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Biomedical subjects

A Bernard

Publications and source records attributed to A Bernard.

At least 469 records · Page 26Linked to original sources
PubMed1987

Endocrine changes following pituitary desensitization with LHRH agonist and administration of purified FSH to induce follicular maturation.

Pituitary desensitization was induced in 13 normally menstruating women by administration of an LHRH agonist, Buserelin, intranasally, 100 micrograms at intervals of 4 h, for a period of 14 days starting on day 22 of the menstrual cycle. Whilst continuing with Buserelin, multiple follicular development was induced by administration of purified FSH (Metrodin) for between 8 and 15 days at a dose of 150 i.u. daily. In one patient no follicular growth was induced after 14 days treatment. In the remaining subjects between 3 and 11 follicles with mean diameter greater than 16 mm were stimulated and between 2 and 10 mature oocytes were recovered laparoscopically for IVF, 34 h after hCG administration. Eight patients underwent embryo transfer and four conceived.

Adult↗
PubMed1987

Outcome of in-vitro fertilization and embryo transfer after different regimens of ovarian stimulation.

Sixty-eight women with bilateral tubal disease and fertile male partners underwent ovarian stimulation in 187 cycles for IVF after randomization to different ovulation induction regimens. All patients initially received 150 mg clomiphene citrate on days 5-9, this regimen induced sufficient stimulation in a smaller proportion of patients than the two other regimens used subsequently which included clomiphene in combination with human menopausal gonadotrophins (hMG). The fertilization rate was significantly reduced (52.4%) in oocytes collected from cycles stimulated with hMG alone (in a small sub-group of poor responders) compared with a rate of 64.1-66.4% in cycles stimulated with clomiphene alone or in combination with hMG. Embryonic development 44-48 h after insemination was significantly retarded when clomiphene alone was utilized but a higher proportion of fragmented or abnormal embryos was observed after stimulation with hMG alone. In 118 cycles embryo transfer was performed and 20 pregnancies were established, a pregnancy rate of 16.9%. All but two pregnancies were established when two or more embryos were transferred and when the embryos were at the 4-cell or later stage of development. The regimen of clomiphene in combination with 150 i.u. hMG resulted in significantly greater numbers of oocytes recovered and embryos available per patient for transfer than the other two regimens studied.

Chorionic Gonadotropin↗
PubMed1987

Metal-induced alterations of delta-aminolevulinic acid dehydratase.

ALAD is a cytoplasmic enzyme that catalyzes the second step of the heme biosynthesis pathway, that is, the condensation of two molecules of delta-aminolevulinic acid into porphobilinogen. ALAD is a zinc-dependent enzyme; thiol groups are essential for its activity; and in vitro experiments show that ALAD can be activated or inhibited by several metal ions including A;3+, Pb2+, Cd2+, Hg2+, Ag2+, and Cu2+. To explain these effects, it has been postulated that metals bind to thiol groups of allosteric sites and, according to their structure, provoke allosteric transitions to the active or inactive form of the enzyme. Under current environmental and occupational exposure levels, lead is practically the only metal that can affect ALAD activity. Erythrocyte ALAD is the most sensitive indicator of lead exposure: effects of exposure are detectable even when blood lead levels are within the "normal" range. Zinc protects ALAD in vitro and in vivo from the inhibitory effect of lead. There is also some suggestion that aluminum could be responsible for the decreased erythrocyte ALAD activity observed in patients on chronic hemodialysis.

Aluminum↗
PubMed1987

Differential intestinal absorption of two fatty acid isomers: elaidic and oleic acids.

The absorption of 14C-labeled oleic acid and 14C-labeled elaidic acid was studied in bile- and pancreatic juice-diverted adult rats. In some cases these acids were compared with 14C-labeled palmitic acid absorption. Sodium taurocholate-emulsified test infusates containing an equimolar mixture of monopalmitin and two fatty acids (oleic and elaidic or palmitic), one of which was 14C labeled, were infused through a duodenal canula. The chyle was collected from the mesenteric lymphatic vessel by plastic tubing. Among the three fatty acids studied, oleic acid exhibited the highest lymphatic recovery rate (43-50%). Elaidic and palmitic acids appeared more slowly and in lesser amounts (10-17%). Simultaneously, the highest amount of chylomicrons was observed when the lipid emulsion contained oleic acid alone; the lowest was observed when elaidic acid was the only unsaturated fatty acid. Experimental data have also shown that compared with elaidic acid, oleic acid is preferentially incorporated into the lymph triglycerides. We can conclude from the data presented that the enterocytic enzymes involved in the absorption of lipids show a high degree of specificity related to the fatty acid isomery, since the absorption of elaidic acid differs markedly from its isomer oleic acid.

