[A catamenial pneumothorax, an unknown entity]. / Le pneumothorax cataménial, une entité méconnue.

A 31-year-old patient is admitted to the emergency room because of an acute right thoracic pain associated with a dyspnea. The patient reports the stopping of Decapeptyl®, a treatment taken in regards to an endometriosis, but interrupted to get pregnant. An x-ray highlights a pneumothorax of 15 mm at the right apical level. It is a second episode for this patient. Catamenial pneumothorax is one of the most frequent manifestation in terms of a thoracic endometriosis syndrome (TES). It concerns a rare pathology, unrecognized and underdiagnosed. The diagnosis should be invoked on all patients having the childbearing age who are presenting themselves at the emergencies with a right thoracic pain. The medical care is multidisciplinary, the association of a hormonal therapy and then a surgical treatment being the best therapeutical approach. This case report describes the recurrence of a catamenial pneumotorax induced by the stopping of the endometriosis treatment and reviews the physiopathology, the diagnosis and its multidisciplinary management.

Une patiente de 31 ans est admise aux urgences pour douleur thoracique droite apparue brutalement et associée à une dyspnée. La patiente rapporte l'arrêt du Decapeptyl®, traitement pris dans le cadre d'une endométriose, mais interrompu pour un désir de grossesse. Une radiographie mettra en évidence un pneumothorax de 15 mm au niveau apical droit. Il s'agit du deuxième épisode chez cette patiente. Le pneumothorax cataménial (PC) est l'une des manifestations les plus fréquentes dans le cadre d'un syndrome d'endométriose thoracique (SET). Il s'agit d'une pathologie rare, méconnue et sous-diagnostiquée. Il est à évoquer chez toutes patientes en âge de procréer se présentant aux urgences avec une douleur thoracique droite. La prise en charge est multidisciplinaire, l'association d'un traitement hormonal, puis chirurgical, semble être la meilleure approche thérapeutique. Cet article rapporte la récidive d'un PC, récidive induite par l'arrêt du traitement de l'endométriose, et revoit la physiopathologie, le diagnostic et la prise en charge de celui-ci.

Improbability of void growth in aluminum via dislocation nucleation under typical laboratory conditions.

The rate at which dislocations nucleate from spherical voids subjected to shear loading is predicted from atomistic simulation. By employing the latest version of the finite temperature string method, a variational transition state theory approach can be utilized, enabling atomistic predictions at ordinary laboratory time scales, loads, and temperatures. The simulation results, in conjunction with a continuum model, show that the deformation and growth of voids in Al are not likely to occur via dislocation nucleation under typical loadings regardless of void size.

Post-translational modification(s) and cell distribution of Streptomyces aureofaciens translation elongation factor Tu overproduced in Escherichia coli.

We cloned EF-Tu from Streptomyces aureofaciens on a pET plasmid and overproduced it using the T7 RNA polymerase system in Escherichia coli. Streptomyces EF-Tu represented more than 40% of the total cell protein and was stored mostly in inclusion bodies formed apically at both ends of E. coli cells. Analysis of the inclusion bodies by transmission and scanning electron microscopy did not reveal any internal or surface ultrastructures. We developed the method for purification of S. aureofaciens EF-Tu from isolated inclusion bodies based on the ability of the protein to aggregate spontaneously. EF-Tu present in inclusion bodies was not active in GDP binding. Purified protein showed a similar charge heterogeneity as EF-Tu isolated from the mycelium of S. aureofaciens and all of the isoforms reacted with EF-Tu antibodies. All isoforms also reacted with monoclonal antibodies against O-phosphoserine and O-phosphothreonine.

Long-term endurance training does not prevent the age-related decrease in left ventricular relaxation properties.

AIM: Diastolic filling dynamics in the long-term endurance trained elderly has previously been examined by transmitral flow velocity, which has been shown to be preload dependent. The aim of this study was to assess the effect of long-term endurance training on left ventricular (LV) relaxation in older individuals by using pulsed tissue Doppler imaging. METHODS: Fourteen master athletes with a history of intensive long-term endurance training, 14 aged-matched sedentary controls and 15 young adult men underwent standard Doppler echocardiography and pulsed Doppler tissue imaging, performed in four-chambers apical view, by placing a sample volume at the level of the mitral annulus. RESULTS: Stroke volume was significantly higher and heart rate lower in master athletes compared with aged-matched sedentary subjects. Transmitral Peak E velocity and ratio E/A were significantly higher in master athletes, but did not reach the values of young men. Peak LV wall motion during the early filling phase, an index of LV relaxation, were significantly higher in young men than in both groups of older individuals. However, similar values were obtained between master athletes and sedentary counterparts. CONCLUSIONS: Our data provide evidence that long-term training does not reduce the age-related decline in LV relaxation properties in humans. This finding implies that other mechanisms, such as increased LV filling pressures due to expanded blood volume, are probably responsible for the higher contribution of early diastolic filling to LV filling in master athletes compared with their sedentary counterparts. However this hypothesis needs to be confirmed.

