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Remy C, Ahumada D, Labine A, Côté JC, Lachaine M, Bouchard H. Predicting breathing target motion from a surrogate signal during radiotherapy: a Bayesian approach. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00172-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Lalonde A, Remy C, Baer E, Bouchard H. PO-0971: Monte Carlo validation of a new dual-energy CT method for proton therapy in a patient-like geometry. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nättorp A, Remmen K, Remy C. Cost assessment of different routes for phosphorus recovery from wastewater using data from pilot and production plants. Water Sci Technol 2017; 76:413-424. [PMID: 28726706 DOI: 10.2166/wst.2017.212] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Phosphorus (P) recovery from wastewater has considerable potential to supplement limited fossil P reserves. Reliable cost data are essential for investor and policymaker decisions. In this study, investment and operational costs for nine P recovery processes were calculated from the investor's perspective, taking into account all relevant side effects on the sludge treatment or the wastewater treatment plant. The assessment was based on pilot and full-scale data which were thoroughly consolidated and standardized with technical and cost data from the German wastewater-sludge treatment train to enable direct comparison. The cost influence of precipitation processes on the current wastewater-sludge treatment train ranges from -0.14 (generating profit) to 0.23 EUR per population equivalent (PE) and year, while the cost influence of sludge leaching processes is around 2.50 EUR/(PE y). The cost influence of processes using dry sludge and mono-incineration ash varies between 0.33 and 3.13 EUR/(PE y), depending on existing disposal pathways, mono-incineration, co-incineration or agricultural use of sludge. The specific costs per kg P recovered (-4 to 10 EUR/kg P) are in general higher than conventional fertilizer production (1.6 EUR/kg P). However, annual costs per PE represent less than 3% of the total costs for wastewater disposal.
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Affiliation(s)
- A Nättorp
- University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Gruendenstrasse 40, Muttenz 4132, Switzerland E-mail:
| | - K Remmen
- University of Applied Sciences and Arts Northwestern Switzerland (FHNW), Gruendenstrasse 40, Muttenz 4132, Switzerland E-mail:
| | - C Remy
- Kompetenzzentrum Wasser Berlin gGmbH, Cicerostrasse 24, Berlin 10709, Germany
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Remy C, Boulestreau M, Warneke J, Jossa P, Kabbe C, Lesjean B. Evaluating new processes and concepts for energy and resource recovery from municipal wastewater with life cycle assessment. Water Sci Technol 2016; 73:1074-1080. [PMID: 26942529 DOI: 10.2166/wst.2015.569] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Energy and resource recovery from municipal wastewater is a pre-requisite for an efficient and sustainable water management in cities of the future. However, a sound evaluation of available processes and pathways is required to identify opportunities and short-comings of the different options and reveal synergies and potentials for optimization. For evaluating environmental impacts in a holistic view, the tool of life cycle assessment (LCA, ISO 14040/44) is suitable to characterize and quantify the direct and indirect effects of new processes and concepts. This paper gives an overview of four new processes and concepts for upgrading existing wastewater treatment plants towards energy positive and resource efficient wastewater treatment, based upon an evaluation of their environmental impacts with LCA using data from pilot and full-scale assessments of the considered processes.
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Affiliation(s)
- C Remy
- Berlin Centre of Competence for Water, Cicerostr 24, Berlin D-10709, Germany E-mail:
| | - M Boulestreau
- Berlin Centre of Competence for Water, Cicerostr 24, Berlin D-10709, Germany E-mail:
| | - J Warneke
- Berlin Centre of Competence for Water, Cicerostr 24, Berlin D-10709, Germany E-mail:
| | - P Jossa
- Berlin Centre of Competence for Water, Cicerostr 24, Berlin D-10709, Germany E-mail:
| | - C Kabbe
- Berlin Centre of Competence for Water, Cicerostr 24, Berlin D-10709, Germany E-mail:
| | - B Lesjean
- Berlin Centre of Competence for Water, Cicerostr 24, Berlin D-10709, Germany E-mail:
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Detante O, Jaillard A, Moisan A, Barbieux M, Favre I, Garambois K, Hommel M, Remy C. Biotherapies in stroke. Rev Neurol (Paris) 2014; 170:779-98. [DOI: 10.1016/j.neurol.2014.10.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 09/29/2014] [Accepted: 10/08/2014] [Indexed: 12/31/2022]
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Remy C, Miehe U, Lesjean B, Bartholomäus C. Comparing environmental impacts of tertiary wastewater treatment technologies for advanced phosphorus removal and disinfection with life cycle assessment. Water Sci Technol 2014; 69:1742-1750. [PMID: 24759537 DOI: 10.2166/wst.2014.087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Different technologies for tertiary wastewater treatment are compared in their environmental impacts with life cycle assessment (LCA). Targeting very low phosphorus concentration (50-120 μg/L) and seasonal disinfection of wastewater treatment plant (WWTP) secondary effluent, this LCA compares high-rate sedimentation, microsieve, dual media filtration (all with UV disinfection), and polymer ultrafiltration or ceramic microfiltration membranes for upgrading the large WWTP Berlin-Ruhleben. Results of the LCA show that mean effluent quality of membranes is highest, but at the cost of high electricity and chemical demand and associated emissions of greenhouse gases or other air pollutants. In contrast, gravity-driven treatment processes require less electricity and chemicals, but can reach significant removal of phosphorus. In fact, dual media filter or microsieve cause substantially lower specific CO2 emissions per kg P removed from the secondary effluent (180 kg CO2-eq/kg P, including UV) than the membrane schemes (275 kg CO2-eq/kg P).
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Affiliation(s)
- C Remy
- Berlin Centre of Competence for Water gGmbH, Cicerostr. 24, D-10709 Berlin, Germany E-mail:
| | - U Miehe
- Berlin Centre of Competence for Water gGmbH, Cicerostr. 24, D-10709 Berlin, Germany E-mail:
| | - B Lesjean
- Berlin Centre of Competence for Water gGmbH, Cicerostr. 24, D-10709 Berlin, Germany E-mail:
| | - C Bartholomäus
- Berliner Wasserbetriebe, Neue Jüdenstr. 1, D-10179 Berlin, Germany
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Abstract
For improved exploitation of the energy content present in the organic matter of raw sewage, an innovative concept for treatment of municipal wastewater is tested in pilot trials and assessed in energy balance and operational costs. The concept is based on a maximum extraction of organic matter into the sludge via coagulation, flocculation and microsieving (100 μm mesh size) to increase the energy recovery in anaerobic sludge digestion and decrease aeration demand for carbon mineralisation. Pilot trials with real wastewater yield an extraction of 70-80% of total chemical oxygen demand into the sludge while dosing 15-20 mg/L Al and 5-7 mg/L polymer with stable operation of the microsieve and effluent limits below 2-3 mg/L total phosphorus. Anaerobic digestion of the microsieve sludge results in high biogas yields of 600 NL/kg organic dry matter input (oDMin) compared to 430 NL/kg oDMin for mixed sludge from a conventional activated sludge process. The overall energy balance for a 100,000 population equivalent (PE) treatment plant (including biofilter for post-treatment with full nitrification and denitrification with external carbon source) shows that the new concept is an energy-positive treatment process with comparable effluent quality than conventional processes, even when including energy demand for chemicals production. Estimated operating costs for electricity and chemicals are in the same range for conventional activated sludge processes and the new concept.
