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Biomedical subjects

A Amrani

Publications and source records attributed to A Amrani.

At least 19 recordsLinked to original sources

[Muscular tuberculosis: an unusual focus of Koch bacillus].

We report an exceptional case of tuberculosis in an 8-year-old girl. The focus of infection was situated in the anterior muscle compartment of the left thigh. Diagnosis was established on the basis of histological findings. A 12-month antituberculosis regimen was given. Outcome was good with no general or functional sequelae. Based on this case and data reported in the literature, we discuss the routes of dissemination of the Koch bacillus explaining this unusual sporadic localization.

Antitubercular Agents↗

[Askin's tumour].

Explore the source record for details and available documents.

Adolescent↗

[Renal hydatid cyst in children: report of 6 cases].

Echinococcosis or hydatid cyst disease of the kidney is extremely rare in children and constitutes only 2-4% of all cases of hydatid disease. We present six pediatric case of hydatid cyst of the kidney. The presentation is a cystic space occupying lesion of the kidney. Three patients have another involvement (lung, liver, and brain). Several diagnostic methods are available, ultrasonography may be sufficient. Surgical conservative treatment is still necessary, range from excision of the cyst. Significant surgical morbidity can be expected.

Child↗

[Role of laparoscopy in intra-abdominal testes in children. 35 case reports].

The impalpable testicles account for approximately 10 to 20% of the total of the not descended testicles. The importance of laparoscopy is increasingly significant, because apart from its diagnostic role recently a therapeutic interest was added. Thirty-five nonpalpable testicles took advantage of laparoscopic exploration at the pediatric's emergency surgery ward at the children's hospital of Rabat within the last 2 years. In 9 cases, total testicular agenesis was found. In 6 cases the testicles were situated very high in the abdomen, so that a first time laparoscopy was performed where the testicles were lowered. In 10 cases, one laparoscopic intervention for lowering the testicles was sufficient. In 10 cases, laparoscopic surgery showed that the vas deferens and the spermatic vessels reunified in the inguinal; so that, Inguinal exploration was necessary. The time of hospitalisation was 24 h with no complications noticed. We present this work to sensitise the surgeons on the new therapeutic approach to optimise the taking care of cryptorchid boys.

Child↗

[Medico-economic study of percutaneous and surgical closure of ostium secundum type interatrial communications].

The aim of this study was the medico-economic evaluation of the closure of ostium secundum type interatrial communications in 32 patients, treated by cardiac catheterisation (group A: n = 17) or by surgery (group B: n = 15). The success rate was 100% with the 2 techniques. With national cost scale data we evaluated the overall cost of the 2 treatments using the information system medical program, starting from homogenous groups of patients: 150 catheterisation, 169 and 170 surgery. As the value for the homogenous group of 150 patients was much lower than the price of the material used for catheterisation, an adjusted group of 150 patients including the price of this material was created. An evaluation in terms of an artificial index of activity was also performed. The average duration of hospital stay for group A was reduced by 6.1 days compared to group B (p < 0.001). The overall cost was lower in group A than in group B (p < 0.001), using the real and "adjusted" homogenous group of 150 patients, with a respective reduction of 7,582 Euros and 3,731 Euros. Surgery and catheterisation scored 8,167 points (17,756 Euros) and 2,726 points (5,926 Euros) per patient respectively on the artificial activity index. In conclusion, catheterisation reduced the duration of hospital stay and brought an economic benefit for the Assurance Maladie compared to surgery. However, surgery is more profitable for the hospital than catheterisation because of the high cost of the prosthesis, which is not taken into account with a homogenous group of non-specific patients. This could hamper the development of this innovative technique in a hospital subjected to overall budgetary constraints.

Adolescent↗

["Small left colon" syndrome (two case reports)].

CASE REPORTS: Two newborns, one female and male were treated for neonatal bowel obstruction. A contrast enema led to the diagnosis of small left colon syndrome and treated those newborns successfully. CONCLUSION: Small left colon syndrome is a very rare cause of neonatal bowel obstruction. The diagnosis and treatment are assured by a simple contrast enema.

Barium Sulfate↗

[The square pronator: an "aspirin" strip in antalgic surgery for painful neuromas of the wrist].

