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Copyright of Annales Françaises de Médecine d'Urgence is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: The use of heat and moisture exchangers (HME) during noninvasive ventilation (NIV) can increase the work of breathing, decrease alveolar ventilation, and deliver less humidity in comparison with heated humidifiers (HH). We tested the hypothesis that the use of HH during NIV with ICU ventilators for patients with acute respiratory failure would decrease the rate of intubation (primary endpoint) as compared with HME. Methods: We conducted a multicenter randomized controlled study in 15 centers. After stratification by center and type of respiratory failure (hypoxemic or hypercapnic), eligible patients were randomized to receive NIV with HH or HME. Results: Of the 247 patients included, 128 patients were allocated to the HME group and 119 to the HH group. Patients were comparable at baseline. The intubation rate was not significantly different: 29.7 % in the HME group and 36.9 % in the HH group ( p = 0.28). PaCO did not significantly differ between the two arms, even in the subgroup of hypercapnic patients. No significant difference was observed for NIV duration, ICU and hospital LOS, or ICU mortality (HME 14.1 vs. HH 21.5 %, p = 0.18). Conclusions: In this study, the short-term physiological benefits of HH in comparison with HME during NIV with ICU ventilators were not observed, and no difference in intubation rate was found. The physiologic effects may have been obscured by leaks or other important factors in the clinical settings. This study does not support the recent recommendation favoring the use of HH during NIV with ICU ventilators. [ABSTRACT FROM AUTHOR]

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Reanimation is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Rationale and objectives: The respective influence on the incidence of ventilator-associated pneumonia of currently available systems used for warming and humidifying the gases delivered to mechanically ventilated patients, that is, heated humidifiers and heat and moisture exchanger filters, remains controversial.Methods: We addressed this question in a multicenter randomized study comparing heated humidifiers (with heated circuits) and filters in an unselected population of 369 intensive care patients receiving mechanical ventilation for more than 48 h.Main Measurements and Results: The diagnosis of pneumonia was confirmed according to strict microbiologic criteria. There was no difference in pneumonia rate between the two groups (53 of 184 [28.8%] versus 47 of 185 [25.4%] for humidifiers versus filters; p = 0.48), or in the incidence density of pneumonia (27.4/1,000 ventilatory days versus 25.3/1,000 ventilatory days for humidifiers versus filters; p = 0.76). The mean duration of mechanical ventilation did not differ between the two groups (14.9 +/- 15.1 versus 13.5 +/- 16.3 days for humidifiers versus filters, p = 0.36). Endotracheal tube occlusion occurred, respectively, in five patients and one patient in the humidifier and filter groups (p = 0.12). Intensive care mortality was identical in the two groups (about 33%).Conclusion: These results suggest that both heated humidifiers and heat and moisture exchanger filters can be used with no significant impact on the incidence of ventilator-associated pneumonia and that other criteria may justify their choice. [ABSTRACT FROM AUTHOR]

We have developed new DNA extraction and purification procedures for investigation of mycorrhized seedlings and canned truffles. Use of these procedures on approximately 100 mg initial material enabled good sample representation. For mycorrhized seedlings, Taq polymerase inhibitors were discarded irrespective of tree species. In routine analysis we systematically used consensus primers ITS1/ITS4 to check the absence of Taq polymerase inhibitors and the presence of fungus DNA. Positive response with ITS validates other positive or negative PCR results. Absence of amplification with ITS prevents validation of other results. For canned truffles, DNA harvested from ascocarps sterilized for one and a half hours at 115°C was amplified with specific primers. We have developed consensus primers, named R12/F12, to check for the presence of amplifiable fungus DNA and the absence of Taq polymerase inhibitors. Here also, positive response with consensus R12/F12 validates other positive or negative PCR results. We have developed one primer pair specific for T. brumale and another specific for T. melanosporum. We can then characterize these two taxa, which enables the use of “truffle or truffled” French designations. We can also characterize T. indicum, the Asiatic black truffle that might fraudulently be sold as T. melanosporum and T. brumale. These three specific primer pairs were used independently of DNA extraction from tree seedlings or canned truffles. Our process is specific, sensitive, convenient, and quick. [ABSTRACT FROM AUTHOR]

Although authorized for the French market, the Asiatic black truffle, Tuber indicum, may potentially be sold as T. melanosporum, the ”Perigord black truffle’’, due to difficulties in distinguishing between them by morphological criteria. A molecular method using a DNA extraction kit and specific primers based on the interspecific polymorphism of the internal transcript spacer DNA region has allowed us to amplify T. indicum samples (mycorrhizas, fresh, dried, and frozen ascocarps) and even to detect as little as 1% of Asiatic truffle in a mixture of ground ascocarps or mycorrhizas containing T. melanosporum. Our process is specific, sensitive, convenient and quick, so it could be used for the rapid detection of T. indicum in non-cooked food products and commercialized mycorrhizal seedlings to avoid the ecological damage which would result from its accidental introduction. [ABSTRACT FROM AUTHOR]

