative care emerges as a respected and important component of contemporary health care, ethical issues will arise that confront and contest the provision of medical care. The basic principles of medical ethics, embodied in beneficence, nonmaleficence, autonomy, and justice, guide primary care physicians in dealing with dying patients. This article will discuss the basic ethical principles and the principle of double effect, decision-making capacity, advance directives, withholding and withdrawing life-sustaining therapy, futility, artificial nutrition and hydration, do-not-resuscitate orders, and physician-assisted suicide and euthanasia.

Advance Directives↗

"Distraction" of grafted alveolar bone in cleft case using endosseous implant.

OBJECTIVE: Presentation of a specific surgical technique of vertical alveolar ridge distraction performed on an alveolar bone graft 1 year after the primary grafting procedure designed to correct a labioalveolar cleft. The graft had not obtained the results desired and presented heavily scarred mucosal tissue. TECHNIQUE: A dental implant placed within the graft once it has been entirely freed by osteotomies functions as an endless screw. To avoid vascular risk, the alveolar bone graft is detached as a whole along its total height. Consequently, no bone remains above it to provide support for a conventional alveolar distractor. An osteosynthetic miniplate, fastened in a horizontal position beneath the nasal mucosae above the graft, is used to replace the missing bony support and to stabilize the implant, which activates the distraction process. PATIENT: This study is based on our first clinical case with a follow-up of 18 months at present. RESULT: A vertical displacement of the entire graft was achieved, including its attached mucosal layer, which repositioned both bone and mucosa on a far better level in the cleft area. Thus, a normal length of abutment was obtained permitting prosthetic rehabilitation based on the same endosseous implant, which was left in place within the graft. CONCLUSION: This technique may prove particularly helpful in certain cases in which a primary alveolar bone grafting procedure has produced borderline results. In such cases, on the one hand, neither the reasonably satisfactory volume of the bone graft itself nor the poor quality of its scarred mucosal tissue argue in favor of a secondary grafting procedure. On the other hand, it is impossible to resort to currently available alveolar distracters since our choice of techniques leaves no bone support above the graft.

Adolescent↗

Death denial.

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Attitude to Death↗