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Biomedical subjects

F Bernard

Publications and source records attributed to F Bernard.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Improving tissue perfusion without invasive monitoring. Apropos of a case].

A case is reported of a 64 year old patient who suffered a septic shock after surgical treatment of a biliary peritonitis. Increasing myocardial contractility and aortic blood flow by dobutamine appeared ineffective; added norepinephrine infusion improved the peripheral perfusion. This clinical improvement in tissue perfusion was evaluated by non-invasive continuous monitoring of the haemodynamic profile, combining aortic blood flow measurement by a transoesophageal echo-Doppler and continuous measurement of end-tidal carbon dioxide.

Carbon Dioxide↗
PubMed1995

[Tumoral sarcoidosis].

INTRODUCTION: We report here an unusual tumoral form of cutaneous sarcoidosis which lead to diagnostical difficulties. CASE REPORT: A 56 year-old woman was hospitalized for a large lumbo-sacral tumor which size had rapidly increased. The tumor was purplish-red, firm, measured 10 x 20 cm and the patient was unable to sit normally. The biopsies demonstrated a dermohypodermal epithelioid and giant cell granuloma without necrosis. We ruled out an infectious granuloma and a foreign body granuloma. There were no extra-cutaneous localizations. This sarcoidal tumor cured with systemic corticosteroids. DISCUSSION: Tumoral cutaneous forms of sarcoidosis are uncommon; 3 other cases of the literature are reported. Before to state positively this forms it is obligatory to rule out all the other aetiologies of sarcoidal granuloma. The existence of extra-cutaneous localizations and multiple skin localizations is helpful to diagnose this uncommon type of sarcoidosis.

Diagnosis, Differential↗
PubMed1994

Toxoplasma gondii oral infection induces specific cytotoxic CD8 alpha/beta+ Thy-1+ gut intraepithelial lymphocytes, lytic for parasite-infected enterocytes.

The first line of defense of the host after primary infection by Toxoplasma gondii is the intestinal mucosal surface, which consists of epithelial cells, intraepithelial lymphocytes (IEL) (mainly of CD8 phenotype), mucus, and secretory Igs. T. gondii cysts were administered orally to CBA/J mice to determine whether parasite-specific cytotoxic IEL can be elicited within the intestine. We found that oral infection led to an increase in the relative percentages of the CD8 beta + and Thy-1+ IEL populations between day 9 and day 13 after infection. At these times, T. gondii-primed, but not control mice, generated parasite-specific cytotoxic effector IEL for toxoplasma-infected macrophages. This cytotoxic activity was genetically restricted. By using magnetically activated cell sorting, the effector IEL were shown to be CD8 alpha/beta + Thy-1+ T lymphocytes and FACScan analysis revealed that they mainly express TCR-alpha beta. A significant level of cytotoxicity was also observed against T. gondii-infected epithelial cells from the MODE-K cell line, suggesting that parasite-specific IEL may ensure epithelial integrity by rapidly killing infected enterocytes. Finally, toxoplasma stimulation in vitro led to IFN-gamma production by T. gondii-primed IEL. Taken together, these data suggest that antigen-specific IEL, bearing the CD8 alpha/beta + Thy-1+, TCR-alpha beta + phenotype, can act directly as effector cells through a specific CTL activity at the intestinal level and may indirectly activate other mucosal effector mechanisms through IFN-gamma secretion.

Administration, Oral↗
PubMed1994

Role of H-2 and non-H-2-related genes in mouse susceptibility to Chlamydia psittaci.

The genetic control of mouse susceptibility to Chlamydia psittaci was investigated after intravenous inoculation of 2 x 10(5) plaque-forming units (pfu). Splenic counts 6 days after inoculation gave the level of susceptibility. Results from inoculation of mice from H-2 congenic strains with three different genetic backgrounds (B10, BALB and C3H) suggested that both the non-H-2 genes and the genes of H-2 complex or those closely associated with it, were responsible for the observed differences in the innate capacity of various inbred lines of mice to control bacterial load in their infected organs following a challenge with C. psittaci.

Animals↗
PubMed1994

Prognostic significance of early cardiac index measurements in severely burned patients.

