Comparison of techniques of detecting immunoglobulin-binding protein reactivity to immunoglobulin produced by different avian and mammalian species.

The rationale of this study was to use several immunological assays to investigate the reactivity of immunoglobulin binding protein (IBP) to immunoglobulins from various avian and mammalian species. The IBP studied were Staphylococcal protein A (SpA), Streptococcal protein G (SpG), Peptostreptococcal protein L (SpL) and recombinant protein LA (SpLA). The various immunological techniques used were double immunodiffusion (Ouchterlony technique) that tested positive high protein reactivities, direct and competitive enzyme-linked immunosorbent assays (ELISAs) that tested moderate and low positive protein binding capacities, respectively. In addition to sandwich ELISAs, immunoblot analyses and Ig-purification by SpA-affinity chromatography, which were sensitive tests and helpful in the screening and confirmatory tests were also used. The Ouchterlony technique showed that compared to the other proteins, SpLA had the highest range of reactivity with animal sera and purified immunoglobulins while SpL was least reactive. With the direct ELISA, SpL reacted with the raccoon sera, rabbit IgG and with IgY from bantam hens and pigeons. While with the direct ELISA, SpA reacted with sera from skunk, coyote, raccoon, mule, donkey and human. The sandwich ELISA revealed high reactivity of both SpG and SpLA with mammalian sera titres ranging from 1:32 (raccoon serum) to 1:1024 (mule and donkey sera). These results suggest that IBP can be used for the detection of immunoglobulin using various immunological assays and this is important for the diagnosis of infectious diseases in animal and bird populations studied and in the purification of immunoglobulins.

Can we predict the spreading of a two-liquid system from the spreading of the corresponding liquid-air systems?

We present new data obtained from the spreading of a series of oil droplets, on top of a hydrophobic grafted silicon substrate, in air and immersed in water. We follow the contact angle and radius dynamics of hexane, dodecane, hexadecane, dibutyl phthalate, and squalane from the first milliseconds to approximately 1 s. Analysis of the images allows us to make several hundred contact angle and droplet radius measurements with great accuracy. The G-Dyna (Seveno et al. Langmuir 2010, 25, 13034) software is then used to fit the data with one of the wetting theories, the molecular-kinetic theory (MKT) (Blake et al. J. Colloid Interface Sci.1969, 30, 421), which takes into account the dissipation at the three-phase zone at the contact line. This theory allows us to extract the coefficient of friction of the contact line, which expresses the relationship between the driving force, that is, the unbalanced Young force, and the contact-line velocity V. It is first shown that the MKT is appropriate to describe the experimental data and then that the contact-line friction is a linear function of the viscosity as theoretically predicted. This is checked for oil-air and oil-water systems. A linear relation between the contact-line friction measured in oil-water systems and the contact-line frictions of the parent single liquid system seems plausible. To the best of our knowledge, this is the first trial to establish a link between the dynamics of wetting in liquid-liquid and in liquid-air systems.

Past climate changes explain the phylogeography of Vitellaria paradoxa over Africa.

The evolution of the savanna biome has been deeply marked by repeated contraction/expansion phases due to climate perturbations during the Quaternary period. In this study, we investigated the impact of the last glacial maximum (LGM) on the present genetic pattern of Vitellaria paradoxa (shea tree), a major African savanna tree. A range-wide sampling of the species enabled us to sample 374 individuals from 71 populations distributed throughout sub-Sahelian Africa. Trees were genotyped using 3 chloroplasts and 12 nuclear microsatellites, and were sequenced for 2 polymorphic chloroplast intergenic spacers. Analyses of genetic diversity and structure were based on frequency-based and Bayesian methods. Potential distributions of V. paradoxa at present, during the LGM and the last interglacial period, were examined using DIVA-GIS ecological niche modelling (ENM). Haplotypic and allelic richness varied significantly across the range according to chloroplast and nuclear microsatellites, which pointed to higher diversity in West Africa. A high but contrasted level of differentiation was revealed among populations with a clear phylogeographic signal, with both nuclear (F(ST) = 0.21; R(ST) = 0.28; R(ST) > R(ST) (permuted)) and chloroplast simple sequence repeats (SSRs) (G(ST) = 0.81; N(ST) = 0.90; N(ST) > N(ST) (permuted)). We identified a strong geographically related structure separating western and eastern populations, and a substructure in the eastern part of the area consistent with subspecies distinction. Using ENM, we deduced that perturbations during the LGM fragmented the potential eastern distribution of shea tree, but not its distribution in West Africa. Our main results suggest that climate variations are the major factor explaining the genetic pattern of V. paradoxa.

