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Biomedical subjects

J Brun

Publications and source records attributed to J Brun.

At least 91 records · Page 5Linked to original sources

A chronobiological study of melatonin and cortisol secretion in depressed subjects: plasma melatonin, a biochemical marker in major depression.

The temporal organization of plasma melatonin and cortisol secretion was examined in healthy rested controls and in depressed patients: 11 patients suffering from a primary affective disorder (10 female, 1 male) and 8 male controls were studied over a 24-hr period; blood was collected at 2-hr intervals during the day at 1-hr intervals at night. Plasma melatonin and cortisol levels were determined by radioimmunoassay. In addition, melatonin was determined in plasma sampled at 3 AM in older male controls (n = 8) and in females (n = 10) at ovulation. The controls showed low or undetectable (less than 5 pg/ml) diurnal plasma melatonin levels and a very marked nocturnal rhythm (acrophase: 2.27 AM, mesor: 34.4 pg/ml, amplitude: 58.7 pg/ml). For the three control groups, no significant difference was observed in the nocturnal melatonin peak at 3 AM. The depressed patients also showed a significant melatonin rhythm but with lower amplitude (14.5 pg/ml) and mesor (19.1 pg/ml). The latter rhythm was not significantly phase-advanced with respect to the controls (acrophase at 1.18 and 2.34 AM, respectively). In 9 of the 11 patients, nocturnal melatonin secretion was less marked and frequently associated with hypercortisolemia. An additional episodic melatonin secretion was observed in the late afternoon in only two patients. In depressed patients, there was an increase in the mean cortisol secretion level (mesor at 13.6 micrograms/100 ml against 9.1 micrograms/100 ml in the controls), but the amplitude and the acrophase were not significantly modified. These data are discussed in terms of both the hypothalamus-pituitary-adrenal-epiphysis and aminergic abnormalities.

Adult↗

[Prognostic value, at the onset of an asthma attack, of respiratory, hemodynamic, and acid-base equilibrium parameters].

Sudden death is still a common complication of acute asthma. The authors analysed statistically the prognostic value of the respiratory rate (RR), the heart rate (HR), blood gases, systolic blood pressure (BP syst), and diastolic pressure (BP diast) and the amplitude of the P wave in lead II on the ECG, recorded at the beginning of the asthma attack. This retrospective study concerns two groups of patients distinguished on the basis of the severity of the attack (group I: simple retrospective study concerns two groups of patients distinguished on the basis of the severity of the attack (group I: simple attack; group II; status asthmaticus). A HR greater than 24 per minute, a P wave greater than or equal to 2.5 mm or a PaCO2 greater than or equal to 6.3 kPa (47.25 mmHg) are three highly sensitive and specific criteria of the evolution of the asthma attack towards a more severe form (status asthmaticus). Patients who present one or more of these parameters should be monitored in a respiratory intensive care unit in order to prevent avoidable sudden death.

Acid-Base Equilibrium↗

Reconstructive operations for esophagogastric corrosive lesions.

Corrosive esophagogastric lesions are common in Algeria and France. Within the past 14 years, our overall mortality has decreased to 6% as compared to 12% in the best results from elsewhere. This report describes our operative experience with 68 patients from 1974 to 1982. According to a prospective interdisciplinary program, lesions in 351 patients were staged by emergency esophagoscopic findings: Stage I, ulceration; Stage II, hemorrhage and ulceration; Stage III, mucosal necrosis, hemorrhage, and ulceration. Total parenteral nutrition or jejunal feeding was given to patients with Stage II lesions for 3 weeks and to those with Stage III lesions for 3 months before repeat esophagoscopy. Operations were required by 68 patients who had Stage III lesions and severe stenosis. Procedures done included 39 retrosternal colon interpositions, 11 partial or total gastrectomies, nine esophagogastrectomies, four esophagoenteral colonic bypasses, six esophagogastric colonic interpositions following partial gastric resection, and one gastrojejunostomy. Eleven of the cervical anastomoses were to the pharynx. There were no operative deaths and no anastomotic leaks. All patients have satisfactory nutrition and rehabilitation. Our operative experience in the preceding 5 years included an 11% mortality; improved results in the past 8 years are attributed to early and accurate staging, planned multidisciplinary management, good nutritional support, and better timing of operations. Stage III esophagogastric corrosive lesions may be treated within 4 to 5 months of injury with low mortality and good functional outcome.

Adolescent↗

[Pulmonary alveolar proteinosis: eleven-year follow-up in one case (author's transl)].

A case of pulmonary alveolar proteinosis followed-up for eleven years is presented and this poorly recognised affection discussed. It is a rare disease arising from filling of the alveoli by a non-surface-acting surfactant, either as a response to a non-specific aggression, experimentally reproducible, or spontaneously. The mechanism by which this accumulation occurs is still a controversial subject: increased production by the granular pneumocytes, deficiency of alveolar clearance, or loss of phagocytic activity of alveolar macrophages. The diagnosis, suggested by the only slightly specific clinical picture after elimination of more common aetiologies, is confirmed by electron microscopy of alveolar lavage fluid without, as in the past, the need for lung biopsy. The various treatments proposed have lacked efficacy and are not really necessary, except for symptomatic extensive pulmonary lavage, which should be reserved for severe cases and may need to be repeated.

Adult↗

Phospholipids and microviscosity study in broncho-alveolar lavage fluids from control subjects and from patients with extrinsic allergic alveolitis.

