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Biomedical subjects

J Berge

Publications and source records attributed to J Berge.

At least 19 recordsLinked to original sources
PubMed2005

An evaluation of immediate sheath removal and use of the Angio-Seal vascular closure device in neuroradiological interventions.

We set out to assess the effect of using an arteriotomy closure device in patients at high risk of access site complications. One-hundred nineteen patients with femoral artery access were prospectively included in five centers in France (56 males, 63 females, age range 20-84 years). The neurointerventional procedures were embolization of intracranial aneurysm (71.4%), carotid angioplasty (11.8%), cerebral angioplasty (1.7%), thrombolysis (0.8%), and other procedures (14.3%). Sheaths were removed and the closure device deployed immediately postprocedure. One patient developed a false aneurysm, and one developed a small hematoma. Neither required treatment. Postdevice deployment bleeding was experienced in three patients (2.5%), requiring minimal management. There were no major complications. Three patients died of causes unrelated to the vessel closure. Patient comfort was 2.2 on a scale of 1 (none) to 10 (severe). The results showed that immediate sheath removal followed by use of the closure device is safe in patients undergoing neurointerventional procedures and offers a low level of patient discomfort. In selected patients, early hospital discharge was possible.

Adult↗
PubMed2005

[Long term clinical follow up of vertebral hemangiomas treated by percutaneous vertebroplasty].

PURPOSE: Long term clinical follow up of vertebral hemangiomas (VH) treated by percutaneous vertebroplasty. PATIENTS AND METHODS: A retrospective analysis of 19 patients treated fro 21 VH associated with chronic pain in 16 cases, using pecutaneous vertebrosplasty. One patient underwent both vertebroplasty and surgery. Long term follow up (mean 38.6 months; 16-83 months) consisted in the evaluation of residual or secondary pain, its impact on daily activities (using the Oswestry Low Back Pain scale) and the need for pain medication. RESULTS: Long term follow up found 56.2% of patients to be asymptomatic (9/16) and 31.2% (5/16) with occasional pain without much impact on daily activities and no need for chronic use of pain medication. The treatment was ineffective in 2 cases. Three patients treated for aggressive hemangiomas remained painless. There was no complication due to the treatment. No poor outcome was noted. CONCLUSION: Percutaneous vertebroplasty appears to be an effective technique in the treatment of VH with approximately 90% of satisfactory results in the short or long term period.

Adolescent↗
PubMed2002

Selective endovascular treatment of intracranial aneurysms using micrus microcoils: preliminary results in a series of 78 patients.

PURPOSE: To determine the safety and reliability of a new platinum microcoil (Micrus), in the treatment of intracranial aneurysms. PATIENTS AND METHODS: Seventy-eight patients (28 male and 50 female patients; age range, 28-83 years; mean age, 44 years) with 80 intracranial aneurysms were treated in 10 centers in Belgium and France. All aneurysms were smaller than 15 mm. Nine aneurysms (11%) were located in the posterior circulation and 71 (89%) in the anterior. Fifty aneurysms (63%) were ruptured and 30 (37%) unruptured. Micrus microcoil is a new platinum coil. It is electrically detached with a time of detachment close to 5 seconds. RESULTS: The degree of occlusion of the aneurysm was classified as total in 49 aneurysms (61%), subtotal in 28 cases (35%) and incomplete in 3 cases (4%). Technical complications were encountered in 10 patients (13%) including parent artery occlusion and thromboembolism (4 cases), coil migration (2 cases) and non-detachment of the coil (2 cases). The immediate morbidity rate was 1.3% and mortality rate 1.3%. CONCLUSION: Micrus microcoils are effective and safe in the selective treatment of ruptured and unruptured intracranial aneurysms. Spherical microcoils are helpful to create a good basket in the aneurysmal sac at the beginning of treatment.

Adult↗
PubMed2002

[Neurosurgical and endovascular treatment of intracranial aneurysms: a cost analysis of two different strategies at the University Hospital of Bordeaux (France)].

