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Biomedical subjects

A Bertrand

Publications and source records attributed to A Bertrand.

At least 19 recordsLinked to original sources

In vitro antibody secretion by peripheral blood mononuclear cells as an expression of the immune response to Brucella spp. in humans.

We developed an assay to detect antibodies spontaneously secreted in vitro by peripheral blood mononuclear cells (PBMC) against Brucella spp. High levels of anti-Brucella immunoglobulin G (IgG) and/or IgM and/or IgA antibodies were detected in the cell supernatant solution of PBMC cultures for 12 patients suffering from acute or focalized brucellosis and for 5 patients recently vaccinated against brucellosis. This spontaneous in vitro antibody production disappeared 5 to 20 months after onset of clinical signs and 20 to 27 days after vaccination. The transient character of this anti-Brucella antibody production by PBMC is consistent with a temporary in vivo stimulation of the immune system by Brucella antigens. Detection of this secretion could improve the diagnosis of evolutive brucellosis.

Adult

Measurement of lymphatic flow variation by noninvasive method cases of lymphedema.

The purpose of this study was to measure the variations of lymphatic flow. A noninvasive isotopic method was used to achieve a functional exploration of lymphatic circulation. Fifteen subjects were used in the study: 10 healthy subjects and 5 patients with lower extremity lymphedema. A first subcutaneous injection of technetium 99m rhenium sulfate (99mTc) was performed in the first interdigital space of both feet. The radioactivity was recorded in two places: the first one on the inguinal site by a gamma camera; the second, below the first, on the precordial site by a multichannel analyzer. With the two types of recording procedures, it was possible to obtain a curve that showed the amount of radioactivity in relation to time. In order to obtain a muscular activity fifty-five minutes after the injection, each subject or patient spent ten minutes on an ergometric bike. A second subcutaneous injection was performed one week later, but prior to the injection, the subject or patient took orally 1800 mg of heptaminol adenosine phosphate (HAP) per day for three days. The radioactivity recording was made under the same conditions as with the muscular activity. The statistical results of the experiment without treatment on the two types of recording show that in the healthy subjects the amount of radioactivity increased during muscular activity. Moreover, the treatment indicated higher radioactivity values, which remained at a higher level. However, the muscular activity performed by a patient was unable to increase the radioactivity. On the other hand, the drug gave radioactivity values that were higher than the previous values of the first curve.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Monophosphate

Characterization of a protein binding sequence in the promoter region of the 16S rRNA gene of the spinach chloroplast genome.

By means of mobility-shift assays and Exonuclease III mapping we have determined a 14 bp sequence (named CDF2 binding site) located in front of the 16S rRNA initiation start site which is protected by a spinach chloroplast extract. This region does not include neither one of the two '-35' nor of the two '-10' E. coli-like promoter elements which are recognised by E. coli RNA polymerase in vitro. The CDF2 binding site is specifically recognized by two small polypeptides which migrate corresponding to 35 and 33 kDa respectively as shown by UV cross-linking experiments. In vivo transcription initiation of the 16S rRNA gene occurs 13 nucleotides downstream of the 14 bp sequence and is different from the transcription start site which is used by E.coli polymerase in vitro.

Base Sequence

Evolution of myocardial ischemia and left ventricular function in patients with angina pectoris without myocardial infarction and total occlusion of the left anterior descending coronary artery and collaterals from other coronary arteries.

Repeated episodes of myocardial ischemia might lead to progressive impairment of left ventricular (LV) function. This radionuclide study assessed myocardial ischemia and LV function several years after documented coronary occlusion without myocardial infarction. Over 5 years, 24 consecutive patients, who underwent cardiac catheterization for angina pectoris without myocardial infarction, had isolated total occlusion of the left anterior descending coronary artery with well-developed collateral vessels. Five patients were successfully treated by coronary bypass grafting and 3 by coronary angioplasty. Among the 16 medically treated patients, 1 was lost to follow-up and 1 died (extracardiac death). The mean (+/- standard deviation) follow-up (14 patients) was 48 +/- 15 months. At follow-up, 8 patients still had clinical chest pain, 11 received antianginal therapy, 4 patients had no stress ischemia and the other 10 had greater than or equal to 1 sign of stress ischemia. All patients had a normal LV ejection fraction at rest (mean 60 +/- 3%; range 55 to 65%). Collateral circulation preserves LV function at the time of occlusion and, in some cases, prevents the development of myocardial ischemia; in patients with persisting myocardial ischemia after well-collateralized coronary occlusion, LV function is not impaired at long-term follow-up.