Animals↗
PubMed1987

Competition between low- and high-molecular-weight proteins for renal tubular uptake.

To explain the occurrence of tubular and glomerular proteinuria in patients with primarily tubular or glomerular dysfunction, it is usually assumed that the mechanisms responsible for the renal tubular transport of small and large proteins are different. The present in vivo study does not support this hypothesis since it clearly shows that small and large proteins (e.g., beta 2-microglobulin and albumin) can compete for renal uptake. Our results lead us to postulate the existence of common tubular reabsorption sites for which proteins exhibit different affinities depending on their charge, size and conformation.

Animals↗
PubMed1987

Prenatal and early postnatal intoxication by inorganic mercury resulting from the maternal use of mercury containing soap.

A case of slight renal tubular dysfunction associated with cataract and anaemia was diagnosed in a 3-month-old black boy in whom high levels of mercury were found in blood and urine. Several arguments suggest that the renal, ocular and haematological defects may have resulted from exposure to mercury during foetal life and the 1-month lactation period due to the extensive use of inorganic mercury containing cosmetics by the mother.

Anemia↗
PubMed1987

Determination of IgE complexes and of total IgE by latex immunoassay.

A sensitive immunoassay based on latex particle agglutination for the measurement of circulating IgE-containing complexes is described. In this method, the anti-IgE-coated particles are incubated with diluted serum and the resulting agglutination is quantified by turbidimetry or particle counting. In the latter version, the assay is fully automated in a continuous flow system. IgE-containing complexes were detected in all tested sera. Increased concentrations were observed in about 80% of the subjects with elevated serum IgE. However, high levels of IgE-complexes may also be found in subjects with a normal or even a very low serum concentration of IgE. The same latex immunoassay can be used for the determination of total IgE, after pepsin digestion of the gamma-globulin fraction of the serum. The results obtained correlate well with those found with a sandwich radioimmunoassay (r = 0.91, n = 83). The present method, however, yields a greater number of significantly positive results than the radioimmunoassay, probably because of its ability to detect IgE entrapped in circulating complexes.

Antigen-Antibody Complex↗
PubMed1987

[Implication of HLA class I molecule from monocyte in T-cell activation by CD2 or CD3 monoclonal antibodies].

The role of monocytes in human T-cell activation by monoclonal antibodies (mAb) recognizing CD3 molecule or by 2 mAb pairs directed against different epitopes of CD2 "GT2+T11(1)" or "D66+T11(1)" has been studied. It appears that HLA-cl I molecules from monocytes are involved in the early activation phase of T-cells stimulated by CD3 or CD2 when direct contacts between T-cells and monocytes are required. Thus, pretreatment of monocytes with HLA-cl I mAb inhibited IL 2 receptor appearance and IL 2 synthesis on T-cells stimulated by CD3 mAb or CD2 "GT2+T11(1)" mAb pair.

Antibodies, Monoclonal↗
PubMed1987

[Surgical treatment of pulsion diverticula of the esophagus].

A retrospective study of 53 patients, operated upon for esophageal pulsion diverticula, is used to compare results with those in the literature in an attempt to improve operative indications with the hope of reducing the number of only fair short and long term results. Findings showed that results were rated as good in 81% of the 35 patients with pharyngo-esophageal diverticula and 65% of the 18 with epiphrenic diverticula. Indications for operation for pharyngo-esophageal diverticula can be based on clinical and radiological signs. Cricopharyngeal manometry indicates that myotomy is a logical procedure but results show that it is not necessary for choice of indications for surgery. Our preference is for a diverticulectomy, with or without associated myotomy, of debatable value. In contrast, for epiphrenic diverticula, functional esophageal explorations provide greater precision of the type of dyskinesia and allow better adaptation of surgery to type of dyskinesia associated with diverticulum.

Adult↗
PubMed1987

[Demonstration of anti-laminin antibodies in the serum of healthy subjects].

