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Biomedical subjects

C André

Publications and source records attributed to C André.

At least 73 records · Page 4Linked to original sources
PubMed2001

Internal carotid artery stenosis: comparison of duplex scan and magnetic resonance angiography with digital subtraction angiography.

OBJECTIVE: We compare duplex scan (DS) and magnetic resonance angiography (MRA) with digital angiography (DGA) in respect to accuracy in measuring internal carotid artery (IC) stenosis in symptomatic patients. METHOD: Ten symptomatic patients with IC stenosis greater than 70% previously diagnosed by DS were submitted to another DS and to both MRA and DGA. Both ICs from each patient (total 20 ICs) were evaluated by physicians blinded for the results of other tests. DS and MRA were compared with DGA, using the intraclass correlation coefficient (r) and its 95% confidence interval (95% ci). For each diagnostic test, the study group (20 Ics) was also divided in surgical patients (IC stenosis between 70 and 99%) and non surgical patients, using kappa concordance coefficient (k) to compare the results. RESULTS: Main comparisons are: DS and DGA, r = 0.71 (0.4 - 0.87); MRA and DGA, r = 0.61 (0.25 - 0.82). After division into surgical vs. non-surgical groups, k = 0.857 (p < 0.0001) between DS and DGA; and k = 0.545 (p = 0.003) between MRA and DGA. Most DS and MRA errors occurred in IC sub-occlusions. CONCLUSION: The results suggest that when they are used together, DS and non-contrast MRA may substitute DGA in the evaluation of patients for IC stenosis surgery, except when there is discordance between their results or when the methods show sub-occlusive stenosis.

Adult↗
PubMed2001

Comparison between the NASCET method and subjective visual impression in the evaluation of internal carotid artery stenosis.

OBJECTIVE: To evaluate the accuracy of subjective visual impression (SVI) of an experienced neuro-radiologist in the measurement of the degree of internal carotid artery (IC) stenosis evaluated by digital angiography (DGA). METHOD: Ten symptomatic patients with internal carotid stenosis greater than 70% in a previous duplex scan were submitted to DGA. The degree of stenosis in both sides (symptomatic and asymptomatic) were evaluated by the same neuro-radiologist who gave his SVI and applied the NASCET method immediately after. Both methods were compared using the intraclass correlation coefficient (r) and its 95% confidence interval (95% ci). For each method, the sample (20 ICs) was also divided in surgical (stenosis between 70 and 99%) and non surgical ICs, using kappa concordance coefficient (k) to compare the results. RESULTS: The results comparing the 20 values obtained by each method are: r = 0.90 (95% ci: 0.77-0.96). Dividing the sample in surgical and non surgical ICs, k = 0.857, p < 0.0001; sensitivity = 100% (39.6%-100%); specificity = 93.8% (67.7%-99.7%); positive predictive value = 80% (29.9%-98.9%); negative predictive value = 100% (74,7%-100%). CONCLUSION: The SVI may be used by at least some experienced neuroradiologists as a preliminary tool to evaluate the degree of IC stenosis with DGA, but a standardised and well established method should be routinely performed.

Angiography, Digital Subtraction↗
PubMed2001

Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report.

Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO) regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT) has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF) during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.

Adult↗
PubMed2001

[Conjunctival provocation test with Dermatophagoides pteronyssinus in the diagnosis of allergic conjunctivitis from house mites].