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Affiliation(s)
- C Remy
- Berlin Centre of Competence for Water gGmbH, Cicerostr. 24, Berlin D-10709, Germany E-mail:
| | - M Boulestreau
- Berlin Centre of Competence for Water gGmbH, Cicerostr. 24, Berlin D-10709, Germany E-mail:
| | - B Lesjean
- Berlin Centre of Competence for Water gGmbH, Cicerostr. 24, Berlin D-10709, Germany E-mail:
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Feloni S, Radermacher L, Remy C, Jousten J, Corman V. [Clinical case of the month. Renovascular arterial hypertension complicated by diabetes insipidus: report of a case and review of the literature]. Rev Med Liege 2013; 68:412-417. [PMID: 24053101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Mrs. A, a 62 year old patient with a history of hypertension, polyuria and polydipsia is hospitalized after a malaise. A severe hypokalemia, which is the cause of the polyuria and polydipsia, is discovered. The presence of hypertension and hypokalemia arises suspicion of a primary hyperaldosteronism and the plasma levels of renin and aldosterone are measured. Elevated aldosterone levels are combined with high plasma renin concentrations which permits to rule out primary hyperaldosteronism. Further explorations reveal a subocclusive ostial stenosis of the right renal artery. A treatment by sartan is instaured, which allows arterial pressure control and kalemia normalization. Chronic hypokalemia can be the cause of tubular nephropathy manifested by nephrogenic diabetes insipidus.
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Affiliation(s)
- S Feloni
- Service de Gastro-Entérologie, CH de Jolimont-Lobbes, Belgique.
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Remy C, Lesjean B, Waschnewski J. Identifying energy and carbon footprint optimization potentials of a sludge treatment line with Life Cycle Assessment. Water Sci Technol 2013; 67:63-73. [PMID: 23128622 DOI: 10.2166/wst.2012.529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This study exemplifies the use of Life Cycle Assessment (LCA) as a tool to quantify the environmental impacts of processes for wastewater treatment. In a case study, the sludge treatment line of a large wastewater treatment plant (WWTP) is analysed in terms of cumulative energy demand and the emission of greenhouse gases (carbon footprint). Sludge treatment consists of anaerobic digestion, dewatering, drying, and disposal of stabilized sludge in mono- or co-incineration in power plants or cement kilns. All relevant forms of energy demand (electricity, heat, chemicals, fossil fuels, transport) and greenhouse gas emissions (fossil CO(2), CH(4), N(2)O) are accounted in the assessment, including the treatment of return liquor from dewatering in the WWTP. Results show that the existing process is positive in energy balance (-162 MJ/PE(COD) * a) and carbon footprint (-11.6 kg CO(2)-eq/PE(COD) * a) by supplying secondary products such as electricity from biogas production or mono-incineration and substituting fossil fuels in co-incineration. However, disposal routes for stabilized sludge differ considerably in their energy and greenhouse gas profiles. In total, LCA proves to be a suitable tool to support future investment decisions with information of environmental relevance on the impact of wastewater treatment, but also urban water systems in general.
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Affiliation(s)
- C Remy
- Kompetenzzentrum Wasser Berlin gGmbH, Cicerostr 24, D-10709 Berlin, Germany.
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Zghikh LN, Legreneur P, Nonclercq D, Remy C, Bels V. Prey effect on Capture Kinematics in Pogona vitticeps(Iguania, Squamata). Comput Methods Biomech Biomed Engin 2012; 15 Suppl 1:135-6. [DOI: 10.1080/10255842.2012.713648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Remy C, Jekel M. Energy analysis of conventional and source-separation systems for urban wastewater management using Life Cycle Assessment. Water Sci Technol 2012; 65:22-29. [PMID: 22173404 DOI: 10.2166/wst.2011.766] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study investigates the cumulative energy demand (CED) of different systems for the management of urban wastewater, following the methodology of Life Cycle Assessment. In a hypothetical case study for an urban area (5,000 inhabitants), all relevant processes for wastewater collection and treatment and the construction of infrastructure are described in a substance flow model. The conventional system requires 1,250 MJ/(pe*a), with the operation contributing 45%, the infrastructure 7%, and the system expansion (production of mineral fertilizer and electricity) 48% to the total CED. The separation systems have a CED of 930-1,182 MJ/(pe*a) depending on their configuration. Results of the impact assessment show that recovering energy from the organic matter of toilet wastewater and household biowaste in a digestion process can decrease the cumulative energy demand by 13-26%. Energetic benefits of mineral fertilizer substitution are relatively small compared to the energy recovered from organic matter. Decisive parameters for the energy analysis are the amount of biowaste which is co-digested with toilet wastewater and the energy demand of the vacuum plant.
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Affiliation(s)
- C Remy
- Kompetenzzentrum Wasser Berlin gGmbH, Cicerostr. 24, D-10709 Berlin.
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Remy C. Équipes ressources en soins palliatifs pédiatriques et équipes de réadaptation : quelle proximité, quels partenariats ? Ann Phys Rehabil Med 2011. [DOI: 10.1016/j.rehab.2011.07.504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Remy C, Colman D, Ledoux D, Jacquemin D. Risk factors for major joints heterotopic ossification after thermal injury. Burns 2009. [DOI: 10.1016/j.burns.2009.06.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rome C, Keramidas M, De Fraipont F, Richard M, Barbier E, Remy C, Coll JL. Vectorization of nanoparticles by human mesenchymal stem cells for diagnosis and therapy in cancer: project of evaluation by in vivo molecular imaging. Rev Mal Respir 2008. [DOI: 10.1016/s0761-8425(08)75031-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Remy C, Jekel M. Sustainable wastewater management: life cycle assessment of conventional and source-separating urban sanitation systems. Water Sci Technol 2008; 58:1555-1562. [PMID: 19001707 DOI: 10.2166/wst.2008.533] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Conventional and source-separating urban sanitation systems are compared with regard to their ecological sustainability using the methodology of Life Cycle Assessment. A substance flow model of all relevant processes in a settlement with 5,000 inhabitants is set up and evaluated with environmental indicators for resource demand and emissions to air, water, and soil. The comparison shows that source separation does not necessarily result in a system with less environmental impacts. If the conventional system is energetically optimized and equipped with extended nutrient removal, its impact is comparable to the source-separating systems. However, source separation has the potential to offer ecological benefits depending on the system configuration. Especially the input of toxic heavy metals to agriculture with sewage sludge can be substantially lowered if separately collected urine and faeces are used as organic fertilizer.
