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S Bernard

Publications and source records attributed to S Bernard.

At least 91 records · Page 5Linked to original sources

Managing cancer pain: content and scope of an educational program for nurses who work in predominantly rural areas.

A great deal of effort is being expended at national, state and local levels to improve cancer pain management in the United States. The fact that cancer patients continue to experience "unrelieved pain" is of concern to professional caregivers and families, as well as to the patients themselves. This article describes the content and scope of an educational program for nurses who work in predominantly rural areas. Content of the program and the evaluation process are described in detail in order to provide other caregivers with a model that could be implemented in similar settings.

Chronic Disease↗

Effects of losartan on contractile responses of conductance and resistance arteries from rats.

We investigated the selectivity of losartan as an angiotensin II (ANG II) antagonist in contractile experiments using segments of small mesenteric arteries and rings of aorta from rat. The concentration-effect curve of ANG II was not different in mesenteric arteries with an without endothelium. In both resistance and conductance vessels, it was shifted toward larger concentrations by losartan (3 nM) with similar apparent inhibition constant (KB) values: 4.1 +/- 1.8 nM (n = 6) in small mesenteric arteries and 1.9 nM (n = 6) in aorta. These values agree with the known affinity of losartan for AT1 receptors. At 1 microM, the AT2-selective ligand CGP 42112A had no effect on contractile responses induced by norepinephrine (NE), serotonin, or neuropeptide Y (NPY). However, it inhibited vasoconstriction elicited by prostaglandin F2 alpha (PGF2 alpha). This latter effect was also noted in the aorta. Similarly, losartan also competitively antagonized aortic contractile responses elicited by U 46619, a thromboxane A2 analogue (TXA2), with a pA2 value of 5.7. Two losartan analogues, DuP 532 and EXP 3174 (a metabolite of losartan), < or = 30 microM, did not antagonize U 46619, showing structural requirements for this antagonistic action of losartan. We conclude that in both rat resistance and conductance vessels, ANG II induces vasoconstriction through activation of AT1 receptors which are selectively blocked by losartan at nanomolar concentrations and that at micromolar concentrations, losartan may also block the vascular TXA2/PGF2 alpha (TP) receptor.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗

Histologic comparison of breast implant shells with smooth, foam, and pillar microstructuring in a rat model from 1 day to 6 months.

The purpose of this study was to determine the soft-tissue response to silicone breast implants with different surface morphologies and to correlate implant microtexturing with capsular formation. Using a rat model, we inserted breast implants having three types of shells: micropillared, silicone foam, and smooth silicone (control). We used 96 adult male Sprague-Dawley rats weighing between 250 and 300 gm. Thirty-two rats were assigned to each of the three shell groups. Within each shell group, 4 rats were implanted for 24 hours, 4 for 4 weeks, 4 for 8 weeks, 4 for 12 weeks, 4 for 16 weeks, 4 for 20 weeks, and 4 for 24 weeks. The rats were sacrificed at the end of each time interval, and periprosthetic tissue was obtained for histologic analysis. Our results show a stable soft-tissue response with some macrophages and fibroblasts for the smooth silicone shell group; capsule thicknesses were 10 to 12 cells with interwoven collagen. The silicone foam prolonged the active cellular response with regard to macrophages, fibroblasts, and multinucleated giant cells, along with random collagen deposition and alternating thin and thick capsular areas. The micropillar group had a more stable cellular response, with macrophages and fibroblasts, along with disruption of the long-range orientation of collagen fibers.

Animals↗

Site-specific alteration of transmissible gastroenteritis virus spike protein results in markedly reduced pathogenicity.

The pathogenicity of neutralization-resistant mutants of the enteric coronavirus transmissible gastroenteritis virus (TGEV) was examined in the newborn piglet. The parental virus (Purdue-115 strain), as well as several mutants selected using monoclonal antibodies (MAbs) directed to antigenic sites A and B, caused an acute enteritis with 100% mortality. By contrast, most of the site D (MAb 40.1) mutants exhibited a strongly reduced enteropathogenicity, leading to the survival of animals inoculated with up to 1000-fold the 100% lethal dose of parental virus. Such a phenotypical change was correlated with point mutations or a small deletion, all located within the S gene sequence coding for the Pro-145 to Cys-155 segment of the mature polypeptide. These observations suggest that an N-terminal subregion of the S molecule is an essential determinant for pathogenesis in TGEV infection.

