Electron acceleration in Nd-laser plasma beat-wave experiments.
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Journal Article↗
Biomedical subjects
D Bernard
Publications and source records attributed to D Bernard.
Anergy induction in encephalitogenic T cells by brain microvessel endothelial cells is inhibited by interleukin-1.
Experimental autoimmune encephalomyelitis (EAE) is an inflammatory disease of the central nervous system (CNS) which can be induced, in susceptible strains like Lewis rats, by transfer of activated myelin basic protein (MBP)-specific CD4+ T lymphocytes. The role of cerebral endothelium in the onset of EAE, with regard to adhesion, activation and infiltration in the CNS of encephalitogenic T lymphocytes, is not fully understood. When pretreated by interferon-gamma, the immortalized Lewis rat brain microvessel endothelial (RBE4) cells expressed major histocompatibility complex class II molecules and stimulated MBP-specific proliferation and cytolytic activity of the syngeneic encephalitogenic T cell line, designated PAS. However, RBE4-stimulated PAS lymphocytes subsequently entered an unresponsive state, known as anergy. When inoculated in syngeneic animals, anergic PAS cells, although still cytotoxic, failed to induce EAE, and no cell infiltration was detectable within CNS. The addition of interleukin-1 beta (IL-1 beta) during MBP presentation by RBE4 cells prevented T cell anergy induction, and maintained T cell encephalitogenicity, although PAS cells stimulated in these conditions caused delayed and attenuated clinical signs of EAE, with only discrete inflammatory lesions in the CNS, compared with EAE induced by PAS cells fully activated by thymic cells. Altogether, our results indicate that MBP presentation by brain microvessel endothelial cells to encephalitogenic T cells induces T cell anergy and loss of pathogenicity. In addition, IL-1 beta co-stimulation of T cells prevents anergy induction in vitro and at least partially maintains encephalitogenicity in vivo.
Animals↗
Treatment of malnourished CAPD patients with an amino acid based dialysate.
Nineteen malnourished chronic peritoneal dialysis patients who were ingesting a low protein intake underwent metabolic balance studies to test whether a dialysate that contained amino acids would improve their protein nutrition. Patients lived in the hospital for 35 days while they ate a constant diet and underwent their usual regimen of continuous ambulatory peritoneal dialysis (CAPD). The first 15 days served as a Baseline Phase. For the last 20 days, the usual dialysate was substituted with a dialysate of essentially the same composition except that it contained 1.1% essential and nonessential amino acids and no glucose. Patients received one or two dialysate exchanges with amino acids each day depending on the amount necessary to bring the individual's dietary protein plus dialysate amino acid intake to 1.1 to 1.3 g/kg body weight/day. During Baseline, patients were in neutral nitrogen balance; net protein anabolism was positive, as determined from 15N-glycine studies. After commencing intraperitoneal amino acid therapy, nitrogen balance became significantly positive, there was a significant increase in net protein anabolism, the fasting morning plasma amino acid pattern became more normal, and serum total protein and transferrin concentrations rose. Patients generally tolerated the treatment well, although some patients developed mild metabolic acidemia. These findings indicate that a dialysate containing amino acids may improve protein malnutrition in CAPD patients ingesting low protein intakes.
Acidosis↗
Antiphospholipids in hemodialysis patients: relationship between lupus anticoagulant and thrombosis.
Vascular access thrombosis (VAT) is frequent in some hemodialysis patients. Antiphospholipid antibodies (APL) have been involved in thrombosis, and have been reported to be present in a high proportion of patients with chronic renal failure. We studied the relationship between APL and thrombosis in 97 hemodialysis patients (HD). Lupus anticoagulant (LA) was assessed by activated partial thromboplastin time (APTT) and by tissue thromboplastin inhibition assay (TTI). IgG-anticardiolipin (ACA) was measured by a solid phase ELISA. The prevalence of APL was 31%; LA was found in 16.5% and was detected in all cases by TTI. Only one patient was positive for APTT. ACA was found in 15.5%. Only one patient was positive for LA and ACA. We found no relation between APL and age, length of time on dialysis, sex, type of dialysis membrane, drugs, and chronic B and C hepatitis. A high prevalence of APL was found in patients with undetermined nephropathy. When histories of thrombosis were examined, VAT was found to be significantly more frequent in patients with LA than in patients without LA (62% vs. 26%; P = 0.01). This relation was not present with ACA. Since VAT is one of the most frequent causes of morbidity for HD, diagnostic evaluation of VAT in HD should now include assay for LA.