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Affiliation(s)
- C Remy
- Department of Water Quality Control, Technische Universität Berlin, Strasse des 17. Juni 135, 10623 Berlin, Germany.
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Abstract
Abstract
Background
Epidural analgesia (EA) with local anaesthetic is considered to play a key role after colorectal surgery. However, its effect on postoperative recovery is still a matter of debate.
Methods
A systematic review of randomized controlled trials comparing postoperative EA and parenteral opioid analgesia after colorectal surgery was performed. The effect on postoperative recovery was evaluated in terms of length of hospital stay, pain intensity, duration of postoperative ileus, incidence of postoperative complications and side-effects.
Results
Sixteen trials published between 1987 and 2005 were included. EA significantly reduced pain scores and duration of ileus (weighted mean difference − 1·55 (95 per cent confidence interval (c.i.) − 2·27 to − 0·84) days). On the other hand, it was associated with a significant increase in the incidence of pruritus (odds ratio (OR) 4·8 (95 per cent c.i. 1·3 to 17·0)), urinary retention (OR 4·3 (1·2 to 15·9)) and arterial hypotension (OR 13·5 (4·0 to 57·7)). EA did not influence duration of hospital stay.
Conclusion
Despite improved analgesia and a decrease in ileus, EA has some adverse effects and does not shorten the duration of hospital stay after colorectal surgery.
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Affiliation(s)
- E Marret
- Department of Anaesthetics and Intensive Care, Tenon University Hospital, Assistance Publique, Hôpitaux de Paris, University of Pierre and Marie Curie, Paris, France.
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Abstract
Postobstructive pulmonary oedema is a complication after extubation that occurs rarely . It can be associated with haemoptysis. We report two cases of haemoptysis occuring in ASA 1 otherwise healthy patients who underwent uncomplicated anaesthesia. Understanding of the mechanism and prompt treatment lead to rapid recovery of this dramatic complication.
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Affiliation(s)
- C Remy
- Service d'Anesthésie-Réanimation, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, 4, rue de la Chine, 75020 Paris, France.
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Corman V, Christelbach S, Remy C. [Clinical case of the month. Turner's syndrome and aortic dissection]. Rev Med Liege 2006; 61:559-62. [PMID: 17020228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
A patient, born in 1961, is hospitalised for pubic abdominal pain with irradiation to the right and left sides. She has a Turner's syndrome. At first evaluation, an abdominal tomography demonstrates a right pyelonephritis. The patient is treated with quinolones and she evolves favourably, except that she continues to present some abdominal pain. She leaves the hospital, but because of permanent abdominal pain, a new abdominal tomography is performed: an aortic dissection type B for (Stanford), or III anterograde for (De Bakey), is diagnosed. Cardiovascular anomalies are frequent in Turner's syndrome. Aortic dissection is a rare complication. Histological analysis shows a cystic medial necrosis. Medical and cardiological follow-up is needed.
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Affiliation(s)
- V Corman
- DES endocrinologie, CHR Citadelle, Liège
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Schulte BU, Brücher D, Trompeter M, Remy C, Reimer P. [Balloon-assisted percutaneous vertebroplasty in patients with osteoporotic vertebral body compression fractures--first results]. ROFO-FORTSCHR RONTG 2006; 178:207-13. [PMID: 16435252 DOI: 10.1055/s-2005-858829] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine the feasibility, efficacy and safety of balloon-assisted percutaneous vertebroplasty (BA-VP) in patients with osteoporotic vertebral compression fractures (VCFs). MATERIALS AND METHODS In 47 patients (29 women, 18 men; mean age: 70 years and 4 months) with severe VCFs, 66 BA-VPs were performed via a unipedicular access. After initial puncture (under combined fluoroscopy and CT guidance) of the vertebral body (VB), the needle was retraced by 1.5 cm, and a 12-mm Fogarty balloon catheter was introduced and inflated using 2-4 ml diluted contrast media (CM). After the subsequent removal of the catheter and repositioning of the needle, vertebroplasty was performed. RESULTS The mean volume of PMMA injected was 4.4 ml (2.5-7.2 ml). Pain reduction (measured by the Visual Analogue Scale) was achieved in 95 % of the patients, dropping from on average 8.0 pre-intervention to 2.2 after a mean follow-up of 8 months. A reduction of the pain relieving medication was achieved in 68 % of the cases and patient activity improved markedly. No severe or clinically relevant complications were observed. Cement leakage occurred by filling of epidural and paravertebral veins in 9.1 and 6.1 % of the cases, respectively. Leakage into the paravertebral soft tissues was seen in 3.0 % of the patients and to the adjacent disc space in 10.6 % of the cases. CONCLUSION Vertebroplasty and kyphoplasty are currently used to treat osteoporotic VCFs but show either a comparatively high leakage rate or are rather complex and expensive. Balloon-assisted vertebroplasty seems to combine advantages from both methods and is effective, safe and comparatively inexpensive.
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Affiliation(s)
- B U Schulte
- Zentralinstitut für bildgebende Diagnostik, Städtisches Klinikum Karlsruhe.
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Schulte BU, Brücher D, Trompeter M, Remy C, Reimer P. Ballonassistierte perkutane Vertebroplastie bei Patienten mit osteoporotischen Wirbelkörperkompressionsfrakturen. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Le Bas JF, Grand S, Kremer S, Tropres I, Jiang Z, Krainik A, Remy C, Berger F, Benabid AL. Place de l’imagerie de perfusion par irm dans la prise en charge des tumeurs cérébrales, gliales en particulier. Neurochirurgie 2005; 51:287-98. [PMID: 16292173 DOI: 10.1016/s0028-3770(05)83490-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECT To discuss the pertinency of perfusion MR imaging for initial diagnosis and follow up of brain tumors. METHODOLOGY Dynamic susceptibility contrast MR imaging was applied. Images were thus obtained with intensities proportional to the cerebral blood volume (CBV). Relative cerebral blood volume (rCBV) maps were then generated by normalizing the signal intensities with respect to measurements made in healthy tissue. RESULTS The method provided interesting data for establishing the differential diagnosis between different kinds of lesions, in particular between lymphoma and pilocytic astrocytoma, and for grading gliomas. DISCUSSION AND CONCLUSION Limits of the approach are discussed, in particular with respect to quantification aspects and interpretation of the results. The approach could be particularly useful for grading oligodendrogliomas, for which histological diagnosis on biopsy is sometimes difficult.
