Proton magnetic resonance spectroscopy of blood plasma in heart transplant recipients treated with cyclosporine: an early prognosis test of long-term graft tolerance.

BACKGROUND: Previous results have established the potential interest of proton magnetic resonance spectroscopy (MRS) of plasma lipoproteins in the detection of rejection processes after heart transplantation. The aim of this study was to determine whether MRS can provide a relevant long-term prognosis factor as early as 1 week after transplantation. METHODS: Eighteen patients were monitored for a mean period of 16 months after transplantation. The ratio of the sum of the MRS total line widths (TLW) for lipoprotein moieties, obtained 1 week after transplantation and cyclosporine administration, over the same sum obtained on the day of transplantation (TLW(8/0)), as well as the ratio between the corresponding intensities of methyl and methylene moieties (IR) were used to quantify the lipoprotein spectral profile. RESULTS: TLW(8/0), with a cutoff value of 0.8, seemed to have the most value in predicting rejection processes (RP) several months later. All six patients with no RP (good prognosis) and all five patients with three or more RPs (poor prognosis) during the entire 16-month follow-up period were correctly detected as early as 8 days after transplantation. The seven patients with only one or two RPs, mainly occurring during the first months after transplantation, were usually classified by MRS as having good prognosis. CONCLUSIONS: The magnetic resonance spectrum depends on both qualitative and quantitative variations in the different lipoprotein fractions, known to be carriers of cyclosporine. The magnetic resonance spectrum could thus be an early expression of the ability of these lipoproteins to modulate the cyclosporine-mediated immunosuppression.

Histological discrimination of idiopathic inflammatory bowel disease from other types of colitis.

AIMS: To assess the value of histology in diagnosing inflammatory bowel disease (IBD) in colorectal biopsy specimens. METHODS: Retrospective, double blind evaluation of colorectal biopsy specimens from 41 patients with colitis (28 with ischaemic colitis and 13 with acute self-limited colitis) and 84 patients with IBD (42 with Crohn's disease and 42 with ulcerative colitis). RESULTS: The features distinguishing IBD from other forms of colitis included distorted architecture, lymphocyte and plasma cell infiltrate, excess of polymorphonuclear leucocytes, polymorphonuclear cryptitis, crypt abscesses, and basal lymphoid aggregates. The features discriminating between Crohn's disease and ulcerative colitis included an irregular or villous surface, distorted architecture, decrease in mucus content, and polymorphonuclear cryptitis. Using multivariate analysis, 90% of patients with Crohn's disease and 71% of those with ulcerative colitis were correctly classified, the former being strongly defined by epithelioid granulomas, microgranulomas and isolated giant cells, and the latter best defined by an irregular or villous surface, decrease in mucus content and crypt atrophy. CONCLUSIONS: Examination of colorectal biopsy specimens is a reliable method for diagnosing IBD. In the absence of epithelioid granulomas, microgranulomas and isolated giant cells a diagnosis of Crohn's disease is based on the absence of histological criteria favouring ulcerative colitis. The histological spectrum of indeterminate colitis remains to be clarified.

Ex vivo studies of polymorphonuclear neutrophils from patients with early-onset forms of periodontitis. (I). Chemotactic assessment using the under agarose method.

The polymorphonuclear neutrophil (PMN) appears to be an important cell in the protection of the host from pathogenic periodontal microorganisms and, despite some reports to the contrary, it is generally assumed that early-onset forms of periodontal disease (including both juvenile and rapidly progressing periodontitis) are associated with a defect in PMN chemotactic behaviour. The purpose of the present study was to examine the peripheral PMN chemotactic behaviour, using the under agarose method, in 4 groups, namely healthy periodontium group (n = 7), gingivitis group (n = 8), early-onset periodontitis group (n = 17) and adult periodontitis group (n = 8). PMN from early-onset periodontitis patients showed normal random and chemotactic locomotory behaviour when compared with those of PMN from subjects of the other groups. No statistically significant difference could be found among the 4 studied groups, with regard to spontaneous and oriented migration.

[Hospital transfer of newborn infants in the Loire-Atlantic area (France)]. / Le transfert hospitalier des nouveau-nés dans le département de Loire-Atlantique (France).