Animals↗

Surface exposure of outer membrane protein and lipopolysaccharide epitopes in Brucella species studied by enzyme-linked immunosorbent assay and flow cytometry.

Seven surface-exposed outer membrane proteins (OMPs) in Brucella supp. have been previously described (A. Cloeckaert, P. de Wergifosse, G. Dubray, and J. N. Limet, Infect. Immun. 58:3980-3987, 1990). OMPs were shown to be more accessible to monoclonal antibodies (MAbs) on rough (R) Brucella melitensis and B. abortus strains than to MAbs on their smooth (S) counterparts. In this work, we have extended this study to representatives of the main Brucella species, using MAbs specific for OMPs and S and R lipopolysaccharides (S-LPS and R-LPS). Enzyme-linked immunosorbent assay (ELISA), flow cytometry, and immunoelectron microscopy showed important differences between strains in the binding of OMP- and R-LPS-specific MAbs which were in part related to the particular expression of S-LPS, irrespective of the species. Results indicated that both the amount and the length of O polysaccharide on S-LPS greatly influenced the accessibility of OMP and R-LPS epitopes to MAbs. S-R B. melitensis EP and S B. suis 40, for instance, which express O-polysaccharide chains in small amounts and with short mean length, respectively, bound a greater number of OMP- and R-LPS-specific MAbs than the other S Brucella strains. The major 31- to 34-kDa OMP was the most exposed OMP on S strains of B. melitensis and B. suis. In most cases, flow cytometry results agreed with those of ELISA and supplied additional data, such as the homogeneity or heterogeneity of OMP expression at the strain level. However, there were some discordances between flow cytometry and ELISA results concerning the surface exposure of the 25- to 27-kDa and 31- to 34-kDa OMPs on S strains and that of minor OMPs in vaccine strain B. melitensis Rev.1. Immunoelectron microscopy confirmed the poor accessibility of OMPs to MAbs on the surface of S Brucella strains. The naturally R pathogenic species B. ovis and B. canis bound the majority of OMP-specific MAbs as well as the R-LPS-specific MAbs. Therefore, the conserved OMP and R-LPS epitopes could play a role as targets of protective antibody-mediated immunity in infections caused by naturally R B. ovis and B. canis.

Antibodies, Monoclonal↗

Positive end expiratory pressure reduces bronchial blood flow after aspiration injury.

We hypothesized that since added airway pressure compresses bronchial vessels, the airway hyperemia found following airway injury would be reduced by positive end-expiratory pressure (PEEP). Accordingly, we measured the effect of 15 cm H2O PEEP on bronchial and pulmonary blood flows by the radioactive microsphere reference flow technique in closed chested goats (n = 7) before and after aspiration injury to the left lung with 0.1 N HCl. Thirty minutes after aspiration, the pulmonary blood flow to the injured left lung was reduced by one third, whereas the total bronchial blood flow to the left lung (normalized to mean systemic pressure of 100 torr) doubled (11.3 +/- 2.2 to 20.6 +/- 1.0 ml/min 100 torr; p < 0.01). Increasing PEEP from 5 to 15 cm H2O decreased total bronchial blood flow by about half both before (11.3 +/- 2.2 falling to 5.7 +/- 1.4 ml/min/100 torr) and after injury (20.6 +/- 1.0 falling to 10.3 +/- 2.7 ml/min/100 torr). The airway portion (down to 2-3 mm airways) of the total bronchial blood flow of the injured lung increased more than three-fold (1.4 +/- 0.5 rising to 5.5 +/- 1.3 ml/min/100 torr; p < 0.01). This increased flow after aspiration was less affected by PEEP of 15 cm H2O (5.5 +/- 1.3 to 2.8 +/- 0.7 ml/min/100 torr, p = 0.09) than before injury (1.4 +/- 0.5 falling to 0.5 +/- 0.1 ml/min/100 torr; p < 0.05). The increase of the parenchymal portion of the bronchial blood flow after injury, although apparent (9.9 +/- 1.8 increasing to 15.1 +/- 1.2 ml/min/100 torr), was not significant (p = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Effect of low-dose endotoxin on pulmonary vascular permeability following acute hemorrhagic shock.

