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Biomedical subjects

L Fournier

Publications and source records attributed to L Fournier.

At least 19 recordsLinked to original sources
PubMed1996

Bone mineral acquisition during adolescence and early adulthood: a study in 574 healthy females 10-24 years of age.

Low bone mass is known to be associated with an increased risk of fractures. Osteoporosis prevention by maximizing bone mass will be crucial and requires a better knowledge of bone mass acquisition during adolescence. Bone mass was assessed in 574 healthy volunteer females aged 10-24 years. Spine bone mineral density (BMD) in anteroposterior (AP L2-4) and lateral (LAT L3) views was measured using dual-energy X-ray absorptiometry (DXA) and AP bone mineral content (BMC) was calculated. At the same time, spine AP-BMD (L2-4) was evaluated in 333 normal menstruating women, aged 27-47 years. Bone values, osteocalcin and IGF-1 serum concentrations were correlated with chronological age, skeletal age, pubertal stages and time after menarche. In this cross-sectional study, AP- and LAT-BMD and BMC increased dramatically between skeletal ages 10 and 14 or until the first year after menarche. Between 14 and 17 skeletal years of age, AP-BMD and BMC increased moderately, whereas LAT-BMD remained unchanged. After skeletal age 17, or the fourth year after menarche, there was no significant increase in BMD or BMC, and their values did not differ from those of menstruating women. A serum osteocalcin peak was observed at skeletal ages 11-12 or at stage P3, whereas IGF-1 peaked at 13-14 skeletal years of age or at P4 and the first year after menarche. Eighty-six per cent of the adult bone mass of the spine is acquired before skeletal age 14 or the second year after menarche; therefore osteoporosis prevention programs will be particularly effective before that age.

Absorptiometry, Photon↗
PubMed1996

The reliability of the community version of the MRC Needs for Care Assessment.

One hundred and nine adults were screened in the community using the abridged version of the CIDI (CIDIS). The subjects comprised DSM-III-R current cases (N = 48), lifetime cases (N = 31) and non-cases (N = 30). The interviews with the 109 subjects were conducted by one of two pairs of clinicians and videotaped. Each interviewer-pair included a psychiatrist and a clinical psychologist. They rated the community version of the Needs for Care (NFCAS-C) by consensus. The other pair of judges then viewed the video and rated the NFCAS-C independently. The agreement on overall needs was excellent (kappa = 0.75), and very good for four of the seven specific sections (from kappa = 0.61 to 0.81). One section could not be rated because of low prevalence, and agreement was less good for the remaining two sections. Agreement was good on specific interventions (medication, kappa = 0.60; specific psychotherapy, kappa = 0.55), but poor on non-specific interventions. The majority of disagreements were due to differences in clinical judgement rather than to technical errors. A new instruction manual has been produced and should help training as well as stabilizing reliability. In devising reliable and valid instruments based on clinical judgement, a balance must be achieved between enhancing reliability with more precise rules and constraining clinical judgement so tightly that validity is lost.

Adult↗
PubMed1996

Incidence of transient congenital hypothyroidism due to maternal thyrotropin receptor-blocking antibodies in over one million babies.

To determine the incidence of transient congenital hypothyroidism due to TSH receptor-blocking antibodies, we screened dried blood specimens obtained from 788 neonates identified as having possible congenital hypothyroidism (from a total population of 1,614,166 babies) and 121 controls. A RRA was used. The potency of blood spot TSH binding inhibitory activity was compared with the severity of congenital hypothyroidism to assess the possible etiological relationship. Maternal serum was studied to confirm the presence of blocking antibodies by both RRA and bioassay. Blood spots obtained from 9 infants contained potent TSH receptor-blocking activity. Samples from 2 additional babies, studied because of clinical suspicion of the disease, were also positive. Long term outcome was known in 8 of the 11 babies, and all had transient disease. Neonates with TSH receptor-blocking activity greater than 132 U/L had a significantly lower T4 level (P < 0.05) and higher TSH (P < 0.005) than those in whom TSH binding-inhibitory activity was less than 132 U/L. All 9 mothers had autoimmune thyroid disease, and 3 had more than 1 affected child. Potent blocking activity was present in 7 maternal serum samples as long as 7 yr after the births of their affected babies. We conclude that measurement of TSH binding-inhibitory activity in dried neonatal blood specimens is a simple and effective method to predict the occurrence of transient congenital hypothyroidism. The incidence of this disorder in North America is 1 in 180,000 normal infants, or approximately 2% of babies with congenital hypothyroidism.

