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Biomedical subjects

B Wallaert

Publications and source records attributed to B Wallaert.

At least 289 records · Page 16Linked to original sources
PubMed1985

Compared evolution of plasma fibronectin and angiotensin-converting enzyme levels in septic ARDS.

Serum angiotensin converting enzyme (serum ACE) levels and plasma fibronectin levels were measured daily in 46 septic patients during a ten day period. Thirty-eight patients developed ARDS; 28 survived (group 1), ten died (group 2), eight patients had no features of ARDS and survived (group 3). Sequential measurements of ACE and fibronectin levels were compared and plotted against indexes of respiratory impairment: PaO2 max Qs/Qt, static compliance and VD/VA ratio. These indexes were taken as criteria of weaning from controlled ventilation. During ARDS (groups 1 and 2), serum ACE levels decreased and were closely correlated with the severity of lung injury. Persistently decreased levels after eight days were consistent with continuing injury or lack of endothelial repair. On the other hand, plasma fibronectin levels increased throughout the study in survivors (group 1 and 3) and decreased in the group with fatal ARDS only (group 2). These results indicate that serum ACE levels might be a good index of endothelial injury and repair during ARDS and fibronectin a better index for evolution of sepsis and vital prognosis.

Fibronectins↗
PubMed1985

Evidence of lymphocyte alveolitis in Crohn's disease.

Cellular characteristics of bronchoalveolar lavage (BAL) were investigated in 18 consecutive patients with Crohn's disease, who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. Total BAL cell count and cellular viability of alveolar macrophages did not differ significantly between patients and control subjects. Percentage of alveolar lymphocytes was increased in 11 of 18 patients (from 18 percent to 79 percent). There was no apparent correlation between BAL differential cell count and abnormal pulmonary function tests noted in 11 patients, drug treatment or Crohn's disease site, and activity. These results demonstrate a high proportion of latent lymphocyte alveolitis as assessed by BAL, suggesting a latent involvement of the lung in Crohn's disease.

Adolescent↗
PubMed1985

Early neutrophil alveolitis after antigen inhalation in hypersensitivity pneumonitis.

Bronchoalveolar lavage (BAL) was carried out before and after antigen inhalation in ten hypersensitivity pneumonitis (HP) and five control subjects. Control subjects did not show any significant variation in BAL cells after challenge with diluted pigeon serum. In HP patients, the total number of BAL cells increased from (41.5 +/- 16.8) X 10(4) cells/ml before challenge to (84.0 +/- 28.9) X 10(4) cells/ml after challenge. Of greater interest, the values of polymorphonuclear neutrophils in patients increased from 8.3 +/- 9.7 percent before challenge to 41.2 +/- 24.35 percent, 24 hours after antigen challenge (p - 0.0001). Another BAL, carried out a week later, recovered a persistently high number of cells, (74.67 +/- 33.36) X 10(4) cells/ml. However, the percentage of polymorphonuclear neutrophils and lymphocytes did not differ from the initial pre-challenge BAL. Our study demonstrates an immediate and transient neutrophil alveolitis after antigen inhalation in patients with acute hypersensitivity pneumonitis.

Adolescent↗
PubMed1985

[The association of asthma and gastroesophageal reflux: strategy of paraclinical studies].

This study was carried out on 104 patients of whom 94 were asthmatic and 10 patients presented with a spasmodic intractable cough; all presented with symptoms evocative of an associated gastro-oesophageal reflux (RGO). The clinical symptoms revealed a nocturnal cough (67%), cough preceeding asthma (46%) and heartburn in 60%. The asthma was severe (type III and IV in 89% of cases), or dependent on corticosteroids (37% of cases). pH monitoring of the oesophagus is the most sensitive examination (88% with positive results) slightly ahead of manometry and scintigraphy (both 81%), these examinations were clearly superior to radiographic examination (49%) and oesophageal fibroscopy (36%). The combination of pH monitoring and of scintigraphy enabled 98% of RGO cases to be identified by their clinical data. Medical treatment with Tagamet, Gaviscon and Primperan (alone or in combination) produced an improvement in the respiratory symptoms in 50% of the cases. Of the 14 surgically treated, 7 obtained an improvement in their respiratory symptoms. Seven of the ten patients with spasmodic cough were improved by medical treatment. Our study shows the frequency of oesophageal reflux in patients with severe asthma. In half of them RGO intervened as an aggravating factor and the medical treatment of RGO led to a clear improvement in the respiratory symptoms.

Adult↗
PubMed1985

[Demonstration of specific platelet function anomaly in asthma induced by aspirin: diagnostic consequences].

