Biomedical subjects
Publications and source records attributed to C Brunet.
The authors report a case of Hodgkin's disease associated with pulmonary and mediastinal sarcoidosis, and they recall the frequency of sarcoid reactions in lymphoma, notably in Hodgkin's disease. The Hodgkin's disease-sarcoidosis association is much less common and sometimes raises difficult diagnostic problems. The physiopathological mechanisms that are possibly involved are analyzed.
Polymorphonuclear neutrophils are the predominant cells in acute inflammatory lesions and their functions and recruitment are regulated by cytokines, including IL1, TNF and IL8. Antibiotic modulation of inflammatory effects has stimulated investigations of antibiotics for their potential activity as immunomodulators over their primary bactericidal or bacteriostatic activities. This study reports the influence of macrolides, spiramycin and dirithromycin on IL1 beta production. Mononuclear cells, isolated from healthy human volunteers, were preincubated with macrolides (0.1 to 500 micrograms/ml) and stimulated by Escherichia coli lipopolysaccharide. Then, IL1 beta production was detected by western blotting analysis. At therapeutic concentrations, dirithromycin and spiramycin seemed to enhance IL1 beta production by LPS-stimulated cells, with +37 per cent and +28 per cent at 1 microgram/ml respectively. At supratherapeutic concentrations, these drugs seemed to inhibit IL1 beta production through protein kinase C inhibition, with inhibitory concentrations 50 per cent of 378 micrograms/ml for dirithromycin and 234 micrograms/ml for spiramycin. So, macrolides may modulate the host defence system through their influence on cytokine production.
The stability and compatibility of 5-fluorouracil (5-FU) in admixtures for continuous intravenous infusion using PVC bags and administration sets were studied. 5-fluorouracil was reconstituted and diluted to 1.8 mg/ml for infusion in polyvinyl chloride and glass containers, and to 1 mg/ml to 16 mg/ml for storage in polyvinyl chloride bags containing 5 per cent dextrose or 0.9 per cent sodium chloride injections. Admixtures were stored at +4 degrees C and with protection from light, for 7 days. Analyses were performed by HPLC. No significant drug loss was observed during simulated infusions using PVC infusion bags and administration sets vs glass bottles and administration sets, over an infusion period used in hospitals (24 h). The solution stored at +4 degrees C with protection from light in PVC bags showed that at 1 mg/ml to 16 mg/ml, 5-fluorouracil was stable at least for 7 days in 0.9 per cent sodium chloride and 5 per cent dextrose.
Glutamate, aspartate and possibly other excitatory acidic amino acids are thought to be, neurotransmitters at the majority of excitatory synapses in the vertebrate CSN. The synaptic response elicited by excitatory amino acids is mediated by at least four (probably five) different receptor subtypes. These were known as the N-methyl-D-aspartate, quisqualate, kainate and L-AP4 receptor subtypes. More recently a fifth receptor subtype has been discovered that is linked to phosphoinositol metabolism. The most well characterized excitatory amino acid receptor subtype is the NMDA receptor. This receptor consists of a recognition site for NMDA, a cation-selective ion channel and binding site for glycine, Zn2+ and phencyclidine-like compounds. In addition the channel can be blocked by Mg2+. New and selective ligands and radioligands have facilitated mapping the distribution of the major excitatory receptor subtypes in normal and diseased brain, examines allosteric interactions within the NMDA receptor, searching for novel therapeutic agents and determining drugs mechanisms.
Tough less frequent that small bowel lesions, injuries and contusions of the colon rank second among the lesions sustained by hollow organs. They can be differentiated into contusions due to pressure in persons with multiple injuries, and penetrating wounds caused by blades or firearms. Although the latter involve multiple sites, they are most often clearly delineated and can be immediately and completely repaired, whereas contusions account for more severe parietal lesions, which sometimes require temporary bypass. The poor reliability of plain radiographs enables clinical investigations to recover an importance they seemed to have lost. Mortality has become very low in younger subjects, but it remains high after 60 years of age, and depends directly on the extent of peritoneal sepsis and on the associated deficiencies.
Several acid and closely related non acid derivatives of 2-phenylthio- and 4-phenylthio-N-acyl phenylamines have been synthesized and tested in vivo, on the carrageenan RFE assay, and in vitro, on prostaglandin synthesis inhibition assay. Compound (XV c), bearing a propanoic acid substituent together with a p-chlorobenzoyl group situated on nitrogen atom in the 2-position, showed a 79% edema reduction (300 mg/kg p.o.) 6 hours after carrageenan injection, but no activity in vitro. The benzyl alcohols (XIV m) and (XIV n), on the contrary, inhibited PG synthesis; their lack of activity in vivo could be interpreted as the result of their oxidation to the inactive benzoic acids (XIV g) and (XIV h).
