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Biomedical subjects

R Pariente

Publications and source records attributed to R Pariente.

At least 55 records · Page 3Linked to original sources

Effects of digoxin on diaphragmatic strength generation.

Contrary to hindlimb muscle, extracellular calcium plays an important role in diaphragmatic strength generation (J. Appl. Physiol. 58: 2054-61, 1985). Since the inotropic effect of digitalis appears to be related to cell membrane transport of calcium, we studied the effect of digoxin on diaphragmatic contractility in 20 anesthetized dogs. The diaphragm was electrically stimulated with intramuscular electrodes. The transdiaphragmatic pressure (Pdi) during supramaximal (50 V) 2-s stimulations applied over a frequency range of 10-100 Hz was measured with balloon catheters at functional residual capacity. Cardiac output was measured with a Swan-Ganz catheter and diaphragmatic blood flow (Qdi) by timed volume collections of left inferior venous effluent. The force generated by the sartorius muscle during electrical stimulations was studied concomitantly to Pdi. In 10 dogs (group A) 0.04 mg/kg of digoxin was infused in 10 min. In 10 other dogs (group B) 0.2 mg/kg was administered. All measurements were performed during control and 30, 60, 90, and 120 min after digoxin administration. In group A, digoxin plasmatic level at 60 min reached a therapeutic range in all dogs (1.8 +/- 0.3 ng/ml), whereas in group B, digoxin plasmatic level was higher (8 +/- 1.3 ng/ml). No significant change in cardiac output and Qdi was noted after administration of digoxin, either in the dogs of group A or those of group B.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Effects of theophylline on isolated diaphragmatic fibers. A model for pharmacologic studies on diaphragmatic contractility.

An in vitro model of isolated diaphragmatic muscle fibers was developed to study the effects of theophylline on diaphragmatic contractility. The effects of theophylline on this model were compared for each dose with the effects of the drugs on a "classic" hemidiaphragmatic muscle preparation. Diaphragmatic strips obtained from 20 rats were placed into an open topped channel of a plexiglass tissue chamber and perfused with continuously flowing Krebs solution heated to 37 degrees and bubbled with a 95% O2 and 5% CO2 gas mixture so as to maintain pH, PO2, PCO2 constant (7.4, 100, and 35 mmHg, respectively). Isometric force generated in response to 1 Hz supramaximal electrical stimulation was measured with a highly sensitive photoelectric transducer. Graded doses of aminophylline (15 to 75 mg/L) were administered and their effect assessed on diaphragmatic peak twitch tension. On the single diaphragmatic muscle fibers preparation, theophylline produced a dose dependent increase in peak twitch tension, which, at a concentration of theophylline of 15 mg/L, a therapeutic dose, amounted to 111 +/- 1.5% of control (p less than 0.05). At a concentration of 60 mg/L the increase in peak twitch tension averaged 35 +/- 2.5% of control, (p less than 0.001). On the other hand, theophylline had no effect on the hemidiaphragm preparation until a dose of 250 mg/L. These findings suggest that the effects of theophylline on diaphragmatic contractility are due to a direct action of the drug on the contractile properties of the diaphragmatic fibers and also validate the presented in vitro model as a promising one for future pharmacologic studies on diaphragmatic contractility.

Animals

[Experimental allergic asthma].

This paper is concerned with the induction of experimental allergic asthma by active sensitization of the airways "vis-à-vis" heterologous protein. Thus in the rodent it is possible to sensitize the airways by direct intra-tracheal injection of the allergen without producing an allergic alveolitis; the concomitant injection of an adjuvant is however indispensable. Confirmation of the sensitized state can be made by in vitro measurements of isometric contraction of tracheal smooth muscle in the presence of the allergen. This active sensitization is accompanied by histocytological changes which are detected by immunomorphological techniques: the rise in the number of plasma cells sensitized to IgE in the mediastinal modes: the appearance (or increase in number) of intra-cytoplasmic IgE in the sub-epithelial tracheal mast cells and in certain non ciliated intra-epithelial cells, probably basophils, morphologically close to the mast cells.

Allergens

[Evaluation of the efficacy of the surgical treatment of panlobular emphysema].

26 patients presenting with panlobular emphysema between 1978 and 1984 were submitted to a thoracotomy for surgical resection of their bullae. Pre-operative and post-operative evaluations of the following were made: The level of dyspnoea in 5 grades. The FEV1 (VEMS) the forced vital capacity (CVF) the functional residual capacity (CRF) measured plethysmographically, the residual volume (VR), the total lung capacity (CPT). Arterial blood gases. The presence of radiological signs of compression on pulmonary angiography and on plain chest radiographs: an index of compression rated 0 to 6 was defined at the outset. The subjects were split into 3 groups based on their post-operative respiratory function: Group 1: no improvement (n = 7). Group 2: moderate improvement of dyspnoea (n = 11). Group 3: a big improvement in dyspnoea (n = 7). These three groups were homogenous as regards their preoperative respiratory function. On the other hand, the compression caused by the bullae based on the pre-operative radiological data was much greater (p 0.01) in the group of patients who improved. In addition when the index of compression was equal or superior to 3 (n = 14) all the patients were improved (n = 6). The comparison of pre- and post-operative values shows the following results: The change in blood gases was very limited in all groups; the ventilatory parameters were unchanged in group 1; on the other hand in group 2 and 3 one notes an overall improvement in pulmonary function. The size of the improvement however, was very variable from one individual to another.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Effect of hypophosphatemia on diaphragmatic contractility in patients with acute respiratory failure.

