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Biomedical subjects

J Milot

Publications and source records attributed to J Milot.

At least 37 records · Page 2Linked to original sources
PubMed1992

Lymphocytic alveolitis and airway responsiveness in recently diagnosed sarcoidosis.

We looked at the relationship between the intensity of the lymphocytic alveolitis and airway responsiveness to methacholine, in patients with recently diagnosed untreated pulmonary sarcoidosis. We studied 19 subjects, 13 M and 6 F, aged 19-58 (mean: 36.6) who had a diagnosis of pulmonary sarcoidosis within the last 6 months (radiologic stages: I, 10 subjects; II, 8; III, 1). One subject had a previous history of asthma but was currently asymptomatic. Five were smokers, 5 ex-smokers and 9 non-smokers. Initial assessment included a flexible bronchoscopy with bronchoalveolar lavage (BAL), measurement of expiratory flows, lung volumes, CO diffusion and a methacholine inhalation test. Pulmonary function tests were repeated six months later, and a second evaluation of airway responsiveness to methacholine was obtained in 13 patients. Mean % of lymphocytes, neutrophils and macrophages on BAL were respectively: 25.4, 2.3 and 72.4. Mean % of predicted values for FVC, FEV1, FEF25-75%, TLC, FRC and DLCO were respectively 91.3, 94.3, 88.8, 97.6, 102.1 and 91.2. In all subjects FEV1 was > or = 80% and PC20 was in the normal range (> 16 mg/ml in all subjects but one who had a PC20 of 12.0). There was no correlation between the % of BAL lymphocytes and the initial PC20. At 6 months, overall airway responsiveness was unchanged (geometric mean initial/6 month PC20 methacholine: 95.9/102.8) whether or not the subjects had a high intensity alveolitis (defined as > or = 30% lymphocytes on BAL).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Ocular manifestations of nephropathic cystinosis. The French-Canadian experience in a genetically homogeneous population.

A large spectrum of ocular pathologic features have been described in infantile cystinosis. Reported symptoms may require corneal transplantation and therapeutic efforts to solubilize cystine crystals with hourly administration of cysteamine (mercaptamine) drops. French Canada has the highest incidence of cystinosis in the world. We studied 18 patients with cystinosis who appeared to have much milder ocular involvement than that in other reported series. No operative interventions were required. Relatively mild photophobia was the most common ocular manifestation of cystinosis.

Adolescent↗
PubMed1991

Antiemetic prophylaxis with promethazine or droperidol in paediatric outpatient strabismus surgery.

This randomized, double-blind study evaluated the antiemetic efficacy and the side-effects of promethazine pretreatment (0.5 mg.kg-1 IV + 0.5 mg.kg-1 IM) versus droperidol + placebo pretreatment (droperidol, 0.075 mg.kg-1 IV + physiological saline, 0.02 ml.kg-1 IM). One hundred unpremedicated ASA physical status I children ranging from two to ten years, and undergoing outpatient strabismus surgery were studied. All children received inhalational anaesthesia with halothane, nitrous oxide and oxygen. Neither opioids nor muscle relaxants were used. The incidence of vomiting and/or retching and the incidence of side-effects were determined in the post-anaesthesia recovery room (PARR), in the short-stay surgical unit (SSSU), and after discharge from the hospital (including the journey and the stay at home during the first postoperative day). Promethazine and droperidol were equally effective in reducing the incidence of vomiting before discharge to two and eight per cent respectively. On the contrary, the incidence of vomiting after discharge and overall were significantly less with promethazine (ten and ten per cent) than with droperidol pretreatment (54 and 56 per cent) (P less than 0.0001). Promethazine permitted the time to discharge from the hospital to be reduced to an average of three hours, without increasing the incidence of vomiting postdischarge. Promethazine pretreatment is much less expensive than droperidol pretreatment. The incidence of restlessness was significantly less with droperidol (eight per cent) than with promethazine (36 per cent) (P less than 0.001). Promethazine pretreatment demands the use of an analgesic like acetaminophen in order to reduce the incidence of postoperative pain and restlessness.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Surgical Procedures↗
PubMed1991

Relationship between changes in diurnal variation of expiratory flows, lung volumes and respiratory symptoms after acute asthma.

