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C Perret

Publications and source records attributed to C Perret.

At least 73 records · Page 4Linked to original sources
PubMed1994

CD11b/CD18 expression, adherence, and chemotaxis of granulocyte in adult respiratory distress syndrome.

The accumulation of granulocytes in the pulmonary microvasculature is generally thought a cardinal event in the pathology of adult respiratory distress syndrome (ARDS). However, the mechanism by which granulocytes are sequestered in the pulmonary vascular bed remains largely unknown. Because the CD11b/CD18 membrane receptors mediate various adhesion-dependent functions, their expression was investigated in granulocytes from patients during the course of ARDS development in relation to adherence and chemotaxis. CD11b expression of ARDS resting granulocytes was increased within 24 h of ARDS onset by a factor of two in comparison with control patients (p < 0.05) and remained significantly increased 72 to 120 h later. In contrast, the stimulated expression was significantly decreased only within 24 h of ARDS onset. Adherence was not modified within 8 h of the onset of ARDS, but was increased at Days 1, 3, and 5. The time course of granulocyte chemotaxis shows a decreased chemotaxis capacity during the first 3 d of ARDS, followed by normalization at Day 5. The dynamic changes observed in the various functions studied indicate a possible relationship between the modulation of the CD11b expression and a hyperadhesive state of granulocytes in ARDS. These sticky granulocytes may potentially contribute to the microvascular injury.

Adult↗
PubMed1994

Calbindin-D9k gene expression in the uterus: study of the two messenger ribonucleic acid species and analysis of an imperfect estrogen-responsive element.

The calbindin D9k (CaBP9k) gene is under strict estrogen control in the rat uterus. This tissue contains two CaBP9k messenger RNA (mRNA) species. We have used primer extension analysis, reverse transcriptase associated with polymerase chain reaction, and RNase H digestion to show that these two mRNA species have the same structural features, including 5'- and 3'-ends, and poly(A) tail length. Our results suggest that the difference in electrophoretic mobilities of the two mRNA species might be due to interaction with another factor. We also analyzed the imperfect estrogen-responsive element (ERE) present on the first 5'-splice site of the rat CaBP9k gene. The oligonucleotide corresponding to the CaBP9k ERE was cloned in the plasmid pBLCAT2 (where the thymidine kinase promoter governs the expression of the chloramphenicol acetyl transferase gene) and transfected into MCF7 cells. This CaBP9k ERE was found to be a hormone-inducible enhancer that worked in an orientation-independent manner on a heterologous promoter and was functional at physiological hormone concentrations. One CaBP9k ERE conferred only weak (about 2-fold) estrogen induction, but two EREs cloned in tandem were strongly synergistic (14- to 16-fold). The CaBP9k ERE also bound to the partially purified estrogen receptor (ER) and to ER expressed in COS cells by gel shift assay. Methylation interference showed that all the guanine residues in both half-sites of the CaBP9k ERE were protected by ER binding. Thus, ER binds to the CaBP9k ERE in a way similar to other EREs. The gel shift assay results indicate that the strong synergistic effect of two EREs cloned in tandem is not due to cooperative binding between the two elements. As the CaBP9k gene is under strong estrogenic control in the uterus in vivo, the imperfect CaBP9k ERE may cooperate with another trans-acting factor to become fully efficient.

Animals↗
PubMed1994

N-acetylcysteine enhances recovery from acute lung injury in man. A randomized, double-blind, placebo-controlled clinical study.

