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Biomedical subjects

M Lorange

Publications and source records attributed to M Lorange.

13 recordsLinked to original sources
PubMed2000

Performance of a multiplex PCR for the determination of Haemophilus influenzae capsular types in the clinical microbiology laboratory.

To improve tools for the surveillance of invasive H. influenzae in the context of the drastic decrease of type b infections following the implementation of vaccination, a two-step PCR technique was developed to detect the capsule and type specific regions of H. influenzae. The technique of Falla et al (1994) was modified to amplify in a first step the capsule and type b regions by multiplex PCR. For non-b capsulated strains, the type a, c, d, e, and f loci were afterward detected simultaneously by an optimized touch-down PCR technique. An internal control of extraction and amplification (16S rDNA) was included for both PCR techniques. Overall, this technique was shown to perform as efficiently or better than the slide agglutination without risks of interpretation errors. Of the 138 H. influenzae strains tested, seven that had given doubtful results by the agglutination technique were unequivocally typed by PCR.

ATP-Binding Cassette Transporters↗
PubMed1999

Arcobacter butzleri isolated from a diarrhoeic non-human primate.

The bacteriological examination of a faecal specimen from a 20-year-old female rhesus macaque (Macaca mulatta) with diarrhoeal illness revealed the presence of a large number of a relatively new enteric pathogen, Arcobacter butzleri. The animal was from a closed colony of about 60 females, some of them were showing intermittent diarrhoea possibly related to Giardia spp. Conditions for the isolation and identification of A. butzleri are reported, as well as discussions about its role as a primary pathogen and its zoonotic potential.

Animals↗
PubMed1997

Standardization and a multilaboratory comparison of Neisseria meningitidis serogroup A and C serum bactericidal assays. The Multilaboratory Study Group.

A standardized serum bactericidal assay (SBA) is required to evaluate the functional activity of antibody produced in response to Neisseria meningitidis serogroup A and C vaccines. We evaluated assay parameters (assay buffer, target strains, growth of target cells, target cell number, complement source and concentration, and methods for growth of surviving bacteria) which may affect the reproducibility of SBA titers. The various assay parameters and specificity of anticapsular antibody to five serogroup A strains (A1, ATCC 13077, F8238, F9205, and F7485) and four serogroup C strains (C11, G7880, G8050, and 1002-90) were evaluated with Centers for Disease Control and Prevention meningococcal quality control sera. The critical assay parameters for the reproducible measurement of SBA titers were found to include the target strain, assay incubation time, and complement. The resulting standardized SBA was used by 10 laboratories to measure functional anticapsular antibody against serogroup A strains F8238 and serogroup C strain C11. In the multilaboratory study, SBA titers were measured in duplicate for 14 pairs of sera (seven adults and seven children) before and after immunization with a quadrivalent polysaccharide (A, C, Y, and W-135) vaccine. The standardized SBA was reliable in all laboratories regardless of experience in performing SBAs. For most sera, intralaboratory reproducibility was +/- 1 dilution; interlaboratory reproducibility was +/- 2 dilutions. The correlation between median titers (interlaboratory) and enzyme-linked immunosorbent assay total antibody concentrations was high for both serogroup A (r = 0.86; P < 0.001; slope = 0.5) and serogroup C (n = 0.86; P < 0.001; slope = 0.7). The specified assay, which includes the critical parameters of target strain, incubation time, and complement source, will facilitate interlaboratory comparisons of the functional antibody produced in response to current or developing serogroup A and C meningococcal vaccines.

Adult↗
PubMed1996

A computer heart model incorporating anisotropic propagation. III. Simulation of ectopic beats.

With the advent of catheter ablation procedures, it has become an important goal to predict noninvasively the site of origin of ventricular tachycardia. Site classifications based on the observed body surface potential maps (BSPMs) during ventricular endocardial pacing, as well as on the patterns of the QRS integrals of these maps, have been suggested. The goals of this study were to verify these maps and their QRS integral patterns via simulation using a computer heart model with realistic geometry and to determine whether the model could improve clinical understanding of these ectopic patterns. Simulation was achieved by initiating excitation of the heart model at different endocardial sites and their overlying epicardial counterparts. This excitation propagated in anisotropic fashion in the myocardium. Retrograde excitation of the model's His-Purkinje conduction system was necessary to obtain realistic activation durations. Simulated BSPMs, computed by placing the heart model inside a numerical torso model, and their QRS integrals were close to those observed clinically. Small differences in QRS integral map patterns and in the positions of the QRS integral map extrema were noted for endocardial sites in the left septal and anteroseptal regions. The simulated BSPMs during early QRS for an endocardial site and its epicardial counterpart tended to be mirror images about the zero isopotential contour, exchanging positive and negative map regions. The simulation results attest to the model's ability to reproduce accurately clinically recorded body surface potential distributions obtained following endocardial stimulation. The QRS integral maps from endocardial sites in the left septal and anteroseptal regions were the most labile, owing to considerable cancellation effects. Conventional BSPMs can be useful to help distinguish between endocardial and epicardial ectopic sites.

