Morphology and nanostructure of CeO2(111) surfaces of single crystals and Si(111) supported ceria films.

The surface morphology of CeO(2)(111) single crystals and silicon supported ceria films is investigated by non-contact atomic force microscopy (NC-AFM) and Kelvin probe force microscopy (KPFM) for various annealing conditions. Annealing bulk samples at 1100 K results in small terraces with rounded ledges and steps with predominantly one O-Ce-O triple layer height while annealing at 1200 K produces well-ordered straight step edges in a hexagonal motif and step bunching. The morphology and topographic details of films are similar, however, films are destroyed upon heating them above 1100 K. KPFM images exhibit uniform terraces on a single crystal surface when the crystal is slowly cooled down, whereas rapid cooling results in a significant inhomogeneity of the surface potential. For films exhibiting large terraces, significant inhomogeneity in the KPFM signal is found even for best possible preparation conditions. Applying X-ray photoelectron spectroscopy (XPS), we find a significant contamination of the bulk ceria sample with fluorine while a possible fluorine contamination of the ceria film is below the XPS detection threshold. Time-of-flight secondary ion mass spectroscopy (TOF-SIMS) reveals an accumulation of fluorine within the first 5 nm below the surface of the bulk sample and a small concentration throughout the crystal.

Duration of immunity induced by an equine influenza and tetanus combination vaccine formulation adjuvanted with ISCOM-Matrix.

Equine influenza is a contagious disease caused by equine influenza virus which belongs to the orthomyxovirus family. Outbreaks of equine influenza cause severe economic loses to the horse industry and consequently horses in competition are required to be regularly vaccinated against equine influenza. Unlike the existing inactivated vaccines, Equilis Prequenza Te is the only one able to induce protection against clinical disease and virus excretion after a primary vaccination course consisting of two vaccine applications 4-6 weeks apart until the recommended time of the third vaccination. In this paper we describe the duration of immunity profile, tested in an experimental setting according to European legislation, of this inactivated equine influenza and tetanus combination vaccine. In addition to influenza antigen, the formulation contains a second generation ISCOM (the so called ISCOMatrix) as an adjuvant. The vaccine aims at the induction of protection from the primary vaccination course until the time of annual revaccination 12 months later, against challenge with a virulent equine influenza strain. The protection against A/equine/Kentucky/95 (H3N8) at the time of annual revaccination was evidenced by a significant reduction of clinical signs of influenza, a significant reduction of virus excretion and a significant reduction of fever. The effect of the annual revaccination on the duration of immunity against influenza and tetanus was also studied by serology. For tetanus, as a consequence of the 24 months duration of immunity, an alternating annual vaccination schedule consisting of Prequenza and Prequenza Te is proposed after the first three doses of Prequenza Te.

The first safe inactivated equine influenza vaccine formulation adjuvanted with ISCOM-Matrix that closes the immunity gap.

Equine influenza is a contagious diseases caused by equine influenza viruses which belong to the orthomyxovirus family. Outbreaks of equine influenza cause severe economic loses to the horse industry and consequently competition horses are required to be regularly vaccinated against equine influenza. Currently available inactivated vaccines are only able to induce protection against clinical disease and virus excretion after a primary vaccination course consisting of three vaccine applications at 4-6 and 22-26 weeks apart, respectively. It has been suggested that these vaccines induce no adequate protection in horses at 22-26 weeks (5 months) in the primary vaccination course (immediately prior to the last booster), despite various alternative vaccination regimens proposed. In this paper we describe the efficacy and safety profile, tested in an experimental setting according to European legislation of a novel inactivated equine influenza vaccine formulation (Prequenza). This formulation consists besides influenza antigen, of second generation ISCOM-Matrix as an adjuvant. The vaccine aims at the induction of protection from the onset of immunity, i.e. after the first two vaccine applications, until the first booster given 5 months later, against challenge with a virulent equine influenza strain. The protection against A/equine/Kentucky/95 (H3N8) was evidenced by a reduction of clinical signs of influenza, a reduction of virus excretion and a reduction of fever. The vaccine was shown to be safe in pregnant mares, foals and is used safely since 2 years as a commercial vaccine in Europe.

Anthracyline-reduced sequential combination chemotherapy for younger patients with good-prognosis aggressive B-cell non-Hodgkin's lymphoma.

INTRODUCTION: Anthracyline-based chemotherapy is the treatment of choice for patients with aggressive B-cell non-Hodgkin's lymphoma (NHL). However, anthracyclines have been associated with long-term cardiac toxicity. METHODS: We conducted a study using a sequential combination chemotherapy with a reduced cumulative dose of anthracyclines in younger patients with good-prognosis aggressive NHL. Chemotherapy consisted of one cycle of vincristine, ifosfamide, etoposide, and dexamethasone, followed by three cycles of epirubicin, cyclophosphamide, vincristine, and dexamethasone, and a fifth cycle containing carboplatin, etoposide, and dexamethasone. 86 patients were treated, 65 without and 21 with additional rituximab. Consolidating involved-field irradiation was applied in patients with stage I/II, bulky disease, or localized residual lymphoma. RESULTS: Complete and partial remissions were achieved in 67 and 27% of patients, respectively, and the 3-year event-free and overall survival estimates were 75 and 87%. The survival estimates were substantially better in patients who received rituximab. Main toxicity was grade 3/4 leukocytopenia in 89% patients with neutropenic fever in 30%. Two patients died of septic shock. CONCLUSION: The treatment appears to be effective in this group of patients. The hematological toxicities, particularly after the first and fifth cycle, require the use of G-CSF and/or a dose reduction in selected patients.