OBJECTIVE: To determine the effects of intravenous N-acetylcysteine (NAC) on the development of severe adult respiratory distress syndrome (ARDS) and mortality rate in patients with mild-to-moderate acute lung injury and to analyze the duration of ventilatory support and FIO2 required as well as the evolution of the lung injury score. SETTING: Three university hospital ICUs and one regional ICU in Switzerland. PATIENTS: Sixty-one adult patients presenting with mild-to-moderate acute lung injury and various predisposing factors for ARDS received either NAC, 40 mg/kg/d, or placebo intravenously for 3 days. MEASUREMENTS: Respiratory dysfunction was assessed daily according to the need for mechanical ventilation and FIO2, the evolution of the lung injury score, and the PaO2/FIO2 ratio. The cardiovascular state, liver function, and kidney function were also monitored. Data were collected at admission (day 0), during the first 3 days, and on the day of discharge from the ICU. RESULTS: The NAC and placebo groups (32 and 29 patients, respectively) were comparable at ICU admission for severity of illness assessed by the simplified acute physiology score (SAPS) (10.8 +/- 4.6 vs 10.9 +/- 4.8) and lung injury score (LIS) (1.39 +/- 0.95 vs 1.11 +/- 1.08) (mean +/- SD). Three patients in each group developed ARDS. The 1-month mortality rate was 22 percent for the NAC group and 35 percent for the placebo group (difference not statistically significant). At admission, 22 of 32 patients (69 percent) in the NAC group were mechanically ventilated compared with 22 of 29 (76 percent) in the placebo group. At the end of the treatment period (day 3), 5 of 29 (17 percent) in the NAC group and 12 of 25 (48 percent) in the placebo group were still receiving ventilatory support (p = 0.01), The FIO2 was 0.37 less than admission value (day 0) in the NAC group, and 0.20 less in the placebo group (p < 0.04); the oxygenation index (PaO2/FIO2) improved significantly (p < 0.05) from day 0 to day 3 only in the NAC-treated group. The LIS showed a significant regression (p = 0.003) in the NAC-treated group during the first 10 days of treatment: no change was observed in the placebo group. No adverse effects were observed during the treatment with NAC. CONCLUSIONS: Intravenous NAC treatment during 72 h improved systemic oxygenation and reduced the need for ventilatory support in patients presenting with mild-to-moderate acute lung injury subsequent to a variety of underlying diseases. Development of ARDS and mortality were not reduced significantly by this therapy.

Acetylcysteine↗
PubMed1994

Malondialdehyde dosimetry in laser-irradiated tissues sensitized by hematoporphyrin derivative.

Photodynamic therapy (PDT) is based on the selective retention of a photosensitizer (hematoporphyrin derivative [HPD]) by tumor tissue and the subsequent irradiation of this tissue with light. Unsaturated phospholipids are important targets of membrane photodamage, and malondialdehyde (MDA), an ultimate marker of lipid peroxidation, can easily be measured by the fluorometric thiobarbituric acid (TBA) assay. To determine whether MDA content represents a reference for PDT intensity, tissue content in 7-week-old male nude mice was studied on biopsy samples after PDT (5 mg/kg HPD injected intravenously 24 hr before irradiation at 632 nm) with or without intraperitoneal injection of WR-2721 40 min before treatment. The FeCl3 method requiring only 15 min of incubation in a 95 degrees C waterbath proved most effective compared with the method involving phosphotungstic acid or the MDA-TBA determination using a commercially available kit. Whatever the method used, the best results were found using a 60-min interval between treatment and freezing. MDA concentration in HPD-PDT-treated samples was significantly higher than in HPD-tested controls (P < .01) and increased at laser irradiation doses ranging from 0 to 50 J/cm2. Administration of WR-2721 intraperitoneally significantly reduced MDA concentration (from 70% to 38%). A maximal effect was obtained with 100 mg/kg for brain (-70%) and 200 mg/kg for muscle (-47%). Higher doses produced no additional changes. The MDA assay is a simple tool for indirect evaluation of PDT, and WR-2721 can decrease MDA content in normal tissue, suggesting the possibility of good protection for normal tissue during PDT.

Amifostine↗
PubMed1993

Comparison of results of intravenous infusion of anistreplase versus streptokinase in acute myocardial infarction.

This randomized study compares the coronary perfusion rate in patients with acute myocardial infarction (AMI) treated with 2 different intravenous thrombolytic agents: streptokinase 1.5 million U given over 60 minutes and anisoylated human plasminogen streptokinase activator complex (anistreplase) administrated as a bolus of 30 U over 5 minutes. One hundred seventy-five patients (149 men and 26 women, mean age 54 years) have been included in this study. Eighty-nine patients were treated with anistreplase and 86 patients with streptokinase. AMI was inferior in 54 patients (61%) in the anistreplase group and in 54 patients (63%) in the streptokinase group. It was anterior in 35 (40%) and 32 (37%) patients, respectively. Coronary angiography and ventriculography were performed at a mean time (+/- SEM) of 207 +/- 11 minutes after the beginning of thrombolysis in 170 patients. A perfusion score grade of 2 or 3 according to the Thrombolysis in Myocardial Infarction trial was found in 63 patients (72%) in the anistreplase group and in 56 patients (68%) in the streptokinase group (p = NS). Severe bleeding occurred in 7 patients (8%) after anistreplase and in 6 patients (7%) after streptokinase. No cerebral hemorrhage occurred. Nine patients (5%) died during their hospital stay: 6 after anistreplase and 3 after streptokinase. It is concluded that intravenous administration of anistreplase or streptokinase is efficient and safe. Coronary patency 207 minutes after fibrinolysis, incidence of adverse events and mortality are similar in both groups.

