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Biomedical subjects

L Brasseur

Publications and source records attributed to L Brasseur.

At least 55 records · Page 3Linked to original sources

[Evaluation of a reference chromatographic method for the determination of blood levels of carboxyhemoglobin].

The FID chromatographic analysis of methane obtained by the catalytic reduction of CO on nickel is a valuable method for the quantity control of the HbCO analyzer in clinical routine. For Hb levels between 9 and 18 g%, the coefficient of variation for the chromatographic method is to 2% for HbCO ranging from 100 to 2%, and 2 to 6% for HbCO ranging from 2 to 0.2%. A simple method for the extraction of blood CO is evaluated.

Carbon Monoxide↗

Smoking, lung function, and body weight.

In a cross-sectional study of steelworkers aged 45-55 years, smokers (n = 105; mean weight 76.1 kg) were found to weigh significantly less than non-smokers (n = 54; 81.6 kg) and ex-smokers (n = 51; 82.6 kg). The lower weight of smokers was attributable to a group with airflow obstruction (n = 37; forced expiratory volume in one second/vital capacity (FEV1/VC) less than 66%), who weighed less (4.8 kg; p less than 0.05) than smokers with normal FEV1/VC (n = 68). In smokers, but not in ex-smokers or non-smokers, body mass index and FEV1/VC ratio were closely related (r = 0.34; p less than 0.001). This association was apparently not due to an effect of body weight on lung function. Weight loss in smokers may be the consequence of impaired lung function or reflect the effect of cigarette smoking on both the respiratory tract and metabolism in susceptible subjects.

Body Weight↗

Effects of gas density on pulmonary gas exchange of normal man at rest and during exercise.

Changes in the physical properties of inspired gas might be expected to influence the distribution of ventilation in the lungs as well as the diffusive and convective (cardiogenic) mixing of inspired gas with lung residual gas, thus possibly affecting pulmonary gas exchange for O2 and CO2. The purpose of our work was to assess to what extent this occurs in practise in human subjects, who could compensate for the changes directly brought about by altering the physical characteristics of the inhaled gas by changing their breathing pattern. Six healthy, non-smoking men breathed, at rest and during moderate exercise, gas mixtures containing 21% oxygen completed either by 79% nitrogen (air), helium (O2-He) or sulphur hexafluoride (O2-SF6). We observed that the inhalation of these three different gas mixtures whilst at rest did not affect arterial partial pressures of O2 or CO2, the physiological dead space to tidal volume ratio, or the alveolo-aADCO2). During exercise, AaDO2 was slightly (2-3 mm Hg) but significantly higher with both O2-He and O2-SF6 than with air. Although minute ventilation did not change, breathing frequency was slightly but significantly affected by the type of gas mixture breathed, being lower with O2-SF6 and higher with O2-He. We conclude that, within the range studied, the physical properties of the inhaled gas do not affect pulmonary gas exchange in healthy man, either because the changes affected are minimal or because they compensate for each other.

Adult↗

Pulmonary vascular tone is a determinant of basal lung perfusion in normal seated subjects.

In the human upright lung the downward increase in lung perfusion reverses in the lower third, thus giving rise to a zone of reduced basal perfusion (zone 4). The flow in zone 4 is regulated by the extra-alveolar vessels, the diameter of which is determined by lung volume, perivascular interstitial pressure, and vasomotor tone. To estimate the role of pulmonary vascular tone in the formation of zone 4, we infused nitroprusside (NTP), a potent pulmonary vasodilator, in six normal seated subjects. We measured their regional perfusion distribution using 133Xe in control conditions and at two dose levels of NTP (20.8 and 52.1 micrograms/min). Regional perfusion distribution was measured similarly and according to the same protocol in six subjects receiving only a placebo solution. In four of the six subjects receiving NTP, right-heart catheterization allowed simultaneous estimations of cardiac output and pulmonary arterial pressure to be made. NTP slightly decreased the perfusion of the nondependent parts of the lungs and markedly increased the perfusion of the lung bases, thus reducing the extent of zone 4. No changes were observed in the placebo experiments. Cardiac output and indices of ventilation and gas exchange did not change significantly. Peripheral and pulmonary arterial pressure fell slightly but significantly during NTP infusion. We attribute the observed changes in basal perfusion to the vasodilatory effects of NTP on the extra-alveolar vessels. Our findings thus support the hypothesis that in normal subjects zone 4 is partly created by the pulmonary vascular tone.