BACKGROUND: Rupture of intracranial aneurysms causes major mortality and morbidity. Moreover, treatment of this vascular malformation generates high medical costs. We compared the cost of two different strategies employed at the University of Bordeaux to prevent aneurysms from rebleeding: a classical neurosurgical technique consisting in clipping the neck of the aneurysm and a new less invasive neuroradiological technique based on embolization using platinum coils. METHOD: A micro-cost study was carried out retrospectively from May 1998 to June 2000) comparing data from 44 patients admitted for ruptured intracranial aneurysm: 22 operated patients and 22 patients treated with an endovascular approach. Each operated patient was matched with an embolized patient for clinical status at admission (World Federation of Neurological Surgeons Scale) and complications resulting from cerebral hemorrhage (hydrocephalus, vasospasm, rebleeding). RESULTS AND CONCLUSION: Our results showed the same cost for the same efficiency . Expenditures are however made differently. The endovascular technique allows a shorter hospital stay (8 days less), balancing the high cost of single use medical supplies (coils, microcatheters.). The endovascular technique has many advantages for the patients, but cannot be successful in all types of intracranial aneurysms. Both techniques remain indispensable.

Aneurysm, Ruptured↗
PubMed2001

Crystal structure of Staphylococcus aureus tyrosyl-tRNA synthetase in complex with a class of potent and specific inhibitors.

SB-219383 and its analogues are a class of potent and specific inhibitors of bacterial tyrosyl-tRNA synthetases. Crystal structures of these inhibitors have been solved in complex with the tyrosyl-tRNA synthetase from Staphylococcus aureus, the bacterium that is largely responsible for hospital-acquired infections. The full-length enzyme yielded crystals that diffracted to 2.8 A resolution, but a truncated version of the enzyme allowed the resolution to be extended to 2.2 A. These inhibitors not only occupy the known substrate binding sites in unique ways, but also reveal a butyl binding pocket. It was reported that the Bacillus stearothermophilus TyrRS T51P mutant has much increased catalytic activity. The S. aureus enzyme happens to have a proline at position 51. Therefore, our structures may contribute to the understanding of the catalytic mechanism and provide the structural basis for designing novel antimicrobial agents.

Amino Acid Sequence↗
PubMed2001

[Color Doppler sonography of superficial capillary hemangiomas].

PURPOSE: Retrospective analysis of the morphologic and hemodynamic characteristics of hemangiomas in infants provided by color Doppler sonography. MATERIALS AND METHODS: 94 hemangiomas were studied in 87 children separated into four classes of age (0-3 months, 3-6 months, 6-12 months, > 12 months). Eleven were followed with several examinations. Echogenicity, compared to normal subcutaneous tissues, and degree of vascularization were assessed qualitatively. Resistive index (RI) was measured in 78 cases. RESULTS: All lesions presented as vascularized solid masses: 63% were hypoechoic, 16% hyperechoic and 21% mixed. All hypoechoic and mixed lesions showed higher vascularity than hyperechoic ones. Hyperechoic hemanigomas were more frequent in the fourth class of age. Mean resistive index was significantly higher in the first (0.61 +/- 0.14) and the fourth (0.6 +/- 0.14) classes of age than in the second (0.51 +/- 0.12) (p = 0.01 and < 0.03, respectively), and higher in the hyperechoic group (0.7 +/- 0.13) than in the hypoechoic group (0.53 +/- 0.11), (p < 0.01). Seven of 11 cases moved from hypoechoic to hyperechoic or mixed. Increase of resistive index with age was noted in 9/11 cases. CONCLUSIONS: Superficial hemangiomas have typical but variable gray-scale, spectral and color flow sonographic patterns. These fluctuations are probably related to phases of evolution.

Age Factors↗
PubMed2000

[Abnormal trajectory of the internal carotid artery in the middle ear. Report of a case].

The authors report a case with an aberrant course of the internal carotid artery within the middle ear--a rare abnormality with only about fifty cases so far reported in the literature. The combination of pulsatile tinnitus and a retro-tympanic mass calls for a precise anatomical investigation of the temporal bone before any surgery is undertaken. The role of the various complementary investigations is discussed. A high resolution CT scan is the key investigation, and is sufficient to give the diagnosis in the majority of cases. Angio-MRI currently affords the possibility of confirming this vascular malpositioning in a non-invasive way. Arteriography should be used only when there is remaining doubt about the possibility of a glomus tumour, or before treatment by clamping. The most logical course to adopt would seem to us to be to abstain from treatment once this diagnosis has been made, given the risk of major haemorrhage and the potential neurological complications.