We looked at the comparative recovery of asthma symptoms and changes in airflow obstruction after an acute exacerbation of asthma in 26 asthmatics, aged 18-69 years (mean = 43). In the 4 weeks following the acute episode, they recorded their respiratory symptoms and twice-daily peak expiratory flow rates (PEFR). In 14 subjects, lung volumes were also measured on days 1, 7 and 30. Mean initial FVC and FEV1 [+/- SEM (% predicted)] were 2.30 +/- 0.16 (61%) and 1.18 +/- 0.08 (39%). The rate of improvement of airflow obstruction initially paralleled that of asthma symptoms in subjects with mild or with a recent onset of asthma. On the first study day, diurnal variation of PEFR was minimal, increased rapidly during the first week of treatment and stabilized thereafter. Mean daily delta PEFR was significantly higher in the first than at the fourth week (P = 0.005). Recovery of asthma symptoms was associated with an overall reduction in FRC and RV but there was no significant correlation between FRC or RV and dyspnea score or PEFR. Perception of airflow obstruction was generally lower, improvement of symptoms slower and of smaller amplitude in those with long-standing asthma. In conclusion, during recovery from acute asthma: (1) diurnal variation of PEFR is initially minimal, increases rapidly after beginning steroids and stabilize in the two following weeks; (2) in patients with more than mild or long-standing asthma, and magnitude and range of perception of asthma symptoms is reduced and correlates less with PEFR; and (3) no significant correlation could be found between FRC or RV and dyspnea score or PEFR.

Acute Disease↗
PubMed1990

Detection by electron microscopy of a small subband 13q14.11 deletion in an hereditary retinoblastoma.

High-resolution banding, specific for electron microscopy, was applied to chromosomes of synchronized blood lymphocytes obtained from a child with bilateral retinoblastoma. Ultrastructural analysis of the subbands in region q14.1, after synchronization and immunochemical banding, showed that the deletion in the abnormal chromosome 13 corresponds to subband 14.11, thus evidencing that the retinoblastoma gene is located within subband q14.11. This first application to a diagnostic problem of immunochemical banding suggests that, coupled with electron microscopy, this banding provides a higher resolution than that obtained with light microscopy and should be useful to pinpoint important localizations.

Child, Preschool↗
PubMed1990

Comparative effects of dilevalol and atenolol on lung function and airway response to methacholine in hypertensive subjects.

1. In this double-blind randomized study, after a 4-weeks placebo period, 18 patients with mild to moderate primary hypertension were assigned to treatment with either dilevalol (n = 9) daily or atenolol (n = 9) over a period of 3 months. 2. Expiratory flows, lung volumes and airway responsiveness (AR) to methacholine were assessed at the end of the placebo period and after an active treatment of 12 weeks. Blood pressure (BP), heart rate (HR) and ECG were monitored during the methacholine challenges. Twice daily peak expiratory flow rates and respiratory symptoms were recorded on a diary card. 3. No significant effects on ECG, HR and BP were observed after methacholine inhalation. In all but one subjects there was no significant change in expiratory flows, lung volumes or AR throughout the study. Mean FEV1, FVC, PEFR, FRC and PC20 methacholine were unchanged after 3 months of treatment, and not statistically different between patients on dilevalol or atenolol. 4. One subject, without previous history of asthma, developed transient airflow obstruction 8 weeks after beginning dilevalol. 5. Dilevalol and atenolol have no significant effects on pulmonary function and AR in most subjects with no baseline airflow limitation. 6. Airflow obstruction may develop in normal subjects on dilevalol. Methacholine challenges are safe in subjects with uncomplicated hypertension.

Adult↗
PubMed1990

Neuronal and photoreceptor differentiation of retinoblastoma in culture.

