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Biomedical subjects

J A Bernard

Publications and source records attributed to J A Bernard.

At least 19 recordsLinked to original sources
PubMed1992

[Canalicular stenoses complicating the insertion of lacrimal plugs. Incidence and mechanisms].

Changes in canalicular permeability following the insertion of punctum plugs was studied. This occlusive method was used to treat dry eye syndrome in 43 patients over a period of 32 months. All had normal canalicular patency, confirmed on the day of implantation. One hundred and five large plugs were used (2.4 plugs per patient). Twenty seven (25.7%) impassable acquired canalicular stenoses were seen in 15 patients. The canalicular site of the 27 stenoses was the same: junction between the vertical and horizontal portions. Among the 27 stenoses: 4 plugs had disappeared at an unknown time, with follow-up probing taking place after a mean interval of 7.5 (months range: 1 to 15 months); 17 plugs had been expelled after being in place for an average of 5 months (range: 1 to 12 months; standard deviation 3.47), with follow-up examination taking place on average 12 months after insertion (range: 6 to 17 months; standard deviation 3.4); and 6 plugs were still in place after a mean of 7 months (range: 2 to 15 months; standard deviation 4.73) and the stenosis was discovered when they were removed. They were intact. These 6 Cases eliminate any possibility of intra-canalicular migration of the prosthesis--of all or part--of the prosthesis. Stenoses appeared to develop rapidly: 45% of cases were discovered during the first 3 months. 16/27 (59%) of stenoses were investigated a second time, 6 months later on average (range: 2 to 12 months): these 16 canaliculi all remained impassable.

Aged↗
PubMed1991

[The dry eye].

After reviewing the anatomy and pathophysiology of the lacrimal circuit, the authors describe the diagnostic approach to dry eye syndrome. Two very different entities can be distinguished: acute dryness generally due to a defect of the palpebral lining, for which urgent treatment is required to prevent corneal perforation, and chronic dryness, generally due to a reduction of lacrimal secretion. The aetiological survey must look for a reversible cause, dominated by drugs. Treatment is symptomatic in every case, consisting of the regular prescription of artificial tears. The use of lacrimal plugs to obstruct the lacrimal draining ducts constitute second-line treatment and may improve the functional tolerance.

Acute Disease↗
PubMed1990

Clinical considerations for neutron capture therapy of brain tumors.

The radiotherapeutic management of primary brain tumors and metastatic melanoma in brain has had disappointing clinical results for many years. Although neutron capture therapy was tried in the United States in the 1950s and 1960s, the results were not as hoped. However, with the newly developed capability to measure boron concentrations in blood and tissue both quickly and accurately, and with the advent of epithermal neutron beams obviating the need for scalp and skull reflection, it should now be possible to mount such a clinical trial of NCT again and avoid serious complications. As a prerequisite, it will be important to demonstrate the differential uptake of boron compound in brain tumor as compared with normal brain and its blood supply. If this can be done, then a trial of boron neutron capture therapy for brain tumors should be feasible. Because boronated phenylalanine has been demonstrated to be preferentially taken up by melanoma cells through the biosynthetic pathway for melanin, there is special interest in a trial of boron neutron capture therapy for metastatic melanoma in brain. Again, the use of an epithermal beam would make this a practical possibility. However, because any epithermal (or thermal) beam must contain a certain contaminating level of gamma rays, and because even a pure neutron beam causes gamma rays to be generated when it interacts with tissue, we think that it is essential to deliver treatments with an epithermal beam for boron neutron capture therapy in fractions in order to minimize the late-effects of low-LET gamma rays in the normal tissue. I look forward to the remainder of this Workshop, which will detail recent progress in the development of epithermal, as well as thermal, beams and new methods for tracking and measuring the uptake of boron in normal and tumor tissues.

Animals↗
PubMed1990

[Postoperative epiphora].

The authors discuss the management of watering of the eyes occurring after facial or palpebral surgery. The most serious form is watering of the eyes associated with a pericorneal ring, which constitutes an ophthalmological emergency. Watering of a "white" eye suggests an abnormality of the lacrimal ducts. The clinical context and instrumental exploration can localize the obstruction, which is an essential step prior to surgical treatment.

Emergencies↗
PubMed1990

[Treatment of dry eye by temporary punctum plug. Comparison with a control group].