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Affiliation(s)
- J-F Le Bas
- Unité IRM et Service de NeuroRadiologie, CHU, Grenoble.
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Remy C, Marret E, Bonnet F. Effects of acetaminophen on morphine side-effects and consumption after major surgery: meta-analysis of randomized controlled trials † †Presented in part at the Annual Meeting of the Société Française d’Anesthésie-Réanimation, Paris, April 2004. Br J Anaesth 2005; 94:505-13. [PMID: 15681586 DOI: 10.1093/bja/aei085] [Citation(s) in RCA: 328] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Acetaminophen is commonly used for the management of perioperative pain. However, there is a marked discrepancy between the extent to which acetaminophen is used and the available evidence for an analgesic effect after major surgery. The aim of this systematic review is to determine the morphine-sparing effect of acetaminophen combined with patient-controlled analgesia (PCA) with morphine and to evaluate its effects on opioid-related adverse effects. METHODS MEDLINE and the Cochrane Library were searched to select randomized controlled trials which compared PCA morphine alone with PCA morphine plus acetaminophen administered orally or intravenously. Studies were evaluated for their quality based on the Oxford Quality Scale. Outcome measures were morphine consumption over the first 24 h after surgery, patient satisfaction and the incidence of morphine side-effects, including nausea and vomiting, sedation, urinary retention, pruritus and/or respiratory depression. RESULTS Seven prospective randomized controlled trials, including 265 patients in the group with PCA morphine plus acetaminophen and 226 patients in the group with PCA morphine alone, were selected. Acetaminophen administration was not associated with a decrease in the incidence of morphine-related adverse effects or an increase in patient satisfaction. Adding acetaminophen to PCA was associated with a morphine-sparing effect of 20% (mean, -9 mg; CI -15 to -3 mg; P=0.003) over the first postoperative 24 h. CONCLUSION Acetaminophen combined with PCA morphine induced a significant morphine-sparing effect but did not change the incidence of morphine-related adverse effects in the postoperative period.
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Affiliation(s)
- C Remy
- Department of Anesthesiology and Critical Care, Tenon University Hospital, Paris VI University, Assistance Publique-Hôpitaux de Paris, Paris, France
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Remy C, Biraben A, Lavernhe G. Évaluation de la gravité de l’épilepsie partielle pharmaco-résistante. Rev Neurol (Paris) 2004. [DOI: 10.1016/s0035-3787(04)71184-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Remy C, Biraben A, Lavernhe G. [Evaluation of severity in partial intractable epilepsy]. Rev Neurol (Paris) 2004; 160 Spec No 1:5S65-70. [PMID: 15331951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
A large number of factors have to be taken into consideration to evaluate the severity of intractable partial epilepsy. These inter-related factors change with compliance and with the frequency of seizures as well as the psycho-social context. We discuss here the different factors which are directly or indirectly related with epilepsy. In clinical practice, only some of these factors are used as criteria of severity. The only truly effective method of determining the real consequences of epilepsy are quality of life could measurements.
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Affiliation(s)
- C Remy
- Centre médical la Teppe, 26600 Tain l'Hermitage, France.
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Grand S, Ternier J, Rousseau N, Ashraf A, Tropres I, Remy C, Le Bas JF. Abcès cérébral : aspects caractéristiques en imagerie morphologique et fonctionnelle. J Neuroradiol 2004; 31:145-7. [PMID: 15094653 DOI: 10.1016/s0150-9861(04)96982-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although rare in non immunodeficient patients, the correct diagnosis of brain abscess is essential in order to initiate urgent medical and surgical treatment. We describe the imaging features including spectroscopy and diffusion MRI.
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Affiliation(s)
- S Grand
- Unité IRM, Hôpital Michallon, 38043 Grenoble cedex 09, France
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Grand S, Pasquier B, Gay E, Kremer S, Remy C, Le Bas JF. Chordoid glioma of the third ventricle: CT and MRI, including perfusion data. Neuroradiology 2002; 44:842-6. [PMID: 12389135 DOI: 10.1007/s00234-002-0820-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2002] [Accepted: 05/28/2002] [Indexed: 11/25/2022]
Abstract
Chordoid glioma is a homogeneous tumour involving the third ventricular region of middle-aged women, containing a small central cyst or necrosis. Histologically the tumour has a chordoid appearance. We report a new case with a haemodynamic imaging approach which indicates tumour angiogenesis at the capillary level.
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Affiliation(s)
- S Grand
- Magnetic Resonance Imaging Unit, Centre Hospitalier et Universitaire de Grenoble, Hôpital Michallon, BP 207, 38043 Grenoble Cedex 09, France.
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Duda SH, Bosiers M, Pusich B, Hüttl K, Oliva V, Müller-Hülsbeck S, Bray A, Luz O, Remy C, Hak JB, Beregi JP. Endovascular treatment of peripheral artery disease with expanded PTFE-covered nitinol stents: interim analysis from a prospective controlled study. Cardiovasc Intervent Radiol 2002; 25:413-8. [PMID: 12042992 DOI: 10.1007/s00270-002-1849-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Current covered peripheral stent designs have significant drawbacks in terms of stent delivery characteristics and flexibility. The aim of this study was to analyze the technical performance, safety and initial clinical efficacy of expanded polytetrafluoroethylene (PTFE)-covered nitinol stents for arteriosclerotic peripheral artery disease. METHODS Eighty-two patients underwent implantation of PTFE-covered nitinol stents for iliac and/or femoral obstructions. The study was conducted prospectively in seven European centers and one Canadian center. Patients were controlled clinically and by duplex ultrasound follow-up. Data up to discharge were collected in 79 patients. Seventy-four patients have thus far received 1 month follow-up and 32 patients, 6 month follow-up examinations. RESULTS The average lesion length measured 47 mm for the common and external iliac arteries and 50 mm for the femoral arteries. The mean severity of the stenoses was reduced from 94% to 4% in the iliac arteries and from 98% to 7% in the femoral arteries after stent placement and dilatation. One device deviation (inadvertent stent misplacement) and one puncture-related severe adverse event with formation of a pseudoaneurysm occurred. There were occlusions of the stent in five patients. No infections were noticed. CONCLUSION The interim analysis of this trial using PTFE-covered nitinol stents indicates that a strategy using primary implantation of this stent type is technically feasible, has an acceptable safety profile and is effective from a short-term perspective.
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Affiliation(s)
- S H Duda
- Division of Diagnostic Radiology, Department of Radiology, University of Tübingen, Tübingen, Germany.
