[Surgery for pyloric stenosis by laparoscopy].
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Humans↗
Biomedical subjects
A Paris
Publications and source records attributed to A Paris.
[Spontaneous ventilation in positive expiratory pressure in cardiogenic pulmonary edema. Prospective study].
New equipment facilitating the use of spontaneous ventilation with positive expiratory pressure (PEP) has become available in France since January 1996. This technique was applied in 38 patients with severe cardiogenic pulmonary oedema and persistent respiratory distress despite high flow classical oxygen therapy and standard treatment. After 1 hour of ventilation with a flow of 220 l/min of 100% oxygen with an average PEP of 7.7 cm H20, a significant improvement of clinical (heart and respiratory rate) and biological parameters (arterial gases) was observed. There were no side effects. Four patients died during the hospital period and only 1 was intubated. Spontaneous ventilation with PEP is a simple technique for coronary care units and, compared with conventional oxygen therapy, it rapidly improves arterial oxygenation, reduces respiratory work and improves conditions of cardiac load. Acute severe cardiogenic pulmonary oedema seems to be an indication of choice, especially in the elderly, where it may help avoid an often controversial intubation.
Aged↗
[Systemic Salmonella arizonae infections in patients with a deficiency of cell-mediated immunity. A report of 2 cases and a review of the literature].
Systemic infections induced by Salmonella arizonae have been described in patients with underlying cell-mediated immunodeficiencies, usually resident in southern countries of U.S. and in Mexico. This peculiar geographic distribution is probably due to the ingestion of meat or drugs from rattlesnakes, that Salmonella arizonae colonize in the intestinal tract and that live in the above areas. In this article we describe two cases of systemic Salmonella arizonae infections, that represent, to our knowledge, the first report in European literature.
Acute Disease↗
Hepatic microsomal membrane lipidic composition and growth hormone effect in adult male rat: evidence for a 'feminization' process of total phospholipid fatty acid pattern.
Growth hormone (GH) effects on fatty acid composition and on delta5-, delta6-, delta9-desaturase and palmitic acid elongation activities were studied in male rat hepatic microsomes. Sham-operated and hypophysectomized animals were injected with two different dosages of GH, mimicking either the male or female GH secretion pattern. Half the hypophysectomized animals received thyroxine and cortisol in concentrations chosen to compensate for the lack of thyroid hormones and glucocorticoids. GH, administered to sham-operated or to cortisol/thyroxine-treated hypophysectomized rats resulted in an increase in stearic and arachidonic acid proportions, while palmitic acid percentage was decreased. Total monounsaturated fatty acids were dramatically reduced by this treatment. DeltaA-desaturase and palmitic acid elongation activities were increased by GH treatment, while delta9-desaturase activity was decreased. These GH effects on desaturation and elongation activities could explain the modifications in microsomal fatty acid composition. Hypophysectomy markedly altered the fatty acid composition by reducing arachidonic and stearic acid proportions and increasing the linoleic acid proportion, while delta9-, delta5-desaturase and palmitic acid elongation activities were decreased. Restoration of most of the fatty acid proportions to control values was realized in hypophysectomized animals with a cortisol/thyroxine replacement administered alone or together with the low dosage of GH mimicking the male secretion pattern. High GH dosage produces essentially a 'feminization' process of the fatty acid composition of the hepatic microsomal membrane in male rats when compared to that of females.
Animals↗
Differential effect of hypophysectomy and growth hormone treatment on hepatic glucuronosyltransferases in male rats: evidence for an action at a pretranslational level for isoforms glucuronidating bilirubin.