The purpose of the current study was to determine the effect of low-dose Escherichia coli lipopolysaccharide (LPS) on pulmonary vascular permeability when administered after hemorrhagic shock (40% of baseline cardiac output) followed by resuscitation. Animals were monitored for 3-4 h after LPS infusion. Thirty minutes prior to termination of the experiment, 3 mCi of 125I-human serum albumin was injected intravenously to calculate a permeability index from the left lung lavage and plasma 125I ratios. The two control groups were (1) shock only (no LPS, n = 4), and (2) LPS only (no shock, n = 8). The permeability index for the shock-only group was 0.0015 +/- 0.0007 (mean +/- SE) and that for the LPS-only group was 0.0035 +/- 0.0014. The permeability index for the experimental group (shock followed by LPS, n = 10) was 0.0071 +/- 0.0030 (p > 0.05). Similarly, there was no difference in the wet-to-dry ratios between the three groups. The shock+LPS group required more intravenous fluids to maintain mean arterial blood pressure at control values than the LPS-only group (p < 0.003). We conclude that hemorrhagic shock and resuscitation do not lead to an acute increased permeability of the lung when it is subsequently challenged by a low dose of bacterial LPS.

Animals↗

Genetic anticipation in Parkinson's disease.

We studied age at onset and family history of 137 patients (probands) with the diagnosis of idiopathic Parkinson's disease (PD). Probands (N = 21) who had an affected parent, aunt, or uncle were younger (p = 0.0001) at the onset of PD (47.7 +/- 8.8 years) than were probands (N = 11) who had an affected sib only (60.3 +/- 12.9 years) and probands (N = 105) who had no affected sib, parent, aunt, or uncle (59.2 +/- 11.4 years). Age at onset of affected family members differed significantly between generations (p = 0.0001). Age at onset was earlier, by an average of 17 years, in the proband generation than in the parental generation. The intrafamily variation in the calendar year of onset was too great to suggest a common point of exposure. Our data are most compatible with genetic anticipation, which could suggest involvement of an unstable trinucleotide repeat.

Age Factors↗

The physician's alternative career transition model: a stepwise approach.

The recent intense focus on marketplace reform has stimulated a reassessment of career planning options for some physicians. These socioeconomic changes have created unique opportunities beyond the traditional arenas of clinical practice and medical management for physicians to leverage their medical degrees and experiences in the business world. This paper presents three case reports of physician executives who have successfully pursued medically related business career options, each following different motivations at various stages of their medical careers. It then discusses the Physicians' Alternative Career Transition (PACT) model developed by the authors to assist other physicians who are considering making transitions into business-related careers. The PACT model is based on four critical steps for practicing physicians to make these transitions successfully: an internal self-evaluation process, an external environmental evaluation process, seeking the best "career match," and securing the career match.

Adult↗

A clinical and pharmacokinetic study of high-dose carboplatin, paclitaxel, granulocyte colony-stimulating factor, and peripheral blood stem cells in patients with unresectable or metastatic cancer.

We have developed a regimen incorporating multiple cycles of high-dose carboplatin and fixed-dose paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) with granulocyte colony-stimulating factor and peripheral blood stem cell support given every 21 days for up to four cycles. Our phase I study of this regimen has treated 26 patients with good performance status and histologically documented unresectable or metastatic carcinoma, sarcoma, or melanoma, 21 of whom received all planned courses every 21 days. Paclitaxel 250 mg/m2 was infused over 24 hours, followed by a 1-hour carboplatin infusion, with doses escalated between area under the concentration-time curve (AUC) targets of 8 and 20. Considering the carboplatin doses administered (two to three times those generally achieved with growth factor support), toxicity has been relatively modest. The median duration of grade 4 neutropenia and thrombocytopenia was not significantly different between the AUCs of 8 and 18, which proved to be the maximum tolerated carboplatin dose. Twelve courses were associated with hospitalization for neutropenic fever or catheter-related thrombophlebitis. One treatment-related death occurred, and severe toxicity caused withdrawal of two patients treated at the AUC of 20. Peripheral neuropathy was the most common serious nonhematologic complication. Pharmacokinetic analysis showed significantly lower measured versus predicted AUC values. Among 25 evaluable patients, preliminary results show one complete response (ovarian cancer) and 11 partial responses, including four in patients with non-small cell lung cancer. Additional issues to be addressed include the effect of a shorter (or longer) paclitaxel infusion on the carboplatin AUC (and the incidence of toxicity) and whether the discrepancy between actual and predicted AUCs (greater in our study than reported elsewhere) is due to the variability of creatinine clearance-determined glomerular filtration rate or to altered carboplatin pharmacokinetics when a short high-dose infusion follows paclitaxel. Additional patients are being accrued at the AUC of 18.