The rate of neonatal referral from the site of birth to a special care centre is generally related to the conditions of the pregnancy and the status of the neonate. The purpose of this study was to investigate other factors affecting referral including obstetric procedures, and equipment and personnel environment. A prospective survey of the neonatal population in 9 maternity hospital in the Loire-Atlantique area in France was conducted. There were, 1.316 births and the referral rate was 10.3% with a range of 1 to 24% depending on the originating hospital. After adjustment for gestational age, multivariate analysis revealed that the medical variables were the main factors affecting referral rate (positive gastric smear, adjusted odds ratio, ORa = 62.6; disease, ORa = 37.7; Apgar score 1 min < 7, ORa = 9.4; monitoring abnormality, ORa = 3.2; coloured amniotic fluid, CORa = 2.7; birthweight, ORa = 0.3). A high risk of referral was observed in only one maternity hospital (ORa = 9.4) related to a poor environment index. This center was in close vicinity to another maternity hospital. In a regional referral programme, high risk neonates should be delivered in maternity hospitals near a special care centre. But, in order to keep the rate of referral, with its adverse effect on the mother-baby relation, low, care for neonates with minor disease or only slightly underweight at birth should be cared for in these centers without referral.

Failure of epinephrine to induce severe cardiac arrhythmia in rats with ventricular hypertrophy secondary to aortic pressure overload.

The arrhythmogenic action of epinephrine was studied in 3 groups of rats: 10 rats with mild constriction of the abdominal aorta (group H1), 10 rats with severe constriction (group H2), 10 sham-operated age-matched rats (group C). Blood pressure and ECG were recorded before, during and after 5 min. perfusion of increasing doses of epinephrine (1, 5, 10 and 25 micrograms.kg-1.min.-1). Ventricular arrhythmia was evaluated from the ECG using a modified Lown's grading system. The ventricular hypertrophy index was calculated from the heart/body weight ratio (mg/g). The mean arterial blood pressure was significantly higher in groups H1 and H2 than in the control group. The ventricular hypertrophy was significant in group H2, but not in group H1. There was no significant difference between the amplitudes of the epinephrine-induced hypertensive responses in the 3 groups but the extent of arrhythmia was significantly lower in the animals with high hypertrophy index.

Preoperative radiotherapy for carcinoma of the esophagus.

From 21 March to 22 June 1976, 124 patients with squamous cell carcinoma of the esophagus were randomized for inclusion in a prospective trial of preoperative irradiation. Fifteen patients were excluded because of inoperability. Sixty-seven patients were randomly selected to receive 4,000 rads of cobalt radiation for eight days prior to operation; 57 patients were operated upon without receiving radiation therapy. No significant differences were noted between the two groups with regard to age, sex, tumor site, experience of the surgeon, method of approach or surgical technique. Eight esophageal resections were performed upon 47 of the 62 irradiated patients and 33 of the 47 nonirradiated patients. Of the 62 irradiated patients, 14 died during operation, compared with 11 of the 47 nonirradiated patients, the difference between the two groups not being statistically significant. Irradiation was associated with a higher mortality for lesions in the mid third part of the esophagus, 11 of 29 versus four of 19, but again, the difference was not significant. In the irradiated patients, the five year actuarial postoperative survival rate was 9.5 versus 11.5 per cent for the nonirradiated patients. In conclusion, preoperative radiation therapy does not produce a statistically significant short term or long term benefit in the management of squamous cell carcinoma of the esophagus.

[Factor analysis of correspondances applied to a study on oral hygiene]. / Analyse factorielle des correspondances appliquée à une enquête sur l'hygiène bucco-dentaire

A global analysis method (the factorial analysis of correspondances) was applied to a study of oral hygiene. This first trial showed that this method of analysis is valid in this field confirming the relationship "absence of hygiene"--"periodontal disease" and the antogonism between the presence of caries and periodontal diseases in young subjects on military duty.

[Genic and antigenic frequencies of ABO, Rhesus(D) systems and HLA in Ille et Vilaine]. / Fréquences antigéniques et géniques dans les systèmes ABO, Rhésus (D) et HLA de l'Ille et Vilaine

The study of the genic and antigenic frequencies of the ABO and Rhesus systems amidst a population of 16559 subjects, reveals are very good correlation as regards the various autors. Considering the HLA typing of 481 subjects, one will point out the lowering of the HLA2 antigen.

[Application of correspondance factor analysis to function testing of the thyroid]. / Application de l'analyse factorielle des correspondances a l'exploration fonctionnelle de la thyroïde

Biological data concerning 249 thyroid patients have been treated by using correspondance factor analysis. This statistical treatment has enabled us to compare 2 types of associated tests (in vitro, in vivo) and to evaluate their respective contribution to the diagnosis of different thyroid diseases. There appeared also certain possibilities for the use of such a method in the future: determination of a biological profile for thyroid disease and for Grave's disease patients in course of treatment.