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Biomedical subjects

B Schaub

Publications and source records attributed to B Schaub.

At least 19 recordsLinked to original sources

Fetal cord blood: aspects of heightened immune responses.

Neonatal immune responses have been associated with the development of atopy in childhood. We assessed in cord blood mononuclear cells (CBMC) whether increased allergen/mitogen-induced lymphoproliferation (LP) is associated with pro-allergic Th2 cytokine IL-13 or Th1 cytokine IFN-gamma secretion. We determined whether LP to one allergen is related to heightened lymphocyte function to other allergens/mitogen. CBMC from 135 neonates were stimulated with house dust mite (Derf1), cockroach, ovalbumin, or mitogen. LP to one allergen was associated with significantly increased LP to other allergens/mitogen. Increased Derf1-LP was associated with increased Derf1-induced IL-13 secretion (r = 0.21, p = 0.01). After adjusting for neonatal gender, race, and maternal smoking, Derf1-LP remained associated with Derf1-IL-13 (OR 3.08, 95% CI 1.56-6.10). Increased mitogen-induced proliferation was associated with increased mitogen-induced IL-13 secretion (r = 0.37, p < 0.001). For some individuals, a predisposition to a heightened immune response is already evident at birth. Whether this phenotype results in atopy in childhood warrants further investigation.

Adult↗

Surfactant protein D deficiency influences allergic immune responses.

BACKGROUND: The collectin surfactant protein D (SP-D) confers protection against pulmonary infection and inflammation. Recent data suggest a role for SP-D in the modulation of allergic inflammation. OBJECTIVE: The aim of this study is to characterize the immune responses of SP-D-deficient (SP-D(-/-)) mice in a kinetic model of allergic inflammation. We determined whether allergic parameters were enhanced in SP-D(-/-) mice in vivo. Further, we examined whether functional immune responses in vitro such as lymphocyte proliferation (LP) and cytokine production were modulated in the absence of SP-D. METHODS: In vivo, wild-type (WT) and SP-D(-/-) mice were sensitized and challenged with the allergen ovalbumin (OVA) and assessed for allergic parameters (bronchoalveolar lavage (BAL) eosinophils, IL-13 production, pulmonary IFN-gamma, IL-10 expression) at early time points (1 and 3 days of challenge) in comparison with late time points (7 days of challenge). In vitro, spleen cells from WT and SP-D(-/-) mice were stimulated with the mitogen concanavalin A (ConA) and lipid A (LpA) and analysed for LP, IL-13 and IFN-gamma production. Toll-like receptor 4 (TLR4), ligand for LpA, was assessed by mRNA expression and immunohistochemistry in vivo. RESULTS: Following allergen exposure in vivo, SP-D(-/-) mice expressed higher BAL eosinophils and IL-13 concentrations and lower IFN-gamma expression at early time points compared with WT mice. IL-10 expression was increased at early time points in SP-D(-/-) compared with WT mice. Allergen-induced TLR4 expression was increased in WT, but not in SP-D(-/-) mice. After stimulation with LpA and ConA in vitro LP was increased and IFN-gamma concentration was decreased in SP-D(-/-) mice. CONCLUSION: SP-D may be critical for the modulation of early stages of allergic inflammation in vivo.

Animals↗

[Acute pulmonary edema caused by tocolytic therapy with salbutamol].

BACKGROUND: Acute pulmonary edema may be induced by beta 2-mimetics used for tocolysis. CASE REPORT: A 41-year-old patient, admitted for preterm labor, presented acute pulmonary edema after parenteral tocolysis using salbutamol in combination with corticosteroid therapy to improve fetal pulmonary maturation. DISCUSSION: The pathogenic mechanism is essentially non-cardiologic. Fluid retention is probably the main cause, potentially worsened by corticosteroid administration. If detected early, pulmonary edema is usually and adequately treated by cessation of beta 2-sympathomimetic therapy, oxygen administration and diuretics. Mechanical ventilation can be required. Cardiac function must be assessed after this complication. In preterm labor, the duration of tocolysis with beta 2-sympatomimetics should be reduced.

Acute Disease↗

Identification of a new HLA-B*78 allele in a Hispanic family.

A new B*78 variant, B*7804, was detected in three members of a Hispanic family. The novel B*78 sequence differs from B*78021 by two substitutions: T at nucleotide 527 (all other B*78s have A) and T at nucleotide 583 (all other B*78s have a C). Both nucleotide substitutions encode amino acid changes at codons 152 and 171, respectively.

