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Biomedical subjects

B Leroy

Publications and source records attributed to B Leroy.

At least 37 records · Page 2Linked to original sources
PubMed1998

Quantification of plasma lipoprotein fractions by wavelet transform time-domain data processing of the proton nuclear magnetic resonance methylene spectral region.

Quantitative analysis of lipoprotein major fractions, LDL, VLDL and HDL, is of great interest for medical purposes, for instance in liver or heart diseases, diet management or cancer. The presently available biochemical methods require time consuming ultracentrifugation. A potentially automated method is proposed, using time domain quantification by Wavelet Transform (WT-NMR) method. The aim of the present study was to evaluate, on a preliminary series of nine human plasmas, the potential interest of WT-NMR in the quantification of both NMR-visible lipids and total lipoprotein fractions. The correlation coefficients between low and intermediate density (LDL+IDL), very low density (VLDL) and high density (HDL) lipoprotein visible lipid quantifications, obtained on nine human plasmas with WT-NMR and standard biochemical methods, were 0.79, 0.84 and 0.92, respectively. For the total lipoprotein assay, i.e. including an estimation of non NMR-visible protein and free cholesterol, the correlation between WT-NMR and the biochemistry were 0.87 for LDL+IDL, 0.81 for VLDL and 0.88 for HDL.

Blood Proteins↗
PubMed1997

[The Pfannenstiel incision in colorectal surgery].

A parietal incision derived from Pfannenstiel's incision has been used since 1983 for surgery of the left colon and rectum. We conducted a prospective study in 100 patients with a mean age of 61 years who underwent surgery from 1984 to 1987 to assess the parietal outcome, postoperative pain and respiratory impact. The most frequent procedures were: sigmoidectomy (n = 48), anterior resection of the rectum (n = 24), rectopexia (n = 12), amputation of the rectum (n = 5) and total colectomy (n = 5). The splenic angle was mobilized in 23 cases. The operation also included a procedure to relieve occlusion in 4 patients. Operative mortality was nil. Parietal complications were bleeding (n = 4) or infection (n = 8). Seven early reoperations used the same access. Mean follow-up for 61 patients was 75 months. No cases of eventration were observed despite factors predictive of failure. Ventilatory impact, as measured by spirometry showed ventilatory peak-flow and blood gases comparable to those observed after a medial hypogastric incision. Pain, assessed on the bases of a visual analog scale and use of antalgesics, was considered to be mild on day 1, low on day 2 and absent on day 5. Sixty-five percent of the patients did not require antalgesics. In conclusion, this incision creates a hypogastric minilaparotomy allowing midline sub- and peri-umbilical, or even xyphoidial access with little pain and operative risk as the parietal risk is eliminated. Oral nutrition and activity can be resumed rapidly, reducing surgical stress in a protocol for minimally-invasive surgery.

Adult↗
PubMed1996

[Digestive manifestations in hemolytic uremic syndrome in children].

BACKGROUND: Gastro-intestinal manifestations are relatively frequent during the course of hemolytic uremic syndrome (HUS), some of them requiring special supportive care. This work was aimed at retrospectively studing gastrointestinal manifestations of HUS and determining their place in the prognosis. PATIENTS: Thirty-seven children aged 4 months to 11 years (22 girls and 15 boys) were included in the study. RESULTS: All children but one had gastrointestinal prodromes. During the course of HUS, various manifestations were seen: bloody diarrhea in 32% of patients, ileo-ileal intussusception in 3%, rectal prolapse in 8% and hepatic cytolysis in 38%. Seven patients with bloody diarrhea had a complicated course, lethal in one. Comparison between these seven children and the 30 others revealed some indicators of severe gut involvement: female sex, short duration of gastrointestinal prodromes, hemorrhagic colitis with rectal prolapse, high WBC count, high neutrophils count and less important degree of anemia at admission. Severity of the gastrointestinal lesions was correlated with that of the outcome of the renal disease. CONCLUSION: Gastrointestinal tract is frequently affected in HUS and severe complications can appear, potentially leading to death. Total parenteral nutrition could prevent occurrence of gastrointestinal complications. Severe gastrointestinal lesions are associated with a poor renal outcome.

Child↗
PubMed1996

Neuropsychological aspects of Marfan syndrome.

We evaluated the neuropsychological status of 13 adults patients with Marfan syndrome. All subjects were administered the same neuropsychological test battery that included nine measures covering a broad range of cognitive abilities such as attention and concentration, learning and memory, and verbal and non-verbal abilities. Compared to a control group of 13 healthy subjects matched for sex, age and verbal intelligence, Marfan patients only performed significantly worse on tests measuring sustained visual attention and visuoconstruction. Although these tests use visual material and depend on visual perception and processing, the visual acuity problems associated with the syndrome could not explain these differences, nor could the use of beta-blocking medication or the presence of joint hypermobility. The findings suggest that problems with sustained visual attention and visuoconstruction may be present in Marfan syndrome over and above visual acuity problems and other phenomena associated with the disease. Further research on the neuropsychological aspects of Marfan syndrome is needed, using larger patient groups and more adequate control groups such as non-affected siblings and matched controls with similar visual impairment.