The influence of growth hormone (GH) on 4-nitrophenol, bilirubin, testosterone, androsterone and estrone glucuronidation activities was studied in fully activated male rat hepatic microsomes. Sham-operated and hypophysectomized animals were injected with two different dosages of GH, mimicking either the male or female GH secretion pattern. Half the animals received thyroxine and cortisol in concentrations chosen to compensate for the lack of thyroid hormones and glucocorticoids in hypophysectomized rats. GH induced a decrease in several glucuronidation activities: bilirubin glucuronidation in both sham-operated and cortisol/ thyroxine-treated hypophysectomized rats in a dose-dependent manner, testosterone glucuronidation in hypophysectomized animals, and androsterone and estrone glucuronidation in cortisol/thyroxin-treated hypophysectomized rats. 4-nitrophenol glucuronidation was not affected by GH treatment. A hypothetical "feminizing" effect of GH (due to an almost continuous secretion) could not be invoked to explain these results, contrary to what has been observed elsewhere for other hepatic enzyme activities. Hypophysectomy altered all the activities tested, with bilirubin the most modified (a 200% enhancement). Restoration of control values was achieved in hypophysectomized animals with cortisol/thyroxine replacement together with a low dosage of GH (mimicking a male GH secretion pattern), except for androsterone glucuronidation activity where both GH and cortisol/thyroxine treatments reinforced the decreasing effect of hypophysectomy. Variations in protein amounts were correlated to variations in bilirubin, testosterone and androsterone conjugation activities induced by hypophysectomy and GH treatment. Reverse transcription-polymerase chain reaction (RT-PCR) mRNA analysis of bilirubin cluster isoforms or uridine diphosphate glucuronosyltransferase 1B1 (UGT1B1), UGT1B2 and UGT1B5 showed that GH controlled the different isoforms involved in bilirubin glucuronidation differentially at a pretranslational level.
Animals↗
B-mode ultrasound in the diagnosis of maxillary sinusitis in intensive care unit.
Radiological maxillary sinusitis (RMS) is not an easily diagnosed in Intensive Care Unit (ICU). B-mode ultrasound of paranasal sinuses, validated for the ambulatory patients, was evaluated in a prospective study. One hundred fifty three ultrasound examinations were performed on 30 critically ill patients and compared to CT scan or radiography (Blondeau's view). Two levels of positive echographia are described: positive echographia corresponding with a moderate lesion, cupuliform echographia when the lesion is more significant. Its good predictive negative value when the echographia is negative and its predictive positive value of 100% when the echographia is cupuliform allow to recommend B-mode ultrasound as the best investigation for the diagnosis of maxillary sinusitis in a ICU. Diagnostic ultrasound represents a rapid, painless, innocuous and easily reproducible means of monitoring.
Humans↗
Concomitant brain radiotherapy and high-dose ifosfamide in brain relapses of lung cancer.
PATIENTS AND METHODS: Twenty patients with lung cancer and brain metastasis were prospectively included in this feasibility study (four small-cell and 16 non-small-cell lung cancers). There were two previously untreated patients and 18 pretreated patients for whom brain metastases constituted the first relapse after a treatment-free interval following chemotherapy for the primary lung cancer. Most of the patients had neurological symptoms and an ECOG performance index over 2. Treatment consisted of three courses of whole brain radiotherapy (18 Gy in 10 fractions) and ifosfamide: 3 g/m2 daily from day 1 through day 4, i.e., during the first four days of radiotherapy with uromitexan uroprotection and haematopoietic support (r-HuG-CSF). RESULTS: Seventeen patients completed the three-cycle programme. Sixteen patients had grade 4 neutropenia and six of them experienced a febrile episode. Other toxicities were mild to moderate and manageable. The received dose-intensity of ifosfamide was 90%. Response evaluation demonstrated stable disease for two patients, partial response for eight, complete response for six and progression for four. All responders benefited by a remission of symptoms and improvement of performance index. Median survival from start of protocol was 13 months. CONCLUSION: Brain radiotherapy plus high-dose ifosfamide is feasible in patients suffering from brain recurrences of lung cancer.
Adult↗
Administration of sufentanil and nitrous oxide blunts cardiovascular effects of desflurane but does not prevent an increase in middle cerebral artery blood flow velocity.
Desflurane has been reported to cause tachycardia and hypertension during induction of anaesthesia. The aim of this study was to determine the effects of desflurane on cerebral blood flow (CBF) velocity using transcranial Doppler ultrasonography in a setting that closely resembled usual clinical practice. In two groups (n = 9 in each) ASA Grade I or II patients, anaesthesia was induced with etomidate and vecuronium intravenously (i.v.), sufentanil (0.3 microgram kg-1 i.v.) was added in the second group. Patients were ventilated by facemask for 2 min before desflurane was administered in steps of 0.5 MAC min-1 until 1.5 MAC was reached and maintained for 7 min. Haemodynamic variables and CBF velocity in the middle cerebral artery (MCA) were monitored throughout the study period. In group 1 heart rate increased to 108 +/- 2 b.p.m. (37% increase) whereas MAP increased to 114 +/- 6 mmHg after administration of desflurane (33% increase). CBF velocity increased to 86 +/- 7 cm s-1 (69% increase). In group 2 no significant changes in systemic haemodynamic responses were measured after desflurane administration; however, CBF velocity increased to 73 +/- 5 cm s-1 (59% increase). The results indicate that desflurane increases CBF velocity concurrently with induction of tachycardia and hypertension. Although sufentanil and N2O attenuate the systemic haemodynamic alterations caused by desflurane, the CBF velocity increases. These data suggest that the abrupt addition of desflurane may have adverse consequences in patients at risk for intracranial hypertension.