Adult↗

Effect of nitroglycerin on pulmonary perfusion distribution and gas exchange of normal subjects.

In eight healthy subjects we assessed the effects of 3 mg sublingual nitroglycerin on lung distribution of ventilation and perfusion using 133Xe (sitting, supine and lateral decubitus) and on alveolo-arterial O2 and CO2 partial pressure differences [(PAO2-PaO2), (PaCO2-PACO2)] and physiological dead space to tidal volume ratio (VD/VT) (sitting). In all studied positions, nitroglycerin induced a significant decrease in uppermost perfusion indices, and a significant increase in dependent perfusion indices, without changing the distribution of ventilation. Significant increases in (PaCO2-PACO2) and VD/VT were observed up to 60 min after nitroglycerin. No changes in (PAO2-PaO2) occurred, except for a transient decrease due to transient hyperventilation following nitroglycerin. The redistribution of pulmonary perfusion after nitroglycerin may be attributed to the passive effects of lowered pulmonary vascular pressures, and to possible action on extra-alveolar vessels. The evolution of the indices of pulmonary gas exchange is compatible with the observed redistribution of ventilation/perfusion relationships.

Adult↗

Effect of nitroglycerin on DL of normal subjects at rest and during exercise.

By use of the single-breath diffusing capacity for carbon monoxide (DL) as an index of the pulmonary capillary filling, the effects of 3 mg sublingual nitroglycerin (NTG) were studied in eight healthy subjects at rest and during exercise. At rest, NTG induced a significant and persistent decrease of DL when subjects were sitting or supine (60 min of observation) and also when they were in the lateral decubitus or supine with legs up position (30 min of observation). Subjects in the supine positions showed more pronounced percentage decreases in DL than when sitting. In the sitting position 1 mg NTG also induces a decrease of DL. During a moderate upright cycloergometer exercise, NTG also induces a significant decrease of DL; the decrease is smaller and of shorter duration (less than 15 min) than at rest, but it reappears as soon as the exercise is stopped. The decrease of DL may be attributed to an outward shift of blood from the thorax to the periphery or to a redistribution of lung perfusion consequent to changes in pulmonary vascular pressures.

Adult↗

Changes in lung function after smoking cessation: an assessment from a cross-sectional survey.

Cross-sectional lung function data of 51 ex-smokers (mean, 8 +/- 7 yr since smoking cessation) were compared with those of 54 nonsmokers and 105 current smokers. All subjects were steel workers 45 to 55 yr of age. In order to assess whether lung function indexes improve after smoking cessation, "expected" values were calculated for the ex-smokers, taking into account both duration of smoking and time since cessation. Observed values of forced expiratory volume in one second, vital capacity, residual volume, peak expiratory flow rate, slope of the N2 single-breath washout, and bolus closing volume were significantly different from "expected" ones. This suggested that smoking cessation not only stopped the smoking-induced fast decline in lung function, but even led to some reversal toward nonsmoking values. This was already apparent in 22 subjects who had quit smoking less than 5 yr previously.

Cross-Sectional Studies↗

Significance of small airway tests in middle-aged smokers.

In 54 asymptomatic lifelong nonsmokers and 105 current smokers, all steelworkers 45 to 55 yr of age, we measured several lung function indexes in order to assess the significance of small airway tests, slope of phase III of the N2 single-breath washout (delta N2), and bolus closing volume and closing capacity (CC/TLC). Smokers had all mean indexes significantly different from nonsmokers, with CC/TLC and delta N2 being the most frequently impaired tests. Smokers with small airway disease (abnormal CC/TLC or delta N2) but normal forced expiratory volume in one second (FEV1) vital capacity had a significantly lower FEV1/height3 (p less than 0.001) than subjects without small airway disease. The latter had indexes similar to nonsmokers. Our data suggested that smokers with small airway disease experience a more rapid decline in their FEV1 and thus are more susceptible to long-term smoking than smokers without small airway disease. The later appear to be resistant to tobacco-induced chronic airflow obstruction.

Aging↗

Assessment of a rapid-L-lactate enzyme analyzer.

