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Biomedical subjects

P Lacombe

Publications and source records attributed to P Lacombe.

At least 73 records · Page 4Linked to original sources
PubMed1997

Left main coronary artery compression during primary pulmonary hypertension.

Primary pulmonary hypertension (PPH) is often associated with angina-like chest pain, the mechanism of which is controversial. A 37-year-old woman with severe PPH and angina had transient ischemic ECG changes and reversible anterior perfusion defect on 201thallium scintigraphy. Coronary angiography revealed severe stenosis of the left main coronary artery (LMCA) and otherwise normal vessels. After heart-lung transplantation, examination of the explanted heart showed normal coronary arteries. Compression of the LMCA by the dilated pulmonary artery trunk was responsible for myocardial ischemia. This mechanism should be considered in patients with PPH and angina and might contribute to the high sudden death rate.

Adult↗
PubMed1997

[Angiographic identification of spinal cord arteries before bronchial artery embolization].

Ischemic spinal cord injury is the major risk of bronchial artery embolization. The spinal artery may be overlooked on initial intercostobronchial trunk arteriography, as a result of reverse flow within the intercostal branch. Its identification, conversely, is easier on postembolization angiography. An illustrative case is presented, with angiographic correlation. The pathophysiology of the reverse flow is discussed. Technical recommendations are proposed for its detection.

Adult↗
PubMed1996

Tacrine overcompensates for the decreased blood flow induced by basal forebrain lesion in the rat.

The effects of tacrine on the cerebral blood flow (CBF) were investigated according to an experimental model of the cholinergic hypothesis in rats with unilateral lesion of the substantia innominata (SI). CBF was measured 1-2 weeks following SI lesion with ibotenic acid, using the tissue sampling [14C]iodoantipyrine technique in three groups of lesioned rats infused i.v. with tacrine at 3 or 8 mg kg-1 h-1 or with saline. SI lesioning resulted in moderate, significant blood flow decreases in the parietal, frontal and occipital cortical areas. In the intact hemi-brain, tacrine at a dose of 3 mg kg-1 h-1 had no significant effect, but at 8 mg kg-1 h-1 tacrine increased the blood flow in most of the cortical and subcortical regions investigated. The increases ranged from 21% (hypothalamus) to 101% (parietal cortex) compared with controls. Tacrine had greater effects in the lesioned hemisphere, even at the dose of 3 mg kg-1 h-1. The flow increases in the frontal or parietal cortex of the lesioned hemisphere were 1.5-3.6 times greater than in the intact hemisphere. Thus, in contrast to what was expected, tacrine overcompensates for the cerebrovascular effects of SI lesions.

Animals↗
PubMed1996

Serotonin in the regulation of brain microcirculation.

Manipulation of brainstem serotonin (5-HT) raphe neurons induces significant alterations in local cerebral metabolism and perfusion. The vascular consequences of intracerebrally released 5-HT point to a major vasoconstrictor role, resulting in cerebral blood flow (CBF) decreases in several brain regions such as the neocortex. However, vasodilatations, as well as changes in blood-brain barrier (BBB) permeability, which are blocked by 5-HT receptor antagonists also can be observed. A lack of relationship between the changes in flow and metabolism indicates uncoupling between the two variables and is suggestive of a direct neurogenic control by brain intrinsic 5-HT neurons on the microvascular bed. In line with these functional data are the close associations that exist between 5-HT neurons and the microarterioles, capillaries and perivascular astrocytes of various regions but more intimately and/or more frequently so in those where CBF is altered significantly following manipulation of 5-HT neurons. The ability of the microvascular bed to respond directly to intracerebrally released 5-HT is underscored by the expression of distinct 5-HT receptors in the various cellular compartments of the microvascular bed. Thus, it appears that while some 5-HT-mediated microvascular functions involve directly the blood vessel wall, others would be relayed through the perivascular astrocyte. The strategic localization of perivascular astrocytes and the different 5-HT receptors that they harbor strongly emphasize their putative pivotal role in transmitting information between 5-HT neurons and microvessels. It is concluded that the cerebral circulation has full capacity to adequately and locally adapt brain perfusion to changes in central 5-HT neurotransmission either directly or indirectly via the neuronal-astrocytic-vascular tripartite functional unit. Dysfunctions in these neurovascular interactions might result in perfusion deficits and might be involved in specific pathological conditions.

Animals↗
PubMed1996

Embolization of multiple pulmonary arterial aneurysms in Behçet's disease.

Arterial manifestations of Behçet's disease carry a particularly poor prognosis, especially pulmonary arterial aneurysms. We report herein the successful embolization of multiple bilateral pulmonary arterial aneurysms in a young Algerian man, whose treatment included corticosteroids and immunosuppressive drugs.

