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Biomedical subjects

M Badier

Publications and source records attributed to M Badier.

At least 55 records · Page 3Linked to original sources
PubMed1993

[Study of tracheobronchial healing after lung and heart-lung transplantation. Apropos of 64 anastomoses].

The authors report an analysis concerning the healing of tracheo-bronchial anastomoses after lung- and heart-lung transplantation. The present study includes 64 anastomoses selected from a total of 80 cases. Sixteen had to be excluded because of early post-operative death; none of these deaths was related to an air-way complication. Bronchial healing was assessed by bronchoscopic follow-up; the appearance of the suture-line was classified according to Couraud's grades. The initial reference was the examination at 2 weeks, which was compared to subsequent follow-up. At the initial assessment, 42 anastomoses were grade I, 4 were grade II, and 18 were grade III. The subsequent anatomic result was satisfactory for 52 sutures (81%). The complications were malacia in 2 cases, stenoses treated with a stenting device in 4 cases, dehiscence in 6 cases. The duration of ischemia and post-operative mechanical respiratory support, as well as the proximal or distal site of the anastomosis appeared to be of significant prognostic value.

Adolescent↗
PubMed1993

Lung size matching for double lung transplantation based on the submammary thoracic perimeter. Accuracy and functional results. The Joint Marseille-Montreal Lung Transplant Program.

The present study evaluates the accuracy of submammary thoracic perimeter for lung size matching between donor and recipient and analyzes the influence of donor lung size discrepancies on functional outcome after double lung transplantation. The population is composed of 18 double lung graft recipients, 16 of whom had cystic fibrosis. The lung size match was assessed by comparison of predicted total lung capacity of donor and recipient: five patients were matched in a 10% confidence interval; four received smaller lungs, and nine received larger ones. The functional outcome was assessed with the spirometric values measured at 3 and 6 months after transplantation. The final functional result was not influenced by the lung size (r = 0.142 for total lung capacity; r = 0.372 for vital capacity; r = 0.378 for forced expiratory volume in 1 second). For larger lungs the final result tended to the recipient's predicted, whereas for smaller lungs, spirometry tended to the donor's predicted (r = 0.906 for total lung capacity; r = 0.875 for vital capacity; r = 0.874 for forced expiratory volume in 1 second). The thoracotomy effect, that is, restrictive syndrome at 3 months that resolves at 6 months, was not correlated with the lung size (r = 0.07 for total lung capacity; r = 0.436 for vital capacity). It is concluded that respiratory functional result is not affected by larger lungs; despite the wide range of error, the submammary thoracic perimeter appeared to be a satisfactory selection parameter in this group of patients.

Adolescent↗
PubMed1992

[Asthma and polyposis. Efficacy and adverse effect of endonasal ethmoidectomy. Results apropos of 70 patients].

The authors report the efficacy and adverse effects of intranasal ethmoidectomy in 70 patients with asthma and persistent severe symptoms from nasosinal polyposis despite repeated prior treatment. The efficacy was defined according to the evolution of symptoms and endoscopic findings. Adverse effects were evaluated according to subjective clinical and therapeutic data in all 70 patients. In addition, 25 patients had complete pre and post-operative pulmonary function tests. The results confirm that intranasal micro-surgery does not increase the severity of asthma. On the other hand, no significant improvement in bronchial function was noted after ethmoidectomy. Finally, the authors emphasize the poorer results obtained in Widal's disease and the importance, after the failure of medical treatment, of using of sufficiently extensive surgical procedure in order to decrease the incidence of recurrences.

Adolescent↗
PubMed1990

[Gastroesophageal reflux and respiratory manifestations: diagnostic approach, therapeutic indications and results].

The authors report a study of 140 patients presenting with a non-allergic respiratory tract disease (121 cases of asthma--19 cases of spasmodic cough). Gastro-oesophageal reflux was detected by 24-hour pHmetry in 86 of these patients. In 34 of them (i.e. 40% of cases), the gastro-oesophageal reflux appeared to be responsible for the initial respiratory tract symptoms. These 34 patients were submitted to a therapeutic trial of high dose anti-H2 therapy for at least two months. Only those patients in whom a marked improvement or even complete resolution of the respiratory tracts symptoms was observed underwent anti-reflux surgery. Out of the 13 patients undergoing surgery, there were two failures and 11 good results after a follow-up of more than 18 months.

