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Biomedical subjects

J P Romanet

Publications and source records attributed to J P Romanet.

At least 19 recordsLinked to original sources
PubMed1998

[Implantation of autologous chondrocytes for cartilagenous lesions in young patients. A study of 24 cases].

STUDY AIM: The aim of this study was to describe the treatment of symptomatic knee cartilage defects on young active patients by autologous chondrocyte implantation and to report preliminary results in 24 patients. PATIENTS AND METHODS: Since April 1996, 24 selected patients underwent 25 implantations in five military hospitals. There were 19 men and five women (all of them practicing sports); mean age was 27. Lesions were localized on left (n = 13) and right (n = 12) aligned and stabilized knees. There were 12 isolated cartilage defects (eight OCD and four posttraumatic) and 13 associated with ligament lesions (n = 8) or multiple and severe lesions (n = 3 indication of salvage). Mean surface of cartilage defects was 6 cm2. Mean preoperative evolution was 11 months and stage was grade IV (Outerbridge) for all. The first step was arthroscopy for classification and biopsy. The second one was implantation after a 3-week delay (for the ex vivo culture) through arthrotomy, under a periosteal flap taken from tibia and sutured on the edges of the prepared defect. Weight bearing was allowed after the 6th week; MRI was performed at 6, 12, 18, 24 months. The follow up was evaluated with three scales: Lysholm 2, Tegner Activity, Cincinnati Knee Rating System. RESULTS: Postoperative complications included: algodystrophy (n = 2) and phlebitis (n = 1). Four patients were revised at 6 months, seven between 6 and 12 months, 11 after. The longest follow-up was 26 months. Results were poor in one patient (salvage). For the others, pain and swelling decreased after 6 months and disappeared after 12 months. CONCLUSION: Autologous chondrocyte implantation used in this senes and in a large international ongoing series seems to be the only procedure allowing a true long-term regeneration of cartilage defects. Some questions remain, on the biological level in relation with the use of some growth factors and the risk of chromosomic abnormalities, and on the economical level because of the high cost of this technique.

Adult↗
PubMed1998

Gelatinase concentration in tears of corneal-grafted patients.

PURPOSE: Gelatinolytic enzymes, which degrade type IV basement membrane collagen, have been shown to be expressed by corneal cells, either constitutively (gelatinase A or MMP-2) or after induction (gelatinase B or MMP-9). Our aim was to determine whether an enhanced MMP-9 and eventually MMP-2 concentration in tears could be evidenced in the case of corneal-graft failure. METHODS: The amount of MMP-2 and MMP-9 gelatinolytic enzymes was measured by quantitative zymography in tears of twenty-one controls (84 samplings) and in tears of twenty-three corneal-grafted patients in a one-year post-graft follow-up study. RESULTS: The mean MMP-2 values in controls were of 8.4 (+/-7.3) pg/10 micrograms protein and the mean MMP-9 values in controls were of 73 (+/-76) pg/10 micrograms protein. No active gelatinase form was detected in any of controls, but in all cases of corneal graft failure, the active forms of both enzymes were present, and enzyme concentrations were higher than control values. All patients had significantly higher MMP-9 values than controls at each sampling time (p < 0.0001). The "corneal-graft failure" patient group had statistically significant higher MMP-9 concentrations in tears than the "successful-graft" patient group at one month (p = 0.0312), four months (p = 0.0158) and one year (p < 0.01) after the graft. The presence of active MMP-9 was highly significant of graft failure four months and one year after the graft (p < 0.0001). In contrast, MMP-2 increase was delayed, with significantly higher MMP-2 values than controls in all patients at four months (p = 0.0231) and one year (p = 0.0001) after the graft, but MMP-2 values could not discriminate between patient groups. CONCLUSIONS: In our study, all cases of graft failure showed abnormally high levels of the active forms of metalloproteinase enzymes, and these values far exceeded the maximum control concentration. MMP-9 measurements in tears made between one and four months after corneal transplantation, and while local corticotherapy is steadily established, should help in predicting corneal graft rejection.

Adult↗
PubMed1997

[Description of the prismation method in the rehabilitation of low visions of macular origin].

GOALS: This work aimed at presenting an original rehabilitation method based on the prismation available for patients with organic lesions of the macula. We report results obtained in our first series of patients. MATERIAL AND METHODS: The treatment was given to 14 patients, 7 women and 7 men, aged from 68 to 92 years, with an average age of 81.64, followed in "Low Vision" consultation, and suffering from bilateral macular diseases. All the patients with age-related macular degeneration developed retinal correspondences. They all received a bilateral prismation over their old correction. The orientation of the prisms taking into account the eccentric fixations. The criteria chosen for surveillance were binocular subjective and objective acuity, contrast sensitivity and vision of colours. RESULTS: For all the patients concerned, the method led to an immediate subjective improvement of the visual function. Tolerance to optical support was improved. The patients recovered better self-sufficiency in their daily life. The objective binocular for VA was improved by at least one line for 92.86% of the patients, by at least 2 lines for 42.85% and by 3 lines for 7.14%. The binocular contrast sensitivity was better for all the patients. Regarding the vision of binocular colours, the examination performance time was improved for all the patients. CONCLUSIONS: Prismation allows optimal use of the corresponding eccentric fixation areas. It appears as an interesting new therapeutic method for patients with macular-related low vision. It is complementary to rehabilitation treatment of such patients.

