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Biomedical subjects

C Lenaerts

Publications and source records attributed to C Lenaerts.

At least 37 records · Page 2Linked to original sources

Pancrease gastroresistance: in vitro evaluation of pH-determined dissolution.

In order to avoid inactivation in the stomach, pancreatic enzymes have been prepared as pH-sensitive, enteric-coated microspheres (Pancrease). An in vitro study was performed to evaluate the pH-related dissolution of Pancrease and to confirm its resistance to gastric acidity. Two assay methods were used with three different batches of Pancrease: (a) Enzyme absorbency at 280 nm was measured at unit pH intervals from pH 1 to pH 8 and at 0.5 pH intervals from the start of dissolution to pH 8. (b) Proteolytic activity was measured at pH 6.8. Significant enzyme dissolution started at pH 5.5 and was maximal at pH 6.0. At pH 6.8, the pH of simulated intestinal fluid, dissolution was complete in less than 15 min. At pH 5.0, no dissolution occurred within the first 10 min and only 13% dissolution was observed after 2 h. At pH 7.0, 100% dissolution was seen within 10 min. Results of the two assay methods were comparable with all three enzyme batches assayed. This study confirmed the gastroresistance of Pancrease. Because of the enteric coating of Pancrease, liberation of enzymes occurs in the duodenum and jejunum, providing maximal enzymatic efficacy in exocrine pancreatic insufficiency.

Biological Availability↗

[Long-term follow-up of abused children (apropos of 65 cases)].

The authors work in an area located north of Paris, which contains roughly a population of .75 million, of which 82,000 are children less than 3 years of age. The center and main city of the area is the town of Amiens. The recruitment of their cases under study was essentially hospital based, which explains the relative severity of the trauma observed. The children were followed by various observation systems. Seventy-four children, of which more than two-thirds were less than 3 years of age were followed for a period varying from two to ten years. Forty-three percent of these children have been maintained in their biological families; the others have been placed. With this system only nine recurrences of abuse have been observed (12%), and only two instances of death have been observed. Other studies have demonstrated higher proportions. However, in two-thirds of the children observed, there were minor or major psychological or even psychiatric sequelae. Protection services have tried to stay away from institutional placement as much as possible; when necessary, the foster home system or adoption has been used. Striking is the lack of means available to help abusing families. Efforts should be made to assist the abusing families stay together.

Battered Child Syndrome↗

[Reactive arthritis in children].

Reactive arthritis is arthritis in which, although the nature of the responsible infection is known or suspected upon serological grounds, attempts at recovering the pathogen from the synovial fluid have failed. One of the main pathogenetic problems is the multiplicity of etiologic agents. Some are exogenous and may be related to the articular tropism of certain microorganisms, to immunologic depression due to an antecedent or coincident infection, and to successive reinfections by the same pathogen or by others which may promote an exacerbation of the disease. Others are endogenous and attention should be given to the local or systemic presence of an antigen as well as, in some instances, to the persistence of residual forms of infecting agents, which are more readily demonstrated with current bacteriological and serological methods. Although reactive arthritis is to be distinguished from septic arthritis, it can no longer be clearly differentiated from the classical post-infectious rheumatism. Once it has been produced, the antigenic stimulation is responsible for an immunologic response which tends to check systemic extension but may also produce tissue damage in the host. Some patients have circulating immune complexes which may bind to the joint, thereby damaging it. In other patients, particularly those who are HLA B27 positive, host-pathogen cross-reactions are demonstrated. Actually, the most frequent pathogenetic sequence seems to be a combination of two or more of these mechanisms, as there are reasons to believe that presence of the pathogen in situ is not required for the persistence of the inflammatory process. Reactive arthritis was first reported in adults following either sexually transmitted urethritis due to chlamydiae, mycoplasma or gonococci, or hepatitis B or an intestinal infection due to Yersinia, Campylobacter, Shigella, Klebsiella or Salmonella. Later, it was described in pediatric patients, particularly in Scandinavia where, for genetic reasons, the HLA B27 group is prevailing. Reactive arthritis seems less frequent in caucasian ethnic groups and above all in Latin Americans among whom HLA B27 carriers are more uncommon; however, it must be pointed out that they have not been as extensively studied and that other etiologic factors may still remain to be discovered. The course and etiology of the different forms of arthritis share certain characteristics which have been determined through a better knowledge of these conditions: onset occurs one or several weeks after a respiratory, urinary or, most often in children, digestive infection. This episode is unremarkable or latent and often overlooked.(ABSTRACT TRUNCATED AT 400 WORDS)

Antigen-Antibody Complex↗

[Prenatal ultrasonic diagnosis of malformation uropathies: 13 cases].