Abdomen↗
Primitive neuroectodermal tumor of the kidney confirmed by fluorescence in situ hybridization.
Peripheral primitive neuroectodermal tumors (PNETs) are rare lesions that form part of the Ewing family of tumors, which includes osseous and extraosseous Ewing's sarcoma and Askins tumor of the thorax. All are characterized by translocations involving the EWS gene at 22q12, usually the translocation t(11;22)(q24;12). PNETs usually occur in soft tissues but occasionally arise within a visceral organ. We describe a PNET of the kidney that showed characteristic microscopic and immunohistochemical appearances of a small, round, dark blue cell tumor with focal rosette formation and strong membrane positivity for the MIC2 gene product. Interphase fluorescence in situ hybridization on touch imprints prepared from frozen tissue using cosmid probes flanking the EWS gene at 22q12 and the FLI1 gene at 11q24 indicated the presence of t(11; = +22)(q24; = +q12), confirming the diagnosis of PNET. This is the first reported PNET of the kidney supported by cytogenetic analysis. We also review the literature on this fascinating tumor in this unusual location.
Female↗
[Bronchial actinomycosis of pseudo-tumor form].
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Actinomycosis↗
[Cardio-thyrotoxicosis with arrhythmia disclosed by an embolic cerebrovascular accident].
We report a case of thyroid cardiomyopathy from an iodine overload in a patient admitted for a cerebrovascular accident. The diagnosis was suggested by a hyperkinetic circulatory status and confirmed by the increased circulating thyroid hormone concentrations. Treatment improved the haemodynamic status, however the patient died from a cerebral herniation.
Atrial Fibrillation↗
Aromatase activity of ovine follicular walls: technical validation and physiological control.
Since aromatase activity quickly disappears in cultured sheep granulosa cells, its control is poorly understood. As a result, an aromatase assay was developed using cultures of follicular walls and measuring the amount of 3H2O generated from 3H-testosterone. Chromatography and mass spectrometry analysis demonstrated that 3H2O production was indeed associated with the production of oestradiol-17 beta. Optimization of the assay demonstrated: (1) a steady increase in the amount of 3H2O produced over at least 12 h; and (2) highly significant correlations between the amounts of 3H2O measured and the weight of the follicular wall or the amount of 3H-testosterone provided. Furthermore, a highly significant correlation (r = 0.82) was observed between the amount of 3H2O produced and the concentration of oestradiol in the same samples. The effects of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and oestradiol on aromatization by follicles at two specific stages of maturation (recruitment, 12 h after luteolysis; dominance, 36 h after luteolysis) were then assessed. At recruitment and dominance, FSH was able to modulate aromatase activity similarly, increasing and decreasing the activity at low concentrations and high concentrations respectively. At recruitment and dominance, oestradiol had no stimulatory effect on basal aromatase activity and even blocked the stimulatory effects of FSH on aromatase at recruitment. LH significantly inhibited the FSH-stimulated aromatase activity of dominant follicles. It is concluded that: (1) FSH may induce the recruitment of follicles by increasing aromatase activity; and (2) neither oestradiol nor LH stimulate the aromatase activity of follicles which could explain maintenance of the dominant follicle.
Animals↗
Effect of a brood pheromone on honeybee hypopharyngeal glands.
In a honeybee colony, brood stimulates development of hypopharyngeal glands of nurse bees. A chemical signal, a blend of 10 fatty acid esters, has been identified on larval cuticle. We demonstrate that the blend of 10 esters, ethyl oleate, and methyl palmitate stimulates the protein synthesis of hypopharyngeal glands of nurses. Thus, in Apis mellifera the chemical signal from the brood acts as a primer pheromone in addition to its previously shown role as a releaser pheromone.
Animals↗
[Chatergee syndrome and anesthesia. Apropos of a case].