Acute Disease↗
PubMed1996

Lymphocyte esterases and hydroxylases in neurotoxicology.

Certain human lymphocytic enzymes, such as neuropathy target esterase (NTE), have become useful markers in clinical toxicology. NTE has been proposed as a predictive marker in organophosphate poisoning for the subsequent development of organophosphate-induced delayed neuropathy. We studied lymphocyte aryl hydrocarbon hydroxylases, and using a differential method based on that of NTE employing a phenyl-alkanoic substrate, developed an enzyme assay for use in toxic neuropathies. The assayed enzyme, which we refer to as neuropathy target hydroxylase (NTH), performed similarly to NTE in the evaluation of coherent clinical data obtained in patients with toxic neuropathies. This study indicates good correlation between the severity of clinical illness and abnormally low levels of NTH in neuropathies of varied etiology. A simplified protocol for NTH assay is presented.

Adult↗
PubMed1995

Where did you go wrong? Errors, partial errors, and the nature of human information processing.

Human performance is seldom perfect, and even when an overt response is correct it may be accompanied by partial-error activity that does not achieve the level of a complete incorrect response. Partial errors can be detected in measures of the lateralized readiness potential, of the electromyogram, and of response force. Correct responses accompanied by partial errors tend to have slower reaction times than "clean" correct responses (because of response competition), and condition differences in reaction time can, on some occasions, be explained in terms of differences in the incidence of partial errors. In two-choice reaction time tasks, partial errors are more frequent when the imperative stimulus contains information that favors both responses, than when it contains information that favors only one response. The non-random nature of partial errors supports the inference that partial information about the stimulus is used to guide responses. A similar inference is supported by the observation that, in hybrid choice Go/No-go tasks, the kinds of partial errors that follow a No-go stimulus represent activation of the response that would have been correct had the stimulus been a Go stimulus. Finally, we note that the human processing system is capable of monitoring its own behavior and of initiating remedial actions if necessary. The activity of an error-detection system, as revealed by measures of the error-related negativity, is related to the degree to which responses are slowed after errors.

Arousal↗
PubMed1995

Combined gas ventilation and perfluorochemical tracheal instillation as an alternative treatment for lethal congenital diaphragmatic hernia in lambs.

Tracheal instillation of perfluorochemical liquid (PFC) lowers surface tension in the lung and thus might reduce barotrauma commonly associated with conventional gas ventilation (GV) in highly immature and hypoplastic lungs. It could be a promising alternative treatment for congenital diaphragmatic hernia (CDH) when GV alone is proving inefficient. The authors compared data for eight newborn lambs with surgically induced CDH. The animals had GV and were studied (in 2 groups) for up to 3.5 hours. Group 1 (GV, n = 4) had gas ventilation only. In group 2 (PFC, n = 4), after 30 minutes of GV, 10 to 12 mL/kg of warmed, oxygenated PFC liquid (LiquiVent) was instilled into the lung via the trachea under pressure-volume curve monitoring. Arterial pressure, blood chemistry, and pulmonary mechanics were evaluated serially; histological analysis was performed. One preassigned animal in group 1 died after 15 minutes. After 30 minutes of life, the cardiopulmonary profile of survivors was indicative of severe respiratory distress (Pao2 < 72 mm Hg with FIO2 at 1.0, PaCO2 > 90 mm Hg, compliance < 0.10 mL/cm H2O/kg) and not different between groups; the severity of pulmonary hypoplasia was further confirmed postmortem; the ratio of lung weight to body weight was 41% of that observed in control lambs, in both gas-only and combined gas/PFC-ventilated animals, compared with their respective controls. After instillation of PFC, there were dramatic improvements in acid-base status and pulmonary compliance in group 2. Survival at 3.5 hours also was markedly different (4 of 4 PFC animals and 1 of 3 GV animals).(ABSTRACT TRUNCATED AT 250 WORDS)

Acid-Base Equilibrium↗
PubMed1994

[Primary adrenal lymphoma. Report of a case].