Validation of a volumic reconstruction in 4-d echocardiography and gated SPECT using a dynamic cardiac phantom.

A dynamic cardiac phantom was used as a reference to compare the volumes reconstructed with 4-D echocardiography and gated single-photon emission computed tomography (SPECT). 4-D echocardiography used a new prototype of rotating scan head to acquire ultrasound (US) images during a cardiac cycle, associated with a new protocol (left ventricular 4-D or LV 4-D) to reconstruct the volume deformations of the heart as a function of time. Gated SPECT data were acquired with a standard single-head gamma camera, and the reconstructions were carried out using the Mirage software released by Segami. The influences of different LV 4-D parameters were tested and analyzed. End-diastolic volume, end-systolic volume, and ejection fraction were measured using both LV 4-D and gated SPECT. Results obtained showed a straight correlation between the two examinations. The agreement confirmed the relevance of the comparisons. This study is an initial step before conducting clinical trials to exhaustively compare the two modalities.

Identification of the EcoKI and EcoR124I Type I restriction--modification enzyme subunits by non-equilibrium pH gradient two-dimensional gel electrophoresis.

Effectively optimized and reproducible procedure for monitoring the composition of type I restriction-modification endonucleases EcoKI and EcoR124I by non-equilibrium pH gradient two-dimensional (2-D) gel electrophoresis is described. Three subunits of the enzyme complex, which widely differ from one another in their isoelectric points and molar mass, were identified in crude cell extracts of E. coli. For the first time all three subunits of both EcoKI and EcoR124I were detected as distinct spots on a single 2-D gel. A sensitive immunoblotting procedure was suggested suitable for routine use in determining the identity of individual subunits. Potential application of this method for detailed studies of regulation of the function and stoichiometry of the enzyme complexes is discussed.

Identification of T helper epitopes from prostatic acid phosphatase.

Helper T cells (Th cells) play a central role in the initiation and maintenance of immune responses, including antitumor immunity. The ability of Th cells in murine models to maintain and enhance the cytolytic efficacy of CD8+ CTLs has led to a renewed interest in identifying human tumor antigens recognized by Th cells. Prostatic acid phosphatase (PAP) is a prostate cancer-associated tumor antigen. A rodent model has demonstrated that PAP-specific CTLs can induce destructive prostatitis. Human MHC class I epitopes derived from PAP have been identified previously, and peptide-specific CTLs have been shown to be able to lyse an MHC-restricted prostate cancer cell line. In the current study, we sought to identify Th epitopes derived from PAP that might be used to elicit PAP-specific Th responses, ultimately in the context of human vaccines targeting PAP. Using peripheral blood mononuclear cells (PBMCs) from subjects with and without PAP-specific Th responses, we screened a panel of 10 potential peptide epitopes for peptide-specific T-cell proliferation. Four peptides, p81-95, p199-213, p228-242, and p308-322, were identified for which peptide-specific T-cell proliferation occurred in the majority of patient PBMC samples that also exhibited PAP-specific T-cell proliferation. PBMCs from patients with prostate cancer and without PAP-specific Th immunity were then cultured in vitro with these four peptides. Peptide-specific T-cell lines could be generated from two of the four peptides, p199-213 and p228-242, that also proliferated in response to PAP protein stimulation. The ability of these two peptides to elicit PAP-specific Th responses suggests that they represent naturally processed PAP-specific MHC class II epitopes.

Naturally occurring prostate cancer antigen-specific T cell responses of a Th1 phenotype can be detected in patients with prostate cancer.

BACKGROUND: Cytotoxic T cells (CTL) are considered one of the primary effector cell populations in antitumor immunity. Recent studies, however, have demonstrated the critical importance of helper T cells (Th), specifically interferon gamma (IFN gamma)-secreting Th1 cells, either by supporting an appropriate CTL environment or by recruiting other effector cells. We evaluated whether patients with prostate cancer have naturally occurring Th-cell responses specific for two prostate cancer-associated antigens, prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP), and whether Th1-type responses to these antigens could be detected. METHODS: Peripheral blood mononuclear cells (PBMC) were collected from 80 patients with prostate cancer and 20 male controls without prostate disease. Th-cell responses were evaluated by measuring antigen-specific proliferation. IFN gamma and IL-5 secretion in response to antigen stimulation was determined by enzyme-linked immunosorbent assay. RESULTS: T cell proliferative responses specific for PSA and PAP could be detected in patients with prostate cancer. Six percent (5/80) of patients had T cell responses specific for PSA and 11% (9/80) for PAP. T cell responses specific for PSA were more prevalent in patients with metastatic disease (P = 0.02), whereas responses specific for PAP could be detected in patients irrespective of disease stage. IFN gamma-producing Th cells, specific for both PSA and PAP, could be identified in patients with prostate cancer. CONCLUSIONS: Patients with prostate cancer can have detectable Th-cell responses specific for the prostate cancer-associated proteins PSA and PAP. The presence of antigen-specific Th1 immune responses in prostate cancer patients suggests that an immune environment capable of supporting antigen-specific CTL may exist in vivo. Prostate 47:222-229, 2001.

