PubMed Health⌕ Search

Biomedical subjects

C Adam

Publications and source records attributed to C Adam.

At least 37 records · Page 2Linked to original sources
PubMed2002

CASTEAUR: a simple tool to assess the transfer of radionuclides in waterways.

The CASTEAUR project proposes a simplified tool to assess the transfer of radionuclides between and in the main biotic and abiotic components of the freshwater ecosystem. Applied to phenomenological modeling, various hypotheses simplify the transfer equations, which, when programmed under Excel, can be readily dispatched and used. CASTEAUR can be used as an assessment tool for impact studies of accidental release as well as "routine" release. This code is currently being tested on the Rhone River, downstream from a nuclear reprocessing plant. The first results are reported to illustrate the possibilities offered by CASTEAUR.

Algorithms↗
PubMed2002

Significance of biodegradable implants in case of midfacial fractures.

The purpose of this prospective clinical study was to evaluate new resorbable implants for bone fixation. The plates and screws are made of poly (D, L)lactide (PDLLA). Bioresorbable osteosynthesis and fixation (ResorbX) has been applied in 22 patients. Indications for operations were craniofacial trauma (malar, orbital-floor or frontal bone fractures) or orthognathic procedures (Le Fort-I-osteotomies) as well as the surgical correction in case of craniofacial syndromes. In the initial follow up, the first patients showed clinically and radiologically uneventful fixation and healing of the bone. There were no implant material related complications. Overall, the advantages of PDLLA-implants appear to be their ease of use, radiolucency and resorption, although further experience is needed to determine the longterm benefits of biodegradable implants.

Absorbable Implants↗
PubMed2002

Hanced biological phosphorus removal in membrane bioreactors.

Enhanced biological phosphorus removal (Bio-P) in a membrane bioreactor (MBR) promises several advantages but was never attempted as not compatible with high sludge ages. This article includes description and results of bench-scale investigations on Bio-P removal in an MBR. An MBR bench-scale plant (210 L) was operated in parallel to a conventional WWTP under comparable process conditions. The results show that Bio-P removal is possible in MBR. The effluent qualities of the plants were comparable. The effluent P-concentration was always lower than 0.2 mg P(T)/L. In the MBR bench-scale plant P-uptake occurred mainly in the anoxic zone. Investigations with P-spiking showed higher Bio-P potential as P-removal increased up to 20-25 mg/L while P/TS rose up to >6%.

Bioreactors↗
PubMed2002

[Recurrent idiopathic stupor in a patient: responsibility of exogenous or endogenous benzodiazepines?].

Recurrent transitory consciousness loss represents a neurological diagnostic difficulty. A 56 year old man was hospitalised for recurrent stupor episodes. Explorations allowed to exclude hepatic, renal or respiratory failures, epilepsy or sleep disorder. During a stuporous state, since the patient was clearly awakened by flumazenil administration, the retained diagnosis was idiopathic recurrent stupor, a rare and not well-known disease. The authors discuss the possible effect of a treatment with zolpidem, though its pharmacokinetic characteristics did not correspond to the patient manifestations, and the possible responsibility of endogenous benzodiazepines in the genesis of this trouble.

Benzodiazepines↗
PubMed2001

Highly specific tumor binding of a 213Bi-labeled monoclonal antibody against mutant E-cadherin suggests its usefulness for locoregional alpha-radioimmunotherapy of diffuse-type gastric cancer.

A monoclonal antibody (E-cadherin delta 9-1) directed against a characteristic E-cadherin mutation (in-frame deletion of exon 9), found in diffuse-type gastric cancer but not in any normal tissue, was conjugated with the high linear energy transfer alpha-emitter 213Bi and tested for its binding specificity in s.c. and i.p. nude mice tumor models. After intratumoral application in s.c. tumors expressing mutant E-cadherin, the 213Bi-labeled antibody was specifically retained at the injection site as shown by autoradiography. After injection into the peritoneal cavity, uptake in small i.p. tumor nodules expressing mutant E-cadherin was 17-fold higher than in tumor nodules expressing wild-type E-cadherin (62% injected dose/g versus 3.7% injected dose/g). 78% of the total activity in the ascites fluid was bound to free tumor cells expressing mutant E-cadherin, whereas in control cells, binding was only 18%. The selective binding of the 213Bi-labeled, mutation-specific monoclonal antibody E-cadherin delta 9-1 suggests that it will be successful for alpha-radioimmunotherapy of disseminated tumors after locoregional application.