Local treatment of pressure sores in the elderly: amino acid copolymer membrane versus hydrocolloid dressing.

OBJECTIVE: To compare the clinical effectiveness and wound management properties of a copolymer membrane, Inerpan (Synthélabo), and a hydrocolloid dressing, Comfeel (Coloplast), in the treatment of decubitus ulcers in the elderly. DESIGN: Open, randomized, multicentric French study, with two parallel groups of patients. PATIENTS: 168 in-patients aged more 65 years (mean age: 82 years) suffering from grade II to grade IV (in the Shea classification) pressure sores. TRIAL PERIOD: Either 8 weeks or until the ulcer healed, whichever occurred first. MEASUREMENTS: In addition to a complete physical examination, patients were evaluated at baseline for nutritional status and risk factors. The wounds were described, their depth scored, and the areas traced at Weeks 0, 1, 2, 4, 6, and 8. The number of dressings used was recorded. RESULTS: Thirty-one Inerpan-treated patients and 23 Comfeel-treated patients achieved healing (P = 0.089), with respective median healing times of 32 and 38 days. Healing times were compared using survival curves (in the whole population) adjusted for ulcer depth effect and showed a significant difference in favor of Inerpan (P = 0.044 and 0.014). Progress of healing (percentage of ulcer healed) was calculated in the two groups. Clinically assessed the treatment performance scored at the completion of the study showed better results with Inerpan (P < 0.05). Both groups were similar in terms of granulation/exudation scores, surrounding skin, and ease of care. CONCLUSION: It is concluded that Inerpan is easy to use, safeguards the healing process, and is of particular value in the management of pressure sores.

Pathophysiology and morphometry of the early pulmonary fibrosis in dogs.

A physiological (hemodynamics, gas exchange and respiratory mechanics) and morphometric evaluation has been undertaken on six normal dogs (N) and seven dogs (F) whose lungs showed variable degrees of fibrosis produced by successive injections of oleic acid. The correlation between the degree of fibrosis and the ratio of measured to predicted alveolar surface was --0.97 (alpha < 0.01). Moderate pulmonary hypertension was present in group F. The greater the fibrosis, the more the volume/pressure curve was displaced downward and to the right. There was a good (positive or negative) correlation between the degree of fibrosis and the following data: expired quasi-static compliance, DLCO, PAO2, (A--a)Do2 and the intrapulmonary shunt. Except for the increase in shunt, the VA/Q distribution was not disturbed.

Distribution of ventilation-perfusion ratios in pneumonectomized dogs.

In this paper, the distribution of ventilation (VA) and of pulmonary perfusion (Q), gas exchanges, and the single breath CO diffusing capacity are measured in 8 dogs before and after left pneumonectomy. During surgery 4 dogs, in which the left pulmonary artery is clamped, and 4 other dogs in which the left mainstem bronchus is clamped, are studied. A minute ventilation (VE) is adjusted during the initial stage in each dog but it is kept constant for the other stages. For the entire group of dogs, the overall VE/Q varies from 0.8 to 3.0 in the baseline study. In the initial study, the perfusion distribution is unimodal and the ventilation distribution is unimodal or bimodal. The percentage of ventilation of the second mode correlates approximately with the overall VA/Q. After clamping the left pulmonary artery, the correlation between overall VA/Q, capillary shunt, and blood gases data is excellent and the ventilation and perfusion distributions are both bimodal. One perfusion mode is situated in the low VA/Q ratios while one ventilation mode is situated in the high VA/Q ratios. After clamping the left mainstem bronchus, the average anatomical shunt is 27%, the ventilation and perfusion are both bimodal, and the mean PaO2 is 55 mm Hg. Ultimately the ventilation and perfusion distributions tend to return to normal after pneumonectomy.

Effect of body position and of respiratory frequency on distribution of pulmonary ventilation and perfusion in dogs.