Antibodies directed against laminin, a glycoprotein of basement membranes, have been sought for in the sera of 347 healthy subjects by a method relying on the agglutination of laminin-coated latex particles. Fifty-five subjects (15.9%) hae been found to be positive, 37 with a titre of 2, 14 with a titre of 4 and 4 with a titer of 8. Applied to 106 patients whose a renal biopsy had been examined by immunofluorescence, the test yielded positive results in 91% of patients with linear deposits as compared to 10.3 and 15.4% respectively in patients presenting with and without granular deposits along the glomerular basement membrane. The titers in anti-laminin antibodies observed in these patients ranged from 2 to 8. The discovery of circulating anti-laminin antibodies in serum from subjects without clinical or subclinical sign of renal impairment rises several questions regarding the pathogenicity of these auto-antibodies and their possible association with genetic or environmental factors.

Anti-Glomerular Basement Membrane Disease↗
PubMed1987

T-cell depletion of bone marrow transplants: assessment of standard immunological methods of quantification.

The efficacy of bone marrow transplant (BMT) T-cell depletion for the prevention of acute graft-versus-host disease (GVHD) has been demonstrated in animal models and in clinical studies. The importance of T-cell depletion has to be evaluated with standardized methods suitable for routine purposes. We report herein an in vitro mature T-cell depletion using a cocktail of three monoclonal antibodies (CD2, CD5, and CD7) and baby rabbit complement in 38 histocompatibility leucocyte antigen (HLA)-identical BMT with no more than grade II acute GVHD. The T-cell depletion was quantified using three prestandardized immunological methods: immunofluorescence (IF) analysis, SRBC-rosetting assay, and PHA proliferation assay. A mean of 97.5% IF-assessed T-cell depletion was achieved in the 38 BMT. The immediate IF analysis using three distinct sets of anti-T-cell monoclonal antibodies allowed us to detect a mean of 1.2% residual T cells. The SRBC-rosetting assay was not useful to quantify T-cell depletion because no residual SRBC-rosette-forming cells could be detected in every case. The results of a prestandardized PHA-induced proliferation assay gave a mean 96.7% inhibition of proliferation, and they were correlated with the IF results although the IF threshold of detection was higher. From these data we conclude that our in vitro T-cell-depletion procedure is reproducible and that standardized simple immunological methods such as immediate immunofluorescence analysis and PHA proliferation assay provide good tools to assess a T-cell depletion effective in the prevention of acute GVHD.

Adolescent↗
PubMed1987

Analysis of CD1 molecules on thymus cells and leukemic T lymphoblasts identifies discrete phenotypes and reveals that CD1 intermolecular complexes are observed only on normal cells.

We looked at the surface expression of the three distinct human thymic cell surface differentiation antigens, CD1a, CD1b, and CD1c, that presently define the first cluster of differentiation (CD) on the cells from 34 patients with acute T cell malignancies. We also studied the expression of other T cell-restricted molecules, including the T cell receptors, on these cells. Our results confirm the extensive phenotypic heterogeneity of the cells from acute T cell malignancies, which contrast with the more limited phenotypic diversity of subacute or chronic T cell malignancies. Our study of normal children and fetal thymus cells shows that the extensive phenotypic heterogeneity of the malignant cells reflects the heterogeneity of the thymic subpopulations and shows that most of the phenotypes observed on malignant T cells have a normal counterpart, particularly in the fetal thymus. Moreover, we demonstrate that the CD1a molecules, which can form three different types of noncovalent intermolecular complexes on the surface of normal thymus cells, do not form any noncovalent intermolecular complexes on the surface of leukemic cells. We also show that CD1a molecules can form covalent intermolecular complexes with CD8 molecules on some but not all malignant cells.

Antibodies, Monoclonal↗
PubMed1987

T-cell depletion does not affect long-term human bone marrow culture.

Bone marrow long-term cultures were studied for 8 weeks in four experiments before and after T-cell depletion with a mixture of monoclonal antibodies directed against CD2, CD5 and CD7. No differences in cellularity or granulomonocytic progenitor numbers appeared during the period of culture. We conclude that in vitro treatment in itself is not likely to explain non-take or graft rejection associated with T-depleted bone marrow transplantation.

Animals↗
PubMed1987

Successful graft-versus-host disease prevention without graft failure in 32 HLA-identical allogeneic bone marrow transplantations with marrow depleted of T cells by monoclonal antibodies and complement.

