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Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation. The B cell longitudinal profile was analyzed in peripheral blood mononuclear cells from patients with bronchiolitis obliterans syndrome and patients who remained stable over 3 years of follow-up. CD24

Background Homeostatic turnover of the extracellular matrix conditions the structure and function of the healthy lung. In lung transplantation, long-term management remains limited by chronic lung allograft dysfunction, an umbrella term used for a heterogeneous entity ultimately associated with pathological airway and/or parenchyma remodeling. Objective This study assessed whether the local cross-talk between the pulmonary microbiota and host cells is a key determinant in the control of lower airway remodeling posttransplantation. Methods Microbiota DNA and host total RNA were isolated from 189 bronchoalveolar lavages obtained from 116 patients post lung transplantation. Expression of a set of 11 genes encoding either matrix components or factors involved in matrix synthesis or degradation (anabolic and catabolic remodeling, respectively) was quantified by real-time quantitative PCR. Microbiota composition was characterized using 16S ribosomal RNA gene sequencing and culture. Results We identified 4 host gene expression profiles, among which catabolic remodeling, associated with high expression of metallopeptidase-7, -9, and -12, diverged from anabolic remodeling linked to maximal thrombospondin and platelet-derived growth factor D expression. While catabolic remodeling aligned with a microbiota dominated by proinflammatory bacteria (eg, Staphylococcus, Pseudomonas, and Corynebacterium), anabolic remodeling was linked to typical members of the healthy steady state (eg, Prevotella, Streptococcus, and Veillonella). Mechanistic assays provided direct evidence that these bacteria can impact host macrophage-fibroblast activation and matrix deposition. Conclusions Host-microbes interplay potentially determines remodeling activities in the transplanted lung, highlighting new therapeutic opportunities to ultimately improve long-term lung transplant outcome., Graphical abstract

The Satisfaction with Life Domains Scale SLDS published by Baker and Intagliata in 1982 and translated in French by Chambon and al. is one of the most used rating scales in the field of Subjective Quality of Life (SQL) for patients suffering from schizophrenia. It comprises 16 scales in 7 points and Likert format exploring the following fields: home/apartment/place of residence, neighbourhood, food, clothes, health, people they live with, friends, love life, relationships with their family, how they get on with other people, job/work day programming, spare time, what they do in the community for fun, services and facilities in their area, economic situation, general quality of life. In this study we present results on SLDS about 139 schizophrenic patients (108 males, 31 females) recruited in two centers Lyon (n = 41) and Saint-Etienne (n = 98). The SLDS was a part of more comprehensive studies including evaluation of needs for care, social support, delivery and costs of services. Diagnosis were confirmed using either the SCAN and CATEGO program (n = 108) or the list of the ICD-10 criteria (n = 31) applied at time of inclusion or on the basis of a representative episode of the illness. Patients were classified in two groups, the S group (S, n = 53) for those patients presenting clinical features at time of inclusion excepted residual forms (F 20.5) and the non S group (N-S, n = 86) for those patients free of symptoms at the time of assessment. Non parametric statistics (U test and Kendall test) were used for comparisons between groups. The field by field comparison of the scores shows the poorest level of SQL for love life (m = 4.2; sd = 1.8) and economic status (m = 4.4; sd = 1.8). Comparisons between S and non-S groups show an average range systematically higher for the non-S group and significant differences for the following fields: food, friends, how they get on with other people. The same comparisons between males and females show no significant differences excepted for the following fields: love life, economic situation. Principal components analysis with Varimax rotation were performed and a 4 factors solution was considered as the best one. Before rotation the first factor accounts for 31% of the variance and comprises all the items with loading higher than 0.4 allowing us to consider the possibility of a global score. This global score is normally distributed (m = 95.1 sd = 17.3) and shows a significant difference between S and non S-groups (S m = 92.2 sd = 20.1; non S m = 99.6 sd = 15.4 p = .02) but not between centers and between males and females. After rotation the first factor comprises relationships with family, how they get on with other people, job/work/day programming, spare time, what they do for fun and life in general. The hypothesis of unidimensionality of QV has to be tested using the RASCH model.

With a sample of 1,331 subjects we form three groups, considering the subjective somatic and psychic state of mind. The first group with a good state may represent the normal subjects N = 780. We else compare here the different groups.

