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Biomedical subjects

J M Gerard

Publications and source records attributed to J M Gerard.

At least 19 recordsLinked to original sources
PubMed2005

Non-linear elastic properties of the lingual and facial tissues assessed by indentation technique. Application to the biomechanics of speech production.

This paper aims at characterizing the mechanical behavior of two human anatomical structures, namely the tongue and the cheek. For this, an indentation experiment was provided, by measuring the mechanical response of tongue and cheek tissues removed from the fresh cadaver of a 74 year old woman. Non-linear relationships were observed between the force applied to the tissues and the corresponding displacements. To infer the mechanical constitutive laws from these measurements, a finite element (FE) analysis was provided. This analysis aimed at simulating the indentation experiment. An optimization process was used to determine the FE constitutive laws that provided the non-linear force/displacements observed during the indentation experiments. The tongue constitutive law was used for simulations provided by a 3D FE biomechanical model of the human tongue. This dynamical model was designed to study speech production. Given a set of tongue muscular commands, which levels correspond to the force classically measured during speech production, the FE model successfully simulated the main tongue movements observed during speech data.

Aged↗
PubMed2005

Metastatic renal cell carcinoma to the temporal bone: case report.

We report an extremely rare case of metastasic renal cell carcinoma to the temporal bone which presented initially as a jugulotympanic paraganglioma. The clinical and radiological appearances were misleading.Investigations of concomitant high blood pressure revealed a tumour of the right kidney. Biopsy of the mastoid mass was histologically compatible with a metastasis from a clear cell renal carcinoma. The patient underwent a radical nephrectomy and local external radiotherapy to the head. He also received adjuvant treatment with interferon-_ and interleukin 2. The clinical presentation, the radiological and histological features, the patterns of spread, the treatment options and the prognosis of these tumours are discussed. A review of the literature confirms the extremely unusual occurrence of this localisation.

Adult↗
PubMed2000

Poison prevention counseling: a comparison between family practitioners and pediatricians.

OBJECTIVES: To compare the current opinions and practices of family practitioners with those of pediatricians regarding poison prevention anticipatory guidance (PPAG) and to further assess which factors, if any, are associated with providing counseling on this topic. DESIGN: Cross-sectional mail survey. PARTICIPANTS: Family practitioners and pediatricians throughout the United States and Puerto Rico, randomly selected from the membership list of the American Medical Association. MAIN OUTCOME MEASURE: Reported frequency of providing parents with PPAG. RESULTS: Of the 1000 physicians surveyed, 975 were eligible and 500 returned surveys that could be analyzed (227 family practitioners and 273 pediatricians), for a response rate of 51.3%. The majority of physicians in each field (family practice, 81.9%; pediatrics, 87.2%) reported that they believe it is their responsibility to provide PPAG to parents (P = .08). Family practitioners, however, were less likely than pediatricians to provide parents with PPAG (66.5% vs 91.9%; P<.001). When adjusted for other variables, such as age and sex, family practitioners were 5.4 times less likely than pediatricians to provide parents with PPAG (odds ratio, 0.19; 95% confidence interval, 0.09-0.37). Family practitioners, more often than pediatricians, cited lack of training on poisoning prevention as a reason for not providing parents with PPAG (46.1% vs 18.2%; P = .02). Among all physicians, those who received postresidency training on PPAG were more likely to provide PPAG than those who had not received postresidency training on this topic (odds ratio, 3.21; 95% confidence interval, 1.44-7.18). Having received residency training on poisoning prevention, however, did not increase the likelihood of providing PPAG (odds ratio, 1.69; 95% confidence interval, 0.86-3.30). CONCLUSIONS: Although it is currently recommended to include PPAG as part of the routine preventive pediatric care, this study shows that one third of family practitioners do not provide parents with PPAG. Family practitioners should increase their efforts aimed at poisoning prevention. Those involved with training residents in family practice and pediatrics should place greater emphasis on this topic to increase the impact of this training on actual PPAG practices.

Adult↗
PubMed1999

Loloatins A-D, cyclic decapeptide antibiotics produced in culture by a tropical marine bacterium.

Loloatins A (1) to D (4), a family of new cyclic decapeptide antibiotics, have been isolated from laboratory cultures of a tropical marine bacterium recovered from the Great Barrier Reef in Papua New Guinea. The structures of loloatins A-D were elucidated via a combination of spectroscopic analyses and chemical degradation. Loloatins A-D exhibit in vitro antimicrobial activity against methicillin-resistant Staphyloccoccus aureus, vancomycin-resistant enterococci, and drug-resistant Streptococcus pneumoniae.

Anti-Bacterial Agents↗
PubMed1997

Sleep apnea in patients receiving growth hormone.

Among 145 patients treated with recombinant human growth hormone (GH), four developed sleep apnea (two obstructive, two mixed) associated with tonsillar and adenoidal hypertrophy in three. These four patients had no local risk factors predisposing to upper airway obstruction (i.e., frequent pharyngitis or sinusitis). Clinical and/or polysomnographic features of sleep apnea improved following cessation of GH therapy in one patient, and following tonsillectomy and adenoidectomy in all patients. The present observations indicate that, albeit rarely, obstructive and/or central sleep apnea may occur in children treated with GH. Polysomnography should be considered if symptoms of snoring, interrupted sleep, daytime somnolence-particularly if associated with tonsillar hypertrophy-appear in children during GH therapy.

Adenoidectomy↗
PubMed1997

An analysis of morning report at a pediatric hospital.