A combination of complete left bundle branch block (LBBB) and symmetrical negative T waves on the ECG characterizes the Chattergee syndrome. This pattern is infrequently and fortuitously detected in the absence of clinical symptoms. However, when appearing during general anaesthesia, it may lead to diagnostic difficulties to rule out a myocardial ischaemia. One case of this pattern was observed near the end of an otherwise non-complicated cholecystectomy in a ASA II 45 year old man, ECG abnormalities lasted for only a short time. Recovery and outcome were uneventful. Investigations were negative except for an early LBBB during the exercise test. Echocardiography and coronarography were normal. No therapy was given. In such perioperative cases, it is recommended to keep a very cautious attitude and to search for an incipient coronary disease which cannot be completely excluded in some cases.
Bundle-Branch Block↗
Molecular cloning and sequence analysis of human preprocathepsin C.
A cDNA clone (C1) coding for human preprocathepsin C was isolated from a human ileum cDNA library using a rat kidney-derived RT-PCR probe and its complete nucleotide sequence determined. The full-length 1857 bp sequence codes for a protein of 463 amino acid residues with a calculated molecular mass of 51848 Da. Comparison of the deduced amino acid sequence with that of rat preprocathepsin C indicates an 87.5% identity. A multiple alignment of the deduced cathepsin C sequence of 233 residues which, by analogy to other cystein proteinases, corresponds to the mature protein, confirms that human cathepsin C belongs to the papain superfamily.
Amino Acid Sequence↗
General high-performance liquid chromatographic procedures for the rapid screening of natural and synthetic corticosteroids.
A study of a multiple high-performance liquid chromatographic procedure for the separation of 30 different corticosteroids is described. Normal- and reversed-phase general methods operating in a wide polarity range have been developed for the rapid screening of multicomponent mixtures. The complementary application of both normal- and reversed-phase methods could permit clarification of uncertainty deriving from analyses performed by only one method.
Adrenal Cortex Hormones↗
Analysis of [3H]estradiol-17beta metabolites in calf perirenal fat.
Residues of estradiol-17 beta (E2 beta) in the kidney fat of one milk-fed calf were studies using radiometric methodologies. A three-month old Friesian male veal calf was injected intramuscularly daily for 3 d with 333 mg of [6,7(n)-3H]-E2 beta (specific activity: 7.55 MBq mmol-1) dissolved in 2 ml of propylene glycol and slaughtered 3 h after the last administration. Total estrogens were about 280 ng g-1 in perirenal fat. After a de-lipidation step, the relatively polar metabolites that were extractable with dichloromethane represented the main fraction of the metabolites, which accounts for almost 50% of the total radioactivity of the tissue, of which E2 beta was the major metabolite (19.7%) and E1 and E2 alpha represented only 7.7 and 3.2%, respectively. Conjugated estrogens accounted for only 15.2% of the total estrogen content. Non-polar estrogens (about 25% of total estrogens) were removed specifically with isooctane during the de-lipidation step and were further purified on silica and alumina columns before being chromatographed by normal-phase HPLC. The radioactive metabolites were eluted as estrogen-17 esters. The HPLC analysis of the estrogens released following hydrolysis of the esters indicated that E2 beta was the main estrogen acylated by long-chain fatty acids in the fraction of lipoidal estrogens. The presence of such a class of estrogens in fat could be of interest for the detection of estrogens a considerable time after estradiol administration.
Adipose Tissue↗
Occupational paternal exposure to benzene and risk of spontaneous abortion.
OBJECTIVE: The purpose of this study was to evaluate the risk of spontaneous abortion among the wives of male workers occupationally exposed to benzene. METHODS: The wives of 823 men working in two chemical plants at the time of the study were asked to complete a questionnaire describing their pregnancies. The analysis of the 1739 pregnancies that ended in a spontaneous abortion or a birth is presented. The firms' payroll records provided all workers' employment history, including dates. Benzene exposure, graded at two levels (< 5, > or = 5 ppm), was determined for every job, so that benzene exposure for each worker's entire professional life (at these companies) could be assessed. This information was linked to the dates of the pregnancies reported in the questionnaires to enable the exposure status of each pregnancy to be defined (1270 non-exposed and 274 exposed). The frequency of spontaneous abortion, defined as the number of spontaneous abortions divided by the total of spontaneous abortions and births was evaluated. RESULTS: When adjusted for tobacco consumption, mother's age and pregnancy order, the odds ratio of the association between paternal exposure to approximately 5 ppm of benzene and the risk of spontaneous abortion was close to and statistically not different from unity (OR = 1.1; 95% CI (0.7-1.8). CONCLUSION: In this study paternal exposure to benzene did not increase the risk of spontaneous abortion.
Abortion, Spontaneous↗