Biomedical subjects
Publications and source records attributed to A Francés.
We describe the first case of infection of a neurosurgical shunt by Candida glabrata in an adult. The risk factors, clinical picture and response to therapy have been similar to similar cases caused by other Candida sp. We must emphasize the unequivocal features of infection and the rapid and probably complete response to removal of the device.
Because of its efficient antiseizure activity, intravenous phenytoin remains a major agent in acute therapy, although it is associated with many pharmacokinetical and toxicological problems. This contribution focuses on the difficulties in finding the appropriate mode of intravenous administration, a matter which is of considerable clinical importance. The fact that precipitations of phenytoin occur when the product is incorrectly diluted is common knowledge--yet the pharmacy department is frequently contacted because of an improper handling of the products available. A review of the factors contributing to precipitation problems, the i.v. products in use in the Grand-Duchy of Luxembourg and the possible i.v. dilutions for these products are discussed.
How implantation is regulated and brought about remains an enigma. The objective of the present review is to propose a hypothetical model based on our actual knowledge of the role of cytokines, adhesion molecules and invasive proteinases in the adhesion and invasion phases of embryonic implantation. For the purpose of clarity we will describe first what is known about the presence of these molecules in the endometrium and embryo in animal models and their relevance in embryonic implantation. Secondly, since human implantation is unique the presence of these factors in the human endometrium and embryo and their possible clinical relevance is considered separately. Finally, the link between cytokines, adhesion molecules and invasive proteinases as well as their endocrine/paracrine/autocrine regulation is put forward as a possible model that could lead us to a better understanding of the implantation process in humans.
In the study reported here, we localized at the protein level the major components of the interleukin (IL)-1 system in the human embryo, and we investigated the endometrial factors influencing their secretion during embryonic development. To localize these components, we performed immunohistochemical experiments in 44 oocytes and 78 embryos. The following primary antibodies were used: monoclonal mouse anti-human IL-1 receptor type I (IL-1R tl), monoclonal mouse anti-human IL-1 beta, and polyclonal rabbit anti-human IL-1 receptor antagonist (IL-1ra). For embryo culture, human embryos at different developmental stages were cultured in 100-microliters drops of Ham's F-10 medium + 4 mg/ml BSA (n = 33), in 100-microliters drops of Menezo B2 culture medium (n = 18), or in wells with 1 ml of Menezo B2 culture medium (n = 8). For embryo coculture, endometrial stromal cells (ESC) and endometrial epithelial cells (EEC) were isolated from human secretory endometrium and cultured until confluence in 75% Dulbecco's Modified Eagle's Medium and 25% MCDB-105 containing antibiotics and supplemented with 10% charcoal-Dextran-treated fetal bovine serum. Individual human embryos were cocultured with experimental EEC and ESC (n = 23 and n = 4, respectively) for 5 days in 600-microliters drops of Menezo B2 medium, and conditioned medium was removed every 24 h. Human embryos were also cultured with EEC-conditioned medium (n = 9). IL-1 alpha, IL-1 beta, and IL-1ra levels were determined by ELISA in the 24-h culture- or coculture-conditioned media. Immunostaining confirmed the presence of IL-1 beta, IL-1ra, and IL-1R tl in oocytes and embryos in all stages analyzed, with no statistical differences. IL-1 alpha, IL-1 beta, and IL-1ra were absent in conditioned media of cultured embryos and embryos cocultured with ESC. However, when human embryos were cocultured with EEC or with EEC-conditioned medium alone, two different populations of embryos were observed: IL-1 producers (57% and 56%) and IL-1 nonproducers (43% and 44%, respectively). Finally, the IL-1 profile of a single human embryo cocultured with maternal EEC which successfully implanted and developed is presented, this pattern being similar to that described in the IL-1 producer population. These results demonstrate the presence of the IL-1 system in the human embryo. However, the selective release of IL-1 only when embryos were cocultured with EEC or EEC-conditioned medium indicates an obligatory role of the endometrium in the regulation of the embryonic IL-1 system. Furthermore, the differential embryonic production of IL-1 may be related to the implantation capability of the embryos.
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Although the immune and reproductive systems have been considered independent of each other, the cooperation of both systems are now known to be crucial for the initiation and maintenance of mammalian pregnancy. Nowadays cytokines and growth factors have became increasingly implicated in embryonic implantation. Endometrial functions, embryonic secretions and embryo-endometrial interactions require a continuous dialogue and synchronism between both partners (endometrium and embryo). The present review focuses on the Interleukin-1 system as an example of local regulator in embryonic implantation. Evidence demonstrating its presence and relevance on human endometrium physiology and human preimplantation embryonic development are presented. Furthermore, we described data suggesting the possible role of this cytokine in human implantation.
Two atypical serological markers of hepatitis B virus (HBV) infection were detected in 19 patients during a 18-month period study. Pattern 1 (10 patients) was consistent with HBV-2 infection. Reactivity of HbsAG was confirmed by neutralization tests; the absence of other markers was also verified, included anti-HBcIgM. Three of the patients were classified in high risk groups and seven in the low risk groups for hepatitis B; in none of them was co-infection with hepatitis A virus (HAV) detected. Pattern 2 (9 patients) was characterized by the detection of HBsAg and HBeAg and the absence of other hepatitis B markers. Six of these patients were HIV-positive patients and had increased and persistent levels (for longer than 12 weeks) of these markers. In the three remaining patients (with no underlying immunological disorders) there was a loss of these markers within a variable time (2 days to 16 weeks). Nevertheless, DNA-VHB was detected in one of these serum samples once all markers of virus B had disappeared.
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