The systematic prenatal diagnosis of 5 cases of urinary tract malformations out of 2 500 pregnancies in 1982 in a special care maternity, or 2 per 1 000 is compared with the discovery of 10 cases in 28 months in 17 960 foetuses, or 0.55 per 1 000 whereas the overall frequency varies from 0.3 to 5.25 per 1 000 in infants. We studied 13 children whose prenatal abnormalities were 2 unilateral ureterohydronephrosis and 7 bilateral dilatations associated to 2 ureteroceles, 1 multicystic dysplasia and 1 ureteral duplicity. All of these except two were confirmed at birth. The exceptions consisted in one unilateral dilatation and one bilateral ureterohydronephrosis which turned out to be dysplastic kidneys unknown during pregnancy. Three ureteral duplicities were also ignored. The results are the following: Three cases were severe: one therapeutic abortion after 27 weeks, one intra-uterine decompression followed after few days by a preterm delivery and neonatal death and one provocated preterm delivery (36 weeks). All the others underwent decompression during the first hours of their life. Five cases can be considered unsuccessful: 2 abortions, the death of a 22 days old infant with an unilateral multicystic dysplasia and 2 bilateral malformations with renal failure, one of which was associated to an unilateral dysplastic kidney. Reliability of sonography as well as its interest in prognosis and prenatal evaluation of renal function are demonstrated.

Amniotic Fluid↗

[Regular dominance of thumb ankylosis with mental retardation transmitted over 3 generations].

A young girl 12 old, sent to us for obesity, and coxa-epiphysiolysis showed signs of mental retardation and bilateral thumb ankylosis. The fact that the mother was also affected by both of these signs, led to a more detailed genetic research. The latter revealed that not only the daughter, the mother, but also their own mother and may be, the sister, the grand-mother and the great-aunt of the patient had a retardation, a slight dysmorphia, a type A brachydactylia, signs of obesity and an identical ankylosis of both thumbs. This vertical inheritance, affecting apparently females only, but not associated with a high rate of miscarriage, has, it seems, never been reported. The characteristics of this family are being considered and discussed.

Adult↗

[Solitary upper incisor, hypopituitarism and monosomy 18p chromosome aberration].

A prepubertal boy with hypopituitarism, mental retardation, dysmorphia and solitary maxillary central incisor is described, karyotypic studies showed deletion of the short arm of chromosome 18 (46, XY, del (18) (p11). It is suggested that caryotypic studies is of interest among the patients with midline defects and/or hypopituitarism.

Child↗

[Panhypopituitarism in one of 2 monozygotic twins].

Anterior panhypopituitarism has been observed in one of monozygous twin girls. Etiologic investigations were negative and only suggested an hypothetic perinatal insult. Genetic abnormalities could be excluded. Replacement therapy with human growth hormone was strikingly successful, with a remarkable catch-up growth and, however, a velocity of bone age comparable with the velocity of growth.

Age Determination by Skeleton↗

[Barotraumatic rupture of the thoracic esophagus in children. Apropos of a case].

Presenting symptoms in an 8-year-old child, subjected to high pressure in the upper respiratory and digestive tracts following bursting of a truck inner tube, were initially only pleuropulmonary in nature. A secondary diagnosis of rupture of the thoracic esophagus was established by radiological follow-through examination using a water soluble medium. The presence of an esophagopleural fistula led to repair of the esophageal tear on the 5th day. Operation involved wide mediastinal and thoracic drainage, protection of the esophageal suture by a minimal pharyngostomy, and the performance of an evacuation gastrostomy and an alimentation jejunostomy. Bipolar esophageal exclusion can be avoided by the use of this technique. When confronted with closed thoracic injuries due to high pressures exerted on the upper respiratory and digestive tracts, radiological examination of the esophagus employing water-soluble media should be conducted, therefore, to enable early diagnosis of any esophageal rupture. Furthermore, from the therapeutic point of view, even after secondary discovery of an esophageal tear, suturing is not contraindicated by the direct approach as long as protection is provided by minimal pharyngostomy and a gastrostomy, this avoiding the need for bipolar exclusion.

Barotrauma↗