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Kremer S, Grand S, Remy C, Esteve F, Lefournier V, Pasquier B, Hoffmann D, Benabid AL, Le Bas JF. Cerebral blood volume mapping by MR imaging in the initial evaluation of brain tumors. J Neuroradiol 2002; 29:105-13. [PMID: 12297732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
PURPOSE To assess the contribution of magnetic resonance (MR) cerebral blood volume (CBV) mapping in the initial evaluation of brain tumors. METHODS 63 patients presenting a brain tumor underwent dynamic susceptibility-contrast MR imaging before surgery or biopsy: 28 high grade gliomas, 8 low grade gliomas, 2 pilocytic astrocytomas, 4 lymphomas, 12 metastases, 9 meningiomas. The CBV maps were obtained for each patient and the relative CBV (rCBV) in different areas was calculated using the ratio between the CBV in the pathological area (CBVp) and in the contralateral normal tissue(CBVn). The maximum rCBV (rCBVmax) for each tumor was determined and the mean values of rCBVmax in each group of tumors were compared using an unpaired Student t test (p=0.05). RESULTS The rCBVmax for high grade gliomas (mean +/- SD: 2.6 +/- 1,2) was statistically different from low grade gliomas (0.9 +/- 0.4) (p<0.001), lymphomas (0.7 +/- 0.2) (p=0.002), meningiomas (9.1 +/- 4.4) (p<0.001) and kidney metastases (8.9 +/- 2.1) (p<0.001). The two pilocytic astrocytomas had a much lower rCBVmax than high grade gliomas. No statistically significant difference was found between high grade gliomas and lung metastases (2.4 +/- 0.9) (p=0.72). CONCLUSION CBV mapping provides additional information on the vascularity of the lesions, which is not available with conventional MR imaging. It might be useful for differentiating certain lesions showing contrast enhancement, mainly high grade gliomas from kidney metastases, meningiomas, lymphomas or pilocytic astrocytomas.
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Affiliation(s)
- S Kremer
- Magnetic resonance imaging unit, Neurosurgery Department, Centre Hospitalier et Universitaire de Grenoble BP 217, 38043 Cedex 09, France
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König CW, Pfannenberg C, Trübenbach J, Remy C, Böhmer GM, Ruck P, Claussen CD. MR cholangiography in the diagnosis of sclerosing cholangitis in Langerhans' cell histiocytosis. Eur Radiol 2002; 11:2516-20. [PMID: 11734951 DOI: 10.1007/s003300100835] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2000] [Revised: 01/05/2001] [Accepted: 01/10/2001] [Indexed: 11/27/2022]
Abstract
Langerhans' cell histiocytosis (LCH) is a disorder of histiocytic proliferation that primarily affects infants. Imaging findings of a rare case of lung and liver involvement in an adult are presented. High-resolution computed tomography (HRCT) of the lungs showed confluent thin-walled cystic air spaces compatible with advanced LCH. Liver CT and MRI revealed unspecific signs of fatty infiltration. Irregular widening of peripheral bile ducts was displayed in breath-hold MR cholangiography. This pattern is considered characteristic for sclerosing cholangitis and should support the diagnosis of LCH in case of concomitant cystic pulmonary disease, even in adult patients.
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Affiliation(s)
- C W König
- Department of Diagnostic Radiology, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany.
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Pageot N, Vial C, Remy C, Chazot G, Broussolle E. Progressive chorea and amyotrophy without acanthocytes: a new case of Fotopoulos syndrome? J Neurol 2000; 247:392-4. [PMID: 10896275 DOI: 10.1007/s004150050610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Dammann F, Momino-Traserra E, Remy C, Pereira PL, Baumann I, Koitschev A, Claussen CD. [Radiation exposure during spiral-CT of the paranasal sinuses]. ROFO-FORTSCHR RONTG 2000; 172:232-7. [PMID: 10778453 DOI: 10.1055/s-2000-118] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Determination of the radiation doses in spiral CT of the paranasal sinuses using a variety of mAs values and scan protocols. MATERIAL AND METHODS CT examinations of the paranasal sinuses were performed using an Alderson-Rando phantom. Radiation dose was determined by LiF-TLD at the level of high risk organs in the head and neck region for combinations of different scan parameters (2/3, 3/3, 3/4 mm) and decreasing charges (200, 150, 100, 50, 25 mAs) on a spiral CT. Additional measurements were performed on three other CT scanners using the 2/3 mm protocol at 50 mAs, and a single slice technique (5/5 mm) on one scanner. RESULTS The lowest dose values found were 1.88 mGy for the eye lenses, 1.35 mGy for the parotid gland, 0.03 mGy for the thyroid gland and 0.1 mGy for the medulla oblongata using 2 mm collimation and 3 mm table feed at 25 mAs. Maximal dose values resulted using the 3/3 mm protocol at 200 mAs (31.00 mGy for the eye lense, 0.65 mGy for the thyroid gland). There were no significant differences found between the different CT scanners. CONCLUSIONS Using up-to-date CT scanners, radiation exposure may be reduced by a factor of 15-20 compared to that of conventional CT technique. Thus, the exposure of the eye lens comes to only a thousandth of the value supposedly inducing a cataract, as published by the ICRP.
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Affiliation(s)
- F Dammann
- Abt. f. Radiologische Diagnostik, Radiologische Universitätsklinik Tübingen.
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Abstract
This paper reviews existing publications on the use of piracetam for the treatment of cortical myoclonus of various etiologies and includes the personal experience of the authors in progressive myoclonus epilepsy. Two double-blind comparisons with placebo provided results which allow recommendations for the dosage and usage of piracetam in cortical myoclonus. Wide individual variation (7-24g daily) exists in dosage requirements but responses are dose-related so that dosage should be increased until an optimum effect is obtained. Tolerability after long-term use of piracetam in high dosage has been very good and without toxicity or serious adverse effects. Side effects have been occasional, mild and transient. The authors present their experience of 12 patients with progressive myoclonus epilepsy in whom the administration of up to 45 g piracetam daily, when added to existing anti-epileptic treatment, caused marked and sometimes spectacular improvement and was without significant adverse effects. Improvement was maintained for up to 7 years. The use of piracetam for disabling cortical myoclonus of any etiology, either as an addition to existing antimyoclonic drugs or as monotherapy, may bring about profound improvement in disability and quality of life. Piracetam should be considered a first-line drug for the treatment of cortical myoclonus.