Invasive monitoring during early resuscitation was performed. To compare the heamodynamic results of severely burned patients, the results of 38 patients hospitalized between 1988 and 1991 in the burn centre of Lyon were retrospectively reviewed. Survivors and non-Survivors' data were compared. No difference existed between the two groups in age, unit burn score, fluid requirement and dose of dobutamine. Survivors had a significantly higher cardiac index, O2 delivery and systolic blood pressure index than non-survivors. It is suggested that the ability to sustain a high cardiac index in response to the burn injury plays a role in the outcome of the patients. There is an indication that dobutamine could have a beneficial effect in this way. Further studies are needed to confirm the benefit of the maintenance of high cardiac index levels by the pressors.

Adult↗
PubMed1994

[Preoxygenation before induction for cesarean section].

In pregnant women at term, the oxygen reserve is decreased while the oxygen consumption is increased, carrying the risk of hypoxaemia during periods of apnea. Moreover, intubation of the trachea can be difficult. Therefore preoxygenation is of particular importance. The conventional method of preoxygenation consists in a 3-5 min breathing of 100% O2. However, in some obstetric emergencies, there may not be an adequate delay of time available for this technique. Recently, 4 maximally deep inspirations were demonstrated to be as effective as a 5-min inhalation of 100% O2 for preoxygenation. To determine whether these two techniques were equivalent before induction of a general anaesthesia for Caesarean section, 27 pregnant women at term (ASA 1 or 2) were studied. Following premedication with atropin sulfate (0.5 mg), the patients were randomly allocated into two groups. Group A (n = 12) was denitrogenated with 100% O2 for 4 min and group B (n = 15) with 4 maximally deep inspirations of 100% O2 within 30 s. Oxygen was administered at a flow rate of 10 L.min-1 via a non rebreathing anaesthesia system and a tight fitting face mask. Arterial saturation was assessed by pulse oximetry. General anaesthesia was induced with thiopentone (7 mg.kg-1) and succinylcholine (1.5 mg.kg-1). The trachea was intubated without previous ventilation and the delay required for the SpO2 to decrease to 93% was measured. This time was 137.9 +/- 79.2 s (extremes 85-320) in group A and 144.5 +/- 57.3 s (extremes 60-285) in group B respectively. These times were not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Glucose, galactose, and glutamine metabolism in pig isolated enterocytes during development.

In the pig, the gastrointestinal tract grows rapidly after birth and undergoes a short postnatal maturation. The objective of the present work was to assess the metabolic characteristics of the small intestinal mucosa during this period by investigating glucose, galactose, and glutamine metabolism in pig isolated enterocytes. Piglets were used immediately after birth or at various stages during suckling or postweaning. Fed animals were taken in a postabsorptive state. The jejunoileum was excised and perfused with an EDTA (5 mM)-containing buffer. The epithelial cell layer was further dissociated in the presence of hyaluronidase (0.01%). The resulting cell suspension (95% absorbing enterocytes; viability greater than 90%) was incubated with 14C-labeled substrates to measure 14CO2 production in parallel with substrate disappearance. The capacity to utilize glutamine was high and remained steady during the suckling period. Glucose utilization capacity was limited at birth and increased more than 3-fold during the first week of suckling. Such an increase was not observed in piglets kept unsuckled since birth. Galactose utilization capacity remained steady during the first week but afterward gradually disappeared. Lactate and pyruvate production through glycolysis was the major pathway accounting for glucose or galactose disappearance. A capacity for a net glucose production from galactose was evidenced during the first week of suckling. Thus, isolated newborn pig enterocytes exhibit specific and transient metabolic characteristics during the first postnatal week.

Animals↗
PubMed1994

Intestinal oxygen uptake and glucose metabolism during nutrient absorption in the pig.

