[Autoimmune bullous diseases and HHV6: retrospective evaluation of active viral replication].
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Aged↗
Biomedical subjects
N Meyer
Publications and source records attributed to N Meyer.
Surgery for non-localized bronchiectasis.
BACKGROUND: Resection for localized bronchiectasis is a well established therapy. However, there is little information on the role of surgery in non-localized bronchiectasis. METHODS: Between January 1992 and April 2001, 55 patients without cystic fibrosis underwent resection. Forty-eight patients (mean age 45 (range 23-74) years; 32 women) were available for long-term follow-up. Twenty-five patients underwent resection for localized disease (group 1) and 23 had bronchiectasis in at least two different lobes (group 2). RESULTS: Thirty-one of the 48 patients were treated by Video Assisted Thoracoscopic Surgery (VATS) resection. There was no 30-day mortality. Mean duration of hospital stay was 10.9 (range 6-31) days in group 1 and 11.1 (range 5-19) days in group 2. Three of 25 patients in group 1 required reoperation. Only minor complications occurred in group 2 (three patients). Mean follow-up for both groups was 37 (range 6-97) months. Twenty-three of 25 patients in group 1 and 16 of 23 in group 2 reported satisfaction at 6 months after the operation. Recurrent infection was noted in three patients in each group. Haemoptysis recurred in only one patient in group 2. CONCLUSION: The surgical treatment of selected patients with non-localized bronchiectasis was safe and most patients were satisfied with the outcome.
Adult↗
[Difficulties and reproducibility of radiological measurement of the proximal tibial axis according to Lévigne].
PURPOSE OF THE STUDY: The angle between the anatomic axis of the tibia and the tangent to the superior borders of the tibial plateaus is, on average, tilted 3 degrees in the varus position. If there is no bone wear, this angle measures the constitutional epiphyseal axis of the proximal tibia. When degenerative joint disease modifies the aspect of the tibial plateaus, this angle measures the sum of the constitutional varus and the bone wear, without distinguishing between the two. It is known however that the respective contribution of these two deformations can have therapeutic implications, particularly when tibial osteotomy for valgus correction or implantation of a unicompartmental prosthesis is proposed. Lévigne proposed a radiographic measurement of the proximal tibial axis to distinguish between these two sources of tibial deformation. We studied the intra- and interobserver reproducibility of these measurements. MATERIAL AND METHODS: Fifty volunteers free of knee disease were chosen at random among a population of patients undergoing upper limb surgery. All patients provided their informed consent for participation in the study. Full-limb radiographs of one lower limb (chosen at random) were obtained using a standardized technique. The proximal tibial axis was measured according to the Lévigne technique using a manual goniometer graduated in degrees. One operator performed two series of measures independently on the same films. Two other operators performed a series of measurements on each film. The intra- and inter-observer reproducibility was determined with the interclass coefficient of correlation (rho). RESULTS: The proximal epiphyseal axis of the tibia could not be determined on 7 to 18 films, depending on the operator. All three operators were able to make the all measurements (four per film) for only 25 patients. The mean epiphyseal axis varied from 2.5 degrees to 4.7 degrees for the four series of measurements. Intra-observer reproducibility was considered good (rho=0.62). Inter-observer reproducibility was considered moderate (rho=0.41). DISCUSSION: The Lévigne technique is to our knowledge the only method described in the literature distinguishing the relative contribution of constitutional varus and bone wear of the proximal tibia. According to the advocates of this method, the angle between the epiphyseal axis linking the center of the tibial plateaus and the center of the proximal growth cartilage scare, and the anatomic axis of the tibia is a measurement of constitutional varus. The average is 3 degrees . The angle between a line perpendicular to the epiphyseal axis and the tangent of the superior borders of the tibial plateaus measures the deformation related to bone wear. In the present work, we found that this technique enables acceptable intra-observer reproducibility but that inter-observer reproducibility is low. The differences observed are certainly related to uncertain identification of the growth cartilage scar. This illustrates the difficulty in generalizing this technique for measuring healthy knees. Such difficulties would be even greater for degenerative knees. CONCLUSION: The Lévigne technique does not appear to be a reliable method for defining indications for different surgical procedures according to the morphology of the proximal tibia.
