Impacts on human mortality due to reductions in PM10 concentrations through different traffic scenarios in Paris, France.

OBJECTIVES: Air pollution is a well-known burden for population health and health systems worldwide. Reduction in air pollution is associated with improvements in mortality and rates of respiratory, cardiovascular and other diseases. Though air quality is a problem globally, efforts to lower air pollutant concentrations are usually regional or local. In industrialized countries, most urban air pollution is caused by vehicles, suggesting reductions in traffic would result in reductions of pollution. However, detailed data on how such reductions can be achieved and impact public health is just beginning to emerge, and other influencing factors, including vehicle flow or urban landscape are largely unaccounted for. METHODS: We utilized a unique combination of vehicle emission measurements combined with simulations of traffic and vehicle variations, as well as urban topographies, to quantify health impacts of PM10 reduction in a single district of Paris, France, for various methods of traffic improvement. Here we rank and evaluate improvements in non-accidental mortality for thirteen possible scenarios to reduce traffic related PM10 emissions. RESULTS: The maximum impact scenario requires all passenger vehicles to meet Euro 5 standards and excludes diesel vehicles, resulting in long-term decreases in non-accidental mortality of 148.79 people per year, or 104.40 per 100,000 people. Similar reductions hold for the scenario requiring a completely electric passenger fleet, with long-term annual reductions of 137.14 premature mortalities. Removing all diesel vehicles is the third most impactful scenario, preventing 135.55 deaths yearly. DISCUSSION: PARTLESS provides comparisons between thirteen different traffic-related air quality reduction mechanisms in terms of improvements in mortality rates. Improving emissions standards, increasing electric vehicle use and removing diesel vehicles can prevent more than 148 deaths per year in this district alone. Further improvements in mortality reduction may require changes to the composition of vehicle components, asphalt or to the management of resuspended particulate matter.

The Study of Host Immune Responses Elicited by the Model Murine Hookworms Nippostrongylus brasiliensis and Heligmosomoides polygyrus.

Hookworm infections (Necator americanus or Ancylostoma duodenale) represent a major neglected tropical disease, affecting approximately 700 million people worldwide, and can cause severe morbidity due to the need for these worms to feed on host blood. N. brasiliensis and H. polygrus, both rodent parasites, are the two most commonly employed laboratory models of experimental hookworm infection. Both parasites evoke type 2 immune responses, and their use has been instrumental in generating fundamental insight into the molecular mechanisms of type-2 immunity and for understanding how the immune response can control parasite numbers. Here we provide a complete set of methods by which to investigate the natural progression of infection and the host immunological responses in the lung and intestine of H. polygyrus- and N. brasiliensis-infected mice. Detailed information is included about the most important parasitological and immunological measurements to perform at each time point. © 2017 by John Wiley & Sons, Inc.

Identification of potential CD8+ T-cell epitopes of the 19 kDa and AhpC proteins from Mycobacterium tuberculosis. No evidence for CD8+ T-cell priming against the identified peptides after DNA-vaccination of mice.

Mycobacterium tuberculosis is one of the major killers among infectious agents. It is of great importance to develop an efficient vaccine against M. tuberculosis since the only available vaccine, M. bovis-BCG, has a low efficacy. Furthermore, the emergence of multi-drug-resistant M. tuberculosis strains makes it difficult to cure the disease. CD8+ T cells have been implied to play an important role in protective immunity against M. tuberculosis. A good vaccination strategy for the induction of cytotoxic CD8+ T-cell responses is naked DNA-injection of eukaryotic expression vectors. The use of DNA-injection in an attempt to induce cytotoxic CD8+ T-cell responses against epitopes of the 19 kDa or AhpC proteins from M. tuberculosis in mice was studied. MHC class I binding assays, of peptides derived from these proteins, demonstrated the presence of potential CD8+ T-cell epitopes. However, CD8+ T-cell responses against the peptides after DNA-injection were not detected. Furthermore, no difference in the kinetics of bacterial clearance was observed in vaccinated versus unvaccinated animals, even though 19 kDa and AhpC specific antibodies were readily detected in the serum of vaccinated animals. Taken together these results suggest that the 19 kDa and AhpC genes are not good candidates for DNA vaccines against M. tuberculosis.

Expression of receptors for atrial natriuretic peptide on the murine bone marrow-derived stromal cells.