Asthma↗
PubMed1989

Tonic activity in inspiratory muscles and phrenic motoneurons by stimulation of vagal afferents.

In anesthetized rabbits, direct and integrated phrenic neurogram (Ephr) and electromyograms from the diaphragm (Edi) and intercostal (Eic) (2nd space) and transversus abdominis muscles (Etr) were simultaneously recorded in two protocols. 1) In animals breathing spontaneously, we used infinite inspiratory (RI) or expiratory (RE) resistive load and intravenous injections of carbachol, histamine, or phenyl diguanide (PDG). All circumstances except RE evoked tonic activities in Ephr, Edi, and Eic but never in Etr. Intravenous atropine abolished carbachol-induced bronchoconstriction and associated tonic inspiratory activities, but this effect persisted with RI, histamine, and PDG. Selective procaine block of conduction in thin vagal fibers (with persistence of the Breuer-Hering inflation reflex) reduced or suppressed the tonic response, which was abolished in all cases after vagotomy. 2) In rabbits artificially ventilated with open chest, passive deflation of the lung or intravenous injections of histamine or PDG also produced tonic discharge in Ephr and often in Eic. The present results demonstrate that 1) stimulation of vagal afferents and mostly thin sensory fibers elicits tonic inspiratory discharges, 2) bronchoconstriction is not necessary for the induction of the response, and 3) reflexes from the chest wall do not mediate this response in rabbits.

Animals↗
PubMed1988

Interaction between SO2 and cold-induced bronchospasm in anesthetized rabbits.

In anesthetized, paralyzed and artificially ventilated rabbits, reflex changes in lung resistance induced by cooling the inspired air from 38 to 15 degrees C were studied before and after 45 min periods of SO2 exposure at two different concentrations (0.5 or 5 ppm). Both concentrations of SO2 induced significant increase in RL in intact animals (+16% and +50%, respectively). The effect of 5 ppm SO2 persisted after vagotomy. The cold-induced bronchospasm was halved after exposure to 0.5 ppm SO2 and was no longer significant after exposure to 5 ppm SO2. In both cases, RL recovered to control values 40 min after the end of SO2 exposure and then, the magnitude of cold-induced bronchospasm also recovered. The reflex bronchoconstrictor response to phenyldiguanide (PDG) i.v. disappeared after exposure to 5 ppm SO2. However, the bronchomotor response to histamine i.v., which involved both reflex and direct actions on airway smooth muscle, was not altered. These results show that (1) prolonged increase in RL measured after SO2 exposure does not result from a vagal reflex; (2) the cold-induced bronchospasm, as well as the bronchomotor response to PDG, are reduced or suppressed during the period where the effect of SO2 persisted. This suggests that 45 min exposure to SO2 induces transient alterations in tracheobronchial wall, which reduce the accessibility to nervous receptors in the airways.

Administration, Inhalation↗
PubMed1988

In vivo and in vitro studies on cold-induced airway response in normal and sensitized rabbits.

We measured the changes in lung resistance (RL) induced by cool inspired air under dry air conditions in anesthetized, paralyzed and artificially ventilated rabbits. We compared the airway response to cold air in non-sensitized (NS) animals with the response in rabbits sensitized (S) to bovine serum albumin. Using in vitro tracheal preparations from the same animals, we observed the effects of lowering the bath temperature on smooth muscle tension and also the response to acetylcholine (Ach). Dose-response curves to Ach were constructed and analyzed in terms of maximal contraction (delta Tmax) and pD2 coefficient (negative logarithm of the molar concentration of Ach producing 50% of maximum contraction). The magnitude of cold induced airway response tested in vivo was significantly greater in S (delta RL = +52% +/- 2) than in NS rabbits (+30% +/- 4; P less than 0.01). In vitro the decrease of temperature in the bathing medium induced a significant relaxation of tracheal spirals in both NS and S preparations (delta T = -2.42 +/- 0.34 g/mg wet tissue, -3.36 +/- 0.8 g/mg wet tissue, respectively). However, an adaptation of this response occurred after 8 min in NS rabbits whereas relaxation persisted in S rabbits. The tracheal contractile response to Ach was decreased by bath cooling in S ans NS animals (delta Tmax = 5.53 +/- 0.15 g/mg wet tissue and 5.03 +/- 0.27 g/mg wet tissue at 37 degrees C; 3.05 +/- 0.30 g/mg wet tissue and 1.93 +/- 0.35 g/mg wet tissue at 17 degrees C, respectively). Moreover, cooling also reduced the velocity of response. In all cases, S preparations displayed hyperresponsiveness to Ach and this was observed for maximal changes in tension as well as for pD2 values. Present observations show that cold induces different effects on airway smooth muscle with the production of a contractile response in in vivo preparations but relaxes isolated tracheal spirals. They also suggest that sensitization by foreign proteins may modify the intrinsic properties of tracheal smooth muscle.