Adult↗
PubMed1998

Comparative evaluation of conventional and dynamic magnetic resonance imaging of the pituitary gland for the diagnosis of Cushing's disease.

OBJECTIVES: The ability of MRI to detect pituitary ACTH-secreting adenomas in patients with Cushing's disease is limited. Owing to different dynamics of contrast enhancement between adenomas and normal pituitary tissue, it has been suggested that obtaining images within seconds after gadolinium (Gad) injection using dynamic procedures increases the sensitivity of MRI in the detection of pituitary microadenomas. The objective of this study was to compare the ability of conventional magnetic resonance imaging (CMRI) and dynamic MRI (DMRI) to detect ACTH-secreting pituitary adenomas. DESIGN: Twenty-six consecutive patients with ACTH-dependent Cushing's syndrome and 10 normal subjects were investigated. According to the results of inferior petrosal sinus sampling, 21 patients had Cushing's disease and five had ectopic ACTH syndrome. Patients with Cushing's disease were operated regardless of the results of imaging studies. All underwent identical MRI and DMRI procedures using a 1.0 T magnet. Image sampling time during DMRI was 19 sec. Scans were randomly mixed and analysed blind, retrospectively and independently by two experienced radiologists. The clarity of the images was assessed by the analysis of agreement among radiologists. MRI findings were compared to surgical and histopathological findings. RESULTS: Surgical exploration identified three macrodenomas and 14 microadenomas. One microadenoma was found at pathological examination after subtotal hypophysectomy and no tumour was found in three cases. According to the combined opinion of radiologists, the three macroadenomas were identified equally well with CMRI and DMRI. Eight ACTH-secreting microadenomas were detected with CMRI and 11 with DMRI. The three microadenomas detected with DMRI only were visualized within 60 sec following Gad injection. No false positives occurred with CMRI. Three false positives were obtained with DMRI: one in a patient with ectopic ACTH syndrome while a silent microprolactinoma and normal tissue were found at the site of the radiological abnormality in two patients with Cushing's disease. In our study, the sensitivity of DMRI is greater than that of CMRI (0.67 vs. 0.52) but is associated with a loss in specificity (0.80 vs. 1.00). False positives may result from the increased sensitivity of DMRI which detects incidental pituitary lesions, technical artefacts or lowest clarity of images, as suggested by a lower observer agreement of DMRI (Kappa statistic 0.66 vs. 0.83). Overall, the two MR procedures had equivalent diagnostic power (0.72). CONCLUSIONS: In our hands, dynamic procedures did not improve the usefulness of MRI in Cushing's syndrome.

ACTH Syndrome, Ectopic↗
PubMed1998

[Severe hemangiomas treated with interferon alpha-2b: seven cases].

INTRODUCTION: High-dose corticosteroids are the primary means of controlling alarming hemangiomas. However, only 2/3 of these life-threatening hemangiomas regress or are stabilized with corticosteroids: and for others there is no regularly safe and effective treatment. Contradictory publications have been reported about the efficacy of interferon (INF) alpha in hemangiomas, we report our experience concerning the management of 7 cases. PATIENTS AND METHODS: Seven infants have been treated with INF alpha-2b in our Pediatric Dermatology Unit. All hemangiomas were corticosteroid resistant. Hemangiomas were located on head and neck in 6 cases and on lower limb in one case in association with platelet trapping syndrome. Mean age at beginning of treatment was 7.5 months and mean duration of treatment was 5 months. INF alpha-2b was given daily in subcutaneous injections of 3 millions units per square meter of body surface area. RESULTS: After one month of treatment, 2 cases of facial hemangiomas showed a dramatic improvement, and INF alpha-2b was maintained for one year. One case was stabilized, but INF was ineffective in 3 cases after 2 months of treatment (the child with platelet trapping syndrome died at 4 months of age). The treatment had to be stopped in one case because of hepatitis. No long term side effects were noted with a mean follow-up of 27 months. CONCLUSION: INF alpha can be an interesting alternative therapy for infantile hemangiomas. However, only a minority of patients can be considered as excellent responders at current dosages and long term secondary effects cannot be excluded.