Aspirin-sensitive asthma is a common and severe disorder characterized by asthmatic attacks after oral ingestion of cyclooxygenase inhibiting drugs. Yet its pathophysiology remains unknown, and no specific in vitro abnormality, neither humoral nor cellular, has been detected in these patients. We have recently described a new model of platelet activation--IgE-dependent platelet activation--expressed by the release of cytocidal mediators and oxygen metabolites. We have now investigated whether cyclooxygenase inhibitors induce a similar response in platelets from aspirin-sensitive asthmatics in vitro. Aspirin or indomethacin strikingly activated platelets from 12 aspirin-sensitive asthmatics to the same extent as IgE-dependent stimuli, but had no effect on platelets from 18 controls (p less than 0.0001). Sodium salicylate, which does not inhibit cyclooxygenase, did not trigger platelets from aspirin-sensitive asthmatics. Preincubation with sodium salicylate or prostaglandin endoperoxides (PGH2), selectively prevented further platelet activation by aspirin or indomethacin (90% inhibition), suggesting that this abnormal platelet activation is the consequence of cyclooxygenase inhibition. This represents the first identification of a specific abnormal cellular response in aspirin-sensitive asthma, provides the basis for an in vitro diagnostic test of the disease, and for new insights on its pathogenesis and its prevention.

Aspirin↗
PubMed1985

[Value of tracheobronchial endoscopy in facial burns].

41 patients suffering from facial burns had a systematic tracheo-bronchial endoscopy in the 24 hours after admission to hospital. There were 21 cases of explosion (town gas or explosives), 11 burns from flames (petrol) and 9 burns occurring during fires (in houses or cars). 12 patients showed isolated mucosal inflammation, 5 blackish deposits (of impacted soot) and blisters in 6 (with shreds of mucosa hanging loose); the endoscopy was normal in 18; 66% of those with blisters (4 cases out of 6) and 40% with blackened mucosa (2 cases out of 5) were observed in burns from fires. The 18 patients without endobronchial lesions and 12 patients with only mucosal inflammation did not develop respiratory complications; 5 patients presenting with blackish deposits later develop complications and 4 out of 6 patients presenting with extensive blistering died from these respiratory complications. A study of the evolution of the lesions, as far as could be ascertained from several cases enabled the rules of local therapy to be set in such patients: aspiration and unblocking of the airways by repeated aspiration and lavage. In conclusion, the frequency of tracheo-bronchial lesions and their significance when planning therapy and their consequences on the prognosis justify tracheo-bronchial endoscopy to be used routinely in burns to the face.

Bronchoscopy↗
PubMed1983

Angiotensin-converting enzyme in human adult respiratory distress syndrome.

Angiotensin-converting enzyme (ACE) levels, complement activation, and intravascular coagulation were studied in 36 patients with adult respiratory distress syndrome (ARDS) (17 aseptic, 19 septic), in order to investigate the possible interrelations among ACE, immunologic data, and hematologic findings. The severity of respiratory impairment was assessed with measurements of mechanical and gas exchange functional qualities of the lung. Serial measurements of ACE could be done in 14 patients during an eight-day period. During the first 24 hours, ACE levels were always normal (38 percent) or decreased (62 percent). No difference could be found between patients with septic and aseptic ARDS. Complement activation occurred in 78 percent (28/36) and used, in most cases, the classic pathway with presence of circulating immune complexes. Criteria for intravascular coagulation were present in 58 percent (21/36). No relation between coagulation, complement, and ACE could be found except for the patients with a greater respiratory impairment, who had complement activation, intravascular coagulation, and significantly lower ACE levels. In all patients together, ACE levels had no diagnostic value for aseptic cause of ARDS and a poor prognostic value. Only intravascular coagulation was linked with a higher significant mortality and a greater functional impairment. Serial measurements showed a diphasic evolution of ACE levels, with a maximum decrease between the 72nd and 96th hours and a further normalization (seventh day). The persistence of low levels seemed to be associated with evolutive sepsis or secondary aggravation and fibrosis.

Adolescent↗
PubMed1983

[Bronchoalveolar lavage in pneumoconiosis of coal miners. Cytologic aspects].

The cytological characteristics of broncho-alveolar fluid were studied in 94 coal workers and six subjects exposed to varied risks of silicosis. In coal worker's pneumoconiosis with the usual micronodular or nodular type, there was a significant increase in the cellularity of the peripheral airways compared to non-exposed controls, making allowances for smoking habits. There were no striking changes in the white cell count nor any correlation with the possible elevation in the serum angiotensin I-enzyme conversion level. On the other hand a striking elevation of the alveolar lymphocyte count was noted in three cases with rapidly developing silicosis. Where there was the co-existence of another disorder (connective tissue disorders, sarcoid, extrinsic allergic alveolitis, radiation lung or diffuse interstitial fibrosis) the anomalies noted were those occurring during the progress of the associated disease. At the time of collection the alveolar macrophages in the dust exposed subjects showed a similar vitality to these observed in control subjects. After 24 hours of observation " in vitro ", the vitality of the cells and their phagocytic and bactericidal activity was markedly diminished.

