Purification and characterization of the endocellular beta-glucosidase of a new strain of Candida entomophila isolated from fermenting agave (Agave sp.) juice.

A yeast strain isolated in the laboratory from fermenting agave (Agave sp.) juice was studied and classified as Candida entomophila. The beta-glucosidase of this yeast was purified by ion-exchange chromatography and gel filtration. Its molecular mass estimated by gel filtration was 400 kDa. The oligomeric structure was determined following treatment of the purified enzyme with SDS. Its optimum pH was between 5 and 6, and its optimum temperature was 60 degrees C. The enzyme was active against soluble glucosides with (1-->3)-beta, (1-->4)-beta and (1-->4)-alpha linkage configuration, and it possesses (1-->6)-alpha-arabinofuranosidase activity. It is competitively inhibited by glucose and by D-gluconic acid lactone. The enzyme was constitutive and a glucosyltransferase activity is observed in the presence of ethanol. Since the glycosides present in wines and fruit juices represent a potential source of aromatic flavour, the possible use of the yeast glucosidase for the liberation of the bound aroma is discussed.

[Use of calcium carbonate as an intestinal chelator of phosphorus]. / Utilizzo del calcio carbonato (CaCO3) come chelante intestinale del fosforo.

Fourteen patients undergoing periodic dialysis who had been taking AL(OH)3 as an intestinal chelant of phosphorus have been examined. AL(OH)3 was replaced by CaCO3 for a period of 6 months. At the end of the study, statistically significant reductions were evidenced in alkaline phosphatase, basal serum aluminiaemia and its increase after Desferal test, while the bicarbonates (HCO3) were found to be increased. Statistically non-significant increases were observed in calcaemia, PTH, and pH. It is concluded that the replacement of AL(OH)3 with CaCO3 is effective in controlling phosphoraemia, in diminishing serum concentrations and tissue deposits of Al and in improving uraemic acidosis.

[Long-term treatment of pulmonary hypertension in chronic obstructive bronchopneumopathies with nifedipine. Hemodynamic study over 18 months]. / Traitement au long cours de l'hypertension pulmonaire secondaire des bronchopneumopathies obstructives chroniques par la nifédipine. Etude hémodynamique sur 18 mois.

The objective of this study was to evaluate the long-term results of an 18 months nifedipine treatment in patients with pulmonary hypertension (PHT) secondary to chronic obstructive broncho-pulmonary disease (COBPD). The possible alterations of the pulmonary vascular reactivity after such chronic treatment were also studied. 20 patients presenting a PHT secondary to a COBPD were randomly distributed in two equal groups: a reference group and a group treated with nifedipine. The haemodynamic work-up and blood gases measurements of patients from both groups as well as the effects of acute sublingual administration of 10 mg of nifedipine were performed at the beginning of the study, under stable conditions. After this initial test, the patients in the treated group, received 30 mg/day of nifedipine per os. The same measurements and pharmacological tests were carried out after 18 months, 24 hours after the treatment was discontinued. All patients completed the study; no adverse reaction was noted, especially no major desaturation. A significant decrease of the cardiac index (p 0.05) was noted in the reference group (-10%). No significant alteration of the pulmonary pressure and resistance, of the blood gases, was noted. The haemodynamic variations during acute testing were similar in both groups before and at the end of the observation period. Chronic administration of nifedipine may prevent the decrease of the cardiac index in patients presenting a PHT secondary to COBPD. The pulmonary vascular reactivity is not affected by this type of treatment.

Long-term treatment of chronic obstructive lung disease by Nifedipine: an 18-month haemodynamic study.

This long-term controlled study was undertaken to assess the haemodynamic effects of chronic administration of Nifedipine (N). Twenty patients suffering from pulmonary hypertension secondary to chronic obstructive lung disease were divided into two groups. One group (treatment group) was instructed to take 30 mg of N daily and the other (control group) did not take N. Haemodynamic measurements were recorded before and after an 18-month observation period. For patients in the treatment group, Nifedipine was stopped 24 h prior to the second investigation. Acute response to a single dose of Nifedipine (10 mg sublingually) was also evaluated in all patients during the first and second investigations in order to estimate a possible tachyphylaxis. No significant modification in heart rate, mean pulmonary pressure, mean arterial pressure or blood gases was observed. Conversely, a 10% decrease in cardiac output (p less than 0.05) occurred in the control group. Pulmonary vascular response to acute administration of Nifedipine was the same in both groups before and after the observation period. These results suggest that while long-term administration of Nifedipine to patients with chronic obstructive lung disease does not improve pulmonary pressure, it may prevent a decrease in cardiac output. No tachyphylaxis was noted.

One-year clinical study on nifedipine in the treatment of pulmonary hypertension in chronic obstructive lung disease.