Aged↗
PubMed1996

Schwannoma of the bulbar conjunctiva.

We describe a conjunctival tumor that occurred in the limbic region of the left eye in a 37-year-old man. The mass was located beneath the conjunctival epithelium. It consisted of a well-demarcated proliferation of fusiform cells arranged in bundles in a fibrous stroma. Tumor cells strongly expressed S-100 protein. On ultrastructural analysis, the tumor was composed of Schwann cells surrounded by a continuous basal lamina. These data led to the rare diagnosis of conjunctival schwannoma.

Adult↗
PubMed1995

Comparative clinical trial of AMO Vitrax and Healon use in extracapsular cataract extraction.

This randomized, single-masked, multicenter clinical trial, comprising 95 patients enrolled at five sites, evaluated the performance of AMO Vitrax and Healon viscoelastic materials during cataract surgery. Patients were examined preoperatively and at one day, four days, one month, and three months postoperatively. The following measurements were recorded and analyzed: percentage of endothelial cell loss from preoperative to three months postoperative; change in intraocular pressure (IOP) from preoperative to 24 hours postoperatively; postoperative corrected visual acuity; subjective assessment of ability of viscoelastic to create and maintain tissue space; intraocular transparency; ease of evacuation. Three months postoperatively, endothelial cell loss was 4.9% (+/- 8.3%) for the AMO Vitrax group and 6.3% (+/- 10.5%) for the Healon group. One day postoperatively, IOP decreased by 1.6 mm Hg and increased by +1.1 mm Hg, respectively. Postoperative visual acuities were similar between the two groups at three months. Subjective assessment of transparency was higher for Healon. Assessment of tissue space maintenance was similar between the two materials. Healon was rated as slightly easier to evacuate.

Aged↗
PubMed1994

24-hour (nyctohemeral) and sleep-related variations of intraocular pressure in healthy white individuals.

Intraocular pressure was measured hourly during 24 hours in 12 young (20.6 +/- 0.3 years, mean +/- SEM) and 12 older (59.5 +/- 1.6 years) healthy white adults to determine whether intraocular pressure followed a circadian rhythm and whether its nocturnal variations were related to the stages of sleep in the subjects. An electronic tonometer (Tono-Pen), working on the applanation principle, which was shown to give accurate intraocular pressure measurements in any posture, was used to measure intraocular pressure. Nocturnal polysomnography was measured. Wakefulness, light sleep (stages 1 and 2), slow-wave sleep (stages 3 and 4), and rapid eye movement sleep were scored. Intraocular pressure followed a circadian rhythm with a nocturnal peak value (acrophase). The variations in intraocular pressure were related to the stage of sleep, being lowest during rapid eye movement sleep, and highest during slow-wave sleep.

Adult↗
PubMed1991

[Ocular toxoplasmosis. Comparison between two biological methods to study aqueous humor].

To diagnose ocular toxoplasmosis with certainty is often difficult and requires anti Toxoplasma gondii antibodies screening in the aqueous humour. We evaluated the results obtained in 30 controls and 5 patients investigated, using the ELISA and indirect immunofluorescence techniques to determine Desmonts's C coefficient and the sera/aqueous humour densities ratio obtained with ELISA. None of the chorioretinitis-free controls showed a false positive result. Negative serum antibodies levels indicated an absence of ocular toxoplasmosis. The sensitivity of this method depends on several biological parameters, notably the extent of ocular inflammation. Evaluating the C coefficient by the ELISA technique increases this sensitivity.

Albumins↗
PubMed1990

[Primary empty sella turcica syndrome].

Authors relate a typical case of primary empty sella turcica. Its physiopathogenesis is not yet well known, ophthalmological manifestations are non specific and variable, and authors point out difficulties in treatment.

Adult↗
PubMed1990

[Epikeratoplasty without sutures using collagen IV lens in monkeys: description of the surgical technic].

The authors describe their original epikeratoplasty technic without sutures which is compatible with the use of collagen IV lens. They describe the first four observations of primates operated on using this technic. At first the epithelium is removed at the cornea center and a trepanation is made of 4 mm diameter and 0.1 mm depth. The bottom of the trepanation is then cut horizontally, and the periphery of the lens is put in the cornea stroma. Later the epithelium will recover the collagen lens. The lens is perfectly set in the cornea. We don't use any suture and so we avoid astigmatism and neovascularisation. The follow-up consisted of biomicroscopic examination photography, specular microscopy, pachymetry, photokeratoscopy (Nidek System) tonometry and histology. Clinical observance showed a perfect lens tolerance. The cornea is immediately transparent and within a week epithelial cells recovered the lens of three animals out of four. The photokeratoscopy study proved the important cornea refraction modification. This technic is reversible and the lens can be exchanged. A study of histology has begun and already shows a pluristratified epithelium. Further studies will test the biomaterial stability and ultra structural relations between the collagen IV lens and epithelial cells.

Animals↗
PubMed1989

Biocompatibility of human collagen type IV intracorneal implants.

A new biomaterial made from human placental collagen type IV has been developed in corneal inlays for refractive keratoplasty. Eight dogs received intracorneal lenses to investigate biocompatibility. Postoperative follow-up observation of 2 years revealed that the eyes remained clear and without inflammatory reaction. Endothelial cells were unaltered. Histological and ultrastructural studies showed no signs of inflammation, ulceration, or encapsulation. No fibroblastic activity was evident at the lens stroma interface.

Animals↗