Intestinal transport of nutrients coincides with their partial catabolism in the gut. The aim of the present study was to measure intestinal oxygen consumption and nutrient metabolism after a meal or during a short fast. Nutrient and oxygen balances across the small intestine were measured in conscious 50 kg (live wt) pigs. Jejunal enterocytes were also isolated from 1-hr postprandial, postabsorptive, or 3-day fasted pigs, in order to evaluate their capacities to metabolize 5 mM glucose and 2 mM glutamine. Whatever the nutritional state, intestinal oxygen consumption was high, since 26 +/- 2% (n = 6) of the oxygen arterial supply was extracted by the small intestine. Furthermore, the consumption of a mixed meal induced a rapid and transient rise in oxygen consumption. In the postabsorptive state, the intestinal uptake of glucose (0.31 +/- 0.08 mmole/min, n = 6) was twice higher than that of glutamine. The role of glucose as a fuel was also evidenced after a 3-day fast. During nutrient absorption, glutamine was highly utilized, and lactate was produced. The capacity of enterocytes isolated from fed pigs to metabolize glucose was dramatically reduced, as was 6-phosphofructo 1-kinase activity. In contrast, intestinal muscle presented a high glycolytic capacity from glucose, suggesting that the main site of intestinal lactate production during nutrient absorption would be the muscular rather than the epithelial layer.

Animals↗
PubMed1994

[Spontaneous dissection of the common trunk and principal branches of the left coronary arterial system. Apropos of a case].

The authors report the case of a 45 year old woman presenting with inaugural anterior myocardial infarction due to spontaneous dissection of the left main and principal branches of the left coronary arterial system. Two attempts of thrombolysis at a one hour interval were made within 6 hours of the onset of symptoms with signs of reperfusion but the ECG and echocardiography showed anterolateral myocardial infarction. A recurrence of chest pain on the fifth day led to emergency coronary angiography. The extent and severity of the observed lesions led to emergency surgical revascularisation with no post-operative complications. Skin biopsy showed signs of dystrophy of the elastic tissues. Angiographic control ten months after surgery showed complete regression of the lesions, especially those of the left main coronary with, however, occlusion of the second segment of the left anterior descending artery and sequellae of anterior myocardial infarction. Treatment of this type of disease is difficult as the outcome is unpredictable and has to be decided case by case.

Aortic Dissection↗
PubMed1993

Differentiation of abortion-inducing and intestinal strains of Chlamydia psittaci isolated from ruminants by the microimmunofluorescence test.

Forty-two isolates of Chlamydia psittaci from ruminants, principally from cases of abortion (21 strains) and from subclinical intestinal infections (13 strains), were serotyped by an indirect microimmunofluorescence test. The strains could be divided into the previously described serotypes 1 and 2. Strains causing abortion and intestinal strains belonged to two different serotypes: the abortion-inducing strains were mostly in serotype 1 whereas the intestinal strains were mostly in serotype 2. A close relationship was found between the serotypes and their invasiveness in mice.

Abortion, Veterinary↗
PubMed1993

Salmonella abortusovis infection in susceptible BALB/cby mice: importance of Lyt-2+ and L3T4+ T cells in acquired immunity and granuloma formation.

The role of T cells in granulomatous responses and in acquired immunity against Salmonella abortusovis (SAO) infection was studied in a murine model. Mice were subcutaneously (s.c.) vaccinated with a live attenuated strain of SAO. One month after vaccination, the transfer of primed spleen cells (1 x 10(8) cells per mouse) to syngeneic recipient mice conferred a significant protection of 3 log10, measured by spleen colonization on day 6 after s.c. challenge. In vitro treatment of spleen cells, before the transfer, with anti-Lyt-2 monoclonal antibody (IgG2b isotype MAb) and complement significantly impaired the protective activity. Treatment with anti-L3T4 MAb also diminished transferred protection, but to a lesser degree. Depletion of both L3T4+ and Lyt-2+ T cells completely abrogated protection. MAb treatment of spleen cells in vitro did not seem to have any effect on antibody response in recipient mice. Six days after the challenge protected recipient mice showed organized granulomas in the liver containing Mac-1+ macrophages and L3T4+ T cells. In non-protected mice at 6 days post-challenge, large infiltrates of T lymphocytes and macrophages were observed, but as numerous lesions with necrosis of hepatocytes; no granuloma were seen. In our experimental conditions, Lyt-2+ and L3T4+ T cells appeared to play, alone and in synergy, a role in vaccine-induced immunity against SAO and hepatic granulomas may contribute to the control of the infection.

Animals↗
PubMed1993

Metabolic characteristics of pig colonocytes after adaptation to a high fiber diet.

