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Biomedical subjects

C Rolland

Publications and source records attributed to C Rolland.

At least 37 records · Page 2Linked to original sources

Effects of halothane on surfactant biosynthesis by rat alveolar type II cells in primary culture.

BACKGROUND: Pulmonary surfactant, which is synthesized by alveolar type II cells (ATII cells) almost exclusively, plays a major role in maintaining alveolar homeostasis by reducing surface tension at the fluid-gas interface. Phosphatidylcholine (PC), the main surfactant lipid component, is largely responsible for this surface activity. The effects of halothane on the phospholipid metabolism of the pulmonary surfactant by ATII cells are unknown, even though these cells are exposed directly to volatile anesthetics during anesthesia and even though any alteration in surfactant biosynthesis by anesthetics may have deleterious effects on lung function and thereby facilitate postoperative pulmonary complications. In the current study, the effects of halothane exposure on surfactant synthesis by rat ATII cells in primary culture were investigated. METHODS: ATII cells were isolated from adult rat lungs and used for the experiments after 24 h in primary culture. The ability of ATII cells to synthesize surfactant was assessed by the incorporation of radioactive precursors in PC. Cytotoxicity was measured by the rate of lactate dehydrogenase release into the culture medium, and the lactate metabolism was taken as an index of glycolytic metabolism. All metabolic measurements were made after 24 h in primary culture. Effects of various halothane concentrations (1, 2, 4, and 8%) exposure for 4 h were studied, as were the effects of 2% halothane for various durations of exposure (2, 4, 8, and 12 h). The reversibility of halothane effects on PC synthesis was assessed after a 2% halothane exposure for 4 h. PC secretion and adenosine triphosphate cellular content were also measured for 4 h exposure at the various halothane concentrations. RESULTS: During a 4-h exposure, PC synthesis was reduced by 10, 24, 29 and 36% for 1, 2, 4, and 8% halothane respectively when compared with control values. At 2% halothane concentration, the observed decreases in PC synthesis were 12, 24, 31 and 34% for 2, 4, 8, and 12 h exposure, respectively. The inhibitory effect of halothane was completely reversed 2 h after the end of exposure. PC secretion was unaffected by increasing halothane concentrations during a 4-h exposure. Halothane did not produce cell damage except for the longest exposure durations (8 and 12 h) at 2% vapor concentration. Whatever the exposure conditions, lactate production by ATII cells exposed to halothane was greater than production by unexposed cells. CONCLUSIONS: These results indicate that halothane decreases the biosynthesis of pulmonary surfactant by ATII cells in primary culture and alters the high energy phosphate metabolism of these cells.

Adenosine Triphosphate↗

rodletless mutants of Aspergillus fumigatus.

Conidia of Aspergillus fumigatus adhere in vitro to host proteins and cells via the outer cell wall layer. The rodA gene of A. fumigatus was cloned by homology with the rodA gene of Aspergillus nidulans, which is involved in the structure of the rodlets characteristic of the surface layer. The A. fumigatus RODA protein sequence has 85% similarity to that of A. nidulans RODA; the sequence codes for a hydrophobin, a low-molecular-weight protein moderately hydrophobic and rich in cysteines. The gene was disrupted with the hygromycin B resistance gene. By transformation of protoplasts with the disrupted gene, RodA- mutants were generated. These mutants are deficient in the ability to disperse their conidia; their conidia lack the rodlet layer and are hydrophilic. The adhesion of the rodletless conidia to collagen and bovine serum albumin was lower than that of the wild type; in contrast, there was no difference between RodA- and RodA+ conidia in adhesion to pneumocytes, fibrinogen, and laminin, suggesting that RODA is not the receptor for these cells and proteins. RodA- conidia were pathogenic for mice.

Adhesiveness↗

Interleukin 6 secretion by monocytes and alveolar macrophages in systemic sclerosis with lung involvement.