From June 96 to January 2001, 25 patients have been operated on for painful neuromas localised at the wrist. They were between 10 and 52 years of age. These neuromas were located in at the median nerve 17 cases, at the ulnar nerve in seven cases and at the radial nerve in one case. In all cases the pain was not spontaneous but triggered off by external stimulus. All these neuromas were in continuity except 1 case at the median nerve where a total severing was present. After external neurolysis, the quadratus pronatus muscle is wrapped around the neuromas in 24 cases and around epineurial suture in one case. No internal neurolysis was done. This flap was vascularized by the anterior interosseous artery in 23 cases and by the posterior interosseous artery in two cases of distal ulnar nerve neuroma. All patients have been improved by using this method. In 21 cases (84%) (17 median, 4 ulnar nerves) the pain has completely disappeared and in four cases (3 ulnar, 1 radial), the pain has considerably decreased but without total disappearance. In the cases of median nerve neuromas the dysaesthesia has greatly decreased. No complications and no sequelae on the donor site are reported.

Adolescent↗

[An unusual localization of solitary bone cyst in a child: the lumbar spine].

Solitary bone cysts involving the spine in children are extremely rare. We report such a lesion in a 7-year-old girl who presented with an expansible, bubbly cystic lesion of the third lumbar vertebra. The intraoperative findings and histologic examination indicated the diagnosis of a solitary bone cyst. She was treated successfully with curettage and bone grafting.

Bone Cysts↗

Expansion of the antigenic repertoire of a single T cell receptor upon T cell activation.

Activated T cells and their naive precursors display different functional avidities for peptide/MHC, but are thought to have identical antigenic repertoires. We show that, following activation with a cognate mimotope (NRP), diabetogenic CD8(+) T cells expressing a single TCR (8.3) respond vigorously to numerous peptide analogs of NRP that were unable to elicit any responses from naive 8.3-CD8(+) T cells, even at high concentrations. The NRP-reactive, in vivo activated CD8(+) cells arising in pancreatic islets of nonobese diabetic mice are similarly promiscuous for peptide/MHC, and paradoxically this promiscuity expands as the aviditiy of the T cell population for NRP/MHC increases with age. Thus, activation and avidity maturation of T lymphocyte populations can lead to dramatic expansions in the range of peptides that elicit functional T cell responses.

Amino Acid Sequence↗

[Laryngeal dyspnea caused by cervical hydatidosis: apropos of a case].

Hydatid cysts rarely present as a cervical tumor. We report a case of hydatid cyst of the neck in a child with multiple hydatid cysts in the liver, which was revealed by laryngeal dyspnea. Symptoms occurred in a six year-old country dweller, who presented with progressive laryngeal dyspnea. The chest radiographs showed extrinsic tracheal compression. A cervical ultrasonography showed a liquid filled mass evocative of hydatid cyst type 1. Explorative cervicotomy confirmed the diagnosis. The treatment was conservative after destruction of the parasite using a hypertonic saline solution. The immediate result was the disappearance of the laryngeal dyspnea.

Albendazole↗

Progression of autoimmune diabetes driven by avidity maturation of a T-cell population.

For unknown reasons, autoimmune diseases such as type 1 diabetes develop after prolonged periods of inflammation of mononuclear cells in target tissues. Here we show that progression of pancreatic islet inflammation to overt diabetes in nonobese diabetic (NOD) mice is driven by the 'avidity maturation' of a prevailing, pancreatic beta-cell-specific T-lymphocyte population carrying the CD8 antigen. This T-lymphocyte population recognizes two related peptides (NRP and NRP-A7) in the context of H-2Kd class I molecules of the major histocompatibility complex (MHC). As pre-diabetic NOD mice age, their islet-associated CD8+ T lymphocytes contain increasing numbers of NRP-A7-reactive cells, and these cells bind NRP-A7/H-2Kd tetramers with increased specificity, increased avidity and longer half-lives. Repeated treatment of pre-diabetic NOD mice with soluble NRP-A7 peptide blunts the avidity maturation of the NRP-A7-reactive CD8+ T-cell population by selectively deleting those clonotypes expressing T-cell receptors with the highest affinity and lowest dissociation rates for peptide-MHC binding. This inhibits the local production of T cells that are cytotoxic to beta cells, and halts the progression from severe insulitis to diabetes. We conclude that avidity maturation of pathogenic T-cell populations may be the key event in the progression of benign inflammation to overt disease in autoimmunity.

Animals↗

Ly-49P activates NK-mediated lysis by recognizing H-2Dd.