INTRODUCTION: Perennial conjunctivitis due to house dust mites is the most frequent form of allergic conjunctivitis in urban environments. However, its diagnosis remains difficult for ophthalmologists. In this study, we evaluated a conjunctival provocation test (CPT) using standardized extracts of Dermatophagoides pteronyssinus (Dpt) and compared it to the diagnostic methods commonly performed in allergology: prick tests with dust and house dust mites and specific and IgE assay. MATERIALS AND METHODS: We performed a CPT on 60 volunteer patients, between the ages of 8 and 64 years, corresponding to 30 patients sensitized to house dust mites with the presence of specific IgE and chronic conjunctivitis, 21 patients not sensitized to house dust mites but presenting features of chronic conjunctivitis, and 9 asymptomatic patients. A house dust mite desensitizing treatment was not an exclusion criterion for a number of allergic patients. CPTs were prepared from Dpt allergenic extracts (Laboratoires Stallergènes, Antony, France) with 5 progressive concentrations by dilution in a nonphenolic physiological solution: 1.2 RI, 3.7 RI, 11 RI, 33 RI, and 100 RI. CPTs were performed in only one eye and asymmetry of the ocular response was evaluated by the cumulative clinical score of Abelson Chambers and Smith. The correlation between the 2 diagnostic tests was established by calculating the Cohen correlation coefficient or kappa. We also evaluated the sensitivity and diagnostic specificity for each test. RESULTS: The statistical correlation between specific IgE and the other allergological tests in for allergic conjunctivitis to house dust mites was 0.93 for the CPT, 0.46 for the prick test to Dpt, and 0.33 for the prick test to dust. The diagnostic sensitivities and specificities for each test were 90% and 100% for the CPT, 60% and 70% for the prick test to dust, 70% and 76% for prick test to Dpt, respectively. Beyond an antigenic cut-off value of 11 RI, we also observed greater hypersensitivity reactions for patients with lacrimal IgE or elevated specific IgE levels. CONCLUSION: The results obtained with the CPT confirm its high antigenic quality. It is a particularly useful, rapid, and perfectly safe clinical test. It is the only test able to establish a relationship between ocular manifestations and specific I(8)E.

Adolescent↗
PubMed2001

[Volumetric determination of cerebral infarction in the acute phase using skull computed tomography without contrast: comparative study of 3 methods].

The determination of lesion volumes in acute cerebral Infarction (CI) has important prognostic and therapeutic implications. Three different methods -computerised technique, linear planimetry and the A.B.C/2 formula - were compared in 27 patients using non-contrast computerised tomography (CT) made at hospital admission (first 48 hours following symptom onset). Two independent observers performed the measurements. The Intra-class correlation coefficients (ICCs) were determined. The three methods exhibited high interrelation. There was a close correlation between the linear planimetry as well as the ABC/2 formula and the computerised method with ICCs of 0.94-0.95 and 0.835-0.90 respectively. Linear planimetry and the ABC/2 formula were also highly correlated, with ICCs between 0.97 and 0.99. In conclusion, the computerised method is probably the most accurate. Linear planimetry and the ABC/2 formula are also reliable, however. The A.B.C/2 formula should be applied routinely to CI volume determination based on its low cost and fast calculation.

Acute Disease↗
PubMed2001

Safety and efficacy of specific immunotherapy with standardized allergenic extracts adsorbed on aluminium hydroxide.

Specific immunotherapy (SIT) with standardized allergenic extracts is the only specific treatment of allergic patients. In order to evaluate the safety, side effects, and efficacy of SIT with standardized extracts adsorbed to aluminium hydroxide manufactured by Stallergènes S.A., a prospective multicenter open study was performed in Switzerland. Fifteen patients suffering from seasonal or perennial rhinoconjunctivitis with or without asthma were included in the trial and received a total of 442 injections with standardized mix of grass pollens (n = 8) or house dust mites (n = 7) over one year. Low incidence of local reactions was noted (7%). Subcutaneous nodules (granuloma) following injections were not recorded. Only a few systemic reactions (one mild rhinitis, one mild asthma attack, one worsening of eczema) were recorded. No anaphylactic reactions requiring adrenaline were recorded. No admission to the hospital was required. Global appreciation of the physicians and the patients after the first year of treatment showed a good efficacy of SIT: Only two patients (13%) did not improve. A worsening of the symptoms was not observed. In order to assess the efficacy, skin reactivity and conjunctival reactivity to allergen challenge were compared before and after one year of treatment as well as immunologic parameters (such as specific IgE, specific IgG4) in blood samples. A significant decrease in skin reactivity (p = .001) and in conjunctival reactivity (p = .01) was observed. Specific IgE level decreased for both types of allergens but to a significantly greater extent for grass pollen allergen (p = .03). Specific IgG4 level increased significantly for grass (p = 0.01) and for mites (p = 0.04). Specific immunotherapy appears to be a valuable tool in the efficient management of the allergic respiratory diseases.

Adult↗
PubMed2000

Comparative study of new alpha-galactosidases in transglycosylation reactions.