Interleukin-6 (IL-6) has been involved in the pathogenesis of inflammatory and/or autoimmune diseases. We characterized the production of IL-6 by blood monocytes and alveolar macrophages (AM) in 11 patients with definite systemic sclerosis (SSc) with lung involvement and in eight normal control subjects. IL-6 levels were determined in serum, bronchoalveolar lavage (BAL) supernatants, monocytes, and AM cell culture supernatants using an ELISA kit. BAL cell analysis evidenced an alveolitis with hypercellularity and increased neutrophils and mast cells absolute counts. Serum and BAL IL-6 levels were low and similar in SSc and control groups. The monocytes of the group with SSc secreted more IL-6 than did the control group, both spontaneously (p = 0.01) and after LPS stimulation (p = 0.0007). Spontaneous secretion of IL-6 by AM tended to be higher in the SSc group than in the control group (p = 0.22). LPS-induced IL-6 secretion by AM was similar in both groups. Our study demonstrates that during SSc lung disease, spontaneous and stimulated IL-6 secretion by blood monocytes is increased, compared with secretion by healthy control subjects. By contrast, IL-6 secretion by AM is normal despite evidence of mild alveolitis.

Bronchoalveolar Lavage Fluid↗

Interleukin-8 and neutrophils in systemic sclerosis with lung involvement.

We investigated the mechanisms and consequences of neutrophil accumulation in the airspace in 11 patients with systemic sclerosis (SSc) and interstitial lung disease. Seven normal subjects served as controls. We measured total neutrophil elastase burden, elastase activity, and alpha-1-antitrypsin (alpha 1AT) in bronchoalveolar lavage (BAL) fluid and we evaluated the in vitro interleukin-8 (IL-8, a potent chemoattractant for neutrophils) secretion by alveolar macrophages (AM). A mild neutrophil alveolitis was observed in patients when compared with control subjects. Total BAL elastase burden was higher in patients than in control subjects and correlated positively with the percentage of neutrophils in BAL. BAL elastase activity was undetectable in control subjects, but it was detected in all patients but one (mean: 257 +/- 87 mU/L). Spontaneous IL-8 secretion by AM was higher in patients with SSc than in control subjects (518 +/- 115 versus 228 +/- 65 ng/ml, p = 0.04) and positively correlated with the percentage of neutrophils in BAL (r = 0.505). We conclude that (1) the neutrophil could participate in the pathogenesis of SSC lung disease through the release of elastase; (2) the AM could contribute to the influx of neutrophils in the alveolus through the release of IL-8.

Bronchoalveolar Lavage Fluid↗

Alveolar type II epithelial cells produce interleukin-6 in vitro and in vivo. Regulation by alveolar macrophage secretory products.

The aims of this study were (a) to determine if rat alveolar type II (ATII) cells and human pulmonary epithelial-derived cells (A549 cell line) could generate IL-6 in vitro, (b) to characterize the cytokine regulation of IL-6 gene and protein expression in these cells, and (c) to detect the in vivo expression of immunoreactive IL-6 by human ATII cells. Rat ATII cells in primary culture secreted bioactive IL-6 and immunostained with an anti-IL-6 antiserum. Spontaneous IL-6 secretion by rat ATII cells amounted to 5,690 +/- 770 pg/ml/10(6) cells (n = 12) and was fivefold higher than spontaneous rat alveolar macrophages IL-6 secretion (1,052 +/- 286 pg/ml/10(6) cells, n = 8, P = 0.001). Rat alveolar macrophage conditioned media (CM) increased IL-6 secretion by rat ATII cells through the effect of IL-1 and TNF. IL-6 gene expression and IL-6 secretion by A549 cells was induced by IL-1 beta, TNF alpha, and by human alveolar macrophages and THP1 cells CM. Induction was abolished when CM were preincubated with anti-IL-1 beta and anti-TNF alpha antibody. The combination of IFN gamma and LPS induced the expression of IL-6 mRNA by A549 cells whereas LPS alone had no effect. Immunohistochemical staining evidenced the expression of immunoreactive IL-6 by hyperplastic ATII cells in fibrotic human lung, a condition in which alveolar macrophages are known to be activated. ATII cells in normal human lung did not express immunoreactive IL-6. Our findings demonstrate that ATII cells may be an important source of IL-6 in the alveolar space thereby participating to the regulation of the intra-alveolar immune response.