Adult↗
PubMed1996

[Failures and complications of bronchial artery embolization].

Bronchial artery embolization (BAE) is well accepted and widely used for management of massive and recurrent hemoptysis. Recurrent hemoptysis occurs in 20% of cases. It may be due to partial embolization, recruitment of other systemic collaterals, recanalization of an embolized artery, or progression of primary disease. Severe complications of BAE are limited to spinal cord injury, oesophageal necrosis, and bronchial ischemia. The proper application of bronchial arteriography and embolization techniques depends on a thorough knowledge of the arterial anatomy, a meticulous catheterization technique, the use of nonionic or lowosmolarity contrast materials, and adequate positioning of the catheter. In these optical conditions of safety, BAE is the treatment of choice for severe and recurrent hemoptysis.

Bronchi↗
PubMed1995

Autoradiographic distribution of cerebral blood flow increases elicited by stimulation of the nucleus basalis magnocellularis in the unanesthetized rat.

The nucleus basalis magnocellularis (NBM) of the rat, equivalent of Meynert's nucleus in the primate, is the origin of the main cholinergic innervation of the cerebral cortex. Stimulation of this area has been previously shown to induced marked, cholinergically mediated, blood flow increases in the frontal and parietal cortices. However, the complete distribution of the cerebrovascular effects of NBM stimulation within the whole brain has not been determined. In the present study, we used the [14C]iodoantipyrine autoradiographic method to measure local cerebral blood flow (CBF) in the unanesthetized rat, chronically implanted with a stimulation electrode. We performed unilateral electrical stimulation of the NBM in order to compare both the interhemispheric differences in blood flow and the differences with a group of sham-stimulated rats. Considerable blood flow increases were found in most neocortical areas, exceeding 400% in the frontal area, compared to the control group. Marked responses also appeared in discrete subcortical regions such as the zona incerta, some thalamic nuclei and structures of the extrapyramidal system. These responses were mostly ipsilateral to the stimulation. The significance and the distribution of these blood flow increases are related first, to anatomical and functional data on mainly the cholinergic projections from the NBM, but also non-cholinergic pathways connected with the NBM, second, to biochemical data on the basalocortical system, and third, to the limited ultrastructural data on the innervation of microvascular elements. This cerebrovascular study represents a step in the elucidation of the function of the basalocortical system and provides data which may be related to certain deficits of degenerative disorders such as Alzheimer's disease in which this system is consistently affected.

Analysis of Variance↗
PubMed1995

Reliability of three methods of radiologic assessment in patients with rheumatoid arthritis.

RATIONALE AND OBJECTIVES: To assess the intraobserver reliability of three methods used frequently to evaluate joint destruction in rheumatoid arthritis: the Sharp method, the Larsen method, and the carpo:metacarpal ratio. METHODS: One observer analyzed twice within a 6-week interval 71 radiographs from patients with rheumatoid arthritis. Reliability was estimated by intraclass correlation coefficient (R) and by Altman-Bland graphical method. Correlations were examined by the Spearman's coefficient (r). RESULTS: The intraobserver reliability of each method appeared satisfactory with a good result for the Sharp method (R = 0.97). The correlation was strong (r > 0.80) between the results obtained by Sharp's and Larsen's methods and weaker between the results of the two former methods and the carpo: metacarpal ratio. CONCLUSIONS: Sharp's method should be used preferentially in studies evaluating the radiologic changes in rheumatoid arthritis over time, especially in clinical trials. The carpo:metacarpal ratio may be considered as a complementary method, when wrist destruction is of conceptual importance.

Adult↗
PubMed1995

[Scanners].

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Tomography Scanners, X-Ray Computed↗
PubMed1994

Is alpha-chloralose plus halothane induction a suitable anesthetic regimen for cerebrovascular research?