The purpose of this study was to determine the types of cases residents select for morning report discussion and the educational value of postdischarge follow-up of unknown cases. Between April and December of 1994, at Cardinal Glennon Children's Hospital in St. Louis, Missouri, random, resident, and group-selected patients listed at morning report were followed up throughout hospitalization. Patients were categorized based upon whether or not their morning report and discharge diagnoses were the same or different. Patients discharged without a diagnosis were followed up by chart review at 6 months to determine whether a diagnosis had been made. Data were analyzed by Chi-square analysis with Bonfferoni adjustment factor for multiple comparisons. Residents were more than two times more likely to select cases for discussion in which the diagnosis changed during hospitalization (P < 0.01). The 6-month follow-up yielded new diagnoses in only 21% of previously unknown cases. We concluded that residents do an exceptional job of selecting difficult diagnostic cases for discussion at morning report. Postdischarge follow up of unknown cases adds little new information for discussion at morning report.

Child↗
PubMed1997

A fatal overdose of arginine hydrochloride.

CASE REPORT: Arginine hydrochloride is used both diagnostically to test for growth hormone deficiency and therapeutically for treatment of metabolic alkalosis. We describe a 21-month-old girl who developed cardiopulmonary arrest following an accidental overdose of arginine hydrochloride. The patient developed acute metabolic acidosis and transient, but severe, hyponatremia. Thirty-six hours after successful resuscitation, she developed fatal central pontine and extrapontine myelinolysis. Unlike previous reports of arginine-toxicity, our patient showed no evidence of hyperkalemia. This case illustrates a previously unreported mechanism of arginine hydrochloride toxicity.

Acidosis↗
PubMed1997

ENT manifestations of relapsing polychondritis.

Relapsing polychondritis is a rare disease probably of auto-immune etiology comprising inflammatory involvement of cartilage as well as phenomena of vasculitis. ENT manifestations are frequent and the authors present a case involving chondritis of the auricle, the nasal septum and affecting the cochleo-vestibular system as well. The diagnosis is based on the evocative clinical picture and on histological confirmation. Treatment consists of corticosteroids and immunosuppressive agents.

Anti-Inflammatory Agents↗
PubMed1990

[Sensory ataxia caused by central axonopathy].

Sensory ataxia with central axonopathy. A case of sensory ataxia of undefined origin is described and the differential diagnosis is discussed. The originality of the case lies in the fact that the nerve sensory potentials are preserved whereas the medullary and cortical somesthesic potentials no longer exist. This situates the pathological process in the central axon of the sensory ganglion, as in tabes or clioquinol poisoning.

Adult↗
PubMed1990

[Congenital fibrosis of thr ocular muscles: a diagnosis for several clinical pictures].

Case report of four members of a family presenting a congenital fibrosis syndrome. The first case has the typical presentation with bilateral ptosis, bilateral hypotrophic, variable horizontal deviation, and restricted ocular movements in all directions. The second case has a unilateral ptosis with Marcus Gunn phenomenon and bilateral restriction of elevation. In the third case, the condition is purely unilateral and associated with a sensorimotor neuropathy. A fourth member presents a unilateral ptosis. Three other members have a simple strabismus without any oculomotor anomaly.

Adult↗
PubMed1988

Inflammatory demyelinating polyradiculoneuropathy associated with human immunodeficiency virus infection.

Five patients infected with immunodeficiency virus who were suffering from chronic polyradiculoneuropathy were investigated during evolution of the disease. Four of them were immunodeficient. The prominent neurological feature was distal and symmetrical weakness of the legs. After 5 months only one patient had improved. All patients had an increased protein level in the cerebrospinal fluid and pleocytosis. Electrodiagnostic studies and sural nerve biopsies indicated demyelination. Sural nerve viral cultures, including human immunodeficiency virus, were negative. The presence of circulating anti-peripheral nerve antibodies and of immunoglobulin deposits in nerve biopsy specimens was investigated by immunofluorescence techniques but failed to demonstrate any immunoreactivity.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Reversible capsulo-tegmental locked-in state as first manifestation of multiple sclerosis.

An 18-year-old girl developed a reversible locked-in state with bilateral ptosis and almost complete ophthalmoplegia. She later presented with a relapsing and remitting course suggestive of multiple sclerosis. Autopsy findings demonstrated bilateral capsular and tegmental demyelinating lesions. In addition to this unusual aetiology, this is the first report with pathological evidence of a locked-in syndrome due to lesions outside the ventral brainstem.

Adolescent↗
PubMed1987

Thoracic spinal epidural cysts.

Two cases of spinal cord compression by thoracic epidural cysts are reported. The first case, associated with a lipoma, is of a congenital type, while the second illustrates a rare mechanism of spinal cord compression caused by a post-traumatic cyst after stretching of the brachial plexus and tearing of the meningeal sheaths of nerve roots. Computed tomography of the spine is helpful in disclosing the cyst and associated malformation, particularly in congenital cases. The prognosis is good after removing the cyst and closing the fistula communicating with the subarachnoid space. Further surgical treatment may be required in complex congenital malformations.

Adult↗
PubMed1984

Sequential CT scanning in radiation myelopathy.

Myelography is usually normal in radiation myelopathy. Occasionally it may show an enlarged spinal cord with block or a spinal cord of reduced size. It is assumed that the enlargement of the spinal cord is transitory, occurs in early stages of radiation myelopathy and is due to oedema, whereas atrophy is seen in later stages of the disease. This assumption however has not been clearly established by sequential radiological examinations. The purpose of this case report is to demonstrate such changes by repeated X-ray investigations.

Adenoma↗
PubMed1977

Pathognomonic aspect of germinoma on CT scan.

Bilateral visual impairment, associated with amenorrhea, diabetes insipidus and mental deterioration were observed in a 28 year old woman. CT scan revealed bilateral symmetrical infiltrative processes surrounding the ventricular system, which was confirmed by postmortem examination. Histologically the lesion was a germinoma.

Adult↗