We studied the effects of hypophosphatemia on diaphragmatic function in eight patients with acute respiratory failure who were artificially ventilated. Their mean serum phosphorus level was 0.55 +/- 0.18 mmol per liter (normal value, 1.20 +/- 0.10). The contractile properties of the diaphragm were assessed by measuring the transdiaphragmatic pressure generated at functional residual capacity during bilateral supramaximal electrical stimulation of the phrenic nerves. Diaphragmatic function was evaluated in each patient before and after correction of hypophosphatemia, which was achieved by administration of 10 mmol of phosphorus (as KH2PO4) as a continuous infusion for four hours. After phosphate infusion, the mean serum phosphorus level increased significantly (1.33 +/- 0.21 mmol per liter, P less than 0.0001). The increase in serum phosphorus was accompanied by a marked increase in the transdiaphragmatic pressure after phrenic stimulation (17.25 +/- 6.5 cm H2O as compared with 9.75 +/- 3.8 before phosphate infusion, P less than 0.001). Changes in the serum phosphorus level and transdiaphragmatic pressure were well correlated (r = 0.73). These results strongly suggest that hypophosphatemia impairs the contractile properties of the diaphragm during acute respiratory failure, and they emphasize the importance of maintaining normal serum inorganic phosphate levels in such patients.

Acute Disease

[Extensive bronchial dystrophy. Physiopathology and treatment of suppurative complications (author's transl)].

Extensive bronchial dystrophy differs by its histopathology, course and treatment from chronic obstructive bronchitis. This dystrophy leads to cavities which are virtually constantly infected. The extension of infection to adjacent alveoli may be dramatic, contrasting with underlying slight chronic respiratory failure. The existence of these cavities explains the preponderant role in therapy of drainage and the fact that antibiotic therapy would appear to be indicated only in the case of extension of infection to the alveoli and the peribronchial tissues.

Anti-Bacterial Agents

[Therapy of asthma].

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Adrenal Cortex Hormones

[Abnormalities in bronchial permeability after induction of a chronic SO2 bronchopathy in rat (author's transl)].

Our aim was to study the effects of a chronic exposure to SO2 on the permeability of bronchial epithelium in the rat, in vivo and in vitro, in relation with a marker (ferritin). The anatomical lesions observed in light and electron microscopy considerably increased the passage of ferritin both in vivo and in vitro through the epithelium of trachea and primary bronchi. This increase was still found although more discrete three months after the end of exposure while the histological appearance returned to normal. Those results showed that SO2 induces in upper airways functional abnormalities persisting beyond the necessary lapse of time for the repairing of histological lesions which could therefore intervene in the pathogeny of chronic bronchopathies.

Animals

[Interest of helium-oxygen flow volume and isoflow volume curves in chronic obstructive lung disease (author's transl)].

We have compared changes in maximal flows induced by breathing gases of different density in 54 patients suffering from emphysema and chronic bronchitis. We considered as positive responders those subjects displaying an increase by at least 20% of maximal expiratory flows while breathing gases of lower density. Such a response was demonstrated in 21 cases, the remainder (33 cases) being non-responders. Hence, in such patients, airways obstruction may primarily be localised in central or peripheral airways. There was no correlation between the nature of this response and the clinical diagnosis, but non-responders, in general, were those in whom respiratory insufficiency was more severe. There seemed to be no additional information gained by measuring isoflow-volume (iso V vol.) in comparison with measuring differences in maximal flows at 50% of vital capacity.

Bronchitis

Experimental modifications induced by membrane oxygenators on lung ultrastructure in dogs and baboons.

Extracorporeal circulation with membrane oxygenator (E.C.M.O.) was performed in 6 dogs and 5 baboons during 4 to 57 hours. Examination of pulmonary samples showed progressive lesions in the two species: at the second hour of E.C., alteration of capillary endothelium, at the sixth, extensive lesions of all the lung structures, worsening later on. We discussed whether these lesions are related to the E.C.M.O., their reversibility and the questionable benefit of E.C.M.O. for management of respiratory distress syndrome.

Animals

[Pan-lobular emphysema: relationship with serum alpha-1-antitrypsin levels, Pi phenotype and the HLA system (author's transl)].

Pi phenotypes have been studied in a group of 433 patients. Patients with panacinar emphysema and/or bullae were identified from careful analysis of their clinical, physiological, radiological and anatomical characteristics. Twenty-five p.cent of the emphysematous patients were MZ; there was no significant difference in the alpha-1-antitrypsin plasmatic levels between the groups. The HLA antigens were studied in order to try to identify the possible cofactors in the development of emphysema. The role of occupational pollutants and/or of tobacco is discussed. The frequency of the MZ phenotype in our series differs from previous publications. This discrepancy is discussed on the basis of the criterious used to identify the emphysematous patients.

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