Adult↗
Flow cytometry analysis of dual red blood cell populations after bone marrow transplantation.
Flow cytometry represents an alternative method to agglutination assays for the accurate quantification of mixed field populations of erythrocytes observed after bone marrow transplantation. Murine monoclonal antibodies directed against the blood group ABH antigens were selected and processed in order to prepare ready-to-use fluorescent reagents. Anti-A (NaM87-1F6; IgG3), anti-B (NaM9-2E11; IgG3) and anti-H (NaM19-7E11; IgM) were purified, labelled with fluorescein isothiocyanate, and used in a direct flow cytometry assay. Anti-A1 (NaM1-1C9; IgG3) was no longer active after FITC-labelling and then was used in an indirect assay. The agglutination was prevented by formaldehyde pretreatment of erythrocytes. Using artificially-made double populations of erythrocytes, measured values with mixtures of 1-100% of cells were very closely related to expected values, showing both the sensitivity and the accuracy of the method. From careful investigation of a series of bone-marrow transplanted patients, we conclude that engraftments could be demonstrated earlier by flow cytometry than by agglutination, because minor populations (1-10%) of cells could be determined accurately only with labelled reagents. In addition, the disappearance of the donor cells on a long-term follow-up of patients enabled an earlier detection of graft failure in one case. The proposed method provides appreciable help to follow engraftment in patients and may have more general applications for the study of other haemopoietic chimaeras.
ABO Blood-Group System↗
Late-onset seizures in alcohol withdrawal.
PURPOSE: To describe the clinical characteristics of alcohol withdrawal seizures in patients treated with a standardized protocol of short-acting benzodiazepines. METHODS: Grand mal seizures were prospectively identified in a cohort of 1044 patients consecutively admitted to an inpatient alcohol detoxification unit at a Veterans Affairs Medical Center. All patients received a 72-hr structured taper of oxazepam with additional oxazepam given without limit in amount and duration in response to alcohol withdrawal symptoms. RESULTS: Eleven seizures occurred for an overall rate of 1.1%. All were single grand mal seizures. Seizures occurred from 52 to 306 hr after admission, with a mean of 122 hr (5 days). A consistent relationship between the seizures and the cessation of oxazepam was noted, with peak incidence occurring 12-48 hr after the last oxazepam dose. In no case did recurrent withdrawal symptoms or delirium tremens develop after the seizure. Patients with seizures were slightly older, more likely to have had withdrawal seizures before (50% vs. 13%, p = 0.03), and had a more severe withdrawal course than controls. CONCLUSIONS: Seizures continued to occur at a low but measurable rate in alcohol withdrawal treated with a short-acting benzodiazepine. Clinical characteristics of the seizures are different from that classically described in untreated patients, with the seizures being closely related to the cessation of oxazepam rather than the cessation of alcohol.
Adult↗
[Dilatation enteroplasty for obstructive Crohn disease. Experience of the University of Montreal].
Multiple small bowel resections for obstructive symptoms caused by Crohn's disease can lead to a short bowel and malabsorption. Preservation of intestinal length is possible by the use of strictureplasty. Between August 1983 and March 1993, ninety strictureplasties were performed in 25 patients. They were 13 males and 12 females with a mean age of 37 years. Fourteen (56%) previously had small bowel resection for Crohn's disease. A mean number of 4.3 strictureplasties per patient were performed. Concomitant resection of bowel with active disease was performed in 18 patients (72%). In this series, no perioperative death occurred and one patient developed an enterocutaneous fistula. The overall complication rate was 8%. Postoperatively, 18 patients (72%) were completely relieved of symptoms, 6 were improved (24%) and one became worst (4%). After a 27 month follow-up period, the symptoms recurred in 13 patients (52%); three had no treatment, 7 had medical treatment and 3 required reoperation (12%). Our results support the safety and the use of strictureplasty for stenotic bowel lesions associated with Crohn's disease.