Animals↗
PubMed2001

Anticipation of epileptic seizures from standard EEG recordings.

BACKGROUND: New methods derived from non-linear analysis of intracranial recordings permit the anticipation of an epileptic seizure several minutes before the seizure. Nevertheless, anticipation of seizures based on standard scalp electroencephalographical (EEG) signals has not been reported yet. The accessibility to preictal changes from standard EEGs is essential for expanding the clinical applicability of these methods. METHODS: We analysed 26 scalp-EEG/video recordings, from 60 min before a seizure, in 23 patients with temporal-lobe epilepsy. For five patients, simultaneous scalp and intracranial EEG recordings were assessed. Long-term changes before seizure onset were identified by a measure of non-linear similarity, which is very robust in spite of large artifacts and runs in real-time. FINDINGS: In 25 of 26 recordings, measurement of non-linear changes in EEG signals allowed the anticipation of a seizure several minutes before it occurred (mean 7 min). These preictal changes in the scalp EEG correspond well with concurrent changes in depth recordings. INTERPRETATION: Scalp-EEG recordings retain sufficient dynamical information which can be used for the analysis of preictal changes leading to seizures. Seizure anticipation strategies in real-time can now be envisaged for diverse clinical applications, such as devices for patient warning, for efficacy of ictal-single photon emission computed tomography procedures, and eventual treatment interventions for preventing seizures.

Electroencephalography↗
PubMed2001

Delayed verbal memory retrieval: a functional MRI study in epileptic patients with structural lesions of the left medial temporal lobe.

In a previous functional magnetic resonance imaging (fMRI) study, we suggested that in left medial temporal lobe epilepsy (LTLE) poor verbal episodic memory performances were sustained by abnormal neocortical and mesiotemporal activations. In the present study, we attempted to examine the evolution of these abnormal neocortical and mesiotemporal activations over 24 h. We thus observed the fMRI brain regions activated during the 24-h-delayed retrieval of a word list in the same sample of healthy control subjects and LTLE patients. In control subjects, a similar left occipitotemporofrontal network was activated during both immediate and 24-h-delayed retrieval conditions. In addition, the 24-h-delayed retrieval also activated a larger parietal region and the right hippocampus. This distributed neocortical and mesiotemporal network was very poorly activated during the 24-h-delayed retrieval in LTLE patients, suggesting the inability to reactivate areas that are keys to retrieving stored information.

Adolescent↗
PubMed2001

Study of Health In Pomerania (SHIP): a health examination survey in an east German region: objectives and design.

OBJECTIVES: The reason for the Study of Health in Pomerania (SHIP) is the lack of epidemiological studies with a broad range of health indicators. Furthermore, in Germany there is a need for studies that take into account the particular situation of life after the reunification. One objective of SHIP is to provide prevalence estimates on a broad range of diseases, risk and health factors for a defined region in the former GDR. METHODS: A sample of 7008 women and men aged 20 to 79 years in a north-east region of Germany, 4900 expected participants. The sample was drawn in two steps: First, 32 communities in the region were selected. Second, within the communities a simple random sample was drawn from residence registries, stratified by gender and age. The data collection and instruments include four parts: oral health examination, medical examination, health-related interview, and a health- and risk-factor-related questionnaire. The oral health examination includes the teeth, periodontium, oral mucosa, craniomandibular system, and prosthodontics. The medical examination includes blood pressure measurements, electrocardiography, echocardiography, carotid, thyroid and liver ultrasounds, neurological screening, blood and urine sampling. The computer-aided health-related interview includes cardiovascular symptoms, utilisation of medical services, health-related behaviours, and socioeconomic variables. The self-administered questionnaire comprises housing conditions, social network, work conditions, subjective well-being and individual consequences from the German reunification.

Adult↗
PubMed2001

Use of hydro-jet cutting for laparoscopic partial nephrectomy in a porcine model.