We have studied the potential of several newly cloned alpha-galactosidases to catalyze the regioselective synthesis of disaccharides using 4-nitrophenylgalactoside as a donor. The kinetics of the reactions were followed by in situ NMR spectroscopy. The following thermophilic enzymes have been tested: Aga A and an isoenzyme Aga B obtained from the strain KVE39 and Aga 285 from the strain IT285 of Bacillus stearothermophilus; Aga T is an alpha-galactosidase from Thermus brockianus (strain IT360). Two other non-thermophilic alpha-galactosidases have also been evaluated: Aga 1 (Streptococcus mutans, strain Ingbritt) and Raf A (Escherichia coli, strain D1021). For all of the enzymes studied, high regioselectivity was observed leading to two (1 --> 6)-disaccharides: 4-nitrophenyl alpha-D-galactopyranosyl-(1--> 6)-alpha-D-galactopyranoside and methyl alpha-D-galactopyranosyl-(1--> 6)-alpha-D-galactopyranoside, which were obtained in 54% (Aga B) and 20% (Aga T) yields, respectively.

Catalysis↗
PubMed2000

An integrated linkage-radiation hybrid map of the canine genome.

Purebred dogs are a unique resource for dissecting the molecular basis of simple and complex genetic diseases and traits. As a result of strong selection for physical and behavioral characteristics among the 300 established breeds, modern dogs are characterized by high levels of interbreed variation, complemented by significant intrabreed homogeneity. A high-resolution map of the canine genome is necessary to exploit the mapping power of this unusual resource. We describe here the integration of an expanded canine radiation hybrid map, comprised of 600 markers, with the latest linkage map of 341 markers, to generate a map of 724 markers-the densest map of the canine genome described to date. Through the inclusion of 217 markers on both the linkage and RH maps, the 77 RH groups are reduced to 44 syntenic groups, thus providing comprehensive coverage of most of the canine genome.

Animals↗
PubMed2000

Comparative mapping between humans and pigs: localization of 58 anchorage markers (TOASTs) by use of porcine somatic cell and radiation hybrid panels.

To increase the number of Type I markers that are directly informative for comparative mapping, 58 anchorage markers, TOASTs (Traced Orthologous Amplified Sequence Tags), were mapped in pig. With specific consensus primers, 76 TOASTs were tested in pig: 50 were regionally localized in pig on a somatic cell hybrid panel (SCHP), and 51 were mapped on the whole genome, INRA/University of Minnesota porcine Radiation Hybrid panel (IMpRH). Comparison of marker positions on RH and cytogenetic maps indicated general concordance except for two chromosomal regions. For RH mapping, all markers, apart from one, were significantly linked (LOD > 4.8) to a marker of the first-generation radiation hybrid map. Localization of new markers on the initial map is necessary for drawing a framework map as shown for Chromosome Sscr 14. The addition of four TOASTs has enabled us to propose an improved map, using a threshold likelihood ratio of 1000/1. At the whole-genome level, this work significantly increased (by 50%) the number of precisely mapped genes on the porcine RH map and confirmed that the IMpRH panel is a valuable tool for high-resolution gene mapping in pig. Porcine PCR products were sequenced and compared with human sequences to verify their identity. Most of the localizations made it possible to either confirm or refine the previous comparative data between humans and pigs obtained through heterologous chromosomal painting or gene mapping. Moreover, the use of TOASTs in mapping studies appears to be a complement to other strategies using CATS, human ESTs, or heterologous FISH with BACs which had already been applied to improve the gene density of comparative genomic maps for mammals.

Animals↗
PubMed2000

[Clinical significance of antiribosomal antibodies. Study Group on Autoimmunity (GEAI)].

PURPOSE: Autoantibodies directed against the ribosomal P proteins, P0, P1 and P2 (anti-P), have been related to lupus-related psychosis and/or depression. The diagnostic value of antibodies directed against other ribosomal proteins or 28S RNA (anti-no-P) remains unknown. A multicenter study including ten centers belonging to the study group for autoimmune diseases (GEAI) was conducted in order to determine the diagnostic value of anti-P and anti-no-P antibodies in a large population of patients. METHODS: The patients were selected on the basis of the presence of serum anti-ribosomal antibodies detected by indirect immunofluorescence (IF) on rat liver/kidney/stomach/pancreas sections and human HEp2 cells. The clinical course of all patients was studied using a predetermined survey. The specificity of anti-P antibodies were determined by Western blot. RESULTS: Anti-ribosomal antibodies were found in 82 patients. Fifty-five of them had systemic lupus erythematosus and 27 had another disease. Only 54% of the anti-ribosomal antibodies detected by IF were anti-P and were found in 69% of the patients with systemic lupus erythematosus. Anti-no-P antibodies (46%) were preferably detected in patients who suffered from another disease (78%). In patients with systemic lupus erythematosus, neurological and psychiatric disorders were more frequent in the no-P group (47% vs. 16%, P < 0.01) than arthritis, which was found more frequently in the P group (78% vs. 53%, P < 0.05). CONCLUSION: Anti P antibodies do not constitute a specific diagnostic marker of systemic lupus erythematosus, and lupus-related neuropsychiatric disorders would be preferably associated with the presence of anti no-P antibodies.