The capacities of viable colonic epithelial cells to metabolize glucose, glutamine and n-butyrate were studied in 30-kg pigs adapted to a high fiber (12% sugar beet fiber) or a low fiber diet. Glucose and glutamine were extensively utilized but predominantly not oxidized, whereas n-butyrate oxidation accounted for 45% of n-butyrate metabolism and was not greatly affected by the presence of glucose or glutamine. With both diets, glycolysis was the major pathway accounting for glucose disappearance. There was a sparing effect of n-butyrate on both glycolysis and glucose oxidation. Moreover, the glycolytic capacity was 25% lower in pigs fed the high fiber diet. Data suggest that 6-phosphofructo-1-kinase could be the regulatory step in glycolysis. Nevertheless, its maximum activity was not affected by the diet or by the presence of n-butyrate. Glutamine metabolism was slightly affected by fiber in the diet and by the presence of n-butyrate. In addition to CO2, butyrate was converted into ketone bodies. Glucose and glutamine did not substantially alter n-butyrate metabolism. We conclude that some metabolic features of pig colonocytes, such as the capacity to oxidize n-butyrate, resemble those of rat and human colonocytes. Moreover, some characteristics, such as the glycolytic capacity, can be modulated by the level of fiber in the diet.

3-Hydroxybutyric Acid↗
PubMed1992

Polyamine metabolism in enterocytes isolated from newborn pigs.

In the pig, the growth of intestinal mucosa is very intense after birth. Since the polyamines are key elements affecting cell proliferation and differentiation, the present work was undertaken in order to know whether this hypertrophy is associated with an adaptation of polyamine metabolism. Villus enterocytes isolated from pig immediately after birth or 2 days later were found to contain similar amounts of putrescine, spermidine and spermine, i.e., 0.23; 0.41 and 1.24 nmol/10(6) cells, respectively. At birth, despite a relatively high ODC activity, putrescine synthesis from 1 mM L-arginine or 2 mM L-glutamine was very low in isolated enterocytes (6.4 +/- 3.8 pmol/10(6) cells per 30 min), while spermidine and spermine production were not detectable. This could be explained by a very low L-ornithine generation from both amino acids and to an inhibitory effect of polyamines on ODC activity. Two days later, polyamine synthesis from L-arginine remained undetectable despite a higher L-ornithine generation. This was concomitant with a dramatic fall in ODC activity. At both stages, enterocytes were able to take up polyamines from the extracellular medium in a temperature-dependent manner. It is concluded that de-novo synthesis of polyamines from L-arginine or L-glutamine does not play a significant role in the control of polyamine content of pig enterocytes during the postnatal period. In contrast, polyamine uptake by enterocytes would contribute to maintain a steady-state polyamine content during this period.

Animals↗
PubMed1992

[Hemodynamic parameters in the severely burnt patient during the 1st 72 hours].

The haemodynamic time course of 16 patients with severe burn injury was investigated using a flow-directed balloon-tipped pulmonary artery catheter. The patients, aged 33.8 +/- 5.5 years, were burnt over 60 +/- 10% of body surface area, with a UBS score of 228 +/- 43. The measurements were obtained every six hours after insertion of the catheter. Fluid load was determined with Evans' formula, and modified according to the haemodynamic data. Catecholamines were introduced when this and a trial of fluid loading with 5 ml.kg-1 of macromolecules during a 20 min period had failed, starting with dobutamine or dopamine, followed by adrenaline as required. During the first hours after the injury, circulatory shock was partly linked to hypovolaemia: mean arterial pressure was 60.1 +/- 7.8 mmHg, right auricular pressure 4.5 +/- 2 mmHg, pulmonary wedge pressure 4.7 +/- 2 mmHg, cardiac index 3.5 +/- 0.8 l.min-1 x m-2. However, during the second and third days, cardiac output increased, with a cardiac index at 4.7 +/- 0.6 l.min-1 x m-2 and 5.2 +/- 0.2 l.min-1 x m-2 respectively, and arterial vascular resistances were decreased (536 +/- 125 dyn.s.cm-5). These data suggest a specific haemodynamic profile in severe burn patients which justifies invasive monitoring, and the use of catecholamines, in those patients that do not respond to fluid loading. The link between these data and the concomitant metabolic disturbances due to the burn injury has not yet been established. The increase in cardiac index could be related to the inflammatory response.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