Alleles↗

Unaltered monocyte function in patients with major depression before and after three months of antidepressive therapy.

Monocyte phenotypes and functions were studied in 22 patients with major depression, and compared with those of 22 matched healthy controls. Immune measures were performed before and after dexamethasone suppression, and after 4 and 12 weeks of moclobemide therapy in patients. Seven patients terminated after 4 weeks because of treatment failure; 11 out of 15 patients responded to therapy after 12 weeks. Monocyte human leukocyte antigen class II and CD14 antigen expression, tumor necrosis factor production, and plasma interferon-gamma and neopterin did not differ in patients before treatment and controls. The reaction to dexamethasone was also similar in patients and controls. Neither antidepressive treatment per se nor the clinical response to it affected any immunological parameter. In conclusion, corticosteroid-controlled monocyte functions were similar in untreated and treated depressed patients and in controls, and unrelated to the clinical course of the disease.

Adolescent↗

[Intravaginal misoprostol before induced abortion in nulliparous women].

One hundred and twenty nine nulliparous requesting first trimester induced abortion between 7 and 12 weeks of amenorrhea (SA) were included in the study to evaluate the effectiveness and the side effects of misoprostol in the cervical ripening before aspiration. Three randomized groups of 43 patients received misoprostol 12 hours before induced abortion: group A received 200 mug inserted vaginally; group B received 400 mu g inserted vaginally and group C received 400 mu g orally. Cervical dilatation after treatment and maximal dilatation realized with Hegar dilatator were significantly higher in group B. The rate of partial abortion is significantly higher in group B. Tolerance is good in the three groups. No significant difference between the three groups related digestive disorders, pelvic pain and hyperthermia were noted. On the other hand the rate of metrorrhagia and hemorrhages more important than menstruation is higher in group B. Misoprostol 400 mu g inserted vaginally 12 hours before induced abortion in nulliparous women seem to be an effective, safe, practical and cheap method for cervical ripening before aspiration.

Abortifacient Agents, Nonsteroidal↗

[Randomized study of sulprostone versus misoprostol in the cervical preparation before elective abortion in nulliparous women].

OBJECTIVE: To assess the effectiveness and side effects of misoprostol versus suprostone in cervix preparation before aspiration abortion in the nullipara. METHODS: Ninety nulliparous women requesting medical abortion with gestations varying from 7 to 12 weeks were included in a prospective randomized study after informed consent. Women with contraindications for prostaglandins and those consulting before 7 weeks gestation were excluded from the study. The women were assigned to 30 groups randomly: women in group A were given 500 micrograms sulprostone in 250 saline solution infused at a rate of 100 micrograms/h 12 hours before the abortion; women in groupe B were given 400 micrograms misoprostol per os 3 hours before abortion; and women in groupe C were given 400 micrograms misoprostol per os 12 hours before abortion. RESULTS: The three groups were not different for age, parity or gestation, gestational age at abortion or type of anaesthesia. Dilatation of the cervix after treatment was identical in groups A and C (8.60 +/- 1.3 vs 8.20 +/- 1.3; NS) but was greater in group A than in group B (8.60 +/- 1.3 vs 7.23 +/- 2.2; p = 0.02). Maximal dilatation was the same in the three groups (9.50 +/- 0.8, 9.10 +/- 1.3, 9.17 +/- 0.8 respectively). Rate of partial expulsion was higher in groups A and C (23 and 6%) compared with group B (0%). Tolerance was much better with misprosol than with sulprostone: 43% digestive disorders in group A versus 15% in groupe B and C (p = 0.003); 80% pelvic pain with sulprostone versus 53% with misoprostol (p = 0.01); 70% metrorrhagie with sulprostone versus 38% with misoprostol (p = 0.04) and 36% with more bleeding than cycles in the sulprostone subjects versus 12% in the misoprostol subjects (p = 0.005). CONCLUSION: Misoprostol at a dose of 400 micrograms per os 12 hours before abortion in the nullipara is an interesting alternative to sulprostone. It is equally effective for cervix dilatation, tolerance is much better and cost is lower.

Abortifacient Agents, Nonsteroidal↗

The crossmatch in renal transplantation. Evaluation of flow cytometry as a replacement for standard cytotoxicity.