Animals↗
PubMed2000

Social phobia in the community: relationship between diagnostic threshold and prevalence.

This paper investigates the prevalence of symptoms and various diagnostic criteria of DSM-IV social phobia in a French national representative population of 12,873 subjects, aged 15 or more. Respondents filled out a mailed questionnaire based on the social phobia section of the Munich-Composite International Diagnostic Interview (M-CIDI) in the year 1996. Response rate was 80.5%. Sixty-seven point one percent of the sample acknowledge having at least once in their lifetime a strong fear of one or more of the six prototypical social fear situations that are used as the CIDI social phobia stem items. However, only a few fulfilled all DSM-IV diagnostic criteria for social phobia. Depending on the type of diagnostic algorithms used and the stringency in which these criteria are applied, the resulting prevalence varied between 1.9 and 7.3%. These findings provide some further evidence about the considerable effects of varying diagnostic criteria and thresholds on prevalence rates for social phobia, explaining why most recent surveys have reported considerably higher rates of social phobia than those in the early 1980s.

Adolescent↗
PubMed2000

House-dust-mite sublingual-swallow immunotherapy (SLIT) in perennial rhinitis: a double-blind, placebo-controlled study.

BACKGROUND: The safety and efficacy of sublingual-swallow immunotherapy (SLIT) in rhinitis caused by house-dust mite were evaluated in a double-blind, placebo-controlled study including 75 patients for 24 months. METHODS: Patients received either placebo or SLIT with a standardized Dermatophagoides pteronyssinus (D.pt.) - D. farinae (D.f) 50/50 extract. The mean cumulative dose was 90,000 IR, equivalent to 2.2 mg of Der p 1 and 1.7 mg of Der f I. Symptom and medication scores were assessed throughout the study. Exposure to house-dust mite, skin sensitivity, and serum specific IgE and IgG4 were assessed before starting treatment and after 12 and 24 months. RESULTS: Seventy-two patients (36 active-36 placebo) were eligible for intent-to-treat analysis. Thirty-six patients dropped out of the study. The number of patients who dropped out due to lack of efficacy was eight out of 37 (21.6%) in the active treatment group compared to 15 out of 38 (39.5%) in the placebo group (chi-square=2.81, P=0.09). Total symptom and medication scores decreased significantly after 12 and 24 months (P<0.05) of treatment in both groups, but no significant difference was observed between the active and placebo groups. After 24 months, the number of patients with high levels of indoor allergenic load decreased significantly in both groups compared to baseline data (P=0.01). Specific IgE (D.pt. and D.f.) increased significantly in the active treatment group after 12 and 24 months, while no change was observed in the placebo group. Specific IgG4 levels were not significantly modified in either group. Two patients in each group reported mild adverse effects. No severe adverse effects were reported. CONCLUSIONS: We conclude that SLIT in rhinitis caused by house-dust mite was safe, but there was a lack of consistent clinical benefit compared to placebo, probably due to the impact of the allergen avoidance measures that lowered the allergen burden.

Administration, Sublingual↗
PubMed2000

Human dendritic cells in the severe combined immunodeficiency mouse model: their potentiating role in the allergic reaction.

Dendritic cells (DCs) are present in the lungs and airways of healthy and allergic subjects where they are exposed to inhaled antigens. After the uptake of antigens, DCs migrate to lymphoid organs where T cells initiate and control the immune response. The migratory properties of DCs are an essential component of their function but remain unclear in the situation of allergic diseases. To better understand the role of DCs in response to allergens, we first investigated their presence in an original experimental model of allergic asthma: the humanized severe combined immunodeficiency (SCID) mouse reconstituted with peripheral blood mononuclear cells from patients sensitive to Dermatophagoides pteronyssinus (Dpt). Human DCs were detected in lungs of mice developing an inflammatory pulmonary infiltrate and appeared to be mainly located in the alveolar spaces. In a second step, human DCs were generated in vitro from monocytes and injected into naive SCID mice exposed or not exposed to Dpt aerosols. Their migratory behavior was explored, as well as their potential role in modulating the IgE production after exposure to Dpt. After exposure to Dpt, the number of DCs present in airways decreased, while it increased into the spleen and thymus of the mice. The IgE production increased in the presence of DCs as compared with mice not injected with DCs. These results suggest that DCs may play a role in the pulmonary allergic reaction developed in response to Dpt in SCID mice.