Antibody immunity to prostate cancer associated antigens can be detected in the serum of patients with prostate cancer.

PURPOSE: Several immune based therapies targeting prostate cancer associated proteins are currently undergoing clinical investigation. In general, however, little is known about the immunogenicity of prostate cancer or which prostate cancer associated proteins elicit immune responses. We determine whether patients with prostate cancer have antibody immunity to known prostate cancer associated proteins, what the prevalence of this immunity is and whether immunity to individual proteins is associated with the stage of disease. MATERIALS AND METHODS: We evaluated the inherent humoral immune response against prostate specific antigen (PSA), prostatic acid phosphatase, p53 and HER-2/neu, all known prostate cancer associated proteins, in 200 patients with various stages of disease and male controls. RESULTS: Antibody immunity to PSA was significantly different between the patient (11%, 22 of 200) and control populations (1.5%, 3 of 100, p = 0.02), and titers 1:100 or greater were particularly prevalent in the subgroup of patients with androgen independent disease (11%, 6 of 56). Antibody immunity to prostatic acid phosphatase and p53 was detected (5.5%, 11 of 200 and 6%, 12 of 200), and was not different from the control population (4%, 4 of 100, p = 0.57 and 7%, 7 of 100, p = 0.74). Antibody immunity to HER-2/neu was significantly higher in patients with prostate cancer (15.5%, 31 of 200) compared to controls (2%, 2 of 100, p = 0.0004), and titers 1:100 or greater were most prevalent in the subgroup of patients with androgen independent disease (16%, 9 of 56). CONCLUSIONS: These findings suggest that prostate cancer is an immunogenic tumor. Moreover, for PSA and HER-2/neu the prevalence of antibody immunity was higher in patients with androgen independent disease, indicating that even patients with advanced stage prostate cancer can have an immune response to their tumor.

Enhancement of calcium transport in the Caco-2 cell monolayer model.

The overall objective of this research was to identify enhancers of calcium transport using an in-vitro Caco-2 cell monolayer model. The enhancers studied were medium-chain triglycerides (MCT) and acylcarnitines (AC). The extent of cell damage associated with the use of these enhancers was determined by monitoring the release of cellular lactate dehydrogenase (LDH). The effect of chain-length and concentration dependence of these agents on enhancement were also determined. The effects of ACs were found to be superior to those of MCTs. However, the ACs elicited a greater release of LDH than the MCTs. The possible mechanisms of enhancer-mediated increase in calcium transport and the potential significance of this study with regard to the prevention of osteoporosis are discussed.

Mechanisms of acylcarnitine-mediated enhancement of calcium transport in the Caco-2 cell monolayer model.

The overall objective of this study was to determine the mechanisms of acylcarnitine-mediated enhancement of calcium transport across Caco-2 cells. The different mechanisms of enhancement postulated are (a) loosening of tight junctions, thereby promoting paracellular transport; (b) opening of calcium channels, thus increasing calcium entry; and (c) stimulation of the basolateral Ca-ATPase pump, thereby aiding calcium extrusion. Although the existence of calcium channels and the reversal of verapamil-mediated inhibition of calcium uptake by acylcarnitines were demonstrated for the first time in Caco-2 cells, the channels do not appear to be a major contributing factor to the enhancement of calcium transport by acylcarnitines. Calmidazolium, a potent Ca-ATPase pump inhibitor in tissues such as rat intestinal segments, failed to inhibit this pump in Caco-2 cells. Thus, the predominant mechanism of enhancement of calcium transport by acylcarnitines in the Caco-2 model appears to be via promotion of paracellular transport.

A comparison of HPLC and bioassay methods for plasma melanotan-II (MT-II) determination: application to a pharmacokinetic study in rats.