Flow cytometry (FC) is increasingly being used as a crossmatch procedure in addition to the standard complement-dependent cytotoxicity (CDC) test. In fact, FC offers a number of advantages over CDC and has the potential to become the primary crossmatch technique for cadaveric donor renal transplantation. We evaluated this possibility in 230 patients crossmatched by both CDC and FC. The results showed that when the T cell crossmatch was negative by FC it was always negative by CDC, and that when the T cell results were positive by CDC (IgM antibodies excluded) they were also positive by FC. As expected, a number of tests were T cell-positive by FC but negative by CDC. A T cell CDC crossmatch was more likely to be positive when FC was positive for both T and B cells and when FC results were quantitatively higher. However, FC was unable to consistently predict a positive, dithiothreitol-resistant B cell CDC crossmatch. A policy to transplant patients with negative FC results (70% of the patients evaluated) and not to transplant sensitized patients with FC+ T cell results (10%) would allow us to make a final decision with only FC in 80% of the cases. Actual graft survival was similar for nonsensitized first-transplant candidates with positive (83%) or all patients with negative (86%) FC results. We conclude that FC is sufficient to make a final decision in most cases. Wider utilization will require improvements in the ability of FC to measure B cell antibodies and to quantitate antibodies to T cells.

B-Lymphocytes↗

[Ultrasonographic fetal growth curves in the West Indies. Apropos of 2930 measures of 889 fetuses].

OBJECTIVE: To establish the echographic foetal growth curves between 20 and 40 weeks amenorrhoea in the specific population of the West Indies. SITE. Gynecology-Obstetrics Unit, Redoute Hospital, Fort-de-France. POPULATION: All echographies performed between the 20th and 40th week of amenorrhoea in single foetus pregnancies in women of local origin who had undergone an echography before 15 weeks of amenorrhoea were included. Major malformations and chromosomic abnormalities were excluded. METHODS: A total of 2,930 measurements of the biparietal, transverse abdominal diameters and length of femur were recorded in 889 foetuses. The curves for the 10th, 50th and 90th percentiles were constructed by smoothing with a second end linear curve for each of the echographic parameters. For each parameter, the growth curves were compared with the curves established by Leroy and Bessis for the French population. The difference in the growth curves between the two populations were correlated to gestational age in order to establish whether there is a difference between the West Indies population and the metropolitan French population. RESULTS: Comparison with the Leroy and Bessis curves revealed that the rate of growth in the transverse abdominal diameter and the length of femur was significantly different between the West Indies population and the French population (p < 0.01). Inversely, the rate of growth of the biparietal diameter was comparable for the two populations. CONCLUSION: These growth curves provide echographists and obstetricians who examine patients of West Indies origin to adapt their obstetrical management. An ethnic factor cannot be excluded in explaining the difference between the two populations. This study confirms the requirement to establish foetal growth curves of each separate region.

Abdomen↗

[Dacryocystocele. Prenatal ultrasonic diagnosis].

The authors report a case of bilateral dacryrocystocele (lacrimal duct obstruction) in a fetus of 32 weeks amenorrhoea, diagnosed by ultrasound. This pathology has been rarely described in a fetus although it is relatively frequent in the new born. This case has made it possible for the authors to define the ultrasound appearances and the prognosis.

Female↗

[Antenatal diagnosis of atrioventricular block. A case report].

The authors report the case of a congenital atrio-ventricular block (AVB) diagnosed after 32 weeks of amenorrhea in a woman, suffering from AVB, fitted with a pacemaker and who had already given birth to two children suffering from congenital AVB. The authors recall the physiopathology and antenatal diagnostic criteria of AVB and how it should be managed.

Adult↗

[Heart surgery with extracorporeal circulation during pregnancy. Review of the literature with a case history].

The authors report a case of replacement of a mitral valve and of tricuspid annuloplasty using extracorporeal circulation in a pregnancy of 23 weeks amenorrhoea with a satisfactory result for the mother and the birth of a healthy baby after 35 weeks of amenorrhoea. A review of the literature made it possible to analyse the problems occurring in pregnancies in woman who have been fitted with a cardiac valve prosthesis and who have to have cardiac surgery in pregnancy.

Adult↗

[The value of myelography, computerized tomography and course of pain for the diagnosis of recurrent herniated disk].

29 patients with recurring symptoms after lumbar disk surgery have been examined with computed tomography and myelography before they underwent a reoperation. This study shows that the myelography has the higher diagnostic accuracy than the CT concerning the differentiation between recurrent disk herniation and scar. The analysis of clinical features is helpful in predicting the etiology of the recurring symptoms.

Adult↗