Adoptive Transfer↗
PubMed2000

Identification and characterization of a set of 100 tri- and dinucleotide microsatellites in the canine genome.

A set of 100 canine microsatellite markers--83 dinucleotides and 17 trinucleotides--is reported. A study of their frequency in the dog genome showed that, while the frequency of the CA repeats is one (CA)n every 47 kb, the 10 trinucleotidic frequencies vary from one every 117 kb (AGG)n to one every 875 kb (AGT)n. Polymorphism analysis performed on 16 unrelated mongrel dogs showed that 80% of dinucleotides are polymorphic, while only 30% of the trinucleotides are so. Of this set of 100 markers, 56 have been mapped on the RHDF5000 dog/hamster whole genome radiation hybrid panel. Moreover, through systematic BLAST analogy searches of the microsatellite-containing clone sequence, three new dog genes could be identified, based on their human ortholog. All of the markers presented may prove useful in physical mapping methods, and polymorphic microsatellites in genetic linkage studies or parentage controls in dog.

Animals↗
PubMed2000

Langerhans-like dendritic cells generated from cord blood progenitors internalize pollen allergens by macropinocytosis, and part of the molecules are processed and can activate autologous naive T lymphocytes.

BACKGROUND: The safety and efficacy of sublingual immunotherapy have been demonstrated in moderate allergic asthma and seasonal rhinitis. However, not much is known about the precise mechanism of action of the allergen when it crosses the oral mucosa. OBJECTIVE: To define this mechanism, we investigated the role of Langerhans' cells in the capture and internalization of allergens. METHODS: We generated dendritic cells in vitro with the phenotypic characteristics of Langerhans-like dendritic cells (LLDCs) from cord blood CD34(+) progenitors. We used two recombinant major allergens: Bet v 1 and Phl p 1 labeled with FITC. RESULTS: Internalization of allergens and control proteins was dose- and time-dependent and related to the immature state of the cells. LLDCs internalized allergens with a high efficiency in comparison with control molecules. Allergens were only internalized by macropinocytosis, as demonstrated by the use of various inhibitors. Addition of intracellular pH-modifying molecules indicated that only a part of the allergens was accumulated in acidic vesicles, whereas the majority remained in other cytoplasmic structures. Pulse-chase experiments calculated a half-life of 4 hours, suggesting that part of the molecules were not metabolized in the lysosome. Allergen internalization by LLDCs might be followed by processing in some experiments, as demonstrated by activation of autologous T lymphocytes in 4 of 9 experiments. CONCLUSION: These elements showed that Langerhans' cells present in mucosa might play an active role in immune responses to allergens.

Allergens↗
PubMed2000

Demonstration of a partially cryptic epitope of the major cat allergen Fel d 1: consequences for mAb-based standardization of cat extracts.

BACKGROUND: Antiallergen mAbs that do not recognize clinically important isoforms have been described, raising the question of the selection of mAbs for quantifying major allergens in order to standardize allergenic extracts. This question is even more critical if mAbs can discriminate between different forms of allergen molecules with the same amino acid sequence. OBJECTIVE: We sought to demonstrate that an anti-Fel d 1 mAb was able to discriminate between two forms of the major cat allergen independently of its amino acid sequence and to determine the relative importance and stability of both forms in various cat extracts. METHODS: Anti-Fel d 1 mAbs were raised in mice and characterized. By using two of these mAbs, a two-site ELISA was developed to quantify Fel d 1 in mass units. RESULTS: One of the anti-Fel d 1 mAbs developed was shown to specifically recognize a particular form of Fel d 1. A two-site ELISA with this mAb to capture Fel d 1 was able to quantify the allergen specifically in this form. It was then shown that (1) the quantitative importance of this form of Fel d 1 could vary from one cat extract to another, (2) Fel d 1 was converted into this form under certain conditions, and (3) both converted and unconverted forms of Fel d 1 may bear IgE epitopes that are specific. CONCLUSION: Although the present study emphasizes the issue of selecting mAbs that are not too specific to standardize allergenic extracts, it also demonstrates that very specific mAbs can be of interest, especially to verify the stability of allergens in extracts, since this stability might have clinical implications.

Animals↗