Aged

Molecular epidemiology of Staphylococcus haemolyticus strains isolated in an Albanian hospital.

A recent outbreak of erythroderma in young children in an Albanian hospital was investigated. The etiology was not established, but Staphylococcus haemolyticus was frequently isolated from the affected children and from staff working in the same unit. Possible relationships among the isolates were investigated by using classical techniques (biotype, antimicrobial susceptibility, and extrachromosomal DNA pattern) and by restriction endonuclease analysis (REA) of total DNA. Control isolates of proven pathogenicity from hospitalized patients in Lyon, France were subjected to the same procedures. Distinct REA patterns were obtained after digestion with two enzymes in 7 of 10 isolates from five affected children. Six distinct patterns were observed in nine isolates from six staff members; two REA patterns from patient isolates and two from staff members were identical, and these were distinguishable by the other markers examined. Only two different REA patterns were found in the pathogenic control isolates despite the use of a third additional enzyme. Again, the isolates with the same REA patterns could be distinguished by their plasmid profile or antimicrobial resistance profile. REA of total DNA used in combination with other markers indicated that the Albanian isolates differed considerably, whereas the French pathogenic isolates showed little variability.

Albania

Reproducibility of image interpretation in immunoscintigraphy performed with indium-111- and iodine-131-labeled OC125 F(ab')2 antibody injected into the same patients.

An important criterion for the clinical use of a new imaging technique is the correct reproducibility of interpretation. Forty-six paired immunoscintigraphic examinations were performed on 43 patients with suspected ovarian carcinoma recurrence using F(ab')2 fragments of OC125 antibody labeled first with indium-111 and then with iodine-131. Planar scintigraphy (PS) and emission computed tomography (ECT) images were interpreted blindly and separately by three observers, and reproducibility was evaluated by a kappa concordance index. Intra- and interobserver reproducibility were generally satisfactory (kappa values of 0.6 and 0.7, respectively). Binomial analysis of kappa values for ECT showed the superiority of indium-111 for intraobserver (p = 0.035) and interobserver (p = 0.0039) study. However, for PS there was no significant difference in reproducibility with the two radionuclides.

Adult

Abstention from alcohol in dilated cardiomyopathy: complete regression of the clinical disease but persistence of myocardial perfusion defects on exercise thallium-201 tomography.

This case report describes a 43-year-old man with dilated cardiomyopathy reversed by abstention from alcohol over 1 year but with persistence of previous myocardial perfusion defects on exercise thallium-201 tomography. This suggests that despite the near normalization of left ventricular function, a permanent myocardial disease seems to persist.

Adult

Iron status in runners of various running specialties.

The blood iron status of 44 male runners of various running specialties (18 sprinters, 13 middle- and 13 long-distance runners) is evaluated by measuring serum ferritin (SF), serum iron (Si), hemoglobin concentration (Hb), hematocrit (Ht), red blood cells content (RBC) and haptoglobin concentration (Hp). The results of these analyses (except Hp) are compared to those obtained in sedentary male subjects (control group) of the same mean age. Mean SF, SI, Hb and Ht measured in athletes are significantly lower than in control group. The remarkably low Hp values obtained in athletes suggests the occurrence of hemolysis. Using unpaired t test, it appears that the blood iron status of these runners does not depend on their running specialty.

Erythrocyte Indices

Comparison of three different regimens in the treatment of acute brucellosis: a multicenter multinational study.