Animals↗

Circulating cytokines in patients undergoing normothermic cardiopulmonary bypass.

To determine the cytokine release during normothermic cardiopulmonary bypass, we have measured plasmatic levels of tumor necrosis factor-alpha and interleukins-1 beta, 6, and 8 in 10 patients during the first 24 hours after the start of bypass. Arterial blood samples were collected at intervals before, during, and after bypass. Interleukin-1 beta was not detectable in the plasma, and traces of tumor necrosis factor-alpha were detected in only three patients at times independent of the cardiopulmonary bypass procedure. Circulating endotoxin remained undetectable. Plasma interleukin-6 and interleukin-8 rose significantly from 2 until 24 hours after the start of bypass (p < 0.05) and peaked respectively at 4 and 2 hours after the beginning of bypass (interleukin-6, 268.1 +/- 131.43 pg/ml; interleukin-8, 370 +/- 420 pg/ml; mean peak +/- standard deviation). Peak values of interleukin-6 and interleukin-8 were correlated neither with the duration of aortic crossclamping or the bypass procedure nor with the hemodynamic parameters recorded at the same times. This study shows that normothermic cardiopulmonary bypass does not induce systemic release of tumor necrosis factor-alpha and interleukin-1 beta. A local production of these cytokines cannot be excluded, because interleukin-6 and interleukin-8 are produced by stimulated macrophages and monocytes in response to tumor necrosis factor-alpha and interleukin-1 beta. Our results, at normothermia, show a similar pattern of interleukin-6 and interleukin-8 release when compared with release during hypothermic cardiopulmonary bypass. Interleukin-8, an important chemotactic neutrophil factor, might play a role in reperfusion injuries observed in lungs and heart after cardiopulmonary bypass.

Adult↗

Cell surface carbohydrates modulate neutrophil adherence to alveolar type II cells in vitro.

We characterized the influence of phosphorylated sugars and cell surface sialic acids on the adherence of human polymorphonuclear leukocyte (PMN) to rat alveolar type II cell (ATII cells) and human-derived A549 cell monolayers in vitro. Percent adherence of radiolabeled polymorphonuclear leukocytes was assessed after incubating cells with the carbohydrates, enzymes, or lectins to be tested. Lactose-1-phosphate (Lact1P) and maltose-1-phosphate (Malt1P) (10 mM) inhibited adherence of PMN to ATII cells and A549 cells. Maximal inhibition followed treatment of both PMN and rat ATII cells and amounted to 85 +/- 7% with Lact1P and 92 +/- 3% with Malt1P. Inhibition was concentration dependent. Incubation of PMN with mannose-6-phosphate reduced adherence to rat ATII cells and A549 cells by 36 +/- 11 and 39 +/- 8%, respectively. Maximal concentrations of sugars did not alter cellular viability. Neuraminidase-induced desialilation of ATII cells increased adherence of PMN by 36 +/- 7% to rat ATII cells and by 86 +/- 18% to A549 cells. Masking of terminal sialic acids on rat ATH cells with Limulus polyphemus agglutinin (100 micrograms/ml) increased adherence by 50 +/- 2%. These results indicate that cell surface carbohydrates are involved in the regulation of the adhesive interaction between PMN and ATII cells in vitro.

Animals↗

The polyurethane foam covering the Même breast prosthesis: a biomedical breakthrough or a biomaterial tar baby?

Because controversy continues to surround the implantation of the polyurethane foam-covered Même breast prosthesis, in vitro experiments were conducted to determine: (1) whether the polyurethane foam contains extractable toluene diamine isomers (TDAs), and (2) whether the polyurethane foam releases TDAs on exposure to mild hydrolytic conditions. Results confirmed the presence of extractable TDAs and other impurities in the foam covering the unused Même prosthesis, and that the concentrations of these impurities could be significantly reduced by washing the foam in a regular detergent. This washing step was omitted from the manufacturer's production process. Furthermore, on exposure to mild alkalis, the foam exhibited significant degradation, rapid fragmentation, loss of mechanical strength and physical integrity, as well as the release of additional TDAs. Because of the potential long-term risks associated with the release of TDAs in vivo, continued clinical use of the Même prosthesis containing this particular type of foam appears questionable.