Anthropometry↗
[Home living conditions in Alsace of the disabled elderly aged 75 years and more].
OBJECTIVE: Our aim was to describe the living conditions of disabled elderly subjects aged 75 years and more living at home. DESIGN: This study was conducted in 1996-97 in the Alsace region in France and included two parts. First, a sample survey was mailed to 15,600 subjects randomly selected from a pension funds list. This survey provided with a reliable representation of the study population in terms of disabilities using the Colvez classification. In the second part, the most disabled individuals were selected and, among them, 1,259 subjects were visited at home. Their disabilities and living conditions were noted using a predefined set of questions. RESULTS: An estimated 71,000 subjects aged 75 years and more lived at home in the study region. The vast majority were free of significant disability. Help to wash and dress was needed by 6,000 until 1,500 were bedridden or confined to an armchair. Between 4,350 and 5,400 met the criteria for iso-resource grades (IRG) 1 to 3. Disability was associated with age, female gender, cognitive impairment and some social and professional characteristics. Family support was routine in almost every aspect of everyday life including personal hygiene. Professional support was mostly limited to technical interventions. Professional nursing care concerned only the most dependent persons. Nevertheless, needs for help in home and social activities remained high even in the least dependent individuals and were strongly age-dependent. Only 10% of individuals with IRG 1 to 3 complained of inadequate help. More than 80% of the elderly felt comfortable with their living conditions at home and were not thinking of moving from home to an institution for old people. CONCLUSION: The present study confirms the important commitment of family members and their close relationships toward their elderly.
Activities of Daily Living↗
CD4+ CD56+ blastic tumor cells express CD101 molecules.
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Antigens, CD↗
Genetic alterations in primary osteosarcoma from 54 children and adolescents by targeted allelotyping.
At present, the only recognised prognostic factor for primary osteosarcoma is the histological response to preoperative chemotherapy. Our study was designed to identify new diagnostic markers that could eventually have a prognostic value. A total of 54 patients under 20 years of age with primary osteosarcomas were studied while under treatment by the French Society of Paediatric Oncology OS 94 protocol. Paired normal and biopsy samples were collected. In addition, surgical resection specimens, following preoperative chemotherapy, were obtained in 13 cases. After genomic DNA extraction, an allelotyping analysis targeting microsatellites linked to Rb and p53 genes, and 9p21, 7q31 and 5q21 regions was performed. In all, 94% of the samples at diagnosis showed allelic imbalance and the biopsies were highly rearranged except for the microsatellite targeting 7q31. The same panel was highly informative at surgical resection. Microsatellites investigating Rb, p53 and the 9p21 region were particularly altered without a significant correlation with prognosis. On the other hand, the alteration of the 7q31 locus at diagnosis was significantly correlated with a worse prognosis and a new frequently altered locus, 5q21, was described. In conclusion, this panel allowed us to characterise paediatric osteosarcomas. Correlation of prognosis with the altered 7q31 region could be a useful tool and further studies are required to confirm the importance of 5q21.
Adolescent↗
Production of interleukin-18 and interleukin-12 in patients suffering from chronic hepatitis C virus infection before antiviral therapy.