Anisotropy↗
PubMed1996

A computer heart model incorporating anisotropic propagation. IV. Simulation of regional myocardial ischemia.

The main goal of this study was to simulate clinical body surface potential maps, recorded during percutaneous transluminal coronary angioplasty protocols, using a realistic geometry computer heart model. Other objectives were to address the question of reciprocal ST-segment changes observed in the 12-lead electrocardiogram during ischemia and to verify the hypothesis that the shortening of the QRS duration observed in left anterior descending (LAD) coronary artery occlusion may be explained by conduction delay in the septal His-Purkinje system. Simulation was achieved by first introducing into the heart model three transmural zones of mild, moderate, and severe ischemia for assumed occlusions in the LAD, left circumflex, and right coronary arteries. The heart model was then excited, in turn, with these three zones present for assumed occlusions in the LAD, left circumflex, and right coronary arteries. Myocardial conduction velocities in the regions of moderate and severe ischemia were assumed to be reduced to 75 and 50% of normal, respectively. Model action potentials in the mild, moderate, and severely ischemic zones were also altered to reflect known ischemic changes in these action potentials. Body surface potential maps and electrocardiograms were computed by placing the heart inside a numerical torso model. Simulated map patterns during both ST-segment and QRS were qualitatively similar to clinical maps. Reciprocal ST-segment depression was observed for all three occlusions in remote leads that did not overlie the ischemic zones. QRS shortening due to septal His-Purkinje conduction delay was verified. The simulation results attest to the model's ability to reproduce body surface potential distributions recorded following percutaneous transluminal coronary angioplasty protocols. The simulations also showed that reciprocal ST-segment changes occur as a natural consequence of the primary ischemic region and that there is no need to invoke a second region of ischemia. Finally, the model demonstrated that QRS shortening can occur in LAD occlusion despite a slowing of conduction down the septal His-Purkinje system.

Angioplasty, Balloon, Coronary↗
PubMed1995

Meningococcal infections in the Province of Québec, Canada, during the period 1991 to 1992.

A total of 234 strains of Neisseria meningitidis obtained from hospitalized patients living in the province of Québec during the period 1991 to 1992 were characterized according to their serogroup, serotype, subtype, electrophoretic type, and antimicrobial susceptibility. All these strains were recovered from sterile body fluids, except for one strain that was isolated postmortem from a cutaneous lesion. For both years, serogroup C was the most prevalent (69.7%), followed by serogroup B (27.4%). Serotype 2a represented 80.3% of serogroup C isolates, and P1.2 was the most common subtype associated with this serotype. Clone ET 15 accounted for 76.5% of serogroup C isolates and 90.0% of serotype 2a strains. Although meningococcal disease occurred mostly in children under the age of 5 (9.7 cases per 100,000 children), with a peak incidence for children under 1 (20.3 cases per 100,000 children), most fatalities occurred among teenagers (12 to 19 years old). The total fatality rate was 11.5%, and serogroup C strains were responsible for 88.9% of these fatalities. Thirteen strains had a reduced susceptibility to penicillin G, and 28 strains were resistant to sulfadiazine. One strain was resistant to both rifampin and sulfadiazine and showed a reduced susceptibility to penicillin G.

Adolescent↗
PubMed1995

Evaluation of commercial antisera for Shigella serogrouping.

Shigella serogrouping antisera from six companies (Becton Dickinson, Denka, Difco, Murex, Roach, and Sanofi-Pasteur) intended for the slide agglutination test and those of the Wellcolex Colour Shigella latex agglutination test were evaluated to identify quality products for Shigella identification. Forty-six reference Shigella strains (one for each serotype and species), 50 clinical strains (21 S. flexneri, 21 S. sonnei, 4 S. dysenteriae, 4 S. boydii) representing the most prevalent species and serotypes encountered in Quebec, and 9 non-Shigella strains were tested according to the manufacturers' instructions. A 3+ reaction (> or = 75% agglutination) was considered positive for the slide agglutination tests. Sensitivity varied from 47% (Roach) to 94% (Difco). For the 105 strains tested, accuracy ranged from 53% (Roach) to 91% (Wellcolex). Specificity varied from 97 to 100% for group A antisera, from 96 to 100% for group B antisera, from 88 to 100% for group C antisera, and from 95 to 99% for group D antisera. The costs of reagents required to test one strain varied from $3.50 to $13.20 (in Canadian dollars). In conclusion, Roach reagents proved to be unsatisfactory for Shigella serogrouping. Among those from the remaining companies, the Denka, Difco, and Wellcolex reagents met a performance standard of 90% accuracy.