The present study was undertaken to evaluate efficacy, safety and patient acceptability of three antibiotic regimens for the treatment of acute brucellosis. Six different centres were involved: three in France, one in Greece and two in Spain. The regimens were: oral rifampicin 900 mg/day plus oral doxycycline 200 mg/day for 45 days (A), oral doxycycline 200 mg/day for 45 days plus im streptomycin 1 g/day for 21 days (regimen B) [corrected] and the WHO regimen (C) combining oral tetracycline 2 g/day for 21 days plus im streptomycin, 1 g/day, for 14 days. Regimens A and B were randomly allocated in all centres, while regimen C was allocated only in two centres. All patients were suffering from acute brucellosis clinically and biologically proven. 143 patients were allocated for treatment and analysed. Their mean age was 41 years (range 13-70), 49 were female and 94 male, and their mean weight was 64 kg (range 35-98). Among these patients, 14% had localized disease (nine orchitis, eight osteo-articular involvement and one pleural effusion), but there was no statistical difference between the three regimens in regard to this localized disease. Forty-five per cent of the patients had positive blood cultures. The cure rate with regimen A was 95%, 96% with regimen B and 59% with regimen C. Thus regimen A presented the same efficacy rate as regimen B, but regimen C cannot be regarded as the treatment of choice for acute brucellosis.

Acute Disease

[Tamponade disclosed by functional right-left shunt reversible after surgical drainage].

The authors report a case of tamponade revealed by the discovery, during emergency radioisotope scanning of the lung, of an acquired right-to-left shunt which was reversed by surgical drainage. The patient was a 60-year old woman treated by anticoagulants for suspected pulmonary embolism who had sudden worsening of her symptoms on the 7th day of the disease.

Cardiac Tamponade

[Venous insufficiency and hemorheology. Influence of venous stasis on erythrocyte aggregation and disaggregation].

UNLABELLED: The aim of this study was to assess the rheological properties of blood in patients with superficial venous insufficiency, in the very exact place of the hemodynamic disturbance i.e. in the veins of the lower limbs. MATERIAL AND METHODS: Several hemorheological parameters were studied in 20 patients (12 females and 8 males, 20 to 44 years old) with varicose veins of the lower limbs (insufficiency of the superficial venous system and no history of thrombosis). The results were compared to those obtained in 20 healthy controls matched for sex, age, weight and schedule for blood withdrawal. Two blood samples were obtained from the veins of the lower limbs of each subject: the first one at rest and the second after 10 minutes of "venous stasis" (standing position and 100 mm Hg tourniquet), in a temperature controlled room (22 degrees C). Every blood test was performed within one hour after blood withdrawal: --hematocrit (microcentrifugation) and fibrinogen (nephelometry); --plasma viscosity in a 37 degrees C temperature controlled capillary viscometer (Myrenne KSPV4); --erythrocyte filterability using the Hemorheometer (8% hematocrit and polycarbonate nuclepore membrane with a pore diameter of 5 microns); --erythrocyte aggregation and disaggregation (Myrenne AMM1 aggregometer and Erythroaggregometer SEFAM). RESULTS: 1. Hematocrit was not significantly different between both groups of subjects at rest. However, it increased significantly after venous stasis in patients with varicose veins (44.2% vs 41.8%, p. less than 0.05) and that was not found in controls. 2. At rest, the fibrinogen level was higher in patients than in controls (3.54 milligrams vs 2.41 milligrams, p less than 0.01). After statis, a significant increased was found only in the patients group (3.93 milligrams, p less than 0.05). 3. In a similar way, plasma viscosity at rest was significantly higher in patients (1.23 mPa.s) than in controls (1.11 mPa.s, p less than 0.01), and after stasis a further increase was found in the patients group (1.32 mPa.s, p less than 0.01). 4. Also the erythrocyte filterability index was altered at rest in patients (20.9) when compared to controls (15.1, p less than 0.01). A significant increase of this index was only found in the patients group (23, p less than 0.01). 5. Every aggregation parameters were significantly different at rest when comparing subjects groups, the most significant difference concerning the threshold of disaggregation (171.2 s-1 vs 106.8 S-1, p less than 0.001. Erythrocyte aggregation index was increased after stasis in patients but not in controls, with both 600 S-1 and 3 S-1 shear rates. 6. Positive correlations were found between low shear rate aggregation index on one hand and fibrinogen (r = 0.61), plasma viscosity (r = 0.51) and erythrocyte filterability index (r = 0.47) on the other hand...