Adult↗
PubMed1983

[Allergic bronchopulmonary aspergillosis. Apropos of 30 cases].

Thirty cases of allergic bronchopulmonary aspergillosis (ABPA) were treated between 1967 and 1981. Developing in patients with a history of chronic asthma (28 of the 30 cases), the initial manifestations of ABPA developed after long periods (an average of 29 years after the onset of the asthma). Chest radiography demonstrated recurrent labile infiltrates in 28 cases, segmental or lobar atelectasis in 7, and proximal bronchiectasis in 16 cases. A circulating eosinophilia was a constant finding, but this varied with time. Immunologic investigations gave positive skin tests, 19 of the 30 patients only presenting a cutaneous reaction delayed until the 6th hour. Total IgE, determined in 18 cases, varied between 600 and 9400 IU/ml (RIST), with identification of specific IgE for Aspergillus in all cases, though to varying degrees. Serial measurements of total IgE levels showed co-existence of an acute progression of the affection and elevated total IgE in 3 cases, but no correlation was found between serum IgE levels and the severity or chronicity of the disease. Physiopathologic features included immediate and partially delayed hypersensitivity to Aspergillus fumigatus. The frequency of ABPA during the course of mucoviscidosis suggests, by analogy, that a local factor may exist which favorizes Aspergillus fumigatus proliferation in patients with ABPA alone.

Adolescent↗
PubMed1983

[Nonsurgical treatment of pulmonary arteriovenous aneurysms].

Four patients with single or multiple pulmonary arteriovenous aneurysms, including three with Rendu-Osler's disease, were treated by occlusion with metallic spirals of the supplying pedicles during angiography. Results are compared with those of 16 cases treated by the same method and reported in the literature. The technique and its therapeutic indications are discussed based on these 20 cases and a review of documented data concerning 502 other cases with these aneurysms.

Angiography↗
PubMed1982

Bronchoalveolar lavage, serum angiotensin-converting enzyme, and gallium-67 scanning in extrathoracic sarcoidosis.

Results of bronchoalveolar lavage (BAL), 67Ga scanning, and serum angiotensin-converting enzyme (SACE) assay are compared in the assessment of pulmonary involvement in ten cases of extrathoracic sarcoidosis. Standard clinical, radiologic, and pulmonary function tests detected no pulmonary changes in these patients, but BAL demonstrated an increased alveolar lymphocytosis in eight of ten cases. SACE levels were increased in two cases, and the thoracic gallium uptake was normal in all cases. BAL appears to be the best technique for diagnosing latent pulmonary involvement in extrathoracic sarcoidosis.

Bronchi↗
PubMed1982

[Cell populations recovered by bronchoalveolar lavage in pneumoconiosis of coal miners].

Studying the cellular products obtained by broncho-alveolar lavage in 81 patients, 77 coal-miners and 4 other subjects exposed to silicotic risks of various origin, the authors could demonstrate the interest of this new method of exploring the peripheral lung tissues. In 57 cases of usual pneumoconiosis and controls matched for the smoking habits, the repartition of the different cellular types was quite similar. On the contrary, the authors observed an increase of the lymphocytes in three cases of accelerated elution of the pneumoconiosis. Moreover various modifications were noticed in cases with morbid associations as conectivitis, sarcoïdosis, allergic alveolitis, and primitive diffuse interstitial fibrosis as well. At the moment they were collected, the alveolar macrophages of the subjects to dust showed the same properties of vitality and adherence capacity as the controls. After 24 hours of survival their vitality and bacterial activity on staphylococcus aureus was clearly diminished.

Adult↗
PubMedDate not supplied

Nickel hydroxy carbonate increases tumour necrosis factor alpha and interleukin 6 secretion by alveolar macrophages.

The aim of the current study was to assess the in vitro effects of nickel hydroxy carbonate (NiHC) at noncytotoxic concentrations on the production of cytokines such as tumour necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) in alveolar macrophages (AMs). The effect of NiHC was evaluated in both unstimulated AMs and cells activated by lipopolysaccharide (LPS). Cytotoxicity was related to lactate dehydrogenase release and ATP cell content. The results confirm that NiHC at concentrations of 0.125, 1.25 and 3.125 micrograms NiHC 10(-6) cells was not cytotoxic. The NiHC exposure of unstimulated AMs significantly increased the release of TNF-alpha at all concentrations and that of IL-6 at 1.25 micrograms NiHC 10(-6) cells. LPS addition significantly increased the secretion of both cytokines. However, NiHC did not cause a significant increase in the release of TNF-alpha and IL-6 in LPS-stimulated cells. In conclusion, the ability of NiHC to activate AMs and to release increased amounts of pro-inflammatory mediators may be responsible, at least partly, for inflammation and pneumotoxicity associated with nickel exposure.

Adenosine Triphosphate↗