The adrenal gland is affected in about 25% of patients with diffuse lymphoma. Conversely, primary lymphoma is a rare cause of non-secreting adrenal tumour. We observed a recent case with exclusive right adrenal localization. An 84-year-old woman was hospitalized for asthenia, anorexia and a 3-kg weight loss. The past history included coronary heart disease. Physical examination was normal and the hemogram revealed pancytopenia. No lymphomatous infiltration was seen on the myelogram or the bone marrow biopsy. Echography of the abdomen showed a well-limited 10 cm mass above the right adrenal gland, distinct from the liver; the left gland had a normal aspect. Hormone assays were within normal limits. The right adrenal gland was removed surgically and histology revealed diffuse proliferation of medium to large sized lymphoid cells invading the entire gland. Immunohistochemistry suggested lymphoid B origin. No curative treatment was begun, but 2 months after surgery local invasion required polychemotherapy. The patient died of septic shock 5 days later. Serum cortisol measured during the septic shock eliminated adrenal gland failure. Malignant primitive non-Hodgkinien lymphomas are extremely rare and usually discovered incidentally. The tumour is always large and sometimes accompanied by adrenal insufficiency when the lesion is bilateral. In spite of suggestive imagery the diagnosis is based on the pathology examination. The lesion is usually a high-grade malignant phenotype B lymphoma. Treatment relies on chemotherapy but is disappointing.

Adrenal Gland Neoplasms↗
PubMed1994

Cyclic AMP triggers large [Ca2+]i oscillations in glucose-stimulated beta-cells from ob/ob mice.

The modulation of intracellular free calcium concentration ([Ca2+]i) by cAMP was compared in pancreatic beta-cells of lean (+/+) and obese (ob/ob) mice. Neither forskolin nor 8-bromo-cAMP significantly affected basal [Ca2+]i in unstimulated lean and obese mouse beta-cells. In obese, but not in lean mouse beta-cells, adding forskolin or 8-bromo-cAMP during the glucose-induced [Ca2+]i response triggered external Ca(2+)-dependent [Ca2+]i oscillations with a duration of 5-11 s and a frequency of 2.3-4.8 min-1. The induction of oscillations by cAMP required both a stimulatory glucose concentration and membrane depolarization. (Sp)-cAMPS, did induce oscillations in lean mouse beta-cells. However, these oscillations were different from those seen in obese mouse beta-cells and required higher concentrations of (Sp)-cAMPS. The inducibility of fast oscillations in obese mouse beta-cells indicates hypersensitivity of these cells to cAMP, and suggests an abnormal behavior of K+ and/or Ca2+ channels.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMed1994

[Value of CT scan in the diagnosis of small pneumoperitoneum].

This case-report concerns a small pneumoperitoneum not demonstrated on plain radiographs and detected on CT scan. The patient had a blunt abdominal trauma with jejunal perforation. The performances of CT compared to other investigations in traumatic intestinal injuries are analysed.

Accidents, Traffic↗
PubMed1994

Serial serum CA 125 measurements for evaluation of recurrence in patients with endometrial carcinoma.