Adult↗
Meltspun cellulose diacetate and polysulfone membranes have the same effect on complement activation and expression of leukocyte adhesion molecules and complement receptors.
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Adult↗
Serum levels of interleukin 1-beta, tumor necrosis factor-alpha, soluble interleukin 2 receptor and soluble CD8 in seronegative spondylarthropathies.
Seronegative spondylarthropathies are disorders with the same predisposing antigen, namely HLA B27, a class I molecule of the HLA system. The mechanisms of the different diseases are unknown, and there is no proof of immune system participation. We have investigated patients with spondylarthropathies in order to search for an immunological component in the pathophysiology of these disorders, by measuring the serum level of two inflammatory cytokines--IL1 beta and TNF alpha--by a radioimmunological assay and the serum level of two soluble T cell activation markers--soluble IL2 receptor and soluble CD8--by an enzyme-linked immunosorbent assay. The choice of soluble CD8 can be explained by the strong link between HLA B27 and spondylarthropathies. Our series compared 24 patients to 24 healthy matched controls. A similar IL1 beta serum level was observed in both groups, while in the patients there was a nonsignificant increase in the TNF alpha level, a significant decrease in the soluble IL2 receptor level and a significant increase in the soluble CD8 serum level. The normal or moderately increased serum IL1 beta and TNF alpha levels in the disease group do not exclude a local role for these cytokines in the synovium or other inflammatory areas. However, we found a higher soluble CD8 serum level in the patient group. Most of these patients were in clinical exacerbation of their disease. As the serum level of soluble CD8 is well correlated with T CD8 lymphocyte activation, our data suggest that this lymphocyte subset is stimulated and consequently probably involved in seronegative spondylarthropathies.
Adult↗
Regulation of experimental autoimmune encephalomyelitis: inhibition of adoptive experimental autoimmune encephalomyelitis by 'recovery-associated suppressor cells'.
We have previously shown the presence of suppressor cells in Lewis rats at the time of spontaneous recovery from experimental autoimmune encephalomyelitis (EAE). These cells, called 'recovery-associated suppressor cells' (RASC), are capable of preventing active EAE and inhibiting in vitro the specific proliferative response of encephalitogenic anti-MBP T cell line cells. The present investigations were undertaken in order to lend support to the hypothesis that RASC play an active role in the recovery. We found that RASC can prevent adoptive EAE when admixed with already activated, but not resting, anti-MBP T cells or when injected into the recipients separately from the encephalitogenic cells. They can also arrest the course of an ongoing disease when injected after the beginning of the clinical signs. This study provides the first direct demonstration of the downregulation of an ongoing EAE by suppressor cells.
Animals↗
Preliminary observations of metabolic characterization of bilateral temporal epileptic focus, using proton magnetic resonance spectroscopy. Three cases.
The authors report the case of 3 patients with bilateral temporal lobe epilepsy demonstrated by EEG and sphenoïdal electrodes. Two out of the 3 patients presented with childhood febrile convulsions. Their neurological and mental examination was normal. EEG showed spikes within the anterior part of the 2 temporal lobes. CT scan and MRI showed no atrophic lesion within the 2 temporal lobes. Proton magnetic resonance spectroscopy, performed within a cube of 8 cube-centimetres localized in the anterior part of the 2 temporal lobes showed a significant decrease of N-acetyl-aspartate in the 2 temporal lobes of the 3 cases, compared with controls matched with age, sex and laterality. Because N-acetyl-aspartate is a marker of the neuronal cells, the decreased level of NAA in the temporal area with spikes, may be related to a decreased number of neuronal cells, developing an abnormal tendency to seizures.
Adolescent↗
Bilophila wadsworthia bacteremia in a patient with gangrenous appendicitis.
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Appendicitis↗
Studies of IgG-class anticardiolipin antibodies in myasthenia gravis.