35 patients with chronic dry eye were treated with punctum plug on one side only. The other side was a control: after simulation dilatation, the patient underwent a simulation insertion. This is an open study in which only the patient ignored the reality of treatment. The study was prospective. 28 females and 7 males were enrolled in this study. The age' average was 53. The follow-up average is 5.3 months. The etiologies were: idiopathic dry eye: 10 cases, Sjögren's syndrome: 11 cases, drug induced dry eye: 6 cases, filamentous keratitis: 4 cases. Other: 4 cases. Enrollment criteria were: functional symptomatology not answering to topical therapy (physiological serum drops) associated with one or more of the following items: positive Rose Bengal staining and/or Schirmer lower than 5 mm in 5 min and/or filamentary keratitis. Subjective improvement is significantly better after closing the two puncta on the same side (77%) than the other side (placebo) (17%) (p less than 0.001). This difference is also demonstrated for the improvement of Rose Bengal staining (p = 0.068) and for Schirmer's test (p = 0.002). These results demonstrated the effectiveness of this therapy versus placebo. Results after closing the 2 puncta on the same side are better than after closing one punctum.

Adolescent↗
PubMed1990

[Complications of punctum plug in the symptomatic treatment of dry eye].

76 patients with dry eyes were treated by mechanical obstruction of lacrymal puncta. The sex ratio is: 62 females and 14 males. The age average was 55, ranging from 12 to 88. The etiologies were: Sjögren's syndrome: 16 cases (21%); filamentous kerato-conjonctivitis sicca: 12 cases (15%); anxiolytical and anti-depressant treatments: 10 cases (13%); complicated viral kerato-conjonctivitis: 4 cases (5%); post radiotherapy dry syndrome: 3 cases (4%); idiopathic and various etiologies: 31 cases (40%). The 149 plugs are completely made of hydrophobic silicone; 20 had a barb inclined on the neck axis. Insertion was achieved after tropical anesthesia in 90% of the cases. 121 plugs (81%) did not lead to any anatomical complication (the average duration remaining on time interval of implantation per plug was of 5 months). Functional tolerance depends on the quality of plug-punctum adjustment. Plug protrusion is the main cause of intolerance and disappearance. The complications were: rupture of punctum during dilation: 1%; suppurative canaliculitis: 1.3%; disappearance: 16%; epiphora: 22%. No intra-canalicular migration was observed. We check canalicular permeability in 26 cases, after loss or removal: che was normal 23 times (average time-interval: 5 months). We had 3 cases of canalicular stenosis after 4 months, 5 months and 18 months of intubation.

Adolescent↗
PubMed1988

[Recent wounds of the lacrimal duct. Apropos of 262 cases treated as emergencies].

From 1982 to 1987, surgery was performed in emergency in 262 patients on lacrimal ducts at the Hotel Dieu Hospital in Paris. The retrospective study of these cases and the comparison with the conclusion of the report of the French Society of Ophthalmology about the lacrimal apparatus (1980) can allow us a few conclusions. The first cause is assault in a 30 year old man, with a left lower canaliculus wound, and 20% of the cases an eye-penetrating wound. With the current use of safety belts, car-related injuries have become the second cause. Children are often bitten by family dogs. Upper lacrimal drainage wounds are associated in 40% of the cases with eye-penetrating wound, and must be repaired. Complications of intubation are: disappearance of silicone tubing 5%; loop retraction: 8%; slit canaliculus: 16% of the cases. This last complication becomes rarer with surgical experience. Concerning nasolacrimal intubation versus pig-tail probe, statistical results lead us to prefer the first technique.

Adult↗
PubMed1986

Post-separation detection of nucleic acids and proteins by neutron activation.

We describe approaches to neutron activation analysis and their application to post-separation autoradiographic detection of biological compounds. Specifically, we have extended the use of a "direct-labeling" method to the post-separation detection of DNA after gel electrophoresis and to the detection of nucleotides separated by TLC. In addition, we describe a more generally applicable "indirect-labeling" method in which separated compounds of interest are selectively bound to ligands containing highly neutron-activatable elements, such as manganese (55Mn), europium (151Eu), or dysprosium (164Dy), and then irradiated with thermal neutrons. This method is illustrated with nucleotides separated by TLC and with proteins separated by polyacrylamide gel electrophoresis. In contrast to the direct-labeling approach, the indirect-labeling method can be adapted to detect any class of substances for which a highly neutron-activatable, selectively binding ligand is available. The theoretically achievable sensitivity of the indirect-labeling method is in the attomole (10(-18) mol) range.

Activation Analysis↗