Little is known regarding the ligand specificity of Ly-49 activating receptor subfamily members expressed by NK cells. A new Ly-49 activating receptor related to Ly-49A in its extracellular domain, designated Ly-49P, was recently cloned from 129 strain mice. We independently cloned an apparent allele of Ly-49P expressed by nonobese diabetic and nonobese diabetes-resistant mouse strain NK cells. We found it to be reactive with the A1 Ab thought to recognize a polymorphic epitope expressed only by the Ly-49A inhibitory receptor of the C57BL/6 strain. Rat RNK-16 cells transfected with Ly-49P mediated reverse Ab-dependent cellular cytotoxicity of FcR-positive target cells, indicating that Ly-49P can activate NK-mediated lysis. We determined that RNK-16 lysis of Con A blasts induced by Ly-49P was MHC dependent, resulting in efficient lysis of H-2Dd-bearing targets. We found that the Dd alpha1/alpha2 domain is required for Ly-49P-mediated RNK-16 activation, as determined by exon shuffling and transfection. Thus, Ly-49P is the second activating Ly-49 receptor demonstrated to induce NK cytotoxicity by recognizing a class I MHC molecule.

Amino Acid Sequence↗

IL-1alpha, IL-1beta, and IFN-gamma mark beta cells for Fas-dependent destruction by diabetogenic CD4(+) T lymphocytes.

Cytokines such as IL-1alpha, IL-1beta, and IFN-gamma have long been implicated in the pathogenesis of autoimmune diabetes, but the mechanisms through which they promote diabetogenesis remain unclear. Here we show that CD4(+) T lymphocytes propagated from transgenic nonobese diabetic (NOD) mice expressing the highly diabetogenic, beta cell-specific 4.1-T-cell receptor (4.1-TCR) can kill IL-1alpha-, IL-1beta-, and IFN-gamma-treated beta cells from NOD mice. Untreated NOD beta cells and cytokine-treated beta cells from Fas-deficient NOD.lpr mice are not targeted by these T cells. Killing of islet cells in vitro was associated with cytokine-induced upregulation of Fas on islet cells and was independent of MHC class II expression. Abrogation of Fas expression in 4.1-TCR-transgenic NOD mice afforded nearly complete protection from diabetes and did not interfere with the development of the transgenic CD4(+) T cells or with their ability to cause insulitis. In contrast, abrogation of perforin expression did not affect beta cell-specific cytotoxicity or the diabetogenic potential of these T cells. These data demonstrate a novel mechanism of action of IL-1alpha, IL-1beta, and IFN-gamma in autoimmune diabetes, whereby these cytokines mark beta cells for Fas-dependent lysis by autoreactive CD4(+) T cells.

Animals↗

Prevalent CD8(+) T cell response against one peptide/MHC complex in autoimmune diabetes.

Spontaneous autoimmune diabetes in nonobese diabetic (NOD) mice is the result of a CD4(+) and CD8(+) T cell-dependent autoimmune process directed against the pancreatic beta cells. CD8(+) T cells play a critical role in the initiation and progression of diabetes, but the specificity and diversity of their antigenic repertoire remain unknown. Here, we define the structure of a peptide mimotope that elicits the proliferation, cytokine secretion, differentiation, and cytotoxicity of a diabetogenic H-2K(d)-restricted CD8(+) T cell specificity (NY8.3) that uses a T cell receptor alpha (TCRalpha) rearrangement frequently expressed by CD8(+) T cells propagated from the earliest insulitic lesions of NOD mice (Valpha17-Jalpha42 elements, often joined by the N-region sequence M-R-D/E). Stimulation of splenic CD8(+) T cells from single-chain 8. 3-TCRbeta-transgenic NOD mice with this mimotope leads to preferential expansion of T cells bearing an endogenously derived TCRalpha chain identical to the one used by their islet-associated CD8(+) T cells, which is also identical to the 8.3-TCRalpha sequence. Cytotoxicity assays using islet-derived CD8(+) T cell clones from nontransgenic NOD mice as effectors and peptide-pulsed H-2K(d)-transfected RMA-S cells as targets indicate that nearly half of the CD8(+) T cells recruited to islets in NOD mice specifically recognize the same peptide/H-2K(d) complex. This work demonstrates that beta cell-reactive CD8(+) T cells mount a prevalent response against a single peptide/MHC complex and provides one peptide ligand for CD8(+) T cells in autoimmune diabetes.

Amino Acid Sequence↗

Two mechanisms for the non-MHC-linked resistance to spontaneous autoimmunity.