Adult↗

Increased risk of Parkinson's disease in parents and siblings of patients.

We studied the incidence of Parkinson's disease in 586 first-degree relatives (parents and siblings) of 114 randomly ascertained white patients with idiopathic Parkinson's disease and in 522 first-degree relatives of 114 age-matched unrelated white control subjects. Sixteen percent of patients had a family history as compared to 4% of control subjects (p < 0.01). The age-specific cumulative incidence was higher in the first-degree relatives of patients than in the first-degree relatives of control subjects (p = 0.007). The age-adjusted odds ratio was 3.5 (95% confidence interval: 1.3-9.4; p = 0.014). These results suggest that genes contribute to the etiology of Parkinson's disease.

Aged↗

Enhanced recovery of ischemic myocardium by combining percutaneous bypass with intraaortic balloon pump support.

Although percutaneous bypass (PB) can support the failing myocardium, regional ischemic damage may still occur beyond a coronary occlusion. This study sought to determine whether the addition of intraaortic balloon pump (IABP) support to PB would result in more optimal salvage of ischemic myocardium. In 30 pigs, the second and third diagonal vessels were occluded with snares for 90 minutes followed by 30 minutes of cardioplegic arrest and 3 hours of reperfusion with the snares released. During the period of coronary artery occlusion, 10 pigs were placed on PB, 10 pigs received PB plus IABP support, and 10 pigs received no support (the unmodified group). The hearts treated with the combination of PB and IABP support exhibited the highest wall motion scores (3.3 +/- 0.20 for the PB plus IABP group [p < 0.05 from the unmodified group and from the PB group]; versus 1.40 +/- 0.30 for the PB group versus 1.37 +/- 0.33 for the unmodified group), the least tissue acidosis (change in pH, -0.30 +/- 0.2 for the PB plus IABP group [p < 0.05 from the PB group] versus -0.60 +/- 0.10 for the PB group versus -0.41 +/- 0.13 for the unmodified group), and the least area of necrosis (25% +/- 5% for the PB plus IABP group [p < 0.05 from the unmodified group and from the PB group]; versus 43% +/- 2% for the PB group [p < 0.05 from the unmodified group] versus 73% +/- 3% for the unmodified group).(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis↗

Reactivity of workshop monoclonal antibodies with normal and pathological ovine lymph nodes.

The monoclonal antibodies (82 mAbs) included in the Second Workshop that belonged to agreed named bovine CD and workshop clusters were tested for their reactivity and tissue distribution on (1) normal sheep lymph nodes and (2) pathological sheep lymph nodes. Pathological lymph nodes were induced following experimental infection with Corynebacterium pseudotuberculosis and were characterized by the presence of typical pyogranulomas. Amongst the 82 mAbs tested, 38 reacted with sheep lymph nodes. The results of these tests are presented and discussed.

Animals↗

Unilateral frontal lobectomy can produce strategy application disorder.

Following a 5 cm left frontal lobectomy for the removal of a mixed astrocytoma-oligodendroglioma, a 51 year old right handed man showed a marked dissociation between his performance on standard neuropsychological tests and his everyday behaviour. In contrast to his intact neuropsychological test performance, he was impaired on a test of "strategy application" which requires goal articulation, plan specification, self-monitoring, and evaluation of outcomes, as well as the establishment of mental "markers" to trigger specific behaviour. Strategy application disorder can therefore be produced by a unilateral circumscribed frontal lobe lesions.

Anger↗

Validation of fluorescent-labeled microspheres for measurement of regional organ perfusion.