OBJECTIVE: To evaluate the usefulness of serum assays for CA 125 to detect recurrent endometrial carcinoma. METHODS: Two hundred sixty-six patients were studied with 1101 post-treatment assays. Patients were categorized as low, medium, or high risk based on surgical-pathologic findings. CA 125 values were analyzed with respect to each patient's disease status. RESULTS: Serial CA 125 levels were elevated (greater than 35 U/mL) in 19 of 33 patients (58%) with recurrent disease. Among 236 surgically treated patients, 97 (41.1%), 42 (17.8%), and 97 (41.1%) were considered low, medium, and high risk, respectively. None of the low-risk and only two (4.7%) of the medium-risk patients developed recurrent disease. One of the latter patients was detected based on an elevated CA 125 level alone. Twenty-seven (27.8%) of the high-risk patients developed recurrent disease, 23 of whom had elevated pre-treatment CA 125. Fifteen of 16 (94%) with recurrent disease had an elevated CA 125 level. Nine of 12 patients with papillary serous carcinoma experienced recurrence; eight of these nine had elevated CA 125 levels at diagnosis and recurrence, in contrast to only one patient with a normal pre-treatment level (P = .018). False elevations were noted in 13 patients, 12 of whom had received radiation therapy. CONCLUSIONS: CA 125, if elevated at diagnosis of endometrial carcinoma, is an important marker for recurrent disease. The use of serial CA 125 assays is most beneficial in diagnosing recurrence in a high-risk population, including patients with papillary serous carcinomas. False elevations may occur following radiation therapy.

Adenocarcinoma, Clear Cell↗
PubMed1993

Comparison of performance from three continents on the WHO-Recommended Neurobehavioral Core Test Battery.

To address the need for standardized test batteries, an expert group convened by the World Health Organization (WHO) and the U.S. National Institute for Occupational Safety and Health during 1983 proposed the Neurobehavioral Core Test Battery (NCTB) to identify nervous system effects of chemical exposures in human populations worldwide. To determine the feasibility of using the NCTB in varied cultures, a cross-cultural assessment was conducted under WHO auspices. Data were collected in 10 countries of Europe, North and Central America, and Asia from over 2300 males and females who were not exposed to chemicals at work, within five age ranges between 16 and 65. Results suggest that performance on two NCTB tests (Simple Reaction Time, Benton Visual Retention) is very similar in a broad range of countries and that performance on four other NCTB tests (Santa Ana, Digit Symbol, Digit Span, Aiming) is relatively more variable from country to country, in both males and females. However, data collected from very poorly educated males in one country revealed very low performance levels suggesting that the NCTB may not provide an adequate reference group for identifying (behavioral) neurotoxic effects in such populations. More research is thus needed on evaluating neurotoxicity in poorly educated subjects.

Adult↗
PubMed1993

Estimation of lungs' hypoplasia on postoperative chest x-rays in congenital diaphragmatic hernia.

Since we stopped inserting ipsilateral underwater chest drains after surgical reduction of the herniated contents in congenital diaphragmatic hernia, both lungs are allowed to expand at their own pace, making it possible to estimate their degree of hypoplasia on postoperative chest x-rays. Thirty-nine consecutive series of postoperative chest x-rays were examined by an independent reviewer in a blind manner and classified into three groups: none to mild pulmonary hypoplasia (group I, 10 cases); moderate to severe (group II, 20 cases); and very severe hypoplasia (group III, 9 cases). Correlations were done among groups and available anatomical and clinical data. Eight patients out of 9 survived in spite of very severe hypoplasia on postoperative chest x-rays, suggesting that indexes of severity may be misleading when they mistake pulmonary hypoplasia for the cause of death.

Chest Tubes↗
PubMed1993

A new method of treatment for pulmonary hypertension in congenital diaphragmatic hernia: experimental study in cats.

This research proposes a new treatment for pulmonary hypertension secondary to perivascular emphysema, the so-called air-block syndrome. Vibrations applied on the thorax can fraction air bubbles around the vessels into smaller ones, facilitating their redistribution and reabsorption, thus reducing the extrinsic compression on pulmonary vasculature. In cats, pulmonary lesions were obtained by continuous insufflation of air at 40 cm H2O for 2 minutes in a lower lobe of the lung. Vibrations applied on the thorax were produced with the same apparatus as used by physiotherapists to eliminate pulmonary secretions. Thirty-three cats were divided into three groups: lesions without treatment, lesions treated by vibrations, and controls. A catheter was inserted in the pulmonary artery for pulmonary artery pressure (PAP) measurements. One carotid was cannulated for arterial pressure and blood gases monitoring. Morphometric analysis of the lung had also to be carried out in all cases. Results showed a very significant decrease on pulmonary hypertension in the treated group after only 20 minutes of treatment by vibrations (P < .004). Results also confirmed the very strong relationship between PAP variations and perivascular emphysema found on postmortem examination (r2 = .64, P < .01). Extrinsic compression decreased from 29% in the untreated group to 21% in the treated one (n = 10 pairs, P < .08). These data suggest that vibrations may be a new simple treatment for pulmonary hypertension, when perivascular emphysema is involved, and could be useful in congenital diaphragmatic hernia as well in other neonatal pathologies.