A normal infant was born to a 25 year-old mother with phenylketonuria who had never been treated. The mother had been fed a phenylalanine restricted diet for 3 months before the beginning of the pregnancy. Dietary control was maintained throughout the whole gestation. The problems of dietary control in a mentally retarded woman are analysed.
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In 1989, we reported our thoughts on the neurophysiological and anatomic aspects of pudendal nerve involvement in certain types of perinal pain. Since that time, the surgical approach has been modified. Here we report our follow-up of 40 patients with 48 operated nerves. Follow-up ranged from 6 months to 7 years and outcome revealed improvement in 67% and no change in 33%. Thus surgery had been useful in two-thirds of the cases; in 44% of the patients, there was either a frank improvement or no change. Early diagnosis appears to be the determining factor in improving results. Operating for the canal syndrome must be performed before lesions to the nervous trunk become too important.
Up til recently, thoracoscopy was essentially performed for diagnostic purposes, allowing biopsies of the pleura or peripheral lesions of the lung tissue. Indications with a therapeutic objective were less frequent, usually in cases of recurrent pneumothorax. The recent development of less aggressive, more surgical instruments has virtually "forced" the surgeon to use the thoracoscope. Video thoracoscopy surgery thus entered the therapeutic armenatum. Small access channels less than a centimeter in diameter are used for videothoracoscopy giving an indirect view on the screed of the thoracic contents. Under these conditions, thoracoscopic procedures are possible to treat pneumothorax and resect small pleural or parenchymatous tumours. Inversely, gross resections (lobectomy, pneumonectomy) are technically more complex and raise the nearly unsolvable problem of removing the surgical specimen. In fact, a mini-thoracotomy has been required in many cases, leading to the development of video-assisted thoracic surgery. This new surgical technique is performed via a small incision and is guided by optic probes connected to the video screen. The surgeon can thus follow the entire operation both directly via the mini-thoracotomy and indirectly on the screen. This new approach is an interesting compromise between conventional thoracic surgery and videothoracoscopy.
Based on a computer assisted analysis of the anatomic and biomechanic features of 200 subjects, the authors propose a dynamic approach to the exploration of the cervico-thoraco-brachial pathway. Results are given for 70 healthy and diseased subjects. Ultrasonic evaluations of the arterial component, dynamic echography of the axillo-subclavian venous component, electrophysiology including conventional electromyography, somesthesic and motor evoked potentials, and advanced imagery provide a panel of complementary diagnostic techniques.
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A radioreceptor assay (RRA) was developed to determine plasma levels of amisulpride. In in vitro binding conditions, the RRA technique was sensitive (11.6 nmol/l) and reliable, with a high degree of precision. The reproducibility of the method through statistical coefficients was < 7%. This method was applied to a pilot pharmacokinetic study in rabbits following single i.v. administration of amisulpride at 10 mg/kg. The results obtained were compared with those obtained by high performance liquid chromatography method (HPLC) in order to assess the validity of this new RRA technique.
Among reactive oxygen species generated by human neutrophils during inflammatory disorders, hypochlorous acid and hydroxyl radical are especially involved in many diseases such as arteriosclerosis or emphysema. It was shown in vitro that two thiol-containing drugs, mesna and N-acetylcysteine, have antioxidant properties towards these oxidants. The 50% inhibitory concentrations (IC50s) of mesna and N-acetylcysteine for hypochlorous acid production by stimulated neutrophils were 29 and 30 mcM, respectively, and for hydroxyl radical production, IC50s were 520 and 480 mcM, respectively. With this in vitro demonstrated effectiveness, both mesna and N-acetylcysteine have been considered as therapeutic antioxidants to decrease tissue damage inflicted by an excess of activated neutrophils by scavenging hypochlorous acid and hydroxyl radical.
From September 1989 to September 1994, 65 patients, 15 females and 50 males, with a mean age of 32 +/- 14 years were admitted in the emergency unit for renal trauma. In 38.5% of cases multiple trauma was present. Lesional mechanism was most frequently contusions (49.2%) and deceleration injuries (43.1%). Gross hematuria or microscopic hematuria were presents in 72.3% of cases. The sensibility of systematic abdominal echography was 100% in case of perirenal hematoma and 65% in case of parenchymatous lesions. Only 23 patients were operated (35.3%) because of low blood pressure. None secondary operation was necessary in abstention group. Global mortality was 7.7%. Postoperative morbidity was 20% and specific morbidity in abstention group was 10.7%.