Interleukin-12 and -18 (IL-12 and IL-18) are known to enhance the cytotoxic T-lymphocyte response synergistically, but their precise involvement in hepatitis C virus (HCV) infection is not well known, especially for IL-18. Enzyme-linked immunosorbent assay (ELISA) was used to study the production of these cytokines in plasma and peripheral blood mononuclear cells (PBMCs) stimulated by lipopolysaccharide (LPS) of patients infected chronically with HCV before initiation of antiviral therapy. Fifty-six patients and 40 healthy controls were evaluated. Patients infected with genotype 1 or with genotype other than genotype 1 HCV had significantly a high production of plasma IL-12 compared with controls (P < 0.05). However, patients infected with genotype 1 HCV had lower levels of PBMC IL-18 than were founded in the controls (P < 0.05); plasma IL-18 also tended to be lower in this group of patients than in the controls, although nonsignificantly. Plasma IL-18 was related to hepatic histological activity (P < 0.05). The data suggest a relationship between these two cytokines and some features of HCV infection, so that their respective production in relation to the outcome of the infection deserves further study.
Adolescent↗
[Medical activity of the French internal medicine departments in 2000-2001 from the DRG system].
PURPOSE: Medical activity of the French Internal Medicine Departments has been described until now only by limited declarative surveys. The aim of this study was to describe this activity using the French DRG system. METHODS: A postal survey was conducted using the list of the French Society of Internal Medicine. The same questionnaire was posted to 212 departments (university, public and private hospitals) to collect the 2000 or 2001 data from the DRG system. RESULTS: 192,197 reports were analysed. One hundred and eighty four groups were listed on a theoretical number of 313 medical groups. The first 10 groups concerned common general diseases (pneumonia, anaemia, heart failure, diabetes, stroke.). The main difference between university and non-university hospitals concerned the management of systemic diseases, which was more frequently quoted in university hospitals. Benign and malignant haematological diseases and oncology were frequently quoted in both types of hospitals. CONCLUSION: This study allows for the first time in France to have an objective survey of the medical activity of Internal Medicine Departments. It confirms that these departments have a central role in the hospital management of current diseases but also of haematological diseases and cancer. University departments are more specifically implicated in the management of systemic diseases.
Diagnosis-Related Groups↗
[Lung contusion: relevance of initial injured pulmonary volume measurement by computed tomography].
OBJECTIVE: To evaluate computed tomography quantification of injured pulmonary volume after thoracic trauma and its relevance for severity grade of patients with lung contusion. STUDY DESIGN: Retrospective study in a major French Level I university trauma center. PATIENTS AND METHODS: Clinical and biological data including oxygenation index (PaO2/FIO2) and therapeutics modalities during the first 5 days: positive end expiratory pressure (Peep) and nitric oxide (NO), were collected on 49 patients with lung contusion resulting from thoracic trauma. Injured pulmonary volume was evaluated on initial thoracic tomodensitometry by 2 senior radiologists. The correlation between oxygenation index, therapeutics modalities and initial injured pulmonary volume was assessed for signification. RESULTS: Injured pulmonary volume larger than 37.75% of total lung volume is associated with both hypoxemia at the twenty-fourth hour (PaO2/FIO2 <300), and need for Peep >6 cm H2O and /or ongoing NO administration on day 5. CONCLUSION: Injured parenchymal pulmonary volume evaluation on initial tomodensitometry seems to be an important indicator of lung contusion severity. Thoracic computed tomography provides additional prognostic information in the initial evaluation of thoracic trauma with parenchymal injury.
Adolescent↗
Perceived risk of bovine spongiform encephalopathy and dietary behavior.
The German BSE crisis in early 2001 can be considered as a natural experiment with strong behavioral consequences. The present study investigated psychological and other factors associated with reduced meat consumption compared to the first months of the previous year. As expected, all types of meat, with the exception of poultry and game, were eaten less often. The effect was strongest in beef, where almost half of the sample reported reduced meat consumption. As predicted by the health belief model, perceived threat was associated with subjective vulnerability. It was not, however, strongly associated with perceived seriousness of BSE, probably due to the ubiquitous public discussion of the topic. Reduced beef consumption has three to four times more frequent in the event of subjective threat.
Adolescent↗
Influence of pre-, intra- and post-operative parameters of donor liver on the outcome of isolated human hepatocytes.