Depolarization and neurotrophins converge on the phosphatidylinositol 3-kinase-Akt pathway to synergistically regulate neuronal survival.

In this report, we have examined the mechanisms whereby neurotrophins and neural activity coordinately regulate neuronal survival, focussing on sympathetic neurons, which require target-derived NGF and neural activity for survival during development. When sympathetic neurons were maintained in suboptimal concentrations of NGF, coincident depolarization with concentrations of KCl that on their own had no survival effect, synergistically enhanced survival. Biochemical analysis revealed that depolarization was sufficient to activate a Ras-phosphatidylinositol 3-kinase-Akt pathway (Ras-PI3-kinase-Akt), and function-blocking experiments using recombinant adenovirus indicated that this pathway was essential for approximately 50% of depolarization-mediated neuronal survival. At concentrations of NGF and KCl that promoted synergistic survival, these two stimuli converged to promote increased PI3-kinase-dependent Akt phosphorylation. This convergent PI3-kinase-Akt pathway was essential for synergistic survival. In contrast, inhibition of calcium/calmodulin-dependent protein kinase II revealed that, while this molecule was essential for depolarization-induced survival, it had no role in KCl- induced Akt phosphorylation, nor was it important for synergistic survival by NGF and KCl. Thus, NGF and depolarization together mediate survival of sympathetic neurons via intracellular convergence on a Ras-PI3-kinase-Akt pathway. This convergent regulation of Akt may provide a general mechanism for coordinating the effects of growth factors and neural activity on neuronal survival throughout the nervous system.

Dynamics of wetting revisited.

We present new spreading-drop data obtained over four orders of time and apply our new analysis tool G-Dyna to demonstrate the specific range over which the various models of dynamic wetting would seem to apply for our experimental system. We follow the contact angle and radius dynamics of four liquids on the smooth silica surface of silicon wafers or PET from the first milliseconds to several seconds. Analysis of the images allows us to make several hundred contact angle and droplet radius measurements with great accuracy. The G-Dyna software is then used to fit the data to the relevant theory (hydrodynamic, molecular-kinetic theory, Petrov and De Ruijter combined models, and Shikhmurzaev's formula). The distributions, correlations, and average values of the free parameters are analyzed and it is shown that for the systems studied even with very good data and a robust fitting procedure, it may be difficult to make reliable claims as to the model which best describes results for a given system. This conclusions also suggests that claims based on smaller data sets and less stringent fitting procedures should be treated with caution.

Embolic thrombus on mitral anulus calcification.

Embolic thrombus on mitral anulus calcification (MAC) was demonstrated in an 83-year-old woman with retinal embolism. Mitral anulus calcification has been associated with a significant increase of stroke in elderly people. Atrial fibrillation and calcific emboli have been reported, and embolic thrombus by MAC may be another potential cause.

The molecular basis of microtubule stability in neurons.