Agglutination Tests↗
PubMed1993

Measurement of respiratory mechanics using the Puritan-Bennett 7200a ventilator.

This study was designed in order to validate the respiratory mechanical variables measured by the Puritan-Bennett 7200a ventilator equipped with the 30/40 module. Two ventilators were connected to a lung model and submitted to several breathing patterns by modifying the respiratory rate, the tidal volume, the inspiratory flow-rate and the model resistance. The inspiratory flow-rate (V), tidal volume (VT), peak inspiratory pressure (Pmax), plateau pressure (Pplat) and PEEP measured by the ventilators were compared with the same variables measured at the connection between the breathing circuit and the lung model. The compliance (C30/40) and the resistance (R30/40) calculated by the 30/40 module were compared with those calculated by using the variables measured by the reference equipment. Both ventilators made a constant underestimation of V by 2.8 and 3.7 L.min-1, respectively. The VT was measured with a mean error of less than 10 ml but did not reflect the preselected values in the presence of an intrinsic PEEP. The Pplat was overestimated by 7 and 10%, respectively. The same calibration error was observed with Pmax which was also affected by a pressure gradient due to the resistance of the breathing circuit. Even in the absence of intrinsic PEEP, C30/40 presented an error due to the combination of the measurement errors on VT, Pplat and PEEP. Finally, R30/40 presented a high percentage of error due to the combination of the measurement errors on V, Pmax, and Pplat, and to a sporadic aberrant selection of V. Due to these numerous sources of error, the two ventilators studied did not give reliable estimates of resistance and compliance.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Resistance↗
PubMed1993

A computer heart model incorporating anisotropic propagation. I. Model construction and simulation of normal activation.

Present-day computer models of the entire heart, capable of simulating the activation isochrones and subsequently the body surface potentials, focus on considerations of myocardial anisotropy. Myocardial anisotropy enters into play at two levels, first by affecting the spatial pattern of activation owing to faster propagation along cardiac fibers and second by altering the equivalent dipole sources used to calculate the surface potentials. The construction of a new and detailed model of the human heart is described, based on 132 transverse sections obtained following a computed tomography scan of a frozen human heart whose chambers were inflated with pressurized air. The entire heart anatomy was reconstructed as a three-dimensional array of approximately 250,000 points spaced 1 mm apart. Conduction in the thin-walled atria was assumed isotropic from the sinus node region to the atrioventricular node, where it was subject to a 50 ms delay. A two-tier representation of the specialized conduction system was used, with the initial segments of the left and right bundles represented by a system of cables that feeds to the second tier, which is a sheet of conduction tissue representing the distal Purkinje system. Approximately 1,120 "Purkinje-myocardium" junctions present at the terminations of the cables and sprinkled uniformly over the sheet, transmit the excitation to the ventricles. A stylized representation of myocardial fiber rotation was incorporated into the ventricles and the local fiber direction at each model point used to compute the velocity of propagation to its nearest neighbors. Accordingly, the activation times of the entire ventricular myocardium could be determined using the 1,120 or so Purkinje-myocardium junctions as start points. While myocardial anisotropy was considered in the ventricular propagation process, it was ignored in the computation of the equivalent dipole sources. Nevertheless, the computed electrocardiogram, vectorcardiogram, and body surface potential maps obtained with the new heart model properly positioned inside an inhomogeneous torso model were all within normal limits.

Anisotropy↗
PubMed1993

A computer heart model incorporating anisotropic propagation. II. Simulations of conduction block.

This study describes the simulation of the more common types of conduction blocks with a computer model of the heart incorporating anisotropic propagation. The rationale was to test the model as to its ability to simulate these blocks by physiologically justifiable adjustments of the conduction system alone. The complete blocks were generated by simply blocking conduction totally at selected sites in the proximal conduction system, and the incomplete blocks by slowing down the conduction velocity in the proximal system. Also simulated were the left fascicular blocks and the bilateral blocks. All simulated electrocardiograms, vectorcardiograms, body surface potential maps, and epicardial isochrones for these blocks were similar to clinically observed data, with the exception of the left posterior hemiblock, which was slightly atypical. This could be because such blocks are usually accompanied by other cardiac pathologies not included in our simulations. The model also supports van Dam's observation that during left bundle branch block the passage of activation from right to left occurs via slow myocardial activation with no evidence of a local delay due to a septal barrier. Finally, the model suggests that a left bundle branch block with a normal frontal plane QRS axis may simply represent a case of an incomplete left bundle block, whereas one that exhibits a left axis QRS deviation in the frontal plane represents a more severe complete left bundle branch block.

Anisotropy↗