OBJECTIVES: To evaluate whether a laparoscopic hydro-jet device can provide a safe and effective partial nephrectomy. Partial nephrectomy is still one of the most challenging operations in urologic laparoscopy. The control of hemorrhage is very difficult to achieve with laparoscopic techniques. In open surgery, hydro-jet resection is used to cut the renal parenchyma selectively, avoiding damage to the vascular structures or collecting system.Methods. Laparoscopic wedge, as well as pole, resections of the kidney were performed in 5 pigs under general anesthesia. After exposure of the kidney, the renal capsule was incised using electrocautery. The hydro-jet was then used to dissect the renal parenchyma. In pole resections, the collecting system and central vessels were divided using an Endo-GIA. Hemostasis was achieved by electrocoagulation or clips. The dissection time and intraoperative complications were evaluated.Results. The operations were performed successfully in all animals without temporary ischemia. The hydro-jet generator allowed precise and effective tissue dissection without significant hemorrhage. The parenchymal vessels were selectively coagulated. The collecting system and central vessels remained intact and could be divided after application of the Endo-GIA. The mean dissection time was 42 +/- 6 minutes for the wedge resections and 54 +/- 8 minutes for the pole resections. CONCLUSIONS: These experimental results demonstrate the suitability of hydro-jet dissection for safe laparoscopic partial nephrectomy without temporary ischemia and with reduction of the operative trauma to the kidney. On the basis of our own experiences with other techniques, including electrocautery and laser technology for partial nephrectomy, we conclude that laparoscopic hydro-jet resection represents an interesting alternative to other techniques.

Animals↗
PubMed2001

Endothelium-dependent relaxation induced by cathepsin G in porcine pulmonary arteries.

Serine proteinases elicit profound cellular effects in various tissues mediated by activation of proteinase-activated receptors (PAR). In the present study, we investigated the vascular effects of cathepsin G, a serine proteinase that is present in the azurophil granules of leukocytes and is known to activate several cells that express PARs. In prostaglandin F2alpha (3 microM)-precontracted rings from porcine pulmonary arteries with intact endothelium, cathepsin G caused concentration-dependent relaxant responses (pEC(50)=9.64+/-0.12). The endothelium-dependent relaxant effect of cathepsin G could also be demonstrated in porcine coronary arteries (pEC(50)=9.23+/-0.07). In pulmonary arteries the cathepsin G-induced relaxation was inhibited after blockade of nitric oxide synthesis by L-NAME (200 microM) and was absent in endothelium-denuded vessels. Bradykinin- and cathepsin G-induced relaxant effects were associated with a 5.7 fold and 2.4 fold increase in the concentration of cyclic GMP, respectively. Compared with thrombin and trypsin, which also produced an endothelium-dependent relaxation in pulmonary arteries, cathepsin G was 2.5 and four times more potent, respectively. Cathepsin G caused only small homologous desensitization. In cathepsin G-challenged vessels, thrombin was still able to elicit a relaxant effect. The effects of cathepsin G were blocked by soybean trypsin inhibitor (IC(50)=0.043 microg ml(-1)), suggesting that proteolytic activity is essential for induction of relaxation. Recombinant acetyl-eglin C proved to be a potent inhibitor (IC(50)=0.14 microg ml(-1)) of the cathepsin G effect, whereas neither indomethacin (3 microM) nor the thrombin inhibitor hirudin (5 ATU ml(-1)) elicited any inhibitory activity. Due to their polyanionic structure defibrotide (IC(50)=0.11 microg ml(-1)), heparin (IC(50)=0.48 microg ml(-1)) and suramin (IC(50)=1.85 microg ml(-1)) diminished significantly the relaxation in response to the basic protein cathepsin G. In conclusion, like thrombin and trypsin, cathepsin G is able to induce endothelium-dependent vascular relaxation. It can be released from activated leukocytes at sites of vascular injury and inflammation and, therefore, sufficiently high concentrations might be reached locally in the vascular space to induce vasodilatation.

Animals↗
PubMed2001

Simultaneous microsurgical spermatic vein ligation and sclerotherapy. a combined procedure for the treatment of recurrent or persistent varicocele.