Acetylcholine↗
PubMed1988

Attenuation of hyperventilation-induced bronchospasm by terfenadine: a new antihistamine.

The effect of terfenadine, a selective H1-receptor antagonist devoid of central nervous system side effects, was evaluated on hyperventilation-induced bronchospasm in 11 adult subjects with asthma in a double-blind, placebo-controlled, crossover study. Increases in specific airway resistance (SRaw) were induced by isocapnic hyperventilation with dry air on two occasions, 7 days apart. Before the tests, the subjects received oral terfenadine (120 mg, twice daily) or placebo for 3 days with the last dose administered 3 hours before the test. Baseline SRaw and spirometric values (vital capacity and FEV1) were similar for the two tests. Terfenadine yielded a significant (p less than 0.001) parallel shift to the right of the stimulus (hyperventilation)-response (SRaw) curve; 100% increases in SRaw occurred at ventilation rates of 44 L/min after placebo treatment and 64 L/min after terfenadine treatment. These data suggest that histamine release plays a role in hyperventilation-induced bronchospasm despite the fact that increase in plasma histamine has not been found in this situation, in contrast to exercise-induced bronchospasm.

Adolescent↗
PubMed1988

Cholinergic responsiveness of respiratory and vascular tissues in two different rat strains.

The airway and systemic arterial smooth muscle responsiveness to cholinergic agents of two strains of rats, Rat Albino (RA) and Brown Norway (BN), was compared in vivo and in vitro. In vivo, we measured the doses of carbachol that induced a 100% increase in lung resistance (PD100 RL), a 50% decrease in dynamic lung compliance (PD50 Cdyn), and the value of systolic blood pressure at the carbachol dose of 10 micrograms (Pa 10 micrograms). In vitro airway smooth muscle and systemic arterial smooth muscle responsiveness was assessed by measuring the maximal response to acetylcholine, the slope of the linear portion of the dose-response curve, and the negative logarithm of the molar concentration of acetylcholine producing 50% of the maximal response (pD2). PD100 and PD50 were about four times greater in BN rats than in RA rats. In contrast, Pa 10 micrograms was 1.5 lower in the BN rats. These differences persisted after bivagotomy. Tracheal pD2 was 25% greater in the RA than in the BN strain. The mean dose-response curve of parenchymal strips of RA rats was situated upward and to the left of the BN curve, but the reverse was observed for aortic smooth muscle dose-response curves. Thus 1) airway smooth muscle responsiveness to cholinergic agents is greater in RA strain than in BN, but the reverse is true for systemic arterial smooth muscle responsiveness; and 2) these differences are not due to factors extrinsic to the smooth muscle, since they occurred in vitro and may depend on different densities of muscarinic receptors.

Acetylcholine↗
PubMed1988

[Medical history of severe respiratory insufficiency].

To evaluate retrospectively health care in severe chronic respiratory failure, we interviewed 38 patients, admitted for the first time to a pulmonary intensive care unit for an acute episode. A standardised questionnaire was devoted to establishing if the patients were aware of chronic respiratory disease prior to admission, if they had visited a general practitioner or a chest clinic, and had undergone a lung function evaluation. Six patients were unaware of any respiratory disease prior to the acute episode. Six others realised they had suffered from a respiratory disease, but had failed to visit a physician. Among the remaining 26 patients, two-thirds had visited a chest physician. Fourteen of them had undergone spirometry and arterial blood gas measurements. One third had visited a general practitioner but spirometry was performed in only 3 and arterial blood gas analysis in only 1. Thus, chronic respiratory failure is sometimes ignored, and most of the time diagnosed with delay and inadequately evaluated.

Adult↗
PubMed1987

Relationship between skin reactions to common allergens and non-specific bronchial reactivity in young healthy subjects.