Animals↗
PubMed1993

Serum squamous cell carcinoma antigen levels in invasive cervical cancer: prediction of response and recurrence.

OBJECTIVE: The rate of normalization of human chorionic gonadotropin or CA 125 in other gynecologic malignancies is highly predictive of response to therapy and recurrence. Serum squamous cell carcinoma antigen (SCC antigen) levels were studied in patients with invasive cervical carcinoma to determine if the rate of normalization was associated with outcome. STUDY DESIGN: One hundred eighty-four patients were studied. A logistic regression of elevated SCC antigen levels was performed. RESULTS: In primary squamous cell carcinoma the SCC antigen level was elevated in stages I, II, III, and IV disease and all stages combined in 24%, 57%, 67%, 71%, and 43% of cases, respectively. Only 27% of patients with nonsquamous carcinoma of the cervix had elevated SCC antigen levels. SCC antigen levels were elevated in 50% of patients with recurrent disease. In both primary and recurrent disease elevated SCC antigen levels decreased with effective therapy. Normalization of elevated SCC levels was associated with a complete response; however, logistic regression of SCC antigen values was not. CONCLUSION: When initially elevated, SCC antigen assays aided in determination of response and detection of recurrences.

Adenocarcinoma↗
PubMed1993

K+ channel and alpha 2-adrenergic effects on glucose-induced Ca2+i surges: aberrant behavior in ob/ob mice.

Glucose-induced shifts in intracellular free Ca2+ concentration ([Ca2+]i) were quantitatively and temporally the same in ob/ob and +/+ beta-cells. In both, epinephrine promptly and protractedly inhibited the glucose-induced [Ca2+]i surge via a pertussis toxin-sensitive alpha 2-adrenergic mechanism that was reversible by potassium depolarization. When added before glucose, epinephrine blocked completely in the ob/ob beta-cells, but in the +/+ beta-cells it produced a delayed, reduced, and transient intracellular Ca2+ (Ca2+i) surge. Neither the ATP-sensitive K+ channel blocker tolbutamide nor the large-conductance Ca(2+)-activated K+ channel (Kmaxi) blocker charybdotoxin reversed the effect of epinephrine. Tetraethylammonium (TEA), a blocker of both the Kmaxi and the delayed-rectifier K+ channel, and forskolin attenuated the effect of epinephrine in +/+ but not in the ob/ob beta-cells. The data show that 1) alpha 2-adrenoreceptor activation decreases the glucose-stimulated Ca2+i surge in +/+ beta-cells primarily by activating a tolbutamide- and charybdotoxin-insensitive, TEA- and forskolin-sensitive K+ channel; 2) the hypersecretion of insulin in ob/ob beta-cells is not due to enhanced glucose-induced Ca2+ influx; and 3) the ob/ob beta-cells are aberrant with regard to alpha 2-adrenergic modulation.

Animals↗
PubMed1993

A comparison of mail and telephone interview strategies for mental health surveys.

The high cost of mental health surveys of the general population has sparked interest in less costly research methods. Two low-cost mental health survey strategies (mail and telephone) were compared in terms of cost, response rate and quality of data obtained. A total of 1,074 persons agreed to participate in the study as a sample, one-half by telephone and the other half by mail. They completed the Diagnostic Interview Schedule Self-Administered, a questionnaire designed to be self-administered, which was used to assess specific mental disorders and to evaluate risk factors. In addition, 239 respondents who were selected according to the presence or absence of specific diagnoses were reinterviewed face-to-face using the Diagnostic Interview Schedule as an external criterion. The telephone method yielded a better response rate (15% higher) and better control over answers (for example, less missing data). The mail strategy was less expensive and appeared to yield data of slightly better quality, particularly for respondents suffering from anxiety disorders.

Adolescent↗