A semi-automatic L-lactate concentration analyzer using an enzyme electrode is compared with the slower and more complicated photometric method using LDH and NAD. The analyzer permits lactate determination in less than 3 minutes with only 100 microliters of sample. The results of comparative measurements carried out on whole blood and plasma are examined with regard to the principle of enzymatic measurement. Since the analyzer only measures plasma lactate, whole blood yields lower values than by photometric methods. The analyzer has good linearity, accuracy, stability, and reproducibility. The influence of blood metabolism on the values of lactate measured is discussed. The long term fiability, an essential feature for a clinical analyzer, is not investigated in this study.

Chemistry Techniques, Analytical↗

Contrasting effect on cardiac output of digoxin and gitoxin in humans during congestive heart failure.

Recent studies have demonstrated that the biovailability of gitoxin could be increased to 100%. Favorable pharmacokinetic parameters for this glycoside have also been found in humans. The present paper deals with the comparative hemodynamic effect of digoxin and gitoxin on nine patients suffering from heart failure. The study was conducted in a coronary care unit with continuous hemodynamic monitoring. After intravenous administration of 1 mg digoxin or gitoxin, only gitoxin was observed to have an inotropic effect leading to significant improvement of the low cardiac output in these patients.

Aged↗

[Study of lung symptomatology and lung function in steelworkers].

We have examined 272 steelworkers, aged 45 to 55 years, by means of the ECSC-questionnaire and the following lung function tests: vital capacity (VC) and forced expiratory volume in one second (FEV1), residual volume (RV) and total lung capacity (TLC); maximal expiratory flow rates (Vmax, Vmax 50, Vmax 75); specific airways conductance (SGaw); slope of the N2 alveolar plateau after oxygen inhalation (delta N2) and the bolus closing volume (CV). The influence of smoking on respiratory symptoms and lung function was confirmed. In order to assess the influence of occupational pollution a sample of 163 workers was classified according to smoking habits and workplace (either LD-steelplant and continuous casting department, or sheet rolling mill). In the nonsmokers group we found that the workers from the steelplant and continuous casting department (n = 12) had a significantly lower SGaw value (delta = 0.065 cm H2O-1 . s-1, p less than 0.01) and a significantly higher CV value (delta = 4.5% VC, p less than 0.05) than the workers from the sheet rolling mill (n = 11). Differences in FEV1/VC, Vmax 50 and Vmax 75 were not significant, but were also consistent with a slight airflow obstruction in the steelplant workers. In the smokers (n = 99) and exsmokers (n = 41) groups no differences existed between both working categories. Our results suggest that nonsmoking workers from the steelplant and the continuous casting department have undergone moderate, but detectable effects from industrial pollution. These effects are probably masked by those of tobacco in smokers and exsmokers.

Air Pollutants, Occupational↗

Impaired early left ventricular relaxation in coronary artery disease: effects of intracornary nifedipine.

It has been shown that the maximal rate of left ventricular (LV) relaxation is impaired in patients with coronary artery disease (CAD) under basal conditions. To test the hypothesis that this impaired LV relaxation could be related to viable but metabolically abnormal myocardium, we studied the time course of isovolumic LV pressure fall in 21 patients with CAD and in 13 control subjects under basal conditions. This study was repeated after intracoronary injection of the calcium antagonist nifedipine (N) in 11 patients with CAD and in eight controls. Our data showed that isovolumic pressure fall was biexponential in 20 of 21 CAD patients and in six of 13 controls. Moreover, the time constant of isovolumic pressure fall during the first 40 msec after peak (negative) dP/dt (T1) was significantly greater in CAD patients than in controls (62 +/- 3 vs 44 +/- 1 msec, p < 0.002); the time constant of pressure fall during the 40-80 msec after peak (negative) dP/dt (T2) was similar in both groups ( 42 +/- 2 vs 39 +/- 2 msec, NS). Thirty seconds after injection of nifedipine, T1 and T2, were significantly prolonged in patients with CAD (14 msec and 16 msec, respectively, p < 0.005) and in controls 12 msec and 14 msec, respectively, p < 0.05), and a negative inotropic effect was observed in both groups (peak (positive) dP/dt - 16% in controls and -23% in CAD patients, p < 0.01). At rest, impairment of isovolumic relaxation in CAD patients is mainly limited to the first 40 msec after peak (negative) dP/dt, suggesting a dyssynchronous wall motion. This impairment of LV relaxation is better identified by T1 than by peak (negative) dP/dt in individual patients, and cannot be improved by administration of a calcium antagonist.

Adult↗