Ventilation (VA) perfusion (Q) ratios distribution measured by the inert gases method is studied in 7 anesthetized dogs in supine position, in prone position at a respiratory frequency of 15 cpm, and in prone position at a respiratory frequency of 10 cpm so as to test the sensitivity of this VA/Q method. Despite the fact that the precise height-width characteristics of the distribution modes are unknown, our results show coherent changes and sensitivity of the log standard deviation of the perfusion curve, of the shunt, and of the dead space obtained with the inert gas method. After the change from supine to prone position, cardiac output increases, shunt, if it exists, diminishes, VA/Q ratios distribution becomes more uniform, and PaO2 increases and (A-a)DO2 decreases. When respiratory frequency changes from 15 to 10 cpm, cardiac output, shunt, and dead space decrease, VA/Q ratios distribution curves are slightly less homogeneous. PaO2 and PaCO2 show no significant variation. This study shows that distribution mode's characteristics can be considered as good and coherent approximations.

Pulmonary neutral fat embolism in dogs.

Twenty-two adult dogs were each given a single, 30-minute injection of 1.5 ml/kg body weight of pure triolein, and their pulmonary, hepatic, renal, and cerebral morphology was observed for 1, 2, 3, 4, 5, 6, 15, 24, and 48 hours; 3,4, and 5 days; 1 and 2 weeks; and 1 month after the injection. A picture of massive capillary occlusion by lipid droplets was followed by rapidly resolvable inflammatory pneumopathy of granulomatous type, leaving a normal lung at the end of the experiment. The cleaning of the capillaries may be attributed to the mechanical action of the blood flow and to the inflammatory reaction with evacuation of necrotic cells via the bronchial route. Transient pulmonary edema is attributed to increased pulmonary arterial pressure. There was no intravacular coagulation. The few pulmonary lesions observed after the triolein injection suggest that the chemical theory of neutral fat hydrolysis by pulmonary lipase and the toxicity of free fatty acids that are released should be reconsidered.

Respiratory mechanics measured by a simple device.

A simple and inexpensive apparatus is described which permits the semi-automatic measurements of pulmonary dynamic compliance (Cdyn) and airway resistance (Raw) while rapid changes of these factors during the experimental induction of pneumopathies can be followed. A diaphragm is used as a pneumotachograph because it was found to be quite sensitive and pulmonary secretions did not disturb the measurements. Volume base line drift is prevented.

Embolic pneumopathy induced by oleic acid. A systematic morphologic study.

This paper presents a systematic study of acute and chronic pulmonary lesions resulting from a single intravenous injection of oleic acid and a new fibrosis lung model is proposed: pulmonary interstitial fibrosis is obtained by means of a number of oleic acid intravenous injections. Nineteen adult dogs received 0.045 g/kg or 0.09 g/kg of oleic acid. A systematic morphologic study was carried out after 1, 2, 3, 4, 6, 12, 24, and 48 hours and 1, 2 and 4 weeks. Eleven other adult dogs received weekly one injection of 0.09 g/kg of pure oleic acid over a period of 1 to 3 months. Examination of the lung was carried out by means of light and electron microscopy and morphometry. An early stage characterized by the formation of thrombosis and cellular necrosis was followed by a repair stage with the proliferation of Type 2 cells and fibrotic foci in the subpleural areas. Lipid staining with Sudan IV allowed the onset and disappearance of lipid-laden macrophages to be ascertained. The late stage showed pulmonary fibrosis. The extent of the lesions is related to the number of oleic acid injections. Since interstitial pulmonary fibrosis invariably appeared, and only 2 dogs out of 11 died, the model is satisfactory for pathologist and physiologist.

An automatic device for single-breath CO diffusing capacity in dogs.

We describe a very simply operated system by which single-breath CO diffusing capacity (DLCO) can be measured in anesthetized dogs. All controls and the automatic system are operated pneumatically. Cams forming an integral part of the pistons of the inspiratory and expiratory syringes activate push buttons which control the valves, enabling dead spaces to be flushed, a specific volume of air to be injected into the dog's lungs, and expiratory samples to be taken. Our results, due account being taken of the dogs' weight, are in the upper range of normal values published in earlier studies; the reproducibility of the method is good.

Extracorporeal oxygenation with various experimental venoarterial bypasses during prolonged apnea.

This work compares various conventional venoarterial closed-chest circuits where satisfactory oxygenation of myocardium and brain in total apnea with extracorporeal circulation is concerned. Eleven dogs were studied during 3 hours of curare-induced apnea. We used single and double vena caval drainages connected to an oxygenator. A single-vein drainage yielded approximately 50 per cent and a double-vein drainage 75 per cent bypass. Two separate roller pumps fed arterialized blood variously into carotid and femoral arteries. In single-vein drainage, the oxygen partial pressure in the coronary artery was consistently poor and carotid oxygen partial pressure was poor for 100 per cent femoral infusion while more and more arterialized blood reached the carotid arteries in the other single-vein drainage circuits. In double-vein drainage, the coronary oxygen partial pressure for 100 per cent femoral infusion remained poor while, for the other circuit types, the coronary arteries received arterialized blood except where 100 per cent carotid infusion was concerned. The carotid oxygen partial pressure was sound for all groups in the double-vein drainage except for some obtained in 100 per cent femoral infusion. Consequently, where the bypass was large and the carotid and femoral arteries received a share of arterialized blood, both heart and brain received sound oxygenation.