Microtubule (Mt) populations show large differences in dynamic properties (i.e., turnover rates) among cell types, and even within the same cell type at different stages of the cell cycle or stages of differentiation. These differences in dynamic properties are correlated with altered sensitivity to Mt-disassembling drugs (e.g. colchicine) which bind specifically to the Mt protein tubulin and to certain toxic metals which also interact with tubulin (e.g. methylmercury) and result in Mt disassembly. Mts in neurons become progressively more stable and more resistant to such compounds during differentiation. We are using the P19 embryonal carcinoma cell line, which can be induced to differentiate along the neural pathway by retinoic acid, as a model system in which to analyze the development of stable Mts. Our results show that during differentiation there is an evolution in the sorting of tubulin isotypes into the stable Mts. This appears related both to the expression of specific Mt-associated proteins and to concomitant posttranslational modifications of tubulin.

Bilateral bronchial anastomosis in double lung and heart-lung transplantations.

During heart-lung or double lung transplantation, the airway anastomosis is usually made at the tracheal level. Healing of this anastomosis is one source of postoperative complications especially after double lung transplantation (DLT). In this series of 10 patients with cystic fibrosis undergoing DLT, the tracheas of donor and recipient were anastomosed with omental wrapping in 2 cases while the two main stem bronchi were joined without omental wrapping in 8. Endoscopy disclosed no sign of ischaemia in the patients with bilateral bronchial anastomoses. Three patients died on day 20, 21 and 35, respectively, after DLT. Two of these patients (one with a tracheal and the other with bronchial anastomoses) showed no complication at the level of the suture line. The third patient (with bronchial suture) suffered dehiscence of both anastomoses which was attributed to a misdosage of corticosteroids. Of the 6 patients alive after bronchial anastomosis, 3 recovered uneventfully and 3 who had required prolonged postoperative mechanical ventilation developed bronchomalacia. Bronchomalacia was treated by laser resection and stenting. Dehiscence did not occur in any of these six cases. This technique was based on the findings of 12 fresh cadaver dissections showing that collaterals between the bronchial arteries and the pulmonary arteries and veins extend up to the origin of the main stem bronchus. Bronchial suture without omental wrap may be used for double lung and heart-lung transplantation instead of tracheal suture.

Thrombosis of the abdominal aorta. A rare complication of the intraaortic balloon pumping device.

We describe a patient who died due to thrombosis of the abdominal aorta and its branches after placement of an intraaortic balloon pumping device. This rare complication, which occurred despite careful insertion technique, underscores the need to select balloon size as a function of the individual patient's morphology.

[Results of cardiac surgery in patients over 70 years of age. Apropos of a retrospective study of 170 patients]. / Résultats de la chirurgie cardiaque chez les patients âgés de plus de 70 ans. A propos d'une étude rétrospective concernant 170 patients.

The ever increasing age of the general population and the frequency of coronary and aortic lesions in patients aged 70 or older make cardiac surgery in the elderly a topic of current interest. In a retrospective study of 170 cases the overall mortality rate was 14 p. 100 (4.7 p. 100 in 1986). During the past two years (1985 and 1986), the mortality rates in patients with coronary disease who underwent elective surgery were 10 p. 100 and 4 p. 100 respectively. Emergency surgery (left coronary trunk and unstable angina excluded) and associated operations on the heart made the prognosis worse with overall mortality rates of 13 p. 100 and 15 p. 100 respectively (9 p. 100 in 1985, 10 p. 100 in 1986). In aortic valve surgery, hospital mortality rates were 28 p. 100 in 1985 and 6 p. 100 in 1986. Post-operative morbidity was high (52 p. 100 of patients) and consisted mostly of respiratory and neurological complications (14.7 p. 100 and 9.4 p. 100 respectively of all patients). Only 4 p. 100 of the patients developed peri-operative myocardial infarction. Functional results were satisfactory in both coronary disease and heart valve disease patients. The survival rate at 4 years was 74.5 +/- 10 p. 100 globally and 87.3 +/- 9 p. 100 in coronary patients operated upon electively. Thus, the considerable advances in surgical techniques and post-operative intensive care achieved during the last few years have significantly improved the results obtained in this population.(ABSTRACT TRUNCATED AT 250 WORDS)

[Indications and results of surgery in native valve infectious endocarditis. Apropos of 104 surgically-treated cases]. / Indications et résultats de la chirurgie dans l'endocardite infectieuse sur valve native. A propos de 104 cas opérés.