Adolescent↗
PubMed1995

Azathioprine-induced pulmonary haemorrhage in a child after renal transplantation.

We report a case of azathioprine-induced haemorrhagic alveolitis, in a 14-year-old boy, after renal transplantation. On day 25 the patient developed haemoptysis, fever and hypoxaemia. Chest X-ray showed diffuse reticulo-nodular shadows in both lung fields. Bronchoalveolar lavage samples were haemorrhagic and demonstrated a relative neutrophilia and a mild lymphocytosis, with a normal CD4/CD8 ratio. Azathioprine was discontinued on day 26. The patient required mechanical ventilation for 4 days. A positive leucocyte migration inhibition test and the recurrence of the symptoms after a second short course of azathioprine therapy suggested a cell-mediated mechanism. This patient is, to our knowledge, the first child to suffer from azathioprine-induced pulmonary haemorrhage.

Acute Disease↗
PubMed1995

[Transient correction of partial congenital factor V deficiency in nephrotic syndrome].

Plasma concentration of several hemostatic proteins may be modified during the acute phase of nephrotic syndrome. The case of such a syndrome in a patient with congenital factor V deficiency is presented. CASE REPORT--A 5 year-old girl with partial congenital factor V deficiency (level: 30%), was admitted for nephrotic syndrome complicating Henoch-Schönlein purpura. Urine protein excretion was 4 g/24 h. Initial plasma concentrations were: protein: 5.5 g/dl; albumin: 3.3 g/dl; factor II: 85%; factor V: 56%; factors VII + X: 80%. The patient was given methylprednisolone (1 g/1.73 m2) followed by prednisone (2 mg/kg/day). Under this treatment, the plasma concentrations were: protein: 4.5 g/dl; albumin: 2.0 g/dl; factor II: 180%; factor V: 84%; factors VII + X: 120%. Values at the onset of remission were: albumin: 3.4 g/dl; factor V: 49%. CONCLUSION--This observation suggests that hypoalbuminemia may enhance liver synthesis of factor V as known for some other coagulation factors, and transiently correct the hereditary deficiency.

Child, Preschool↗
PubMed1994

Intrauterine growth retardation leads to a permanent nephron deficit in the rat.

Intrauterine growth retardation (IUGR) was induced in Sprague-Dawley rats by partial artery ligation of one uterine horn in the mother on day 17 of gestation or by feeding the mother a 5% protein diet from day 8 of gestation. The controls were pups of the contralateral uterine horn or pups born to mothers fed a normal (22%) protein diet. The number of nephrons present at birth and the final number of nephrons in 2-week-old rats were counted throughout the entire kidney. The number of nephrons present at birth and the final number of nephrons were significantly correlated with birth weight for growth-retarded rats of both groups and their corresponding controls (P < 0.02 for the poorest correlation). Clearance experiments and morphometric studies of 2-week-old rats born to mothers with uterine artery ligation indicated that, despite a large compensatory hypertrophy of the nephrons in those animals born with a nephron deficit of about 30%, the overall renal function was impaired. We conclude that IUGR is accompanied by a nephron deficit which may not be fully compensated for within the first weeks after birth.

Animals↗
PubMed1994

Ocular anomalies in an unbalanced translocation between chromosomes 7 and 8.

A translocation between chromosomes 7 and 8 was found in several members of a family. We describe two family members with an unbalanced form of this translocation with the derivative of chromosome 7:der(7),t(7;8)(q34;q24.1). Both present multiple congenital systemic anomalies and ocular aberrations. Of those the coloboma of the optic disc is the most obvious. We discuss the pathology of the eyes of one of our patients.

Abnormalities, Multiple↗
PubMed1994

[Acute urine retention: a rare mode of revelation of cervico-dorsal syringomyelia caused by cyproheptadine].

BACKGROUND: Syringomyelia is rare in children aged less than 10 years, and bladder dysfunction is an unlikely first manifestation. This report describes a case of repeated episodes of acute urinary retention in a young girl revealing syringomyelia and Arnold-Chiari malformation. CASE REPORT: A 2.5 year-old girl was admitted because she was suffering from acute urinary retention. Her poor appetite had been treated with cyproheptadine, a histamine type I blocking drug. Clinical investigation revealed no local cause for this bladder dysfunction except moderate spasticity of the legs. Cystography showed no vesicoureteral reflux. Because the episodes of urinary retention recurred each day, magnetic resonance imaging (MRI) was performed; this showed the typical features of syringomyelia extending from C5 to T11 plus Arnold-Chiari malformation. The cyproheptadine was discontinued and the urinary retention disappeared. CONCLUSION: Cyproheptadine may have revealed latent neurogenic bladder in this case, although urodynamic studies, performed 3 months later, detected no bladder dysfunction.

Acute Disease↗
PubMed1993

[Treatment of urinary infection in children].