In patients with respiratory symptoms, several studies have provided data supporting the hypothesis that there is a casual relationship between allergen exposure and variations in bronchial reactivity. In order to determine if this relationship holds when atopy is defined only on the basis of positive skin tests to common allergens, we compared bronchial reactivity in a group of twelve healthy subjects with positive skin tests and twenty-eight healthy subjects with negative tests. The two groups were comparable in terms of gender, age, smoking habits and family history of atopic diseases. The slopes of the dose-response curves, using airway conductance as an index of response, were similar in the two groups. Thus, in this healthy group of subjects, there was no relationship between skin and bronchial reactivity. It can be hypothesized that, if genetic factors determine bronchial reactivity, such reactivity might not be revealed until skin-test positive subjects have received repeated bronchial stimulation through inhalant allergens.

Adult↗
PubMed1987

Different bronchoconstrictor effects of carbachol boluses inhaled near residual volume or total lung capacity.

The purpose of this study was to determine if the lung volume at which aerosol inhalation begins (LVi) influences airway responses to bronchoconstrictor agents. We compared the effects of carbachol boluses (25, 50 and 100 ml), inhaled at high and low LVi (averaging 72.2 and 15.8% of vital capacity, respectively) on specific airway resistance (SRaw). In order to eliminate the possible influence of airway obstruction on aerosol distribution and deposition, we selected 5 asthmatic subjects with normal respiratory function (spirometry, SRaw, nitrogen washout and closing volume); furthermore, non-cumulative dose-response curves were obtained (i.e. the patients inhaled only one dose of carbachol on a given test day). Inhaling carbachol at low LVi yielded a significantly (p less than 0.01) larger degree of bronchoconstriction. Differences in bronchial responses were probably due to differences in the amount of particles deposited in the airways and/or to their distribution. These data suggest that LVi should be controlled for quantified inhalation provocation tests.

Adult↗
PubMed1986

[Trial of a new technic of transcutaneous diaphragmatic electrostimulation in man].

A new method of diaphragmatic pacing by transcutaneous electrical stimulation, using alternative currents with frequency and amplitude modulations, was tested in 12 subjects: 3 were normal and awake (group I); 4 were studied in acute respiratory failure while under mechanical ventilation and central apnea (group II) and 5 were studied while anaesthetized for peripheral venous surgery and breathing spontaneously (group III). Stimulation was performed either during spontaneous ventilation (groups I and II) or during short periods of respiratory depression (group III). Tidal volume was measured by pneumotachography. A positive correlation was found between stimulus intensity and inspired volume. This effect was not due to voluntary control alone, since diaphragmatic stimulation could support 24% of the theoretical minute ventilation in group II subjects and 64% in group III subjects. These preliminary results demonstrate the relative efficacy of this new method of diaphragmatic pacing using computerized alternative currents.

Adult↗
PubMed1984

Spontaneous and provoked resistance to isoproterenol in isolated human bronchi.

Cumulative concentration-response curves to isoproterenol were constructed in 74 preparations of human airways (group A) contracted with acetylcholine (80% of maximal contraction). In 52 bronchi (group A1), the maximal relaxation to isoproterenol represented at least 70% of the acetylcholine contraction (average 98% +/- 3) and the mean concentration (+/- SD) causing 50% of the relaxation (EC50) was 6.0 X 10(-8)M +/- 0.8. Resistance to isoproterenol (significant decrease of the maximal relaxation and right shift of the concentration-response curve) was provoked in 25 preparations by incubating them with isoproterenol (concentration 100 times higher than the individual EC50) for 30 min. The response to isoproterenol remained stable over the same time interval in eight control preparations. Incubation with isoproterenol did not modify the relaxing response to theophylline (n = 8). Indomethacin had no effect on the resistance provoked by isoproterenol incubation (n = 11). Incomplete relaxation to isoproterenol (maximal relaxation averaging 47% +/- 2 of the acetylcholine contraction) was observed in 22 preparations (group A2; mean EC50 = 1 X 10(-6)M +/- 0.2, significantly different [p less than 0.001] from group A1). Such preparations could be completely relaxed by theophylline (n = 7). For the whole group A, a significant negative correlation was found between isoproterenol EC50 and the magnitude of the maximal relaxation to isoproterenol (expressed as percent of acetylcholine contraction). There was no significant correlation between acetylcholine EC50 and isoproterenol maximum relaxation. Spontaneous resistance to isoproterenol was neither related to the technique of isoproterenol administration (cumulative versus noncumulative; n = 11) nor the magnitude of acetylcholine contraction (70% and 95% of maximal contraction; 14 bronchi, group B).

Airway Resistance↗