Anti-Inflammatory Agents↗
PubMed1997

Human dendritic cells handling of binding, uptake and degradation of free and IgG-immune complexed dinitrophenylated human serum albumin in vitro.

The handling of free and IgG-complexed dinitrophenylated human serum albumin (DNP-HSA) by human dendritic cells (DC) cultured with granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4) was studied. It has been shown that the amount of uncomplexed or IgG-complexed antigen required by DC to start an immune response is low compared with other antigen-presenting cells. We therefore examined whether such efficient presentation of immune complexes is due to an enhanced Fc gamma RII-mediated endocytosis or to a specialized and efficient antigen handling, i.e., macropinocytosis. The Fc gamma RII expression was found to be heterogeneous on the GM-CSF- and IL-4-cultured DC, i.e. it ranges from low to high expression. The handling of antigen and immune complexes revealed, that the level of binding and uptake of IgG-DNP-HSA complexes by in vitro expanded DC is low compared with free antigen. Uncomplexed DNP-HSA is probably handled either by endocytosis via receptors being more abundant and/or efficient than the Fc gamma RII or via non-receptor-mediated endocytosis. The binding and uptake of IgG-complexed DNP-HSA was blocked by anti-Fc gamma RII antibody, indicating the specificity of the interaction.

Antigen-Antibody Complex↗
PubMed1996

Inducibility of the Drosophila melanogaster cytochrome P450 gene, CYP6A2, by phenobarbital in insecticide susceptible or resistant strains.

The importance of cytochrome P450s in the biology of cells or organisms is clearly established. While numerous studies concern vertebrates, little is known about invertebrates cytochrome P450s. In this paper, we have focused on CYP6A2 gene expression in Drosophila melanogaster. We show the expression of this cytochrome P450 gene in the Canton(s) strain (wild type) to be under the control of phenobarbital. In adults treated with phenobarbital, this gene is transcribed in the midgut, the pericuticular fat bodies and the Malpighian tubules. The induction factor is 15. In the RDDTR strain of Drosophila melanogaster, which is resistant to the insecticide DDT, this gene is constitutively overexpressed in the same tissues (overexpression factor is 6 relative to untreated Canton(s) flies). Phenobarbital is not as effective on RDDTR (induction factor is 2.5 relative to untreated RDDTR flies) as on wild type strains.

Animals↗
PubMed1996

[MRI and Listeria monocytogenes rhombencephalitis].

Rhombencephalitidis is a serious form of brainstem inflammation, difficult to diagnose on the basis of clinical and laboratory findings alone. We describe the MR appearance of 3 cases of Listeria monocytogenes rhombencephalitidis and correlate the findings with clinical information. MR imaging is crucial for early diagnosis of this illness: patchy signal hyperintensity throughout the medulla and cerebellar peduncles on T2 weighted images, always in association with a hypointense dot; numerous gadolinium-enhanced microabcesses in the rhombencephalon. MR imaging is very useful for follow-up examinations.

Brain Abscess↗
PubMed1996

[Agenesis of the internal carotid artery associated with an aneurysm of the anterior communicating artery].

We report a case of agenesis of the internal carotid artery which was revealed by a subarachnoid hemorrhage. Angiography showed a ruptured aneurysm of the anterior communicating artery and unilateral absence of the left internal carotid artery. Both the left anterior and middle cerebral arteries were perfused from the right carotid artery via the anterior communicating artery. Absence of the left carotid canal was proved on bone CT. Such an association is discussed. An hemodynamic stress on a congenital defect of the cerebral arterial wall could be the origin of the aneurysm development.

Adult↗
PubMed1995

[Diagnosis of extrapontine myelinolysis preceding central pontine myelinolysis].

An MR study performed on a patient who presented a tetraplegia after liver transplantation, revealed bilateral hypersignal of internal globus pallidus on T2 weighted images. Diagnosis of extrapontine myelinolysis was proposed based on clinical presentation and lesions topography, although absence of natremic disorders. Confirmation of diagnosis was obtained on an MR study performed a month later, which demonstrated a pontine extension. Extrapontine myelinolysis can precede pontine involvement. Diagnosis of myelinolysis should be evoked although MR normal appearance of the pons.

Demyelinating Diseases↗