OBJECTIVES: Microsurgical ligation as well as antegrade sclerotherapy have been established in varicocele treatment. The aim of this study was to evaluate whether a combination of microsurgery and sclerotherapy can provide a safe and effective treatment of varicocele recurrence or persistence. METHODS: Nine patients with recurrent or persistent varicoceles were operated by means of the combination method. Under microscopic control varix veins were ligated selectively preserving lymphatics and arteries. Ectopic veins as a possible source for varicocele persistence or recurrence were also ligated. Finally, an intraoperative venography with subsequent sclerotherapy was performed through one of the dissected veins. RESULTS: Despite difficult anatomical situations after previous surgical interventions, the operations were performed successfully without any complications. Clinical controls showed varicocele disappearance without damage of the testis. No varicocele recurrence or persistence was observed. CONCLUSIONS: This method combines the advantages of both methods. Precision of the microsurgical technique is combined with velocity of sclerotherapy. Thus, it may represent an interesting alternative to conventional operation methods especially in the treatment of recurrent or persistent varicoceles.

Combined Modality Therapy↗
PubMed2000

[Surgery of epilepsy: current status].

PRELIMINARY EXPLORATIONS: The advent of magnetic resonance imaging and its capacity to detect fine structural injury and SPECT and PET functional imaging as well as the generalization of EEG-video and the simplification of intracranial electrode implantation techniques has given a whole new life to surgery in epilepsy. Preoperative explorations are shorter and less invasive, allowing surgery without implantation of intracranial electrodes in more than 70% of the cases. SURGERY: New surgical techniques (subpial transection, neuro-navigation...) and improvement in well-known procedures (amygdalo-hippocampectomy...) has made it possible to propose lower risk procedures with minimal trauma (overall complication rate < 10%), particularly for temporal epilepsy where the success rate is greater than 80%. FUNDAMENTAL RULE: The key to success however directly depends on rigorous application of the fundamental rule of anatomo-electro-clinical correlation.

Amygdala↗
PubMed2000

Accurate prediction of postoperative outcome in mesial temporal lobe epilepsy: a study using positron emission tomography with 18fluorodeoxyglucose.

BACKGROUND: Recent studies suggest that positron emission tomography may be a reliable predictive indicator of clinical outcome following surgical treatment for epilepsy. OBJECTIVE: We evaluated 30 patients with documented medial temporal lobe epilepsy to determine if prediction of postoperative outcome is improved with the use of positron emission tomography with (18)fluorodeoxyglucose. PATIENTS AND METHODS: We performed a discriminant analysis to determine the combination of metabolic asymmetry indexes in temporal and extratemporal regions defined by magnetic resonance imaging that best predicted the postoperative outcome. Seizure outcome was assessed at least 2 years after surgery: patients were classified as seizure free (n = 14, group A), mostly improved (n = 10, group B), or as having persistent seizures (n = 6, group C). RESULTS: Discriminant analysis was first performed in groups A and C. The temporal pole seemed to be the only temporal region for which metabolism was a significant predictor of the postoperative outcome (F(1,18) = 10.19; P =.005). The predictive value of positron emission tomography with (18)fluorodeoxyglucose was considerably improved by the multivariate analysis (F(4,15) = 7.21; P =.002), which correctly predicted the 2 -year prognosis in 100% of the patients using 4 regions: the temporal pole, the medial temporal region, the anterior part of the lateral temporal neocortex, and the basofrontal region. As a validation, we performed this 4-region analysis in the patients in group B. The difference among the 3 groups was highly significant (F = 15.5, P<.001). CONCLUSION: These findings suggest that the interictal metabolic pattern reliably predicts the 2-year prognosis after surgery in patients with medial temporal lobe epilepsy.

Adult↗
PubMed2000

Experimental kinetic rates of food-chain and waterborne radionuclide transfer to freshwater fish: a basis for the construction of fish contamination charts.