Adult↗
PubMed1993

Cardiac arrest: prognostic factors and outcome at one year.

This study was designed to determine by multivariate statistical methods the influence of 38 variables on outcome after cardiopulmonary resuscitation (CPR) and to assess neuropsychological status in long-term survivors. The charts of 181 consecutive patients resuscitated in a 1,100-bed University Hospital over a 2-year period were analyzed retrospectively. Of the 181 resuscitated patients, 23 (13%) could be discharged. Outcome was significantly affected by the following variables: presence of shock or renal failure before cardiac arrest (CA) (odds ratio = 10.6; 95% confidence interval = 1.3-85.8 and odds ratio = 13.8; 95% confidence interval = 1.7-109.2, respectively), administration of epinephrine (odds ratio = 11.2; 95% confidence interval = 3.2-39.2) or prolonged CPR (> 15 min) (odds ratio = 4.9; 95% confidence interval = 1.7-13.7). By contrast, when CA occurred in uncomplicated acute myocardial infarction a significantly better prognosis could be demonstrated (odds ratio = 0.2; 95% confidence interval = 0.0-0.6). The 10 long-term survivors investigated lead an independent life and all returned to former occupation. The most common complaint was moderate memory disturbance (five patients). The conclusion is that this study confirms the critical influence of cellular anoxia on prognosis and allows the improved delineation of the situations in which cardiopulmonary resuscitation appears to be hopeless or likely to be successful. The follow up in a small number of survivors has shown a good quality of life and minor neuropsychological sequellae.

Cardiopulmonary Resuscitation↗
PubMed1993

Colon cancer in seven siblings.

In a case-control study of cancer of the colon it was found that 96 out of 332 (29%) cases had a positive family history of cancer of the colon (2 cases and more) as compared with 19 out of 473 (4%) controls. 3 colon cancer cases reported that 6 of their respective relatives were also affected with the same cancer. We were able to do a complete follow-up study of one family where 7 out of 12 sibling (P < 0.05) had confirmed pathological diagnoses of cancer of the colon. The mean age at diagnosis among these familial colon cancer cases was 64 years (60 years for females and 73 years for males) and all tumours were located in the caecum or right colon (a common characteristic of colon cancer in this family). There was no history of familial adenomatous polyposis in this family. It is unlikely that the significantly high proportion of familial colon cancer found could be due to chance. This suggests that both environmental and genetic factors play an important role in the aetiology of colon cancer.

Adenocarcinoma↗
PubMed1993

Estrogen-induced calbindin-D 9k gene expression in the rat uterus during the estrous cycle: late antagonistic effect of progesterone.

Progesterone modulates estrogen-stimulated responses in the uterus. Calbindin-D 9k (CaBP9k), a 17 beta-estradiol-responsive gene expressed in the uterus, was used as a marker to examine the interactions between endogenous progesterone and estradiol in the rat. The variations in uterine CaBP9k messenger RNAs (mRNAs) during the rat estrous cycle indicated that CaBP9k gene expression was greatest during the estrogen-dominated phases (proestrus and estrus) and became totally repressed during diestrus, when progesterone predominates. Estradiol was found to be the major controlling factor of CaBP9k gene expression in vivo, progesterone antagonizing estrogen-induced CaBP9k gene expression. The inhibitory role of progesterone was further examined in two experiments. Mature cyclic rats were injected with the progesterone antagonist RU486 before the progesterone surge of proestrus, and the estrous cycle was mimicked in ovariectomized rats by sequential injections of estrogen and progestin. Progesterone did not appear to be involved in the rapid decrease in CaBP9k mRNA during estrus but was implicated in the down-regulation of the estrogen-stimulated CaBP9k gene expression at the end of estrus and during diestrus. This delayed effect of progesterone was confirmed in the ovariectomized rat model. CaBP9k mRNA accumulation in estrogen-primed ovariectomized rats was suppressed by estrogen followed 1 h later by the progesterone agonist R5020. This effect occurred more than 24 h after progestin treatment. The inhibition of the estrogen-induced CaBP9k gene expression in the rat uterus by progesterone is certainly mediated by the progesterone receptor, because progesterone had no effect without estrogen priming or when the antagonist RU486 was used. The delayed progesterone effect probably does not involve depletion of nuclear estrogen receptors, the major rapid mechanism proposed for estrogen inhibition by progesterone in the rodent uterus, or control of estrogen receptor synthesis, as shown by Northern blot analysis of estrogen receptor mRNA.