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Affiliation(s)
- P Genton
- Centre Saint Paul, Marseille and Department of Neurophysiology, Hôpital Pasteur, Nice, France
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Trouillas J, Chevallier P, Remy C, Rajas F, Cohen R, Calle A, Hooghe-Peters EL, Rousset B. Differential actions of the dopamine agonist bromocriptine on growth of SMtTW tumors exhibiting a prolactin and/or a somatotroph cell phenotype: relation to dopamine D2 receptor expression. Endocrinology 1999; 140:13-21. [PMID: 9886801 DOI: 10.1210/endo.140.1.6450] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Dopamine (Da) and Da agonists are known to inhibit secretion and proliferation of normal and tumoral PRL cells, through receptors of D2 subtype. Because of the lack of an experimental model, the relationship between bromocriptine (BR) sensitivity and D2 receptor expression is poorly documented. Such a relationship was analyzed using five lineages of spontaneous transplantable rat pituitary tumors (SMtTW) exhibiting different PRL/GH phenotypes. From plasma PRL and GH concentrations of rats bearing the tumors and tumor messenger RNA contents, tumors were classified as PRL (SMtTW2), somatotroph (SMtTW10), or somatomammotroph (SMtTW5) tumors. Two lineages (SMtTW3 and SMtTW4) represented variants producing PRL and GH but with a high predominance of PRL. With the exception of SMtTW4 tumors, which were malignant, all the tumors were benign and differed in their growth rate. Hormone production and growth of tumors with a PRL or a somatomammotroph phenotype were reduced by about 90% under BR treatment, whereas somatotroph tumors and the PRL malignant tumors were totally insensitive to BR. D2 receptor messenger RNA was present in all BR-sensitive tumors and was not detected in BR-resistant tumors. In conclusion, using five lineages of SMtTW tumors that are representative of the most frequent tumors encountered in human pituitary pathology, we found a full concordance between tumor responses to BR and the expression of D2 receptor by the tumors. The identification of a tumor lineage with a malignant phenotype, secreting high amounts of PRL and presenting a resistance to BR, supports the idea that Da-resistant prolactinomas are aggressive tumors.
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Affiliation(s)
- J Trouillas
- Institut National de la Santé et de la Recherche Médicale, Unité 369, Faculté de Médecine Lyon RTH-Laennec, France.
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Abstract
Apoptosis might be involved in the reduction of the thyroid cell population in physiopathological situations such as goitre involution and autoimmune deleterious processes. Up to now, little attention has been paid to the apoptotic phenomenon in the normal thyroid gland the specialized metabolism of which is expected to generate reactive oxygen species. Indeed, thyroid cells have the capacity to synthesize H2O2. In this study, we have analyzed the capacity of H2O2 to trigger apoptosis of pig thyrocytes in culture to try to determine whether thyrocytes exhibit a particular resistance to apoptosis induced by an oxidative stress. We show that exposure of thyrocytes cultured as monolayers to exogenous H2O2 induced cell death with characteristics of apoptosis. The effect of H2O2 was concentration-dependent; apoptotic cells were already observed after exposure to 50 micro M H2O2. At high concentrations (millimolar range), H2O2 exerted toxic effects leading to rapid cell disruption. Within the first hour after the onset of exposure to 50-300 micro M H2O2, early signs of apoptosis, i.e. DNA fragmentation, appeared in a low (0.1-1%) but definite fraction of thyrocytes. The proportion of adherent cells exhibiting DNA fragmentation remained fairly constant after 6, 15 and 24 h. During the 24-h period, an increasing number of cells detached from the culture dish and up to 30-40% of cells in suspension displayed apoptotic features. The fraction of cells that lost contact with the culture dish amounted to up to 25% 24 h after addition of 300 micro M H2O2. In conclusion, as reported for other cell types, low H2O2 concentrations are capable of triggering apoptosis in thyrocytes cultured as monolayers. Thyrocytes that undergo apoptosis secondarily lose contact with neighbour cells and the substratum; cell detachment from the monolayer probably happens within 1-2 h after initiation of DNA fragmentation. Our data show that the apoptotic commitment can take place many hours after initiation of the oxidative stress.
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Affiliation(s)
- C Riou
- INSERM U 369, Faculté de Médecine Lyon-RTH Laennec, France
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van Hout B, Gagnon D, Souêtre E, Ried S, Remy C, Baker G, Genton P, Vespignani H, McNulty P. Relationship between seizure frequency and costs and quality of life of outpatients with partial epilepsy in France, Germany, and the United Kingdom. Epilepsia 1997; 38:1221-6. [PMID: 9579924 DOI: 10.1111/j.1528-1157.1997.tb01220.x] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The relationship between seizure frequency and both health care costs and quality of life (QOL) was investigated in a retrospective, cross-sectional, multicenter study in France, Germany, and the United Kingdom. METHODS Three hundred outpatients with stable partial epilepsy were approximately evenly distributed among five seizure-frequency groups, ranging from seizure-free in the last 3 months (group 1) to daily seizures (group 5). Economic data, obtained through patient interviews and record abstraction, comprised direct medical costs, direct nonmedical costs, and indirect costs for the preceding 3 months. Total societal costs in the three countries were pooled and converted to United States dollar equivalents. QOL was assessed through a self-administered questionnaire, the Functional Status Questionnaire (FSQ). RESULTS Mean total costs increased from $780 in group 1 to $2,171 in group 5 (p = 0.0001), with significant increases in each cost category as seizure frequency increased. Greater seizure frequency also significantly (p = 0.0270) correlated with lower employment rates, which ranged from 57% in group 1 to 30% in group 5. QOL declined as seizure frequency increased. Particularly affected were basic and intermediate activities of daily living (ADL), mental health, social activity, and feeling about health. CONCLUSIONS The study results show that higher seizure frequencies are associated with higher direct and indirect costs and with reduced QOL for patients with epilepsy.
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Affiliation(s)
- B van Hout
- iMTA, Erasmus University Rotterdam, The Netherlands
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38
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Remy C. [The outcome of the patient treated with methadone]. Rev Med Brux 1997; 18:312-6. [PMID: 9411666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The treatment of drug addiction by methadone is questioned: there is a shift from "all of abstinence" to "all for risk limitation". There is a modification of the clinical relationship, due to specific resources allocated for methadone treatment, modifying also the connections between medicine, Public Health and Public Security.