The advantages of long-term administration of vasodilators in the treatment of chronic cor pulmonale were investigated after informed consent in 60 patients with obstructive respiratory insufficiency (56 men, 4 women, mean age 63.5 +/- 1.5 years; mean pulmonary pressure 30.4 mm Hg). They were randomly divided into two groups of 30, a control group and a group treated with nifedipine, 10 mg three times a day. The following parameters were recorded every 3 months for a year: dyspnea, degree of right ventricular failure, number of days spent in hospital, survival and arterial blood gas tension. On the first day of study, no significant difference existed between the control and the treated groups. After 1 year 22 patients in the control group were still followed and 8 were dead. In the treated group 19 were followed, 7 were dead and 4 stopped treatment, generally due to ankle edema. At the end of the study, the only significant modification was improvement of the dyspnea in the nifedipine group (p less than 0.01). In conclusion, in spite of an improvement in the dyspnea index, clinical study for 1 year failed to demonstrate any objective benefit of nifedipine treatment.

[Nifedipine in the treatment of chronic cor pulmonale]. / Apport de la nifédipine dans le traitement du coeur pulmonaire chronique.

The effects of a single dose of nifedipine (20 mg sublingual) on the haemodynamics and parameters of tissue oxygenation were assessed by right heart catheterisation and oximetry of mixed arterial and venous blood in 24 patients with pulmonary hypertension secondary to severe chronic obstructive airways disease. The haemodynamic effects of 15 days' oral therapy (30 mg/day) were studied in 10 other patients. Significant improvement in right ventricular pump function (25 p. 100 increase in cardiac index. average reduction of 3 mmHg of right ventricular end diastolic pressure), and lowering of pulmonary hypertension (mean pulmonary artery pressures reduced by an average of 10 p. 100 and total pulmonary resistance by 25 p. 100) were observed after the single dose of nifedipine. This improvement was maintained after oral therapy for 15 days. The significant improvement of tissue oxygenation was reflected by an increase in oxygen transport (+ 24 p. 100), in the coefficient of delivered oxygen (+ 19 p. 100), in the oxygen partial pressure (+ 4 p. 100) and saturation (+ 3 p. 100) in the mixed venous blood. Arterial lactate concentrations fell by about 28 p. 100. In addition, a moderate fall in ppO2 and arterial saturation was observed due to a weak shunt effect which was more than compensated by the increase in cardiac output, and especially by the increase in the coefficient of relieved oxygen. These results show that nifedipine may be a valuable addition in the treatment of cor pulmonale secondary to chronic obstructive airways disease by improving right ventricular haemodynamics and pulmonary circulation and by increasing the quantity of oxygen delivered.

Two-week nifedipine treatment for pulmonary hypertension complicating chronic obstructive lung disease.

The effects of nifedipine on hemodynamics and blood gases were studied in 10 patients with pulmonary hypertension secondary to chronic obstructive lung disease. Two different sets of test data were recorded. The first set of readings was taken immediately before and during the initial hour after sublingual administration of 20 mg of nifedipine. The second set was taken after 2 weeks of therapy with 3 X 10 mg per day. After the acute sublingual dose, a significant decrease in pulmonary arterial pressure and pulmonary vascular resistance was recorded: 13% and 26% respectively. This decrease was accompanied by a 32% increase in cardiac output. Similar findings were recorded at the end of the 2-week therapy. Moreover, at this time, although blood gas tension had not been significantly altered, oxygen delivery was 35% higher. No adverse side effects were observed. This study suggests that nifedipine therapy can improve hemodynamics and tissue oxygenation in patients with pulmonary hypertension complicating chronic obstructive lung disease.

[Use of azlocillin in the treatment of Pseudomonas bronchopulmonary infections]. / Utilisation de l'azlocilline dans le traitement des infections broncho-pulmonaires à Pseudomonas.

Eleven patients with severe bronchopulmonary infection due to Pseudomonas were treated with azlocillin in doses of 250 mg/kg/day. Severe preexisting respiratory diseases, such as bronchopulmonary carcinoma, bronchiectasis or respiratory insufficiency were present in all cases. All patients had been unsuccessfully treated with various antibiotics before they received azlocillin. The pathogenicity of the isolates was assessed by germ counts in sputum. Comparative in vitro sensitivities to carbenicillin and azlocillin were determined by the disc method and by measurement of the minimum inhibitory concentrations in liquid medium. All strains of Pseudomonas aeruginosa isolated were sensitive to azlocillin with minimum inhibitory concentrations of 0.5 to 64 micrograms/ml. When tested against carbenicillin, 4 of the strains were resistant and 1 had intermediate sensitivity. The carbenicillin/azlocillin minimum inhibitory concentrations ratio was usually equal to 4. Clinical results were satisfactory in 7 cases; inadequate response or failure was observed in 4 cases and attributed to the replacement of Pseudomonas by another pathogen (Proteus morganii or Klebsiella pneumoniae). This study suggests that azlocillin is of value in the treatment of bronchopulmonary infections caused by Ps. aeruginosa.