The aim of the present study was to analyse, retrospectively on a large panel of patients (149), the influence of the donor liver characteristics on the outcome of human hepatocyte isolation obtained from resected liver biopsies from surgical waste after hepatectomy. Among the pre-operative parameters, the type of disease, age and sex of the patient, previous chemotherapy, alcohol or tobacco consumption did not affect the yield, viability, attachment rate and function of the isolated human hepatocytes. Pre-operative biological and anatomopathological data indicated that, while mild steatosis (</=10% steatotic hepatocytes) did also not affect the outcome of hepatocyte isolation, stronger steatosis (>10% steatotic hepatocytes) tended to decrease hepatocyte yield. Cholestasis, as assessed by gamma-glutamyl transferase serum values, significantly negatively correlated with the percentage of digested liver and the yield of viable cells. Intra-operative clamping time, that is, warm ischaemia, longer than 30 min was found to decrease both the percentage of digested liver and cell yield. Among the post-operative parameters, the percentage of digested liver decreased when biopsy weights were higher than 100 g, the use of glue tended to increase both the percentage of digested tissue and the yield of viable cells.In conclusion, human diseased livers appear to be a valuable source of isolated functional human hepatocytes. We recommend, for an optimal isolation, to use liver biopsies weighing less than 100 g, to glue the section surfaces of the biopsies and to avoid the use of moderate steatotic livers (>10% steatotic hepatocytes) and cholestatic livers, as well as livers undergoing warm ischaemia or clamping during resection due to the decrease in cell yield.
Journal Article↗
[Evalutation of health monitoring in Bavaria by computer-assisted telephone interviews (CATI) in comparison to the German National Health Examination Survey conducted in 1998 by the Robert Koch Institute].
Between June 1999 and May 2000, 2051 residents of Bavaria were interviewed on health and health-related behaviour. The objective of the study was to assess the representativeness and validity of data acquired by computer-assisted telephone interviewing (CATI) as compared to results of the German National Health Examination Survey 1998. The following variables showed excellent agreement: subjective health status, lifetime disease prevalences, such as myocardial infarction, stroke, cancer, asthma, diabetes, hypertension, hypercholesterolaemia, utilisation of medical services, and smoking habits (prevalence of present and former smoking, average cigarette consumption per day). Minor differences were found with respect to the frequency of consulting naturopathic doctors. Self-reported anthropometric data from the present study differed considerably from the results of the objective measurements during the German Health Survey. We conclude that, in terms of data quality, CATI compares well with traditional methods such as face-to-face interviewing or mailed questionnaires. In view of several practical advantages of the method, we recommend CATI as a future basic methodology of a German health surveillance system consisting of different coordinated health data collections.
Adolescent↗
[Regional and sex-specific differences in fulfillment of patient rights: results of a representative population survey in Munich, Dresden, Vienna and Bern].
OBJECTIVES: The European Office of the World Health Organization formulated the Amsterdam Declaration in 1994, demanding thereby the realisation of the principles of a humane health care. These principles relate to the protection of dignity of personhood, to self-determination, the right of information, and the right of quality, continuity and equality in health care. The present study aims at a gender-specific analysis of the fulfillment of these rights. METHODS: Computer-assisted telephone interviews were conducted during the months February and March 2000 in four German speaking European cities (Munich, Dresden, Vienna and Berne). A paragraph of the Declaration on the Promotion of Patients' Rights was regarded as fulfilled if there was at least 80% agreement. RESULTS: Deficiencies were most pronounced for the provision of community and domiciliary services after hospital treatment and for the right concerning humane terminal care and death in dignity. Moreover, regional differences were found between Munich, Dresden and Vienna on one side and Berne on the other side, with degrees of fulfillment being higher in Berne. CONCLUSIONS: In summary, these regional differences are more pronounced than single gender-specific differences, which may be due to chance. Areas with potential for improvement could be identified and can be actively restructured, e.g., in the context of the setting of health targets. An evaluation of the influence of the managed care system which has been established only sporadically in Berne requires more data.