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Affiliation(s)
- C Remy
- Médecin généraliste, Collectif de santé La Perch, Réseau d'Aide aux toxicomanes, Bruxelles
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Morand I, Fonlupt P, Guerrier A, Trouillas J, Calle A, Remy C, Rousset B, Munari-Silem Y. Cell-to-cell communication in the anterior pituitary: evidence for gap junction-mediated exchanges between endocrine cells and folliculostellate cells. Endocrinology 1996; 137:3356-67. [PMID: 8754762 DOI: 10.1210/endo.137.8.8754762] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The ability of rat anterior pituitary cells to communicate through gap junctions (GJ) was studied using a fluorescent molecule, Lucifer Yellow (LY), which freely passes through GJ channels. The probe was introduced into the cell cytoplasm by using either the cut-end loading method on intact tissue, or cell microinjection on cultured cells. The identification of communicating cells was performed by immunofluorescence labeling of specific hormones in endocrine cells and of S100 protein in folliculostellate (FS) cells. Rat anterior pituitary cells in their physiological organization, i.e. in the intact tissue, exhibited a high level of coupling through GJ. LY-labeled cells were found up to 300-microns apart from its site of introduction. The communicating cells were primarily PRL cells, GH cells, and FS cells. Only a few LH, TSH, and ACTH cells were labeled with LY. Anterior pituitary cells, isolated from the rat tissue by mild protease treatment and cultured for 3 days, reestablished functional GJ as demonstrated by microinjection of LY into individual cells. By immunolabeling of specific hormones and/or S100 protein, we found a GJ coupling between FS cells, and between FS cells and endocrine cells, including PRL cells. The communication between FS cells was by far the most frequent. In conclusion, we demonstrate the presence of functional GJ between anterior pituitary cells of the same type and between anterior pituitary cells having distinct differentiated functions.
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Affiliation(s)
- I Morand
- Institut National de la Santé et de la Recherche Médicale, U369, Faculté de Médecine Alexis Carrel, Lyon, France
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Steins G, Remy C. [Self concept and need for social approval in bulimia patients]. Z Psychol Z Angew Psychol 1996; 204:187-198. [PMID: 8659210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
The present work concerns the relation between the need for social approval (assessed as social desirability) and bulimia with respect to gender-differences. Since bulimia is mainly a female issue, a relationship was predicted between the development of bulimia and the internalization of a socially desired feminine sex-stereotype with respect to the self-concept. The need for approval was assessed for male subjects, female subjects not suffering from eating-disorders, and female bulimic subjects. The results show that bulimic women have significant higher self-ratings concerning the need for approval. Without neglecting multicausal explications, the results suggest that social desirability as an expression of social approval should receive more attention as a facilitating factor in the development of bulimia.
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Affiliation(s)
- G Steins
- Fakultät für Psychologie und Sportwissenschaft Universität Bielefeld
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Delhase M, Rajas F, Verdood P, Remy C, Chevallier P, Velkeniers B, Trouillas J, Hooghe-Peters EL. Prolactin and growth hormone mRNA and protein characterization in SMtTW rat pituitary tumours. J Mol Endocrinol 1995; 15:233-43. [PMID: 8748129 DOI: 10.1677/jme.0.0150233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We have combined different techniques to analyse passages of five different rat spontaneous pituitary tumours (SMtTW) that were transplanted under the kidney capsule. These tumours were secreting prolactin (PRL), GH or both hormones. RIA, immunocytochemistry (ICC) and Western blot analysis were applied to characterize the hormone(s) stored (ICC and Western blot) and secreted (RIA). mRNA content was analysed by PCR, Northern blot analysis and in situ hybridization. The data point not only to the reliability of the techniques used at both protein and RNA levels for each tumour studied but also to the complementarity of some techniques. For example, whereas Northern blot analysis demonstrates the presence and size of hormone mRNA, in situ hybridization indicates the percentage of cells expressing a given hormone mRNA and allows the presence of one population (or more) of cells in a given tumour to be identified. Moreover, the tumours were compared with normal rat pituitary. Although the PRL and GH mRNAs were identical in size, the amount of mRNA was lower in the tumours. At the protein level, the PRL and GH variants exhibited a different pattern of expression in tumours compared with the normal rat pituitary. The biological significance of these differences is discussed.
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Affiliation(s)
- M Delhase
- Pharmacology Department, Medical School, Free University of Brussels (VUB), Belgium
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Verny C, Remy C, Sachon C, Bosquet F, Casanova S, Grimaldi A. [Nocturnal hypoglycemia in insulin-dependent diabetics]. Presse Med 1995; 24:1198-200. [PMID: 7567846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Repeated hypoglycaemia has been reported to impair recognition of subsequent hypoglycaemia with a high risk of severe hypoglycaemia. This intensified insulin therapy may be dangerous in insulin-dependent diabetes mellitus (IDDM) patients with unawareness of hypoglycaemia. METHODS We assessed the incidence of nocturnal hypoglycaemia and the benefit of an additional bedtime snack in IDDM patients treated by 2 or 3 daily injections. Capillary blood glucose was measured by finger strip at 10 p.m. and plasma venous glycaemia was determined at 0, 2, 4 and 8 a.m. RESULTS The study was composed of two phases. In the first phase, patients (n = 93) did not receive any snack at bedtime. Blood glucose fell to 2.75 mmol/l or less in 33%. Among the 40 patients with a 10 p.m. glycaemia of 9 mmol/l or less, 57.5% experienced nocturnal hypoglycaemia vs 15% of the 53 others. The second phase concerned 106 IDD patients. An additional bedtime snack was given when 10 p.m. blood glucose was 9 mmol/l or less. The incidence of hypoglycaemia fell to 32% (14 of 44 IDDM) i.e. a significant benefit of 44% (p < 0.01). However patients who received this additional bedtime snack had a slightly higher 8 a.m. glycaemia than those with 10 p.m. glycaemia at 9 mmol/l or less during the first phase (9.61 +/- 5.67 mmol/l vs 7.75 +/- 4.30 mmol/l) but this result is not significant. CONCLUSION Prevention of nocturnal hypoglycaemia may be achieved in IDDM patients by bedtime glucose determination and an additional snack when glycaemia is 9 mmol/l or less.
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Affiliation(s)
- C Verny
- Service de Diabétologie-Métabolisme, Hôpital de la Pitié, Paris
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Abstract
The literature was reviewed to define the role of clobazam (CLB) in the treatment of epilepsy. CLB is an effective antiepileptic drug (AED) in most varieties of seizures and epilepsies for both short-term and long-term treatment. Tolerability of CLB is satisfactory, better than for conventional benzodiazepines. CLB has no significant interaction with other drugs. Tolerance may develop, but this aspect may have been overemphasized: a long-term benefit figure of 28% can be expected without tolerance. When CLB maintains efficacy, patients continue to benefit for years without drug dependence or unwanted side effects. CLB appears to be a useful treatment for epilepsy as intermittent or short-term add-on therapy; but it should also be tried as long-term therapy in some situations, especially as add-on therapy for patients with refractory epilepsy, as add-on or monotherapy for patients with anxiety, or in some women in association with oral contraceptives.
