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Biomedical subjects

C Durand

Publications and source records attributed to C Durand.

At least 109 records · Page 6Linked to original sources
PubMed1986

Intra-erythrocytic sodium in uremic patients, as determined by "high-resolution" 23Na nuclear magnetic resonance.

The use of 23Na nuclear magnetic resonance with aqueous shift reagent has made it possible to determine intracellular sodium concentrations in living erythrocytes. We applied this technique to samples from 16 healthy subjects and 41 uremic patients. The results seem to show distinct populations among the latter. Classically, two different relaxation times are obtained for intracellular sodium in biological media, according to relaxation NMR theory. Some patients, however, exhibit abnormal results that cannot be accounted for by this theory.

Adult↗
PubMed1985

A compound from uremic plasma and from normal urine isolated by liquid chromatography and identified by nuclear magnetic resonance.

A compound present in normal urine and in ultrafiltrates of uremic plasma in the fraction of so-called "uremic middle molecules" was isolated by liquid chromatography. Preliminary studies, including amino acid analysis, characterization of uronic acids, and ultraviolet spectroscopy, show that the molecule contains glycine, a uronic acid, and an aromatic ring. Characterization by 1H and 13C nuclear magnetic resonance spectrometry shows conclusively that this compound is a double conjugate of glucuronidate--o-hydroxyhippuric acid, which has been previously described by Zimmerman et al., using quite different techniques of isolation and identification (Clin Nephrol 14: 107, 1980; FEBS Lett 129: 237, 1981).

Chemical Phenomena↗
PubMed1985

Sequential sodium therapy allows correction of sodium-volume balance and reduces morbidity.

We investigated whether individually adjusting Na+ dialysis levels (Na+Di) combined with Na+ and UFR (ultrafiltration rate) programming, and a sodium/volume model (sequential sodium therapy, SST) can improve the end stage renal failure (ESRD) patient's homeostatic equilibrium intra- and interdialytically. One hundred and fifty patients were included in the study over a one year period. The results show that the patients are divided into two groups: 50 patients respond according to the sodium/volume model developed by F. Gotch [1983]. In this group it is possible to predict pre- and post dialysis plasma Na+ concentration (Na+o, Na+t) as a function of Na+Di and it becomes possible to choose Na+Di to allow Na+o and Na+t to virtually coincide, eliminating severe shifts in plasma tonicity. In the second group two subgroups can be distinguished: excess Na+ or excess H2O post dialysis, without possible correction at a single sodium level. SST corrects sodium/volume balance in this group by using sequential intermittent hypo or hypertonic dialysate, combined with fluid removal adapted to each episode. In both groups there was a significant improvement in the clinical condition of the patients who previously were less equilibrated. It is possible to conclude that SST improves tolerance intradialytically and achieves better equilibrium interdialytically. Implementation of SST requires precise control of the concentrate and the water, and equipment adapted for accurate, programmable sequential control of Na+Di and ultrafiltration rate.

Adolescent↗
PubMed1983

Inhibition in vitro of the polymerization of tubulin by uremic middle molecules: corrective effect of isaxonine.

The polymerization of tubulin leads to the formation of microtubules which are one of the components of the axons of nerve cells. This reaction is the limiting factor in the growth of axons. Uremic middle molecules inhibit in vitro the polymerization of tubulin in a dose dependent way. It is possible that a similar phenomenon could occur in vivo in uremic patients, and this might be involved in the development of neuropathy. In addition, isaxonine phosphate counteracts the inhibitory effect of uremic middle molecules on the polymerization of tubulin.

Adult↗
PubMed1980

[Respect for the patient in the face of medical progress].

The psychological aspects of medical ethics are described and analysed in terms of the doctor-patient relationship. Analysing the patient's needs, the doctor ceases to regard him as an "object" for his diagnostic and therapeutic procedures and makes him the "subject"; this implies respect for his person and his rights. From this psychological and ethical perspective, questions of patient information, professional secrecy, therapy transfer and the doctor's authority are discussed. Psychiatry poses specific problems both in practice (admission of patients to hospital although their illness prevents them from giving their consent) and in its theory (is mental illness real?). Ethical problems force the practitioner to reconsider his concept of man and his options in respect of freedom.

Commitment of Persons with Psychiatric Disorders↗
PubMedDate not supplied

A submicroscopic unbalanced subtelomeric translocation t(2p;10q) identified by fluorescence in situ hybridization: fetus with increased nuchal translucency and normal standard karyotype with later growth and developmental delay, rhombencephalosynapsis (RES).

Reaching an accurate diagnosis in children with mental retardation associated or not with dysmorphic signs is important to make precise diagnosis of a syndrome and for genetic counseling. A female case with severe growth and development delay, dysmorphic features and feeding disorder is presented. Antenataly, the fetus was observed to have increased nuchal translucency and a slight hypoplastic cerebellum. A standard karyotype was normal. RES and a submicroscopic unbalanced subtelomeric translocation t(2p; 10q) were demonstrated after birth. We show that within the framework of a collaborative approach, a concerted research of submicroscopic subtelomeric rearrangements should be performed in case of mental retardation associated with facial dysmorphic features, and when other etiologies or non-genetic factors (iatrogenic, toxic, infectious, metabolic...) have been ruled out.

Cerebellum↗
PubMedDate not supplied

Diagnostic and therapeutic dilemma with large prenatally detected cystic adrenal masses.

OBJECTIVES: The prenatal finding of a large cystic adrenal mass raises the dilemma of the differential diagnosis between adrenal hemorrhage and cystic neuroblastoma. The possibility of a neuroblastoma usually leads to surgical excision of such tumors. Nevertheless, an adrenal hemorrhage has to be recognized, so that unnecessary surgery may be avoided. METHODS: Three cases of large prenatally detected adrenal masses managed nonoperatively are reported. Data studied were: age at the diagnosis, prenatal and postnatal ultrasonographic consistency, and tumor marker levels. Size and sonographic evolution were also studied. RESULTS: In all 3 cases, a cystic mass, measuring more than 40 mm in size, was detected during the 3rd trimester of pregnancy. The sonographic appearance evolved from a sonolucent tumor to a heterogeneous mass with hyperechoic areas. The tumor marker levels were normal. All infants had a documented decrease in mass size at birth and were managed nonoperatively. All these tumors were considered adrenal hemorrhages. CONCLUSIONS: Prenatal ultrasonography rarely permits to distinguish an adrenal hemorrhage from a cystic neuroblastoma. The differential diagnosis, even in large masses, is based on close postnatal follow-up with serial sonography. Surgery is not mandatory, unless the size does not decrease. However, without pathologic proof, it is not possible to differentiate an adrenal hemorrhage from a spontaneously resolved neuroblastoma.

Adrenal Gland Diseases↗