Atrial natriuretic peptide (ANP) receptors were identified on both murine bone marrow-derived stromal cell lines A-3 and ALC and primary cultured cells using [125I]ANP binding assays and Northern blot analyses. The binding of [125I] ANP to the stromal cells was rapid, saturable, and of high affinity. The dissociation constants between ANP and its receptors on these cells showed no difference among cell types, while maximal binding capacity values were different among cell types. Competitive inhibition of [125I]ANP binding with C-atrial natriuretic factor, specific for ANP clearance receptor (ANPR-C), revealed that most of [125I]ANP-binding sites corresponded to ANPR-C. Northern blotting data corroborated that bone marrow-derived stromal cells expressed ANPR-C. However, in ALC cells, ANP biological receptors (either ANPR-A or ANPR-B), the mol wt of which is approximately 130K, were detected, and cGMP was accumulated after stimulation with ANP. On the other hand, in another stromal cell clone, A-3 cells, the expression of biological receptor was not detected in the affinity cross-linking and competitive inhibition experiments using [125I]ANP. However, A-3 cells accumulated cGMP by responding to ANPR-B-specific ligand, C-type natriuretic peptide. These results suggest that ALC cells equally express ANPR-A and ANPR-B, while A-3 cells express ANPR-B dominantly. Although the physiological roles of these receptors in the bone marrow is still not resolved, ANP is expected to play a role in the regulation of stromal cell functions in bone marrow.

Cytology: a simple, rapid, sensitive method in the diagnosis of Helicobacter pylori.

Cytology and the rapid urease test on gastric biopsies may diagnose Helicobacter pylori (H. pylori) infection within an hour. We evaluated the sensitivity and reproducibility of touch cytology (imprints from biopsies). In 19 patients with duodenal ulcer, biopsies were obtained from the antrum, fundus, and bulb. H. pylori was diagnosed in 42 sites on smears: 28 by culture and 23 by histology. H. pylori was present in the antrum and fundus in 16 and in the bulb in 11. Assessment of paired antral biopsies in 29 additional patients with or without touch cytology (imprints) before specimens were sent for histology or culture revealed no difference for the presence of H. pylori. A second reading of the 58 smears by a second observer revealed agreement on the presence or absence of H. pylori in 53 (91%). In conclusion, touch cytology is a simple rapid, sensitive, and reproducible diagnostic method for H. pylori that does not alter the quality of biopsies for subsequent culture or histologic examination. For the first time, diagnostic methods have been compared on the same biopsies, eliminating sampling variation.

Production of interleukin-4 and other cytokines following stimulation of mast cell lines and in vivo mast cells/basophils.

Interleukin-3 (IL-3)-dependent mast cell lines, upon stimulation by calcium ionophores or by Fc epsilon RI cross-linking, express mRNA for, and secrete, a distinct pattern of cytokines, similar to those secreted by cloned mouse T cells of the TH2 type. The mast-cell-derived cytokines include IL-3, IL-4, IL-5 and IL-6. Not only in vitro mast cell lines, but also in vivo derived peritoneal mast cells secrete cytokines. An in vivo derived cell, in mouse spleen and bone marrow, secretes IL-4 and other cytokines upon stimulation with calcium ionophores or by Fc epsilon RI cross-linking or Fc gamma RII cross-linking. The IL-4-producing cells are highly enriched in the Fc epsilon R+ subset of spleen and bone marrow cells. These Fc epsilon R+ cells produce large amounts of IL-4, and they have characteristics similar to those of immature mast cells and/or basophils. It is possible that cytokines produced by mast cells and/or basophils participate in allergic inflammatory diseases.

Interleukin 7 is a T-cell growth factor.

Interleukin 7 (IL-7) is a 25-kDa cytokine which was purified and its corresponding cDNA was cloned based upon its ability to stimulate the proliferation of pre-B cells. It has been shown that IL-7 can also function as a costimulator with Con A for the proliferation of T lymphocytes by inducing the production of interleukin 2 (IL-2). We demonstrate here that IL-7 in combination with phorbol 12-myristate 13-acetate can directly drive the proliferation of purified T cells and that this response is not inhibited by cyclosporine A or by antibodies to IL-2 and IL-4. Stimulation of T cells with phorbol myristate acetate and IL-2, IL-4, or IL-7 prepared T cells to respond to any of the three lymphokines. Although T cells activated in vitro by anti-CD3 or allogeneic cells failed to proliferate when challenged with IL-7, T cells primed in vivo to the same stimuli demonstrated a significant proliferative response when restimulated in vitro with IL-7. IL-7 can, therefore, function both as a growth factor for T cells in an IL-2-independent manner and as a competence factor for the induction of lymphokine responsiveness. The ability to induce IL-7 responsiveness via stimulation of the T-cell receptor complex in vivo, but not in vitro, raises the possibility that IL-7 may play a role in T-cell growth and differentiation in vivo.