The authors report a case of cardiac arrest occurring in a patient who had just entered the catheter laboratory for coronary angioplasty. Opacification of the left coronary artery revealed a proximal occluding double spasm unrelated to the distal stenoses for which angioplasty had been requested. Resuscitation and antispastic therapy with intracoronary injection of a nitrate derivative resulted in a complete recovery without any sequellae. The role of coronary spasm in sudden death and the value of the ergometrine test in patients with coronary stenosis are discussed.

A total of 388 patients from 10 Belgian and French Centers were evaluated with the 1981 revision of the psychopathological and somatic scales of the AMDP System. Principal components factor analyses indicate that the somatic items contribute little to the structure. A 10-factors solution of the psychopathological items generate the following factors after orthogonal rotation: Obsessions-Phobias, Dramatization, Anxiety, Depression, Retardation, Organicity, Dissociation, Delusions, Mania, Dysphoria. This structure is similar to the analyses of the previous German edition except for Anxiety (due to additional French items) and Dramatization (which replaces the German factor on Hypochondriasis). The correlations between raw factor scores and item scores of the BPRS and of a similar AMDP-derived scale contribute to the validation of the AMDP factors and to the justification of a 13-item AMDP Syndromic Scale.

The electrophysiological properties of bepridil suggest a possible ventricular antiarrhythmic effect. This prospective multicentre trial was undertaken to study the antiarrhythmic efficacy of oral bepridil on ventricular arrhythmias in patients with stable coronary insufficiency and more than 1 000 ventricular extrasystoles per 24 hours or ventricular tachycardia. The patients were divided into 3 groups according to the arrhythmias observed and the dosage used. In group I, the dosage was 300 mg/day and 12 out of 44 patients (27%) responded favourably to two criteria of efficacy (decrease of 84% of the number of ventricular extrasystoles; suppression of complex ventricular extrasystoles). In group II, the dosage was 300 mg/day, and then increased to 500 mg in non responders. Using the same criteria of efficacy, 13 out of 19 positive results were observed (68.4%). Group III comprised all cases of ventricular tachycardia; bepridil was effective in 3 out of 6 cases, associated with amiodarone in 1 case. The results demonstrate an antiarrhythmic effect of bepridil which is modest at 300 mg/day but which becomes more marked at the dosage of 500 mg/day.

The authors have applied to 493 Belgian and French patients the French version of the AMDP Psychopathology and Somatic scales, made of 140 items from the original German version and of 22 items specific to its French adaptation, among others anxiety items. By applying a principal components factor analysis to this sample, a 17-items. Anxiety Scale was extracted from the 162-items complete scales. This new scale is characterized by a predominence of tension/irritability items over somatic items as compared to the Hamilton Anxiety Scale. On 116 cases, the correlation between both scales is .59 (p less than .0001). A cut-off score for anxiety and an inclusion score for drug trials are suggested on the basis of statistical data.

Left ventricular failure is one of the most common complications of acute myocardial infarction and may have very serious haemodynamic consequences. Isosorbide dinitrate administered by intravenous infusion in doses of 3 to 7 mg/hour had highly beneficial effects on pre-load and frequently improved cardiac output. The results obtained in this series of 10 consecutive patients demonstrate that the drug has very favourable effects on the immediate prognosis of myocardial infarction.

The right ventricular ejection fraction is rarely measured, as conventional diagnostic methods (radiology, echocardiography) are confronted with the problem of representing the right ventricle as a simple tridimensional geometrical model. This is not necessary with the radio-isotopic techniques. However, all those used for the measurement of right ventricular ejection fraction lead to important methodological problems. We have therefore developed a technique of measuring this parameter with an infusion of 81 m Kr. This radioactive gas is pure gamma-ray emitter with a 13 second period. Dissolved and infused intravenously, it is eliminated during the first passage through the lung. The continuous separation of the generator of 81 m Kr is performed with isotonic dextrose solution which is then infused for a period of 7 minutes. During this time, the activity detected by the scintillation camera inclined in the 30 degrees RAO projection is stored, together with the electrocardiogram in a computer. The precordial radioactivity of the retrocardiac lung tissue is subtracted after injection of 74 MBq of 99 mTc microspheres. A graph of right ventricular activity can then be reconstructed and the right ventricular ejection fraction calculated. The left ventricular ejection fraction is then measured with 99 mTc--labelled RBCs. This method allows the right ventricular ejection fraction to be measured in the RAO projection, the best incidence for the separation of the right atrial from the right ventricular activity without interference from left ventricular activity because of the pulmonary elimination of the Krypton radioactivity. The measurement performed on a large number of cardiac cycles allows a continuous study of the right ventricular ejection fraction. At the end of the infusion there is no circulating radioactivity so that the measurement can be repeated. This technique was used in 17 patients with acute myocardial infarction. In the 7 patients with anterior infarcts reduction of the left ventricular ejection fraction was the predominant finding (21,6 +/- 6,8%). The right ventricular ejection fraction was 34,2 +/- 6,4%. On the other hand, patients with a postero-inferior infarction had little change in left ventricular ejection fraction (59,2 +/- 12%) but those with right ventricular extension of their infarcts had very reduced right ventricular ejection fractions (less than 23%). The measurement of right ventricular ejection fraction with 81 m Kr is a reliable atraumatic method for diagnosing right ventricular infarction by the quantification of its functional impairment.