Diagnosis of duodenal and pancreatic injuries is frequently delayed, and optimal treatment is often controversial. Fourteen children with duodenal and/or pancreatic injuries secondary to blunt trauma were treated between 1980 and 1997. The pancreas was injured in all but 1 child. An associated duodenal injury was present in 4. The preoperative diagnosis was suspected in only 6 patients based on clinical signs and ultrasonography. One patient was treated successfully conservatively; all the others required surgical management. At operation, three procedures were used: peripancreatic drainage, suture of the gland or duodenum with drainage, and primary distal pancreatic resection without splenectomy. A duodenal resection with reconstruction by duodeno-duodenostomy was performed in 1 case. The overall complication rate was 14%: 1 fistula and 1 pseudocyst. Pancreatic ductal transection was recognized 3 days after the initial laparotomy by endoscopic retrograde cholangiopancreatography (ERCP). The mortality was 7%; 1 patient died from septic and neurologic complications. When the diagnosis of pancreatic ductal injuries is a major problem, ERCP may be a useful diagnostic procedure. Pancreatic injuries without a transected duct may often be treated conservatively. The surgical or conservative management of duodenal hematomas is still controversial; other duodenal injuries often need surgical treatment. [ABSTRACT FROM AUTHOR]

Simple considerations of statistical mechanics show that the association of an enzyme with another protein or with an ‘inert’ surface results in a decrease of its information content and thus that it receives an ‘instruction’ from this protein or from the surface. As a consequence, the free energy stored in the enzyme increases, and this energy may be used to alter the intrinsic catalytic properties of the enzyme. This may imply, for instance, that an enzyme which is devoid of activity may have its activity enhanced when bound to another protein or to a membrane. A possible consequence of this communication between proteins is that, upon dissociation of the complex, one of these enzymes may transitorily retain an imprinting of the other protein and this imprinting may in turn alter the properties of the enzyme. Different enzyme systems may illustrate this view. A particular emphasis has been put on the study of a phosphoribulokinase-glyceraldehyde phosphate dehydrogenase complex from Chlamydomonas chloroplasts. Whereas the isolated oxidized phosphoribulokinase is almost completely inactive, it becomes active when bound to glyceraldehyde phosphate dehydrogenase. Moreover, upon dissociation of the complex, the phosphoribulokinase retains for a while an imprinting exerted by glyceraldehyde phosphate dehydrogenase. It then displays properties that are markedly different from those of the free stable enzyme. Thermodynamics allows us to calculate the amount of energy stored in this enzyme and used to facilitate substrate binding and catalysis. There is thus little doubt that information and instructions are transferred from protein to protein within enzyme complexes that result in a complete change of their biological function. [ABSTRACT FROM AUTHOR]

Aluminate sodalite ceramics, (Sr8Al12O24)(CrO4)2) — SACR, have been prepared from solution spray-dried precursors. The spray drying of a mixed aqueous nitrate solution gave an anhydrous powder which was thermally decomposed in air at 1350 °C to give a crystalline SACR powder with a median volume diameter of 4–6 μm. The SACR powder was dry pressed and sintered to >90% density. The yellow SACR powder showed two phase transitions between 10 and 45 °C with a 25 ° intermediate phase region indicative of a low defect concentration in the crystalline structure. A colour change observed in the sintered ceramic (changing to a mixed green/yellow) and a narrowing of the phase transition region (15–40 °C) are discussed. Dielectric measurements were consistent with the presence of two extrinsic ferroelectric transitions at 17 and 35 °C. [ABSTRACT FROM AUTHOR]

The effects of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin 1-α (IL-1-α), and interleukin 6 (IL-6) on the growth of the Toxoplasma gondii RH strain were studied in vitro using a human astrocytoma-derived cell line. Cells were treated with cytokines at different concentrations at 24 h prior to infection with T. gondii tachyzoites. IFN-γ did not induce any modification in T. gondii growth, whatever the concentration used. TNF-α induced a significant decrease in the total number of tachyzoites, whereas IL-1-α surprisingly induced an increase in the number of tachyzoites. Our results show that the effects of cytokines on T. gondii growth may be of great importance in the control of cerebral toxoplasmosis but that they can vary, depending on the cell type considered. [ABSTRACT FROM AUTHOR]