This study describes an in vitro system, which favors attachment and differentiation of primary retinoblastoma cells. Indeed, tumor cells from primary retinoblastomas were successfully grown as long-term monolayer cultures, using collagen type-1 coated flasks, preincubation of tumor cells in fetal calf serum and a medium richly supplemented with serum. This reliable system allowed growth and attachment and induced differentiation towards neuronal and photoreceptor morphology. Each of the nine tumors studied showed substantial cell proliferation and differentiation. Cells with glial characteristics were observed in lower numbers. Furthermore, in five cell-lines, some cell clusters showed pigmentation characteristic of pigment epithelial cells (PE). By electron microscopy, a significant proportion of cells showed conventional neuronal differentiation; others formed typical Flexner-Wintersteiner rosettes with individual photoreceptor cells showing a more highly differentiated pattern quite similar to fleurette inner segments. Immunohistochemical studies did not reveal evidence of transition between undifferentiated retinoblastoma cells and glial cells, although foci of multipolar cells were found resembling glial elements and containing glial fibrillary acidic protein. Thus no definite sign of glial differentiation was observed. These results show that most primary retinoblastoma cells can grow in attachment culture and differentiate into at least two distinct morphological cell types. This study also offers a potentially rewarding system to analyse the factors controlling growth and differentiation of human tumor cells in vitro.

Cell Adhesion↗
PubMed1989

Pulmonary function and airway responsiveness during long-term therapy with captopril.

Angiotensin-converting enzyme inhibitors sometimes cause cough; the mechanism is unknown. We therefore studied the effects of ambulatory treatment with captopril on pulmonary function and on nonspecific bronchial responsiveness to methacholine in 15 hypertensive subjects. Lung volumes, expiratory flows and nonspecific bronchial responsiveness to methacholine using doses up to 64 g/L were measured before and four and eight weeks after captopril treatment was started. Throughout the study the subjects recorded respiratory symptoms and peak expiratory flow rates. In four subjects a persistent cough developed related to the use of captopril, but this was not associated with the development of airflow obstruction or bronchial hyperresponsiveness. The mean provocative concentration of methacholine that resulted in a 20% fall in the forced expiratory volume in 1 s was 43.6 +/- 1.8 g/L after eight weeks of captopril treatment compared with 61.6 +/- 1.2 g/L at the baseline evaluation. We concluded that there was no significant change in lung function during treatment with captopril. The development of a cough related to this medication is not associated with the development of airflow obstruction or airway hyperresponsiveness.

Aged↗
PubMed1989

First cytogenetic evidence of homozygosity for the retinoblastoma deletion in chromosome 13.

Retinoblastoma (Rb) provided the first model in which both normal alleles of a recessive gene had to be lost as a prerequisite for tumorigenicity. However, region q14 of chromosome 13 appears cytogenetically normal in the majority of Rb tumors, and no homozygotic deletion had previously been observed. High-resolution cytogenetics of an Rb tumor revealed a homozygotic deletion in bands q13.3-14.2 of chromosomes 13 in 35% of the cells and a heterozygotic deletion, involving the same region, in 17%. In one third of the cells, although random chromosome loss occasionally occurred, no specific anomaly was detected. The remaining cells showed either monosomy 13, tetraploidy, or an i(1p). Revealing a homozygotic deletion in subbands 14.1 and 14.2 of chromosomes 13 provides the first cytogenetic evidence of the two somatic mutations considered essential to inactivate the Rb gene. These results allow insight into the succession of events necessary for tumor development.

Chromosome Banding↗
PubMed1989

Bronchial responsiveness increases after seasonal antigen exposure in non-asthmatic subjects with pollen-induced rhinitis.

This study looked at the effects of natural antigenic exposure on non-specific airway responsiveness (NSAR) in pollen-sensitized non-asthmatic subjects with seasonal rhinitis. Eight subjects had daily recordings of their respiratory symptoms and peak flow rates during and out of the pollen season. Airway response to methacholine was measured at 1-week to 2-week intervals. Pre-season spirometry and NSAR were normal in all subjects. Their PC20 methacholine ranged from 64 to greater than 256 mg/mL. During natural pollen exposure, all subjects had symptoms of rhinoconjunctivitis. The only chest symptom observed was coughing. No significant change in peak flow rates was observed throughout the study. A significant increase in bronchial responsiveness to methacholine occurred in five subjects although it did not reach the asthmatic range (less than 16 mg/mL). This change in NSAR was reproduced after antigen (tree pollen) challenge in the laboratory in one of the subjects. A significant increase in blood eosinophils was observed during seasonal pollen exposure. This study shows that following natural antigenic exposure, NSAR can increase in non-asthmatic subjects with allergic rhinitis, although it may not reach the "hyperresponsive range," and is associated with the development of a cough. These data suggest that natural exposure in non-asthmatic atopics may induce an inflammatory reaction in the airways to a degree that may increase NSAR.