This study was based on a series of 486 patients with acute myocardial infarction. All were treated with heparin and nitrite derivatives. 320 patients received 600 mg/24 h Potassium Canrenoate for 5 days (long duration); 90 patients received 1000 mg of Potassium for the first 36 hours only. 76 patients did not receive the drug and served as controls. The biochemical changes due to Potassium Canrenoate are discussed with special emphasis on the serum and intraerythrocytic potassium levels. The antiarrhythmic action of the potassium was assessed directly (the number of ventricular extra systoles decreased significantly) and indirectly (the amount of antiarrhythmic therapy required in association was three times less in patients treated by Potassium Canrenoate). The mortality rate changed from 17 to 12%. The beneficial effect of Potassium Canrenoate is attributed to the maintenance or the restoration normal potassium levels of ischaemic myocardial tissue.

154 patients investigated for chest pain underwent 12 lead exercise electrocardiography and also exercise 201-Thallium myocardial scintigraphy performed at coronary angiography. 92 patients had typical angina; in this group the sensitivity and specificity of exercise electrocardiography was good (91% and 86% respectively) and exercise myocardial scintigraphy did not give significantly better results. On the other hand, in cases when exercise electrocardiography was negative (27%) exercise myocardial scintigraphy was positive in 75%. 201-Thallium did not discriminate between ischaemia and necrosis in patients with previous myocardial infarction, ischaemia alone causing hypofixation on basal myocardial scintigraphy. 62 patients had atypical chest pain. The low incidence of coronary artery disease in this group (30%) increases the value of exercise 201-Thallium scintigraphy as it is both more sensitive (59% compared to 21%, p less than 0,05) and more specific than exercise electrocardiography (43% compared to 85%, p less than 0,1). 29% monotruncular lesions had negative exercise electrocardiography and myocardial scintigraphy. However, multivessel and left main coronary disease may be excluded with great probability by a negative exercise 201-Thallium scintigraphy.

The antiarrhythmic efficiency of quinidine arabogalactan-sulphate (QAGS) and disopyramide were determined in 38 patients showing chronic, stable frequency premature ventricular beats (PVB). The study which was carried out in 4 medical Centers, used a longitudinal cross-over design. After a baseline evaluation which consisted of two 24 hours electrocardiograms, the patients were randomised to one of the two drugs during a period of 6 or 7 days. The drug sequence were followed by a placebo sequence. A 24 hours electrocardiogram was performed at the end of each sequence. The daily doses were equivalent to 660 mg of quinidine base for QAGS and 600 mg for disopyramide. Among the 38 patients who entered in the study, 32 went through each sequence of the test. The average number of PVB was significantly reduced by QAGS and disopyramide (p less than 0.0001). With QAGS 18 patients had more than 65 p. 100 reduction of PVB and 12 of them more than 80 p. 100. With disopyramide, 14 patients had more than 65 p. 100 reduction of PVB and 12 of them more than 80 p. 100. There was no statistical difference in the overall efficiency of the two drugs. Three patients died, one from myocardial reinfarction, one from ventricular fibrillation; in one other case, the cause of the death remained undetermined. QAGS was better tolerated than disopyramide; adverse effects occurred in 6 patients with QAGS and in 10 with disopyramide. The responsibility of disopyramide in the occurrence of two severe ventricular arrhythmia may be questioned.