IgG-class anticardiolipin antibodies (IgG-ACA) were found in 25% of patients with myasthenia gravis. The prevalence and the level distribution were significantly different from those of a normal donor population (p < 0.001). In myastenic patients, IgG-ACA bound negatively charged, but not zwitterionic, phospholipids. They were significantly associated with the thymic abnormalities, thymoma and thymic hyperplasia, but not with various factors such as age, sex, antinuclear antibodies, severity of the disease and clinical thrombosis. The IgG-ACA levels did not correlate with titers of anti-acetylcholine receptor antibodies. Thus in Myasthenia Gravis, asymptomatic IgG-ACA could reflect an immune dysregulation under the influence of thymic alterations.
Adolescent↗
[Contribution of L lactate and amino-acid enzymatic biosensors for the analysis of Frey syndrome].
Twelve patients with Frey's syndrome after total parotidectomy for plemorphic adenoma were analysed using simultaneously 2 biosensors. Biosensors allowed for detection of L lactate and amino acid level on intact skin. The assay procedure and the results achieved with the simultaneous use of these 2 biosensors are presented. The L lactate biosensor appears to be an interesting tool for Frey's syndrome analysis. The sensibility of the amino acid biosensor is not sufficient enough to allow its use at time of Frey's syndrome analysis.
Amino Acids↗
[Autoimmune paraneoplastic cerebellar degeneration].
Paraneoplastic cerebellar degeneration is a well-defined clinical entity typically associated with ovarian or breast carcinoma. Serum or CSF of these patients has been shown to contain autoantibodies against the cytoplasm of Purkinje cells. These antibodies have been referred to as anti-Yo. We report the case of a 67-year old woman with ovarian adenocarcinoma presenting with subacute cerebellar dysfunction. Her serum was found to react with the cytoplasm of Purkinje cells and HeLa cells. On Western blot analysis a 60 to 70 kD reaction was obtained. This suggests the presence of a classical anti-Yo antibody.
Adenocarcinoma↗
[Results of anal sphincteroplasty for post-traumatic incontinence: with or without colostomy].
Surgical repair of the anal sphincters after previous trauma is generally successful. In earlier publications, a protective colostomy was recommended but in most recent series colostomy is omitted. We have been through both phases and this is the first comparative study done on 82 consecutive repairs: 45 with colostomy from 1977 to 1986 (Group I) and 37 without colostomy from 1986 to 1992 (Group II). Causes of trauma were obstetrical: 50, surgical: 24 and violence: 5. Apart from colostomy related morbidity, postoperative complication rates were similar in the two groups. Results were graded excellent, good, fair or poor according to continence to solids, to liquids and soiling. Good and excellent results were obtained in 82% (Group I) and 87% (Group II) after a mean follow-up duration of 42 and 23 months respectively. Furthermore there was no difference between Group I and II in the rate of good/excellent results for cases who had undergone prior repairs (98% v. 100%) and also when the duration of incontinence was more than 10 years (71% v. 83%). We conclude that colostomy is not a determinant factor in the outcome and is therefore not required, avoiding all colostomy related morbidity and disability.
Anal Canal↗
Trial of intravesical versus extravesical ureteroneocystostomy in renal transplant recipients.
We carried out a trial to evaluate the complication rate of intravesical (LP) versus extravesical (Lich) ureteroneocystostomy in recipients of renal transplantation. Ureteric stenosis was the predominant complication in the LP technique, which was more difficult to correct. Complications by the Lich technique were urinary leaks, which were managed successfully by prolonged bladder drainage. We conclude that the Lich technique is simpler to perform and avoids the complication of ureteric stenosis, and should therefore be the procedure of choice for ureteric implantation in recipients of renal transplants.
Adult↗
[Criteria of genetic predisposition to hereditary non polyposis colorectal cancers].
Clinical and histological characteristics of non polypoid colorectal cancers with an hereditary predisposition are presented. The various known genetic syndromes (hereditary non polyposis colorectal cancers, Lynch syndrome type I and type II, Torre-Muir's syndrome, hereditary flat adenoma syndrome) are discussed to find a possible correlation between this nosological classification and their molecular substratum. The main problem today, is to correctly define the population of hereditary predisposed patients to colon cancer, in order to seek and identify the major responsible gene. Any physician, specialist or not, should be encouraged to give the details of the cancer familial context of his patients, in order to aid the oncologist geneticist in his task.
Adult↗