Bronchoalveolar lavages were studied in control subjects and patients with extrinsic allergic alveolitis. Phospholipids, fatty acid composition of the different phospholipid species found and cholesterol were investigated. In allergic alveolitis, the phosphatidylcholine was absent, whereas two usually minor components in lung surfactant, phosphatidylethanolamine and phosphatidylinositol, were considerably enhanced. The tensio-active properties of the phospholipids present in fluids were investigated by a fluorescence polarization technique. Microviscosity of the phospholipids was studied, using 1,6-diphenyl-1,3,5-hexatriene. High values for the microviscosity were encountered in samples from patients. Phosphatidylethanolamine present at a high level exhibits the highest microviscosity. Saturated fatty acids in phospholipids and cholesterol are rigidifying factors contributing to the high microviscosity values found in allergic alveolitis. Moreover, one very important point microviscosity values found in allergic alveolitis. Moreover, one very important point brought out by the this technique is its full independence from the fluid volume recovery.

Adult↗

[The relevance of chest X-rays and respiratory function tests to the assessment of occupational hazards in asbestos factory workers (author's transl)].

The authors have analyzed the medico-legal records of 70 workers from an asbestos factory, who developed pneumoconiosis, sometimes after prolonged exposure. X-ray films were interpreted (though not without some difficulty) according to the I.L.O. classification criteria. Respiratory function tests included spirometry, gas exchange determination and blood gas measurements. There was a correlation between the duration of occupational exposure and the onset of chest lesions visible on X-ray films (pleural thickening, pulmonary fibrosis and later, pleural calcifications) and a closer correlation between these and the results of the two main respiratory function tests: vital capacity and fractional global and arterio-alveolar CO uptake coefficient (DuaCO). It appeared, however, that lung function impairment sometimes preceded radiological abnormalities, and this should be taken into consideration when assessing the financial compensation due to workers exposed to asbestos.

Asbestosis↗

A cytogenetical analysis of sterile mutants in Caenorhabditis elegans.

The regulation of gametogenesis in the hermaphrodite and proterandrous nematode Caenorhabditis elegans is introduced here through the analysis of nonconditional sterile mutants. To investigate the mechanisms which allow the two gametogenetic phases to succeed each other in the same ovotestis, three mutants were studied cytogenetically. Two of the mutants exhibit only the spermatocyte phase and the third shows a greatly reduced and disturbed oogenesis. These three mutations all produce large decreases in ovotestis size and gonocyte number. Each of the three is monofactorial, recessive, autosomal and independent. Homozygous mutant males are also sterile. The gametogenesis phases which could be disturbed by mutation were determined by cytological analysis of the ovotestis of 12 other sterile strains. These phases occur during mitotic divisions of the genital primordium, zygotene chromosome pairing, male meiosis and spermiogenesis, oogenesis induction and oocyte maturation. These steps of gametogenesis need a wild-type genic activity to occur normally. It appears that spermatogenesis and oogenesis are two genetically independent processes, and that oogenesis is rather autonomous and its induction would depend on a hormonal factor.

Animals↗

[Bronchial cytology of "occult" lung cancers (author's transl)].

Having underlined the value of bronchial cytology for the early diagnosis of lung cancers, the authors report 7 observations concerning a particular clinical form: the "occult" lung cancer with a malignant cytological precession more or less in advance in relation with the radiological or fibroscopical data. Malignant cells can be found in sputum from 9 months to 8 years beforehand. All histological types can be seen but no cancer of the anaplasic type with small cells was identified either in this series or in the literature. The authors insist also on the difficulty in localizing these cancers in situ at a very early stage. They set apart the insufficiencies of the X-ray results in several observations and the limits of other investigating techniques (bronchography, scintigraphy, echotomography, ...). These tumours seem to have a mild evolutivity.

Aged↗

[Nieman-Pick disease revealed by a pulmonary miliary tuberculosis (author's transl)].

A diagnosis of Niemann-Pick disease was made in a 26 years old man with chronic pulmonary miliary tuberculosis and splenomegaly. It was confirmed by the drop of sphingomyelinase level in leucocytes and fibroblasts of the skin. The authors showed the presence of foamy cells with sphingomyelin in the spleen and bone marrow. They underlined the value of dosing sphingomyelinase in leucocytes for diagnosis purposes. They also observed blue histocytes in the spleen and bone marrow, next to the foamy cells which are not specific of Niemann-Pick disease and can be found in numerous other affections. This pure visceral form with delayed development without neurological involvement, corresponds to the phenotype B of Crocker.

Adult↗

[Tumours or mediastinal pseudo-tumours of Castleman? One observation (author's transl)].

Through a routine examination a Castleman tumour of left hilary topography was discovered in a 30 years old man. No recurrence followed exeresis. With regard to this case, the authors underlined the infrequency of these tumours with no preferential mediastinal topography and its occurrence at any age. Diagnosis is often reached after surgery by histological analysis of the tumour which enabled the distinction in two types according to Flendrig: type I plasmocytic with inflammatory signs; type II hyalino-vascular without any inflammatory signs. Surgery usually advised is not without any drawbacks because of the vascularization of the tumour and its adherence to neighbouring organs. But Castleman tumours still set nosological problems and the debate remains opened on the question of a nodal origin or a true neo-formation.

Adult↗