Urinary tract infection in children includes several and totally different diseases which must be managed according to circumstances. In all cases of acute pyelonephritis the patients must be investigated for abnormalities of urinary tract structures. A strong and prolonged treatment reduces the risk of scars. Lower urinary tract infection without potential deleterious effects on the renal parenchyma requires an oral antimicrobial therapy of not more than 7 days duration. Asymptomatic infection with normal urinary tract structures does not need an antimicrobial treatment. Long-term prophylactic antimicrobial treatment administered in full doses produces bacterial selection. Very low doses are sufficient to reduce the virulence of the pathogen and the risk of infection, without altering the gastrointestinal flora.

Acute Disease↗
PubMed1993

[A rare cause of bone pain in children: primary hyperparathyroidism caused by adenoma].

BACKGROUND: Primary hyperparathyroidism is rare in children and adolescents. Bone changes may produce pain in the back or extremities, but this is rarely the first symptom of the disease. CASE REPORT: A 13 year-old girl suffered from pain in the back and lower extremities. Progressive bilateral genu valgum appeared. One year later, she became lame because of the deformity. ECG showed cardiac arrhythmia with atrial extra systoles. The serum calcium concentrations were 3.36 and 3.8 mmol/l, phosphate 0.76 mmol/l and alkaline phosphatases 6,612 U/I (N: 90-300). Urinary excretion of calcium was 17 and 26 mg/kg/day and the renal tubular reabsorption of phosphate was 77%. Radiological studies revealed resorption of subperiosteal bone, best seen along the margins of the phalanges, demineralization of the skull vault, bilateral coxa vara and zones of calcification on knee metaphyses. The serum concentration of parathyroid hormone (PTH) was 1,066 pg/ml (N: 10-55) and that of 1-25(OH)2D3 was 125 ng/ml (N: 20-80). Ultrasonography showed a heterogeneous mass, 23 x 15 mm, suggesting a parathyroid adenoma. This adenoma was independent of the left inferior parathyroid. It was removed and the biochemical findings gradually returned to normal. Bone demineralization also disappeared and the knee deformities were surgically corrected 9 months later. CONCLUSIONS: Bone changes may occasionally cause severe pain, indicating demineralization and hypercalcemia: hyperparathyroidism is one cause of such changes.

Adenoma↗
PubMed1993

[Transcutaneous electric stimulation of the brain: a comparative study of the effects of its combination with peridural anesthesia using bupivacaine-fentanyl during obstetrical analgesia].

In order to test the effectiveness of Anesthelec (transcutaneous cranial electrical stimulation with Limoge currents) during labour and delivery, a randomized study was carried out in 120 primiparous women with extradural anaesthesia during active labor. Combination of transcutaneous cranial electrical stimulation with epidural bupivacaine administration has been showed to provide a 20% pain relief prolongation of the first bupivacaine injection. Statistical studies of drug requirement during labor, of cervical dilatation duration, of mode and duration of delivery and of analgesia quality showed no beneficial additive effect of electrical stimulation for obstetrical analgesia when extradural anaesthesia is performed.

Adult↗
PubMed1993

[Effect of the treatment with human recombinant erythropoietin on anemia in children with end-stage kidney failure. French multicenter study].

BACKGROUND: The production of recombinant erythropoietin, has made large quantities of pure protein available for clinical studies. Published reports have concentrated on patients with end-stage renal disease, who develop transfusion-dependent anemia. MATERIAL AND METHODS: A total of 58 children aged less than 18 years (mean age: 11.48 +/- 4.62 years) with end-stage renal disease (hereditary in 9, congenital in 21 and acquired in 28) treated between July 1987 and February 1990, were included in the study. The mean duration of dialysis (hemodialysis in 56, peritoneal dialysis in 2) at the onset of the study was 35 +/- 28 months. 3 children had undergone bilateral nephrectomy, and 2 were infected with HIV. 54 children were given a phosphate-binder, 10 were given iron and 20 were given folic acid supplements. During the 6 months preceding the study, 51 patients received at least one blood transfusion (40 received 1 to 4 and 11 received 5 to 9 transfusions of packed red blood cells). Recombinant human erythropoietin (rHu EPO) (40 units/kg) was given intravenously three times per week for at least 6 weeks, with the exception of the first 9 patients who were given 80-100 units/kg. When the hematocrit increased less than 0.5% per week (or 3% for 6 weeks), the dose of rHu EPO was increased in stages, without exceeding 200 units/kg/injection. When the hematocrit reached 30 to 35%, the dose of rHu EPO was decreased by half, then gradually adjusted to maintain the hematocrit within this range. RESULTS: The mean value of reticulocytosis increased from 4.88 to 10.58% and the hematocrit increased from 19.34 to 29.95% during the study. The patients also reported that their appetites and general condition improved. The need for transfusion dramatically decreased after the first month of treatment. The main adverse effect of the rHu EPO administration was an increase in the number of patients with hypertension (31/45 versus 19/45), indicating the need for good control of blood pressure before treatment. CONCLUSION: Erythropoietin treatment increases packed blood volume in a dose-dependent fashion. Most patients need no further transfusion and the quality of life clearly improves.

Adolescent↗