Biocompatible Materials↗

[Tick spirochetosis by Borrelia burgdorferi in wild carnivores in France. Results of serologic tests in 372 foxes].

The authors made serological examination, by passive hemagglutination, of 378 wild carnivores killed in 17 departments of western, central and eastern parts of France: 372 of foxes, of which more than 90 per cent less than one year aged, 4 raccoon dogs and 2 lynx. In foxes, they found significative seropositivity (greater than or equal to 1/200) with mean frequencies of 12.77 per cent in young animals and 42.86 % in those of 1 year and more. According the parts of France, frequency is greatly varying, being highest in the department of Ain, in Jura. The frequency of antibodies against B. burgdorferi in foxes brings the authors to think that it is necessary to define precisely their importance as reservoirs for this infection.

Age Factors↗

Nondestructive investigations on ninety-seven surgically excised mammary prostheses.

The information contained in the medical files of 68 patients having undergone surgical excision of a total of 97 internal mammary prostheses allowed us to define a typical patient profile at time of first implantation. Age: 33 years 11 months, height: 1.59 m, weight: 51.5 kg, two children. Twenty-one percent of these patients had the operation done subsequent to a mastectomy, while 79% requested it for cosmetic reasons. The duration of implantation was less than 55 months for 76% of the prostheses received after excision. The most frequent evolutive complications were the formation of a fibrous capsule followed by silicone bleeding, as well as mineralization. Macroscopic examination of the 97 explanted prostheses provided information on their integrity (38.1% of prostheses ruptured), gel differentiation (24.7%), sticky surfaces (26.8%), surface deposits (33%), memory folds (54.6%), and Dacron fixation patches (20.6%). According to the medical files, a fibrous capsule was found in association with 69.8% of the breast implants. We received only 46 capsules. The average thickness was 1.4 mm. Mineralizations were present on 15 capsules (32.6%). Two zinc phosphates were identified, for the first time, in human body: parascholzite and hopeïte. Statistical examination showed that Heyer-Schulte prostheses stayed in place for a longer time. Integrity and gel differentiation depended on the duration of the implantation. Presence of mineralization was model-related (Dow Corning prostheses were associated with deposits) and depended on the presence of fixation patches.

Adult↗

First observation of hopeïte and parascholzite in fibrous capsules surrounding silicone breast implants.

We observed mineralization in 32.6% of the capsular tissue of 97 mammary prostheses recovered after surgical excision. Three distinct mineralogical phases were identified. The first was composed of common hydrated carbonate hydroxylapatite, a well-known physiological and pathological mineral. Hopeïte and parascholzite constituted the second and third phases. They are zinc and calcium hydrate phosphates that have not been observed previously in human tissues. Statistical analysis of the data showed relationships between the presence of mineralizations and the manufacturers on the one hand, and the presence of Dacron fixation patches at the surface of the prostheses on the other.

Breast↗

[B27-negative spondylarthritis. Results of 3 familial surveys, with monozygotic twins in one].

With the typing of the major histocompatibility complex (HLA, A, C, B, Bf, C4, DR, GLO), the authors study three (3) family investigations of patients suffering from primary ankylosing spondylarthritis, B27 negative, including one concerning a discordant pair of monozygotic female twins. The possible links between the patient's haplotypes and the phenotypic expression of their ankylosing spondylarthritis, B27 negative, is discussed: a complotype (C4 A4 B2) and 2 antigens (B18 and Bw62) from the group B35 CREG over-represented in ankylosing spondylarthritis (Family n degree 1): presence of antigen B40 of B7 CREG in the patient of Family n degree 2, contrasting with the presence of antigen B27 in 2 first-degree parents, apparently healthy; presence of antigen B7 from the B7 CREG and the possible role of an environmental factor in the discordant monozygotic female twins (Family n degree 3). The results are compared to the studies of families with ankylosing spondylarthritis, B27 negative, of monozygotic twins and discordant ankylosing spondylarthritis-antigen B27 reported in the literature. Pathogenetic implications are discussed (linked gene hypothesis, direct role and/or heterogeneity of B27).