Thirty-two patients with acute leukemia, chronic granulocytic leukemia, or multiple myeloma received a T lymphocyte-depleted HLA-identical marrow. After being treated with pan-T monoclonal antibodies (MoAbs) and one round of baby rabbit complement, the mean percentage of T cell depletion was 94% +/- 4%. The number of residual viable T cell infused to the patient was 0.99 +/- 0.65 X 10(6) per kg body weight. The patients were conditioned with fractionated total body irradiation (TBI) (12 Gy) preceding high doses of cyclophosphamide (120 mg/kg). Methotrexate was used as an additional immunosuppressant in the first ten patients. For the following 22 patients no posttransplant immunoprophylaxis was administered. Eight patients died within three months due to complications related to transplantation. Engraftment was achieved in all evaluable patients, and no patient has a late graft failure. The proof of total chimerism was established in 24 patients. Twenty-four of 27 evaluable patients (88%) did not have an acute graft-v-host disease (GVHD) greater than grade 0 to 1. Two patients had a grade 2 (skin only), and one patient had a grade 4 acute GVHD (the latter had only 80% of T cell depletion). A medullary relapse occurred in 11 patients (nine of them had previously been defined as "high risk leukemia"). Our data suggest that it may not be necessary to deplete nearly all T cells to prevent acute GVHD in recipients of HLA-identical marrow.

Adolescent↗
PubMed1987

Dopamine compared with dobutamine in experimental septic shock: relevance to fluid administration.

The hemodynamic effects of dopamine and dobutamine (at doses of 6 micrograms X kg-1 X min-1) were compared during fluid resuscitation from septic shock induced by endotoxin (3 mg/kg) in the dog. In the first part of the study, when a standard amount of saline solution was infused (in 24 dogs), dopamine infusion resulted in higher cardiac filling pressures than did dobutamine infusion, whereas dobutamine infusion resulted in higher cardiac output. In the second part of the study, when fluid infusion was titrated to maintain pulmonary artery balloon-occluded pressure at constant level (in 24 dogs), the total amount of fluids was significantly greater with dobutamine than when dopamine was used (109 +/- 13 vs 71 +/- 10 ml/kg). The combination of dobutamine with fluids resulted in significantly greater stroke volume (39.6 +/- 3.8 vs 21.0 +/- 4.0 ml, P less than 0.05) and oxygen consumption (194 +/- 18 vs 144 +/- 8 ml/min, P less than 0.05). The different effects of dopamine and dobutamine on cardiac filling pressures can be due to differences in effects on myocardial contractility, ventricular afterload, and cardiac compliance. This experimental study indicates that when fluid therapy is combined with adrenergic agents in resuscitation from septic shock, dobutamine can be associated with higher cardiac output and oxygen transport and can result in higher tissue oxygen consumption than dopamine.

Animals↗
PubMed1987

[Analysis of the complications of coronarography. Apropos of a series of 2,300 consecutive tests].

The coronarographic risk is 3 deaths per thousand and 2 non-fatal complications per cent. Fatal cases are always related to severe coronary lesions, particularly stenosis of main trunk. Their incidence is equivalent during catheterization by the humeral or femoral routes whereas local complications are more frequent by the humeral approach. In the series of 2,300 successive coronarography examinations reported there were less than 4 deaths per thousand and 1.82 complications per cent. Four factors contribute to the reduction in high risk coronarography mortality when the following protocol is used. First, routine coronary opacification at start of investigations after determination of left ventricular pressures allowing, in patients with very severe coronary lesions and/or markedly altered left ventricular function, the ventriculography to be postponed until the following day or even cancelled. Second, use of a new contrast medium of lower osmolarity possessing advantages over older products. Third, and principally, institution of a very strict pre- and per-coronarography drug protocol, controlled use of an intraaortic diastolic counter-current balloon, and notably placed in position during examination in patients with very pronounced stenosis of main trunk. In these cases the arterial desilet is left in place for 24 hours after examination to delay vagal reflex provoked by compression and to allow urgent insertion if necessary of an intra-aortic diastolic counter-current balloon catheter. Fourth, use of Diltiazem intracoronary in case of major spasm and Streptokinase and possible metallic guide to obtain repermeability of a thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Anaphylaxis↗