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Affiliation(s)
- C Remy
- Centre Medical la Teppe, Tain l'Hermitage, France
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Proux J, Baskali A, Remy C, Creminon C, Pradelles P. Development of an enzyme immunoassay for arginine-vasopressin (AVP)-like insect diuretic hormone. Comp Biochem Physiol B 1993; 106:659-66. [PMID: 8281761 DOI: 10.1016/0305-0491(93)90146-v] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
1. The AVP-like insect diuretic hormone is a biologically active antiparallel dimer present, along with its non-active monomeric form (Cys-Leu-Ile-Thr-Asn-Cys-Pro-Arg-GlyNH2), in the African locust. 2. It exhibits diuretic activity by increasing fluid excretion at the level of the Malpighian tubules. 3. To date, both monomer and dimer have been assayed using a radioimmunoassay originally prepared for mammalian AVP. 4. We have developed here an original enzyme immunoassay based on the use of antibodies to insect AVP-like raised in rabbits against synthetic monomers and dimers, using acetylcholinesterase conjugate as an enzymatic tracer. 5. This enzyme immunoassay enables measurement of the dimer to be made with adequate sensitivity (0.3 nmol/l, i.e. 21 pg/well) and reproducibility while sensitivity of the monomer is somewhat lower (14 nmol/l, i.e. 480 pg/well). 6. The assay was validated by assaying native dimer and monomer throughout the different steps of purification (from a crude extract to reversed-phase liquid chromatographic fractions). 7. A good correlation was observed between radioimmunoassays and enzyme immunoassays. 8. The enzyme immunoassay was also used to measure the level of AVP-like peptides in several insect tissues not explored to date.
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Affiliation(s)
- J Proux
- Laboratoire de Neuroendocrinologie, URA CNRS 1138, Université de Bordeaux 1, Talence, France
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Le Fur Y, Ziegler A, Bourgeois D, Decorps M, Remy C. Phased spectroscopic images: application to the characterization of the 1H 1.3-ppm resonance in intracerebral tumors in the rat. Magn Reson Med 1993; 29:431-5. [PMID: 8464358 DOI: 10.1002/mrm.1910290402] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Spectra obtained with phase-encoding techniques show phase-shifts varying from voxel to voxel. The procedure allowing voxel-dependent phase-shifts to be compensated is presented. The method has been applied to the characterization of the 1.3-ppm resonance observed in intracerebral tumors in the rat.
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Affiliation(s)
- Y Le Fur
- Unité INSERM U. 318, Université Joseph Fourier, Hôpital Albert Michallon, Grenoble, France
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Abstract
Intrarectally (i.r.) administered diazepam (DZP) solution at doses of 20 and 30 mg in the treatment of serial seizures was studied in 39 adult patients with refractory partial epilepsy. Patients were randomly distributed into two groups (20 mg, n = 21; 30 mg, n = 18). Plasma levels of DZP were assessed over 24 h following i.r. injection. The efficacy of i.r. DZP in the treatment of serial seizures in adults was confirmed; onset of effect was noted approximately 10 min after the injection, and the effective dose was 0.50 mg/kg. Tolerance and acceptability were good. Intrarectal injection of DZP can be performed even by unskilled personnel and may be recommended in patients with serial seizures in the hope of preventing development of status epilepticus.
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Affiliation(s)
- C Remy
- Centre Medical La Teppe, Tain L'Hermitage, Laboratoire de Pharmacologie, Grenoble, France
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Luauté JP, Sanabria E, Remy C. [Psychiatric disorders and diaschisis. Conclusions drawn from brain imaging]. Ann Med Psychol (Paris) 1992; 150:168-73. [PMID: 1343513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Affiliation(s)
- J P Luauté
- Service de Psychiatrie Générale, C.H. Romans
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Bourgeois D, Remy C, Lefur Y, Devoulon P, Benabid AL, Decorps M. Proton spectroscopic imaging: a tool for studying intracerebral tumor models in rat. Magn Reson Med 1991; 21:10-20. [PMID: 1943666 DOI: 10.1002/mrm.1910210104] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Water-suppressed 2D 1H spectroscopic imaging was used with surface coils to study in vivo the cerebral metabolism changes in rat brain induced by a glial tumor growing in situ. To achieve slice selection without a chemical-shift artifact, we exploited the depth pulse properties of a spin-echo sequence. In order to give a spectral response which is independent of the position, the water suppression was achieved by using a spin-locking excitation and a binomial refocusing pulse. Spectroscopic images were obtained with an in-plane resolution of 1.1 X 1.1 mm and a slice thickness of roughly 3 mm. The growing of the tumor induced dramatic modifications in the proton spectra, including a nearly complete loss of N-acetyl aspartate, an increase of the 1.3-ppm peak, an increase in choline, and a decrease in creatine. The results demonstrate the potential of spectroscopic imaging in the study of intracranial tumor models in rats.
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Affiliation(s)
- D Bourgeois
- Groupe de Résonance Magnétique en Biologie et Médecine, DRF/SPH, Centre d'Etudes Nucléaires, Grenoble, France
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Chauvin C, Suh M, Remy C, Benabid AL. Failure to detect viral genomic sequences of three viruses (herpes simplex, simian virus 40 and adenovirus) in human and rat brain tumors. Ital J Neurol Sci 1990; 11:347-57. [PMID: 2174028 DOI: 10.1007/bf02335937] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Little is known about oncogenesis in brain tumors. Viruses are thought to be involved in some neurological diseases, the presence of subfractions of viral DNA has been reported in various circumstances and the oncogenicity of some viruses has been demonstrated in animal experiments. The discovery of homologies between retroviral oncogenes and normal cellular genes (proto-oncogenes) has stimulated once again the search for viral responsibility in oncogenesis. Having a large bank of tumor material available, we systematically examined 39 brain tumors using Southern blot hybridization with DNAs of three viruses, known to be involved in neurological diseases: herpes simplex virus (HSV), simian virus 40 (SV40) and adenovirus type 2 (Ad2). We detected no homology between the DNAs of the examined material and the viral DNA probes. We compare these negative results with those of other published studies and discuss the experimental conditions, with special reference to the possibility of non-specific hybridization, which could account for the positive results reported. The present negative results could be interpreted either as absence of involvement of the three investigated viruses in brain tumor oncogenesis, or an indirect involvement through a hit-and-run mechanism or a highly dispersed state of the viral sequences among the host genome, which would prevent hybridization with the probe, as it has been supposed to be the case during the latency phase of herpes virus.
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Affiliation(s)
- C Chauvin
- Laboratoire de Médecine et Chirurgie Expérimentales et Comparées, Université Joseph Fourier de Grenoble, La Tronche, France
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Remy C. [Practical and theoretical aspects of the strabismic deviometry]. Bull Soc Ophtalmol Fr 1990; 90:371-2. [PMID: 2208492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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