Adult↗

[Progressive complications associated with polyester arterial prostheses. Study of 61 specimens following surgical excision].

Reports of individual surgical cases tend to be anecdotal because of the unique circumstances surrounding the patient, the surgeon, the intervention and, where applicable, the prosthetic device. To overcome this limitation the authors have taken a wider collaborative approach and report the analysis of 61 explanted polyester arterial prostheses associated with delayed complications on 53 patients reoperated upon in six different French hospitals. One advantage of such an independent and centralized retrieval programme is that the impact of centre specific factors, such as patient selection and surgical techniques, is minimized. Consequently, by following a standardized protocol for the evaluation of the morphologic, pathologic and mineralogic characteristics of the tissue surrounding the excised grafts, as well as the textile structure of the prostheses themselves, it has been possible to distinguish between iatrogenic and disease related complications and to demonstrate a number of general findings associated with the clinical performance of polyester arterial prostheses. Complications such as thromboses, infections and false aneurysms appear to occur randomly after different lengths of implantation, thicker fibrous tissue capsules are associated with velour grafts with highly textured yarns, the incidence of mineralized tissue and of endothelialized luminal surfaces is rare, weft knitted textile prostheses appear less mechanically stable and more sensitive to iatrogenic trauma than warp knitted, and the incidences of lipid and cholesterol adsorption, bacterial colonization and sterile fluid loss need further investigation. These observations lead to the recommendation that for patients with longer life expectancies surgeons should consider selecting low porosity, woven or warped knitted prostheses which contain yarns that have not been highly textured.

Adult↗

Medical and administrative information modelling of a hospital university centre pneumology department.

Instead of a technology-oriented approach of a hospital information system (HIS), the authors present a structure oriented approach built on three elements: objects, events and operations which allow one to model a static and dynamic schema of an information system (IS). Objects of the static schema lead to a relational model. Events expose various states of Information System; operations allow one to build a dynamic schema. Such a schema is interesting for IS description in order to enhance the analytical capability of the designer, to define IS solutions and to limit the risks of errors. It allows the clinician better management of information relative to patients, especially thanks to the dynamical schema which enables one at any moment to know the patient's state. Finally, it has to free clinicians from managing information and allow them to give an always more important consideration to human relationships in medicine.

Hospital Departments↗

[Case summaries in real-time. Accomplishments with a microcomputer].

A study of the key wordings used by the doctors in medical records in I.C.U. preceded this implementation, they constitute a thesaurus (2,700 strings) organized in two trees. These strings are proposed along the dialogue which occurs between the microcomputer and the user; on these bases, several graphs allow to move in the tree by minimization of the pathway. The use of the thesaurus with the corresponding graphs necessitates only one automaton program. This medical data microcomputerized system is transparent for the user, thanks to a multilayers software. In the external layer the microcomputer provides access to the system by one of the following function keys: creation of a medical record, additional information on a medical record already known, research of a medical record, listing of the open medical records, printing of a medical record. Each one of these function keys provides access to the following five rubrics keys: identity, antecedents, reasons for admission, evolution, destiny; these rubric keys use parameterized procedures. This software is implemented on a low-cost microcomputer fitted with a dual drive disk (170 k. bytes each) and a printer (90 char/s).

Computers↗

[Value of an automatic chronometer in epicardial mapping].

The use of a digital display automatic chronometer during epicardial mapping is reported. The epicardial potential recorded by a tripolar electrode is transformed electronically by amplification, filtering, rectifying negative deflections and then summation. The interval between the reference signal (electrical impulse or other cardiac potential) is calculated automatically and displayed at an adjustable rate. The presence of a delay increases the range of application of the apparatus. Epicardial mapping is thus simplified and shortened.

Electrocardiography↗