Adult

[From poliomyelitis to myopathies: management of respiratory insufficiency in neuromuscular disease].

Chronic respiratory insufficiency by neuromuscular disease is a problem with unknown fullness. Thirty eight patients were followed in a specialized center and have been treated by several means: Intermittent positive pressure breathing was employed for 6 patients with a vital capacity which was between 30 and 50% of normal values. It prevents thoracic deformation and aggravation of restrictive syndrome. It was used for preventive effect. Endotracheal ventilation by tracheostomy (13 cases) is an invasive but necessary method which was employed when there were obstructive bronchial secretions and very deep respiratory insufficiency (vital capacity under 30%). Ventilation by extra thoracic prosthesis was used in eighteen patients. Body ventilator, wrap, pneumo-belt were chosen in function of abdominothoracic morphology. "Personalized" nasal mask ventilation is a great interest non invasive method. It was applied in one case (myopathy with sleep apnea syndrome).

France

[In vitro bactericidal effect of a piperacillin-pefloxacin combination against isolated strains of nosocomial pneumopathies in intensive care].

Combinations of piperacillin and pefloxacin are evaluated in vitro using checkerboard and killing-curves methods against 19 clinical isolates: S. aureus, K. pneumoniae, K. oxytoca, C. freundii, P. stuartii, Ps. aeruginosa, Ps. maltophilia and Ac. anitratum. The static checkerboard method showed more synergistic antibacterial effects than the killing curves method. The best synergistic effects appeared against S. aureus, K. oxytoca, P. stuartii, Ps. aeruginosa Ac. anitratum, including a notable increase of the rapidity of bactericidal activity. The combination PIP 64 micrograms - PEF 4 micrograms prevents the frequent secondary regrowth seen after 6 hours with the antibiotics used alone. No activity is obtained against S. aureus meti-R and Ps. maltophilia.

Cross Infection

Effect of diltiazem on myocardial infarct size estimated by enzyme release, serial thallium-201 single-photon emission computed tomography and radionuclide angiography.

Diltiazem is a calcium antagonist with demonstrated experimental cardioprotective effects. Its effects on myocardial infarct size were studied in 34 patients admitted within 6 hours after the first symptoms of acute myocardial infarction. These patients were randomized, double-blind to placebo or diltiazem (10-mg intravenous bolus followed by 15 mg/hr intravenous infusion during 72 hours, followed by 4 X 60 mg during 21 days). Myocardial infarct size was assessed by plasma creatine kinase and creatine kinase-MB indexes, perfusion defect scores using single-photon emission computed tomography with thallium-201 and left ventricular ejection fraction measured by radionuclide angiography. Tomographic and angiographic scanning was performed serially before randomization, after 48 hours and 21 days later. Groups were comparable in terms of age, sex, inclusion time and baseline infarct location and size. Results showed no difference in creatine kinase and creatine kinase-MB data between controls and treated patients, a significant decrease in the perfusion defect scores in the diltiazem group (+0.1 +/- 3.0 placebo vs -2.2 +/- 1.9 diltiazem, p less than 0.02) and a better ejection fraction recovery in the diltiazem group (-4.2 +/- 7.4 placebo vs +7.7 +/- 11.2 diltiazem, p less than 0.05). Myocardial infarct size estimates from perfusion defect scores and enzyme data were closely correlated. These preliminary results suggest that diltiazem may reduce ischemic injury in acute myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Enzyme Tests