A standardized procedure is proposed to obtain from laboratory experiments the kinetic accumulation and release rates necessary to calibrate dynamic models to quantify radionuclide direct and trophic transfer in fish. The model takes into account the food-chain effect, the feeding rate, and the growth of organisms. It takes as examples (54)Mn, (60)Co, and (137)Cs transfer dynamics through a simple pelagic food-chain (phytoplankton, zooplankton, prey fish, and predator fish). The estimated kinetic rates used in quantifying all the transfers of the three radioactive pollutants through the pelagic food chain are compared from the radioecological point of view. For fish, comparison was based on the calculation of concentration factors referring to direct transfer from water and trophic transfer factors. For the prey fish and the predator fish, direct transfer gave the following order for accumulation (60)Co < (137)Cs < (54)Mn. Values reached at equilibrium in L/kg WW were respectively for the prey fish and the predator fish: 8.7 < 27.4 < 107 and 4.14 < 6.59 < 13.4. For the trophic route, (137)Cs is the most accumulated (TTF(eq) = 0.485 in 291 days for the prey fish and TTF(eq) = 1.45 in 17 years for the predator fish). A sensitivity analysis adapted to the case of a chronic contamination scenario of a watercourse was run. It showed that the phytoplankton biomass, the contact time of these drifting particles from a release point to the station where they are ingested and the feeding rates of the fish are the most influential parameter with regard to the concentration in fish, whatever the trophic level. Contamination charts are constructed for the predator fish to illustrate the relationship between the most influential ecological parameters and the radionuclide concentration in fish for simple contamination scenarios. They are shown to be effective tools for helping in the choice of the most relevant value of aggregated concentration factors (ACFs: radionuclide concentration ratio between the organism and the water, referred to steady-state and to all possible transfer pathways) for a given key ecological situation in a given ecosystem. An example is given of a simple chronic release scenario of 1 Bq/L and a phytoplanktonic bloom period. For (137)Cs, the ACF increases with increasing contact time and increasing feeding rate, to nearly 550 L/kg WW at equilibrium. For (54)Mn, ACF reaches 65 L/kg WW. For (60)Co, the general pattern of the relationship is due to the rapid kinetic rates governing the distribution of the radionuclide between dissolved and solid (phytoplankton) phases with a maximum value for ACF of 7.2 L/kg WW for the case study. Analysis of these charts provides a basis for overall guidelines for chronic releases in a given watercourse.

Animals↗
PubMed2000

Postictal aphasia and paresis: a clinical and intracerebral EEG study.

BACKGROUND: We examined the lateralizing value of postictal language and motor deficits and studied their underlying mechanisms. PATIENTS AND METHODS: The total sample consisted of 35 patients (26 temporals, 8 frontals, 1 parietal) with a good postsurgical outcome (Engel's class I and II). Postictal examination was blindly reviewed on videotapes. In 15 cases (29 seizures), postictal language manifestations were analyzed in relation with the diffusion of the epileptic discharge recorded by intracerebral EEG. Language dominance was determined by the intracarotid amobarbital test. RESULTS: Postictal aphasia was observed only when (1) seizure originated in the dominant hemisphere and (2) ictal activity spread to language areas (Wernicke and/or Broca areas). When the epileptic focus was in the nondominant hemisphere, no postictal aphasia was observed even if there was secondary generalization of ictal activity affecting the language areas of the dominant hemisphere. Postictal motor deficits also had a strong lateralizing value even when seizures were secondarily generalized. CONCLUSION: Postictal aphasia in temporal epilepsies and postical motor deficits in temporal and extra temporal epilepsies provided excellent lateralizing information. Postictal deficits appear to be the result of inhibitory mechanisms induced by previous ictal activity of the structures related to these functions.

Adolescent↗
PubMed2000

Effects of capsaicin-induced sensory denervation on osteoclastic resorption in adult rats.

Many recent findings suggest that the nervous system has efferent effects on bone. A putative role of the sensory innervation has been assessed by using a synchronised rat model of bone resorption after treating adult animals with the neurotoxin capsaicin. Fourteen days after capsaicin treatment (50 mg kg-1) the right maxillary molars were extracted to activate a wave of resorption along the mandibular cortex. The rats were killed 4 days later (i.e. at the peak of resorption in this model), and their right mandibles were processed for histometric evaluation of resorption along the cortex and of calcitonin gene-related peptide (CGRP)- and substance P (SP)-immunoreactive (IR) fibres in the dental pulp. CGRP-IR and SP-IR fibres were significantly reduced in numbers by the capsaicin treatment (by 58 and 49%, respectively), confirming the success of sensory denervation. The resorption surface was significantly reduced (P < 0.005) versus the sham-treated animals. Although the size of the osteoclast population recruited in the site was not modified, the number of actively resorbing osteoclasts was significantly reduced (P < 0.03). However, the activity of the resorbing cells was not modified. Non-specific esterase-positive osteoclast precursors were also significantly few after capsaicin treatment. These data show that the sensory nervous system is involved in the control of bone resorption at two different levels: (1) in the recruitment of osteoclast precursors, and (2) in regulating the access of recruited cells to the bone surface.

Animals↗