Estimations of dog lung, pig heart, and pig kidney regional perfusion by use of fluorescent-labeled microspheres were compared with measurements obtained with standard radiolabeled microspheres. Pairs of radio- and fluorescent-labeled microspheres (15 microns diam, 6 colors) were injected into a central vein of a supine anesthetized dog and the left ventricle of three supine anesthetized pigs while reference blood samples were simultaneously withdrawn from a femoral artery in the pigs. The lungs were cubed into approximately 2 cm3 pieces (n = 1,510). Each pig heart and kidney was cubed into approximately 1-g pieces (total n = 192 and 120, respectively). The radioactivity of each organ piece and reference blood sample was determined using a scintillation counter with count rates corrected for decay, background, and spillover. Tissue samples and reference blood samples were digested with KOH and filtered and the fluorescent dye was extracted with a solvent, or the dye was extracted from lung tissue without filtering. The fluorescence of each sample was determined for each color by use of an automated spectrophotometer. Perfusion was calculated for each organ piece from both the radioactivity and fluorescence. Correlation between flow determined by radio- and fluorescent-labeled microspheres was as follows: r = 0.96 +/- 0.01 (SD) (lung, filtered, n = 588), r = 0.99 +/- 0.00 (lung, nonfiltered, n = 710), r = 0.95 +/- 0.02 (heart, filtered), and r = 0.96 +/- 0.02 (kidney, filtered). Compared with colored microspheres, methods for quantitating fluorescent-labeled microspheres are more sensitive, less labor intensive, and less expensive. Fluorescent-labeled microspheres provide a new nonradioactive method for single and repeated measurement of regional organ perfusion.

Animals↗

Transmissible gastroenteritis coronavirus: the development and applications of the fixed-cell immunoperoxidase technique.

Since the first demonstration in 1971 that solid-phase enzyme-linked immunosorbent assays (ELISAs) could be used for the quantitative determination of antigens and antibodies, this method has been widely applied in serodiagnosis of parasitic and infectious diseases. In addition to the classic ELISA variants using antigen or antibody to coat the plastic plates, there has recently been growing interest in the application of fixed-cell ELISA to research and diagnostic work on viral diseases. The authors discuss the development and applications of this technique to basic research and diagnosis of transmissible gastroenteritis, a highly contagious disease of swine. The success of this technique, as the name suggests, is largely due to the use of a suitable fixative, which preserves the antigenicity of the neo-synthesised viral proteins, and the presence of optimal conditions for viral antigen synthesis. In addition, various parameters are optimised, and this is discussed with reference to transmissible gastroenteritis virus. These parameters would help veterinarians and research workers to develop this technique in their own laboratories.

Acetone↗

Resistance of NOD mice to salmonellosis.

The NOD mouse strain has become one of the most popular animal models for exploring insulin dependent type 1 diabetes. Genetic studies have underlined the polygenic nature of the murine disease. Two such genes were mapped on chromosome 1. One, associated with diabetes onset, is strongly linked with the Lsh, Ity, bcg genes encoding for resistance against L. donovani, S. typhimurium and Mycobacterium. We have undertaken to phenotype NOD mice with regard to one of these resistance genes. After infection with Salmonella abortusovis, we found that NOD mice bore the resistant phenotype/Ityr, which is responsible for early resistance against Salmonella infection.

Animals↗

Comparative study of different immunoserological techniques for the detection of antibodies against transmissible gastroenteritis (TGE) coronavirus.

In order to carry out a sero-epidemiological survey of transmissible gastroenteritis (TGE) infection in a high-density pig-breeding area the Murcia region, Spain), the sensitivity and the specificity of 5 different techniques were compared. Twenty-four sera from non-infected and infected pigs were analyzed by the following tests: in vitro neutralization, indirect ELISA with concentrated virus, indirect ELISA with purified virus, immunocapture ELISA and VELCIA (virus-enzyme linked cell immunoassay). All sera from infected pigs were detected as positive only by seroneutralization, ELISA with purified virus and VELCIA (sensitivity 100%). False-positive sera were detected with several tests (ELISA with purified virus and concentrated virus, ELISA immunocapture with a specificity of 88, 88 and 76% respectively). Only VELCIA provided a specificity as high as that obtained with seroneutralization (100%).

Animals↗