From 1972 to 1984, 104 cases of aortic valve infectious endocarditis were treated surgically. The average age of the patients was 40 years and the majority were men (69/104). Forty patients had no previous cardiac disease; 44 patients had documented valvular heart disease, which was unlikely in the remaining 20 patients. There were 16 mitral valve, 55 aortic valve, 1 tricuspid, 30 mitro-aortic, 1 mitro-tricuspid and 1 mitro-aorto-tricuspid valve infections. Aerococcus viridans was isolated in only 4 out of 71 positive cultures: the prevalence of the infecting organisms was otherwise normal (30 staphylococcus, 30 streptococcus, 7 rare organisms). Forty one patients were operated because of haemodynamic deterioration, 13 for resistant infection and 13 for an association of both indications; 37 patients were operated for embolism or threatening vegetations. Eight patients were in functional Class I, 26 in Class II, 52 in Class III and 17 in Class IV. The patients were divided into 4 groups according to the degree of surgical emergency (26 extremely urgent, 26 semi urgent, 32 controlled endocarditis and 20 chronic endocarditis). The actuarial survival rate was 70% at 5 years. Poor prognostic factors were the presence of previous valve disease, the isolation of a staphylococcus and an aortic valve localisation. The degree of emergency and the precise surgical indication did not seem to be important. Most patients at long term were in functional Classes I or II. There was no preferential indication for bioprosthetic or mechanical valve replacement in endocarditis.(ABSTRACT TRUNCATED AT 250 WORDS)

[Tricuspid endocarditis with right-left shunt in the atrium]. / Endocardite tricuspidienne avec shunt droite-gauche à l'étage auriculaire.

A case of tricuspid regurgitation due to endocarditis causing a right-to-left shunt through a patent foramen ovale is reported. Tricuspid valve endocarditis occurred after septic abortion and caused valvular regurgitation with dyspnea and cyanosis. The diagnosis was made by echocardiography and the finding of peripheral arterial desaturation, and it was confirmed at surgery. The physiopathology of these right-to-left shunts is the same as that already described during traumatic tricuspid regurgitation: reopening of the foramen ovale by the right atrial dilatation and ventricularisation of right atrial pressures. The presence of a shunt is an indication for surgery.

[False subaortic aneurysm after surgery of calcified aortic stenosis. Apropos of a case treated successfully]. / Faux anévrysme sous-aortique après chirurgie d'un rétrécissement aortique calcifié.

The authors report a case of false aneurysm of the posterior subaortic region of the left ventricle after a technically difficult surgical decalcification in a case of aortic stenosis. At reoperation, the surgeon used the femoral artery and both vena cavae for canulation. A direct approach of this "vascular" tumour, which was exterior to the great vessels, confirmed the diagnosis and enabled the localisation of the internal orifice inside the left ventricle. This was closed simply by suturing. No previous cases of this kind were found in the literature. This report underlines the necessity of taking the greatest care when decalcifying this region in order to avoid this type of serious complication.

[Myxoma of the mitral valve; apropos of 2 surgically treated cases. Review of the literature]. / Myxome de la valve mitrale; á propos de deux cas opérés. Revue de la littérature.

The authors report two cases of anterior mitral valve myxoma. This is an exceedingly rare localisation and these cases add to the other 8 previously reported cases. Intracardiac tumours and valvular endocarditis may be detected non-invasively by echocardiography but the precise diagnosis may be extremely difficult: mitral valve myxoma is an exceptionally rare condition. Treatment was surgical in both reported cases.