Adult↗
PubMed1988

The oculorespiratory reflex revisited.

Continuous measurement of the intratracheal pressure and capnography are very simple and accessible methods for the detection and recording of the oculorespiratory reflex (ORR). Eight healthy children (five to 14 years old) undergoing strabismus surgery under halothane-nitrous oxide anaesthesia with spontaneous ventilation were studied. The ORR was evoked by traction on the extrinsic muscles of the eye (four medial recti and four lateral recti). Slowing of the respiratory rate and/or shallow respiratory movements were observed in each patient. One patient developed apnoea of 20 seconds duration which forced the use of manually controlled ventilation. Intravenous atropine (0.01 mg.kg-1) reduced the incidence of positive OCR (to 37.5 per cent) but did not diminish the incidence of the ORR (100 per cent). Since the ORR may lead to hypercapnia and hypoxaemia, controlled ventilation is recommended for patients undergoing strabismus surgery at least immediately before and during the muscular traction. It is now clear that the ORR may be evoked by traction on the extrinsic muscles of the eye, may produce hypercapnia and hypoxaemia and so, may aggravate the consequences of the OCR.

Adolescent↗
PubMed1988

Preschool vision testing with a new device, the Scolatest.

To determine the reliability of results obtained in preschool children by school nurses with a new device for testing vision, the Scolatest, 153 children aged 4 to 5 years were presented with the Snellen E on the standard American Optical projector and with five letters of the Sheridan test (H, O, V, T and X) on the Scolatest. Another 212 children aged 3 to 4 years were presented with the Allen symbols on the projector and with the Pigassou symbols on the Scolatest. The tests with the projector were given at 6 m by an experienced pediatric orthoptist, those with the Scolatest at 2.5 m by a school nurse. The proportion of good responses was higher with the Pigassou symbols than with the Allen symbols. The results with the Sheridan letters and the Snellen E were similar up to 20/30; beyond 20/30 the Snellen E appeared unreliable. The four vision-testing systems were also presented by a school nurse at 2.5 m on the Scolatest to 102 children aged 4 to 5 years (Snellen E and the five Sheridan letters) and 80 children aged 3 to 4 years (Allen and Pigassou symbols). The proportions of good responses were more comparable. The results suggest that a working distance of 2.5 m should be used in testing vision in preschool children. Visual screening at this distance should test acuity beyond the 20/30 equivalence if results comparable to those at 20 feet with the 20/30 standard requirement are to be obtained.

Child, Preschool↗
PubMed1983

Waardenburg syndrome--penetrance of major signs.

We have estimated that 83% of individuals carrying the gene for Waardenburg syndrome type I show penetrance of the gene as measured by dystopia canthorum. This is lower than previous estimates, which failed to consider the frequency of equivocal dystopia in the general population. The addition of three other major signs (hearing loss, white forelock, and premature graying of the hair or vitiligo) does not substantially increase the discrimination of gene carriers (85% versus 83%). We estimate that about 75% of the first-degree relatives of probands can be assigned as normal or a gene carrier on the basis of the four major signs.

Abnormalities, Multiple↗
PubMed1983

The oculocardiac reflex: a graphic and statistical analysis in infants and children.

A new method for the detection and recording of the oculocardiac reflex (OCR) is described and applied to 49 healthy infants and children (six months to nine years old) undergoing strabismus surgery under halothane anaesthesia with spontaneous ventilation. Eighty-one extraocular muscles were studied. Square wave stimuli (abrupt and sustained tractions) were definitely more reflexogenic than slow slope stimuli (very gradual, progressive and gentle tractions). Vagal escape, as well as fatigue of the OCR, are graphically documented and analysed. In this series, using well-defined and controlled tractions, the medial rectus was not more reflexogenic than the other extraocular muscles. Hypercapnia was an important adjuvant factor of the OCR. Controlled ventilation is recommended. The routine use of intravenous anticholinergic drugs is briefly discussed. Prevention of the OCR, and prophylaxis of cardiac arrhythmias during strabismus surgery, now seem to be placed on a more rational basis.

Age Factors↗
PubMed1982

[Not Available].

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France↗