Touch cytology, a useful diagnostic method for diagnosis of upper gastrointestinal tract infections.

Candida albicans, Campylobacter pylori, and Giardia lamblia are microorganisms that are frequently found in the upper gastrointestinal tract. A cytological smear of biopsies obtained at endoscopy was compared with the pathologic examination of biopsies. Candida albicans was found in 55 patients, Campylobacter pylori in 54, Giardia lamblia in 31; cytology was positive in 43, 46, and 22 cases, respectively, and biopsy in 29, 43, and 22 cases. Cytology was thus the only positive test in 26 cases with Candida albicans (47% of the 55 cases), in 11 cases of Campylobacter pylori (20%), and in nine cases of Giardia lamblia (29%). We believe that the cytological smear of biopsies (touch cytology) is a quick and sensitive method for diagnosing infections of the upper gastrointestinal tract, increasing the diagnostic yield obtained by biopsy alone.

[Evaluation of per-endoscopic cytology in the identification of Campylobacter pylori on gastric mucosa]. / Evaluation de la valeur de la cytologie perendoscopique dans l'identification du "Campylobacter pylori" sur la muqueuse gastrique.

The presence of Campylobacter pylori on gastric mucosa was evaluated by touch cytology of gastric biopsies in a series of 100 patients. Results were compared to biopsy cultures. Of 43 culture-positive patients, cytology was positive in 37 (86 p. 100). Cytology was positive in 16 of 57 culture-negative patients, who had peptic ulcer and/or gastritis on biopsy, conditions widely associated with the presence of Campylobacter pylori. Cytologic examination, yielding quick results, is thus a sensitive diagnostic method for Campylobacter pylori. In addition, retrospective studies of previous specimens are possible: among 11 patients with a follow up of more than one year, three of the four Campylobacter pylori carriers subsequently developed an ulcer.

Blunt diaphragmatic rupture.

Diaphragmatic injury is often a missed diagnosis in patients with multiple trauma. For this reason, mortality can be high. From 1970 to 1981, 32 patients with diaphragmatic injuries were seen at Maisonneuve-Rosemont Hospital. Twenty-four of the patients (22 men and 2 women aged 18 to 79 years) had blunt abdominal or thoracic trauma causing diaphragmatic disruption. Rupture occurred 20 times on the left side of the diaphragm, and 3 times on the right side. There was one pericardiophrenic rupture. Motor vehicle accident was the most common cause of trauma. On arrival, 21 patients had acute diaphragmatic rupture. Clinical signs and radiography permitted early diagnosis in 15 patients, whereas diagnosis was made later in 3 other patients because of deterioration of vital signs. In two patients, diagnosis was made at laparotomy for another reason. Four patients were operated on for post-traumatic chronic diaphragmatic hernia. The abdominal approach was used in 18 patients, the thoracic approach in 4, and the thoracoabdominal approach in 2. Three patients died, two of whom had a late diagnosis. Fourteen patients had no complications. Diaphragmatic trauma can be easily managed surgically when diagnosis is made early after trauma. It must always be looked for in patients with multiple trauma.

Retained and recurrent bile duct stones. Surgical or nonsurgical removal?

An experience with 69 patients who underwent 72 common bile duct reoperations for retained or recurrent choledocholithiasis is presented. The mean age of the patients was 57 years, and 35 patients had associated conditions. In this series six patients (8.3%) had minor complications and no patient developed major complications or died. Two (2.9%) patients developed recurrent choledocholithiasis. In recent years, nonoperative removal of retained stones through a T-tube by mechanical extraction or chemical dissolution, and removal of retained or recurrent stones by endoscopic sphincterotomy has gained widespread popularity. Retained or recurrent choledocholithiasis should be managed on an individual basis. Reoperation has a good success rate, low morbidity and mortality rates. It should be considered as the treatment of choice in low risk patients, in whom a retained stone cannot be mechanically extracted through a T-tube, and in patients with recurrent choledocholithiasis diagnosed after removal of the T-tube.

Sacrococcygeal tumour in infancy.

A newborn infant delivered after 33 1/2 weeks' gestation was operated on for sacrococcygeal teratoma. This tumour contained an unusual intra-abdominal cystic component that caused pulmonary problems. Amniography and echography were useful for diagnosing this lesion in utero.

Pancreatic trauma: a new diagnostic approach.

The difficulties encountered in the diagnosis of solitary pancreatic injury when there is no other indication for surgical exploration of the abdomen are discussed. We suggest that endoscopic transduodenal pancreatography is a reliable diagnostic tool of great help in evaluating such injuries with little morbidity.