[Plasma concentrations of lidocaine in bronchial fibroscopy]. / Concentrations plasmatiques de lidocaïne au cours de fibroscopies bronchiques.

Certain accidents related to local anaesthesia during bronchial fibroscopy may be due to overdosage of local anesthetic drugs. In view of the various techniques employed, the various doses used and the different serum levels obtained, we decided to study the passage of lidocaine into the systemic circulation during bronchial fibroscopy in order to confirm that the doses required for good anaesthesia are not toxic. We studied the kinetics of lidocaine on 10 occasions in 9 patients. All patients had normal renal, hepatic and cardiac function. The anaesthetic was administered in standardized doses (by pharyngo-laryngeal spray of a 5% solution followed by injection via a laryngeal syringe and finally by the operating lumen of the fibroscope with a 1% solution). The total dose of anaesthetic was administered at the beginning of the examination in order to avoid contamination of the aspirated secretions after connection of the traps. The mean dose administered was 9.2 +/- 0.5 mg/kg (range of 380 to 800 mg). The maximal serum levels never attained toxic levels (9 mcg/ml). The highest levels (7 mcg/ml and 5.7 mcg/ml) were observed in a patient with a bronchial epithelioma, normal biochemistry and normal liver ultrasonography, who died two months later with hepatic metastases. The mean maximal serum levels for this group of patients was 2.8 +/- 0.6 mcg/ml between the 5th and 45th minute, which is equivalent to anti-arrhythmic doses (therapeutic level of 1.2 to 5 mcg/ml). The levels obtained are not negligible, but they achieve very good quality anaesthesia with a good margin of safety, apart from the one case with hepatic metastases.

[Frequency of chronic rhinitis in a population of young adults. Influence of pollen allergy and tobacco addiction (author's transl)]. / Fréquence des rhinites chroniques dans une population d'adultes jeunes. Influence de l'allergie pollinique et du tabagisme.

A survey of 27 604 sujets aged mostly between 17 and 19 revealed that 33.5% of them had a regular nasal obstruction and that 13.6% repeated sneezing fits. Prevalence of nasal manifestations related to an allergy to graminaceae pollen was estimated at 5%. Besides there was a close relationship between the chronic nasal symptomatology and the smoking habits of the subjects concerned.

A prospective national study of the safety of immunotherapy.

A prospective study was made in France to determine the frequency, nature, causes and consequences of systemic reactions occurring during specific immunotherapy. One hundred and fifty five reactions were recorded in 151, 997, injections given to 19,739 patients; a percentage of 0.1. It was higher with pollen extracts (0.2%) and practically nil with other extracts (house dust, Dermatophagoides, insect body, bacteria). Asthma, spasmodic rhinitis and urticaria were the most frequent, 80% of systemic reactions. In 59% no explanation could be found. The main known causes of adverse reactions were excessive doses of antigen, improper timing of treatment or incorrect technique of injection. After appropriate treatment the immunotherapy was continued in nearly 90% of the cases. Specific immunotherapy with the majority of extracts now being used, namely adsorbed extracts, is not dangerous but it must be precisely and cautiously done because errors are responsible for nearly 50% of the recorded systemic reactions.

[Objective immunological and clinical data observed during an altitude cure at Briançon in asthmatic children allergic to house dust and dermatophagoides (author's transl)]. / Données objectives cliniques et immunologiques observées au cours d'une cure d'altitude à Briançon chez des enfants asthmatiques allergiques à la poussière de maison et à dermatophagoides.

In 42 asthmatic children with positive intradermal skin tests to Dermatophagoides pteronyssinus and domestic dust, assays of total and specific IgE were done at regular intervals during a prolonged (9 months) stay at high altitude (Briançon 1300 m). Geometric mean of total IgE (1047 UI/ml at the beginning) dropped to 40% (p less than 0,001) after the stay. In the same way, specific IgE to dermatophagoides, to domestic dust and to grass pollen dropped during the stay (p less than 0,001). On the other hand, other immunoglobulins (IgG, IgA and IgM) did not undergo any significant variations. Clinical improvement of asthma in these allergic children was observed at the first week of stay and could be maintained without drugs during all the 9 months in altitude. Rather than a consequence of an aspecific effect of altitude on the biosynthesis of reaginic antibodies, it would seem that the very consistent fall in total and specific IgE and the clinical improvement should be interpreted as the result of removal from antigenic provocation into a hypoallergenic atmosphere.