[Decompensated valvular disease and coarctation. One-stage repair using a median approach with an ascending aorta-abdominal aorta shunt]. / Valvulopathie décompensée et coarctation. Cure en un temps par voie médiane avec dérivation aorte ascendante-aorte abdominale.

The tactical decision in patients with decompensated valvular disease associated with a severe stenosis of the aortic isthmus is always difficult. One stage surgical repair using two separate approaches is a long and high risk procedure. It would seem more logical and safer to treat the lesions in two stages a few weeks apart, the severest lesion being managed first. In the two cases reported. The isthmic stenoses and valvular lesions were of the same severity and made both classical techniques impracticable. Therefore the patients underwent a single stage procedure by a median approach associating valve replacement under cardiopulmonary bypass (mitral and tricuspid in one and aortic in the other case) and an ascending aorta-abdominal aorta dacron conduit. The present postoperative survival periods are 30 and 9 months. The functional result was good (Class 1 and 0) and postoperative angiography has shown the montage to be working satisfactorily. This technique is exceptional but may be useful in borderline cases with decompensated valvular disease and severe isthmic stenosis.

[Detection by echocardiography of a thrombus of the right cavities in acute pulmonary embolism]. / Détection par échocardiographie de thrombus des cavités droites dans l'embolie pulmonaire aiguë.

Echocardiography evaluates the severity of acute pulmonary embolism from its repercussions on haemodynamics. However, many authors have reported the discovery of thrombosis in the right heart cavities of patients with acute pulmonary embolism. In order to assess the frequency of intracavitary thrombosis and to evaluate the practical problems it raises, we have systematically examined by echocardiography 84 patients hospitalized for severe, acute pulmonary embolism (mean Miller's score: 21). In this series of 39 men and 45 women (mean age 62 years), 9 thrombi were detected, i.e. an incidence of 11%. Depending on the ultrasonographic images they presented, these patients were divided into two groups: 1. Six patients with low mobility thrombi attached to the cardiac wall. All benefited from a medical treatment consisting of heparin in 4 cases and a thrombolytic drug in 2 cases. There was no clinical evidence of recurrent embolism. Echocardiography showed complete disappearance of the thrombi in 5 of these 6 patients and partial regression under heparin therapy in one. 2. Three patients with a large and mobile thrombus threatening to prolapse through the tricuspid valve during atrial systole. It seemed rational to regard such thrombi as carrying a high risk of embolism with recurrences, especially since they had formed in patients already with severe pulmonary embolism. This view was confirmed by a search in the literature which yielded a 40% death rate figure when these thrombi were associated with pulmonary embolism. This high mortality, however, can be reduced by diagnostic and therapeutic measures.(ABSTRACT TRUNCATED AT 250 WORDS)

[Septal rupture repaired in the acute stage of myocardial infarction. Clinical, hemodynamic and angio-coronarography findings in the evaluation of surgical risk]. / Ruptures septales opérées à la phase aiguë de l'infarctus du myocarde. Evaluation du risque opératoire par les données cliniques, hémodynamiques et angio-coronarographiques.

Between 1977 and 1987, 27 consecutive patients (16 men, 11 women, mean age 66 years, range 54 to 75 years) with ventricular septal rupture complicating acute myocardial infarction underwent surgical repair. The purpose of this retrospective study was to analyse the post-operative mortality factors from clinical, haemodynamic and operative data in all patients and also from coronary angiographic data in 23/27 patients whose haemodynamic status allowed this type of exploration. Seventeen patients (63 p. 100) died during the first post-operative month, 10 survived and were discharged. Factors that influenced the prognosis were: (1) inferiorly-located necrosis associated with a 75 p. 100 mortality rate (9 out of 12 patients), as opposed to 53 p. 100 (8 out of 15 patients) with anterior necrosis; (2) right ventricular dysfunction, observed in 83 p. 100 of patients with inferior necrosis and 53 p. 100 with anterior necrosis, which was responsible for 7 out of 9 deaths in the inferior necrosis subgroup and contributed to 3 out of 8 deaths in the anterior necrosis subgroup; this established a cause-effect relationship between right ventricular function and the overmortality of patients with inferior necrosis; (3) independently of the haemodynamic status, two- and three-vessel lesions (56 p. 100 of all lesions) which had an 84 p. 100 mortality rate as opposed to 40 p. 100 with one-vessel lesions; (4) the presence of a state of shock which was associated with a 78 p. 100 mortality rate as opposed to 55 p. 100 in patients without shock. We conclude that when permitted by the patient's haemodynamic status coronary angiography should be part of the pre-operative evaluation to assess the operative risk and guide the surgical procedure.