The pharmacokinetic profile of the melanotropic peptide, melanotan-II (MT-II), was determined in rats following a 0.3 mg kg-1 intravenous dose. Regression analysis of the plasma MT-II concentrations determined using HPLC and bioassay methods indicated the existence of a significant linear correlation (r = 0.90, p < 0.001). The plasma concentration versus time plots determined using the two assay methods yielded biphasic disposition profiles that were essentially superimposable. The following pharmacokinetic parameters were assessed from plasma concentration versus time data using both methods: Cmax, AUC, CLs, t1/2 beta, MRT, Vd beta, and Vss. Statistical comparison showed that the parameters measured by each method were not significantly different (at the 0.05 level) except for t1/2 beta, MRT and Vss. The presence of even one aberrant data point in the beta-phase can significantly influence t1/2 beta when only a few data points are available in the beta-phase. Since MRT and Vss were calculated from t1/2 beta it is not surprising that these two parameters also differed between methods.

Effects of intravenous and oral dexamethasone on selected lymphocyte subpopulations in normal subjects.

Our studies describe the effects of 1 mg oral (PO) and intravenous (IV) administration of dexamethasone (DEX) on certain subpopulations of circulating lymphocytes in normal subjects. We compared the outcomes of PO and IV DEX administration because of individual differences in gastro-intestinal absorption of DEX and the issue of noncompliance in patients undergoing the dexamethasone suppression test (DST). Both routes of DEX administration were equally effective in suppressing plasma cortisol levels below 5 micrograms/dl, the customary criterion level. Both routes of DEX administration also significantly decreased the percent and absolute number of CD4+ cells, the CD4+/CD8+ ratio, and the percent and absolute number of virgin, but not of memory, CD4+ cells.

Pituitary-adrenal-immune system in normal subjects and in patients with anorexia nervosa: the number of circulating helper T lymphocytes (CD4) expressing the homing receptor Leu8 is regulated in part by pituitary-adrenal products.

The association between plasma pituitary-adrenal (PA) hormones and the number of certain populations of peripheral blood lymphocytes (PBL) was examined in subjects with normal PA function and in patients with anorexia nervosa (AN). AN patients display several neuroendocrine dysfunctions, including hypercortisolemia. In the normal subjects there were positive correlations between adrenocorticotropic hormone (ACTH) and the number of PBL and helper T lymphocytes expressing the homing receptor Leu8 (CD4+Leu8+); there was a negative relationship between cortisol and these lymphocyte populations. These latter, inverse correlations did not occur in the AN patients, either while underweight or after weight recovery, with some persistence of hypercortisolemia. Administration of dexamethasone (DEX) suppressed cortisol levels and reduced, perhaps via a receptor-mediated mechanism, the number of circulating PBL and CD4+Leu8+ in the normal subjects but not in the AN patients. These results support the physiological relevance of PA-CMI interaction in subjects with normal PA function and indicate that the PA-CMI interrelationship is disrupted in AN patients with hypercortisolemia.

[Detection of silent ischemia in hypertensive subjects with high vascular risk using continuous electrocardiogram in real time]. / Détection de l'ischémie silencieuse chez des sujets hypertendus à haut risque vasculaire par électrocardiogramme continu en temps réel.

UNLABELLED: To assess the prognostic value of ECG repolarisation abnormalities (negative T wave and/or ST downslopping (STD) less than 0.1 mV) in systemic hypertension, we compared the frequency of STD greater than or equal to 0.1 mV and greater than 40 s (Qmed real-time ambulatory ECG system) in asymptomatic high-risk hypertensive men with or without ST-T abnormalities on resting ECG (less than or equal to 0 T wave and less than 1 mm ST downslopping). Among 68 hypertensive patients in the upper quintile of risk distribution according to the Paris prospective study, 32 were R+ and 36 R-. Mean age (R+ 53, R- 53 yrs), blood pressure (R+ 180/106, R- 175/102 mmHg), body-mass index (R+ 27, R- 28 kg/m2) risk score (R+ 5.8, R- 5.4), and Sokolow index (R+ 2.7, R- 2.5 mV) were similar in both groups. Left ventricular mass index was different (R+ 152, R- 118 gr/m2, p less than 0.02). Mean recording duration was 35 hours. Eighty-nine episodes of STD were detected in 7 R+ patients (lasting 3 to 136 mn) and one R- patient (lasting 60 s), p less than 0.001. Echographic LVH was present in the 7 positive patients of the group R+. 6 patients underwent thallium scanning and/or coronary angiography: thallium was positive in 4 patients; coronary artery angiography was performed in 3 patients, showing bitroncular stenosis in 1 patient. CONCLUSION: in the present group of high-risk asymptomatic hypertensive patients, the frequency of STD was higher (p = 0.05) in the presence of repolarisation abnormalities on the resting ECG. STD suggests silent ischemia and could account for the excess of cardio-vascular mortality connected with ST-T abnormalities in hypertension.