Genetic susceptibility and resistance to most autoimmune disorders are associated with highly polymorphic genes of the MHC and with non-MHC-linked polygenic modifiers. It is known that non-MHC-linked polymorphisms can override or enhance the susceptibility to an autoimmune disease provided by pathogenic MHC genes, but the mechanisms remain elusive. In this study, we have followed the fate of two highly diabetogenic beta cell-specific T cell receptors (Kd and I-Ag7 restricted, respectively) in NOR/Lt mice, which are resistant to autoimmune diabetes despite expressing two copies of the diabetogenic MHC haplotype H-2g7. We show that at least two mechanisms of non-MHC-linked control of pathogenic T cells operate in these mice. One segregates as a recessive trait and is associated with a reduction in the peripheral frequency of diabetogenic CD8+ (but not CD4+) T cells. The other segregates as a dominant trait and is mediated by IL-4- and TGF-beta1-independent immune suppressive functions provided by lymphocytes that target diabetogenic CD4+ and CD8+ T cells, without causing their deletion, anergy, immune deviation, or ignorance. These results provide explanations as to how non-MHC-linked polymorphisms can override the susceptibility to an autoimmune disease provided by pathogenic MHC haplotypes, and demonstrate that protective non-MHC-linked genes may selectively target specific lymphoid cell types in cellularly complex autoimmune responses.

Amino Acid Sequence↗

Autoantigen-independent deletion of diabetogenic CD4+ thymocytes by protective MHC class II molecules.

Some MHC class II genes provide dominant resistance to certain autoimmune diseases via mechanisms that remain unclear. We have shown that thymocytes bearing a highly diabetogenic, I-Ag7-restricted beta-cell-reactive TCR (4.1-TCR) undergo negative selection in diabetes-resistant H-2g7/x mice by engaging several different antidiabetogenic MHC class II molecules on thymic (but not peripheral) hemopoietic cells, independently of endogenous superantigens. Here we have investigated 1) whether this TCR can also engage protective MHC class II molecules (I-Ab) on cortical thymic epithelial cells in the absence of diabetogenic (I-Ag7) molecules, and 2) whether deletion of 4.1-CD4+ thymocytes in I-Ab-expressing mice might result from the ability of I-Ab molecules to present the target beta-cell autoantigen of the 4.1-TCR. We show that, unlike I-Ag7 molecules, I-Ab molecules can restrict neither the positive selection of 4.1-CD4+ thymocytes in the thymic cortex nor the presentation of their target autoantigen in the periphery. Deletion of 4.1-CD4+ thymocytes by I-Ab molecules in the thymic medulla, however, is a peptide-specific process, since it can be triggered by hemopoietic cells expressing heterogeneous peptide/I-Ab complexes, but not by hemopoietic cells expressing single peptide/I-Ab complexes. Thus, unlike MHC-autoreactive or alloreactive TCRs, which can engage deleting MHC molecules in the thymic cortex, thymic medulla, and peripheral APCs, the 4.1-TCR can only engage deleting MHC molecules (I-Ab) in the thymic medulla. We therefore conclude that this form of MHC-induced protection from diabetes is based on the presentation of an anatomically restricted, nonautoantigenic peptide to highly diabetogenic thymocytes.

Animals↗

Perforin-independent beta-cell destruction by diabetogenic CD8(+) T lymphocytes in transgenic nonobese diabetic mice.

Autoimmune diabetes in nonobese diabetic (NOD) mice results from destruction of pancreatic beta cells by T lymphocytes. It is believed that CD8(+) cytotoxic T lymphocytes (CTLs) effect the initial beta-cell insult in diabetes, but the mechanisms remain unclear. Studies of NOD.lpr mice have suggested that disease initiation is a Fas-dependent process, yet perforin-deficient NOD mice rarely develop diabetes despite expressing Fas. Here, we have investigated the role of perforin and Fas in the ability of beta cell-reactive CD8(+) T cells bearing a T-cell receptor (8.3-TCR) that is representative of TCRs used by CD8(+) CTLs propagated from the earliest insulitic lesions of NOD mice, and that targets an immunodominant peptide/H-2Kd complex on beta cells, to effect beta-cell damage in vitro and in vivo. In vitro, 8.3-CTLs killed antigenic peptide-pulsed non-beta-cell targets via both perforin and Fas, but they killed NOD beta cells via Fas exclusively. Perforin-deficient 8.3-TCR-transgenic NOD mice expressing an oligoclonal or monoclonal T-cell repertoire developed diabetes even more frequently than their perforin-competent littermates. These results demonstrate that diabetogenic CD8(+) CTLs representative of CTLs putatively involved in the initiation of autoimmune diabetes kill beta cells in a Fas-dependent and perforin-independent manner.

Animals↗

[Congenital urethrocele in children. A case report].

Congenital urethrocele is a fairly rare disease in children. The authors report the case of a 9-year-old child presenting with a penoscrotal mass. Pressure on the mass produced urine. The diagnosis of urethrocele was established by ultrasonography and cystourethrography. Urethroplasty was successfully performed.

Child↗