The aim of this study was to determine whether alpha-chloralose, when associated with an initial period of halothane, is a suitable anesthetic regimen for cerebrovascular studies. For this purpose, rats anesthetized with alpha-chloralose plus halothane induction were first subjected to noxious stimuli, and the behavior, EEG and systemic variables were recorded. During a second step, cortical blood flow was measured with laser-Doppler flowmetry and the time-course of the cerebrovascular reactivity to hypercapnia were measured in artificially ventilated rats anesthetized with either alpha-chloralose (40 mg.kg-1, s.c.) plus halothane induction (1.5% given during the first 45-60 min) or halothane alone (1.5%). Finally, an experimental paradigm was developed that allowed the comparison of the hypercapnic reactivity, both in awake and anesthetized conditions in the same animal. Our results show that the association of alpha-chloralose with halothane leads to stable cardiovascular parameters and immobility of ventilated rats, placed in ear bars without curare, for 3 h without any sign of discomfort. Based on EEG criteria, we found that halothane induction lengthens the duration of alpha-chloralose anesthesia (253 +/- 19 vs. 200 +/- 15 min, P < 0.01). Under alpha-chloralose alone or in association with halothane induction, the vascular reactivity to hypercapnia was considerably impaired (-85% compared to the awake state, P < 0.01), but this impairment was transient, since a control reactivity was restored 150-190 min after induction of anesthesia. Under halothane alone, the vascular reactivity remained reduced throughout the experiment. These results provide evidence that alpha-chloralose plus halothane induction is a suitable anesthetic regimen which displays a temporal window of normal cerebrovascular reactivity.

Anesthesia↗
PubMed1994

Basal forebrain control of cortical blood flow and tissue gases in conscious aged rats.

Cholinergic projections from the basal forebrain are capable of influencing local cortical blood flow (CoBF). The effect of age on this influence was investigated by measuring CoBF and tissue gas partial pressures (PtO2, PtCO2) by mass spectrometry in conscious young adult (2-4 months) and aged (22-28 months) Fischer 344 rats. Electrical stimulation (50 microA) of the substantia innominata (SI) increased frontal (+100.9%) and parietal (+28.4%) CoBF in young rats, but the effects were less in aged rats (frontal, +48.6%, P < 0.05; parietal, +18.9%, difference N.S.). Frontal PtO2 was increased in young but not aged rats (P < 0.01.). During standard hypercapnia, changes in CoBF, PtO2 and PtCO2 did not differ between young and aged rats. Under physostigmine infusion (0.15 mg/kg/h, i.v.), the CoBF increases to SI stimulation were approximately doubled in both cortices, in young and aged rats, and PtO2 increases were also significantly greater. However, frontal PtO2 increases were significantly smaller in aged (+7.6%) than in young (32.7%) rats, as were frontal PtCO2 reductions. We conclude: (i) the influence of the SI on frontal CoBF and PtO2 is substantially reduced with age; (ii) although physostigmine treatment potentiates this influence in both groups, the beneficial effects are relatively limited for aged rats.

Aging↗
PubMed1994

Autoradiographic study of the cerebrovascular effects of stimulation of the substantia innominata: convenient stimulation paradigm.

The aim of this study was to determine the distribution within the whole brain of the vascular effects of stimulation of the substantia innominata. This basal forebrain nucleus is the major cholinergic input in the neocortex in the rodent. The local cerebral blood flow was measured by the autoradiographic [14C]iodoantipyrine technique in a group of control and a group of stimulated unanesthetized rats. The substantia innominata was electrically stimulated through a chronically implanted electrode. The stimulation induced blood flow increases exceeding 200% in the hemisphere ipsilateral to the stimulation and 100% in the contralateral hemisphere compared to the control group. The ipsilateral vasodilations were observed not only in the cortical areas but also in some subcortical structures. Comparison with previous data suggests that part of the effects is due to cholinergic neurons of the substantia innominata and part to non-cholinergic neurons and indirect effects. However, only two out of eight stimulated rats displayed this response. The low reproducibility of the results is discussed, considering the stimulation paradigm which has been developed for future measurements of the cerebral glucose utilization which requires a long duration stimulation period.

Animals↗
PubMed1994

Serum lipoprotein changes after prolonged intralipid infusion in malnourished haemodialysis patients.

Fat emulsions have been shown to be on efficient source of energy support in malnourished haemodialysis patients. This work was conducted in order to study the effect of prolonged intralipid infusion, during dialysis, on lipid metabolism. The following fasting serum parameters were measured before and after a 1 month infusion of 20% Intralipid (67 kJ/kg body wt/dialysis) in 10 malnourished patients undergoing dialysis: total cholesterol, triglycerides, phospholipids, HDL-cholesterol, LDL-cholesterol, HDL2-cholesterol, HDL3-cholesterol, apolipoproteins A-I, A-II, A-IV, C-II, C-III, and lipoproteins A-I, A-I A-II, EB and (a). After prolonged lipid infusion, the apoprotein B (p < 0.05) and C-II (p < 0.005) increased suggesting a triglyceride transport activation. Apolipoprotein A-I (p < 0.05) and lipoprotein A-I (p < 0.05) decreased without a change in total cholesterol. Lipoprotein (a) decreased in each case (p < 0.005), suggesting a reduction of its related risk of atherogenesis.

Journal Article↗