[Heart and heart-lung transplantation. 3 years' experience in Timone CHU (Marseilles 1985-1988)]. / Transplantation cardiaque et cardio-pulmonaire. Trois ans d'expérience au CHU Timone (Marseille 1985-1988).

Since December 1985, we have performed 38 transplantations: cardiac (CT) n: 31, cardiopulmonary (CPT) n: 1, or bipulmonary (BPT) n: 6. There were 31 male and 7 female patients, aged 7 to 62, mean 46. In the cardiac group, the cardiomyopathy was primitive in 13, ischemic in 16, valvular in 2. Five patients had undergone one or more previous operations. Three patients had a biventricular assist device (1,6 and 7 days before transplant) for acute cardiac failure. The indication of CPT or BPT was pulmonary artery hypertension (1), silicosis (1), cystic fibrosis (4). There were 4 post-operative deaths in the CT group (12.9%); failure of graft, low cardiac output, pulmonary artery hypertension by multiple pulmonary thrombosis, and 2 deaths in the CPT and BPT groups (28%). The mean post-operative hospital stay was one month. All patients with CT were treated by an initial maintenance bitherapy protocol (cyclosporine, steroids) and observed by myocardial biopsies and echocardiograms. In 40 per cent of the patients, Azathioprine was subsequently added. The patients had 2.1 rejection episode/patient/year, either spontaneously reversed of treated medically. There were two late deaths (2 and 7 months) by refractory rejection. 78 per cent of the patients were alive one year after transplant. All survivors have recovered a normal life, some of them with full-time work.(ABSTRACT TRUNCATED AT 250 WORDS)

[Successful cardiac transplantation after 38 days of circulatory assistance with a heterotopic artificial heart]. / Succès d'une transplantation cardiaque après 38 jours d'assistance circulatoire par coeur artificiel en position hétérotopique.

The survival of a patient with irreversible cardiac failure on the cardiac transplantation waiting list was assured for 38 days by circulatory assistance with heterotopic Pierce Donachy prosthetic ventricles and followed by successful cardiac transplantation. This method of circulatory assistance is relatively simple to install from the technical point of view and provides a satisfactory haemodynamic result whilst waiting for a compatible donor organ. Several complications, some of them serious, were observed. Some were related to the patient's poor preoperative condition: acute renal failure, disorders of coagulation. These regressed slowly when the patient's haemodynamic status improved. On the other hand, septic problems and local haemorrhage were inherent to this technique. These are the commonest complications reported by other authors. Although the mortality rate during the period of circulatory assistance may appear to be high, this technique remains a valuable method of survival for selected patients and does not affect the chances of success of ulterior cardiac transplantation.

[Giant leiomyoma of the inferior vena cava]. / Léiomyome géant de la veine cave inférieure.

The authors report an uncommon case of giant leiomyoma of the inferior vena cava with intracardiac extension and arising from the external iliac vena. This case report illustrates the diagnostical problems usually encountered with this type of tumour. Indeed, despite ultrasound and transverse CT scan, the diagnosis was only assessed by histopathological analysis following a successful surgical removal of the leiomyoma. Only 7 cases of leiomyoma of the inferior vena cava are already reported in the literature. Relationship with intravenous leiomyomatosis of the uterus is also discussed.