Adult↗
Raman spectroscopic surface characterization of cellulose derivatives.
First results of experiments on the surface characterization of cellulose derivatives are presented. Different water contents of the surface of microcrystalline cellulose have been investigated by means of Raman spectroscopy, SERS, and environmental scanning electron microscopy (ESEM).
Journal Article↗
Standardization of non-aggregated data: theory and practice.
Direct standardization of rates is a classical method in epidemiology by which the relationship between confounders and variables of analysis is balanced between the samples or populations to be compared. While the method is appropriate if single variables of aggregated data sets are to be compared, it is limited with respect to handling many variables of different measurement scale, especially in primary data situations. Therefore the method of direct standardization is adapted to the analysis of non-aggregated data. Computation of not only rates but other statistics of central tendency and dispersion as well as confidence intervals hence becomes feasible. In addition it is possible to re-adjust the primary data weights in order to perform stratified analyses. A procedure to do so, based solely on the available original weights without the need for analyzing the standard population is proposed along with an extensive SAS macro. The utility allows for the rapid and standardized analysis and tabulation of large multi-variable data sets. Both the statistical and technical properties of the macro are discussed and its usage is explained as well as exemplified.
Computational Biology↗
[Population-based health monitoring via computer-assisted telephone interviews in Bavaria].
From June 1999 until May 2000, 2051 computer-assisted telephone interviews concerning health and health related behaviours were assessed in Bavarian households. The aim of the study was the evaluation of the validity and representativity of this data by a comparison of selected variables from the Bavarian Mikrozensus-survey 1999. The distribution patterns of the marital status, the size of the households, the gainful employment, the household-netto-income, the school qualification and of the smoking status correspond well with those of the Mikrozensus 1999. As often found in questionnaire based surveys, a disproportionately high rate of participation of highly educated persons was observed. This led to an effect only in terms of a too small rate of persons with a low household-netto-income. Within the study, two different designs were compared. The commitment of the telephone numbers to a gender for an equal quotation of men and women led to an under-representation of single-households and therefore also of unmarried persons, but it had no effect on the other characteristics. The results of this study show, that the method of computer assisted-telephone interviews is a valid and cheap basis for the establishment of an exhaustive health surveillance system in Germany.
Adolescent↗
Genes other than TLR4 are involved in the response to inhaled LPS.
For several decades, the mouse strains C3H/HeJ and C57BL/10ScNCr have been known to be hyporesponsive to endotoxin or lipopolysaccharide (LPS). Recently, mutations in Toll-like receptor (TLR) 4 have been shown to underlie this aberrant response to LPS. To further determine the relationship between TLR4 and responsiveness to LPS, we genotyped 18 strains of mice for TLR4 and evaluated the physiological and biological responses of these strains to inhaled LPS. Of the 18 strains tested, 6 were wild type for TLR4 and 12 had mutations in TLR4. Of those strains with TLR4 mutations, nine had mutations in highly conserved residues. Among the strains wild type for TLR4, the inflammatory response in the airway induced by inhalation of LPS showed a phenotype ranging from very sensitive (DBA/2) to hyporesponsive (C57BL/6). A broad spectrum of airway hyperreactivity after inhalation of LPS was also observed among strains wild type for TLR4. Although the TLR4 mutant strains C3H/HeJ and C57BL/10ScNCr were phenotypically distinct from the other strains with mutations in the TLR4 gene, the other strains with mutations for TLR4 demonstrated a broad distribution in their physiological and biological responses to inhaled LPS. The results of our study indicate that although certain TLR4 mutations can be linked to a change in the LPS response phenotype, additional genes are clearly involved in determining the physiological and biological responses to inhaled LPS in mammals.
Animals↗