Animals↗
PubMed1993

[The pulmonary manifestations of diving accidents].

Scuba diving is associated with risks of drowning, lung barotrauma and decompression sickness. In case of near-drowning, irreversible neurologic lesions or death may follow an acute hypoxemia or a cardiopulmonary arrest. Therefore, victims of drowning should benefit from an immediate and prolonged cardiopulmonary resuscitation. Lung barotrauma are due to the failure of expanding lung gases to escape during ascent; they are likely to be complicated by arterial gas embolism. They can follow a panic ascent even from a shallow depth. Most of decompression procedures induce the formation of asymptomatic venous gas bubbles, normally filtrated and eliminated by the lungs. In case of massive intravenous bubbling, the filtering capacity of the lungs can be overwhelmed and the lung microcirculation damaged up to the point of provoking a cardio-respiratory failure.

Adult↗
PubMed1993

[Biological and parasitic variations in horses infested and reinfested by Trichinella spiralis].

Seven mares were infected with 20,000 Trichinella spiralis larvae; 2 of them were reinfected 22 wk later with the same amount of larvae. The course of infection in horses was assessed by serology (ELISA), biochemistry (aldolase activity), parasitology and histopathology. In each animal, infection was followed by a significant rise in specific antibody titers culminating at 5-10 wk post-infection (pi) and decreasing thereafter. Reinfection was followed by a slight rise in antibody levels. Aldolase activity increased during the first infection, but was not modified by reinfection. The parasite burden was maximum 20 wk pi (24-145 larvae/g according to localisation) and was very low at 52 wk pi (0.4-5 larvae/g). Compared to mares infected only once, the number of parasites in the reinfected animals was similar 28 wk pi but much lower 40 wk pi. Moreover, 6 wk post-reinfection, the larvae were surrounded by a large inflammatory granuloma which could have been caused by larvae from the reinfection batch. These experiments confirm the susceptibility of horses to Trichinella spiralis and the rapid disappearance of specific antibodies which prevents usual serological methods from being used in the diagnosis of infected animals. Reinfection could help the horse to eliminate the larvae more rapidly.

Animals↗
PubMed1993

[Contribution of imaging techniques in acute neonatal renal pathology].

Ultrasound is the first imaging modality used to evaluate acute renal disease in neonates. Normal findings and abnormalities seen in venous or arterial thrombosis, hemodynamic shock, or sepsis are reviewed. Transient changes due to intoxications, tubular disorders, or congenital nephrotic syndrome are considerably less common.

Acute Disease↗
PubMed1992

[Rhabdomyolysis, acute renal insufficiency and hypercalcemia].

Acute renal failure is a severe and frequent complication of rhabdomyolysis. During the early polyuric phase, hypercalcemia is observed in around 30% of cases. The principal mechanism is the liberation of calcium from areas of muscular necrosis. Two cases of toxic rhabdomyolysis with secondary hypercalcemia are described.

Acute Kidney Injury↗
PubMed1992

[Sepsis: confusion of terms].

Recent developments in the pathophysiology and treatment of sepsis have clearly shown the confusion produced by the imprecise terminology used to define the various facets of the sepsis process. The criteria required to diagnose bacteremia, sepsis, sepsis syndrome or septic shock vary from one author to the other. This inaccuracy accounts for the inability to compare the results of therapeutic investigation from different groups. The aim of this article is to point out the necessity of standardized terminology and to propose definitions which might be appropriate.

Bacterial Infections↗