The role of cytokines in the pathogenesis of toxoplasmosis remains unknown to a large extent, especially in the case of reactivation that occurs in immunocompromised patients. To assess the importance of tumor necrosis factor alpha (TNFα), interleukin 1 alpha (IL1 α), and interleukin 6 (IL6), we studied the expression of these three cytokines by human astrocytoma cells after infection by three different strains of Toxoplasma gondii. The virulent RH strain, the intermediate 76K strain, and the cystogenic Prugniaud strain did not induce significantly different levels of expression of the cytokine messenger RNAs when the cytokines were studied at 1, 3, 6, and 24 h after parasitic infection. These results could indicate that infection by T. gondii strains of different virulence do not involve strong differences in TNFα, IL1α, or IL6 expression by human astrocytoma cells. [ABSTRACT FROM AUTHOR]

A hexokinase has been isolated from Baker's Yeast, purified and obtained in crystalline form. Its specific activity is between 600 and 700 units/mg. This enzyme is homogeneous on DEAE-cellulose chromatography. The molecular weight, estimated by molecular sieving on Sephadex G-100, is around 49000. The authors of the present article have been able to show, by equilibrium dialysis on Sephadex G-25, that one molecule of the enzyme (MW 49000) binds one molecule of [14C]glucose in the absence of ATP. The value of the affinity constant for [14C]glucose, under the experimental conditions used and in the absence of ATP, is 10000 M-1. This value is nearly identical, within experimental errors, to 1/Km obtained from the measurement of hexokinase activity. The binding of the Mg[14C]ATP²- chelate on the enzyme cannot be detected in the absence of glucose and under the experimental conditions used. This result implies that the affinity constant of the hexokinase for MgATP2- is lower than 800 M-1. The value of 1/Km for the ATPase reaction, determined under the same experimental conditions, is around 200 M-1. These results arc compatible with an ordered mechanism of hexokinase catalysis, in which the enzyme binds glucose first. They seem difficult to reconcile with a rapid equilibrium random mechanism. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article regarding use of extracorporeal carbon dioxide removal in 2339 intensive care units (ICU).

The article discusses a hypothesis on early renal replacement therapy (RRT) increasing mortality in critically ill patients wit acute and chronic renal failure, and a post hoc analysis of the artificial kidney initiation in kidney injury (AKIKI) trial. It states that the data acquired supports the working hypothesis of an adverse efect of early RRT on survival of patients with acute on chronic kidney injury, and suggests using RRT withextreme caution in such patients.

Ten, creosote treated, Douglas-fir poles infected with Poria carbonica at the ground line zone were inoculated artificially with Scytalidium sp. FY strain in January 1967. FY became established in the poles. One pole was set aside for comprehensive sampling and thirty-six samples were taken from the ground line zone of it seven years later (January 1974). One sample yielded live FY, 2 samples yielded bacteria, 9 samples showed scanty fungal growth and 24 samples yielded no microorganisms. None of the 36 samples showed advanced decay or Poria carbonica. These observations are consistent with the mechanical condition of the wood in the other 9 poles inoculated with FY after decay had begun. [ABSTRACT FROM AUTHOR]

The far-field acoustic-radiation pattern of a large single-frequency cylindrical transducer was computed, using various methods, employing data taken in the near field of the transmitter. Beam patterns thus computed are compared to the measured far-field beam pattern from the same transmitter. Two ground rules were imposed on this study: (1) No assumptions would be made as to any relationship between the pressure and its gradient which cannot be justified theoretically. (2) Any approach which led to the equivalent of the spheroidal wavefunction method would not be considered further, unless the formulation was such that the computation time involved was considerably less. The Kirchhoff-Helmholtz formula, using both the measured pressure and pressure gradient, gave the best agreement with the measured far-field directivity. Poorer agreement was shown when the wave equation was approximated by a difference equation, using the measured pressure and its gradient as boundary conditions, and calculating the pressure step by step from the near field to the far field. Other methods employed for calculating the far-field pressure were found to be inadequate. [ABSTRACT FROM AUTHOR]

Pulsed cw signals were transmitted from an electromagnetic transducer situated in the deep sound channel, and were received by a hydrophone at a similar depth, at ranges of from 1 to 6 kyd. A study of the fluctuations of ∫ P2dt has shown that for the sound channel arrival, the relative fluctuations increase with range. For ranges from 2 to 6 kyd, the relative fluctuation is approximately KR1.1. The surface reflected arrival has a maximum relative fluctuation at 1 kyd, a minimum relative fluctuation at 3.4 kyd, and increasing scatter out to the maximum range. Tentative explanations for these phenomena, justification for the relating of results using ∫ P2dt to those using Bmax, plus correlation with results published by other scientists will be discussed. (This work was supported by the Office of Naval Research.) [ABSTRACT FROM AUTHOR]