Evolution of intestinal microbiota and body compartments during spontaneous hyperphagia in the Greylag goose

The aim of this work was to study the effects of spontaneous hyperphagia on the evolution of intestinal microbiota and body compartments in old goose. From October 25th to November 26th, 5-yr-old breeding Greylag Landaise geese (106 males and 106 females) were fed with grass during 1 mo (G period). From November 26th (0 d) the birds had ad libitum access to pellets (AMEn: 10.5 MJ/kg, CP: 18.9 g/kg; spontaneous fattening (SF) period). Some birds were killed at -31 d (n = 24; 50/50 sex ratio), 0 d (n = 48), 14 (n = 46), 22 d (n = 46), and 70 d (n = 48) after the start of G period to measure body traits. For microbial analysis, 10 of the samples per sex at 0 d, 14 d, and 70 d were selected to be representative of body traits. Between 0 and 22 d, liver weight increased from 98 g to 194 g in males and from 89 g to 199 g in females (P < 0.001). Liver weight decreased between 22 and 70 d from 194 to 174 g in males and from 199 to 163 g in females (P < 0.001). Irrespective of the diet (G or SF period) and the sex of the bird, the two major phyla were Proteobacteria (49%) and Firmicutes (48%). Bacteroidetes represented around 3.0% of the sequences. At order level, Firmicutes were dominated by Clostridiales (33% of total sequences) and Lactobacillales (13% of total sequences) and Proteobacteria were dominated by Campylobacteriales (34% of total sequences). Finally, Bacteroidetes were dominated by Bacteroidales. SF and sex did not change the microbial diversity but sparse partial least squares discriminant analysis allowed us to highlight discriminant operational taxonomic unit between experimental groups. In conclusion, our result showed that changes in the body compartments of old geese during spontaneous hyperphagia depend on the sex of the birds, but not so much in gut microbial composition. Further investigations are necessary to understand the functional microbiota and highlight the role of gut microbiota in hepatic steatosis induced with hyperphagia in geese.

The influence of whole-corn feeding method during the finishing stage on the performance of overfed mule ducks

The aim of this trial was to compare 2 feeding systems based on whole corn, a loose-mix and a free-choice feeding system, during the finishing stage on the performance of ducks. Five hundred sixteen day-old male mule ducks (Muscovy drake × Pekin duck) were divided into 3 groups that differed in the presentation of the diet they received between 58 and 88 d of age: a complete pelleted diet (Control (CON) group; AMEn 12.1 MJ/kg, CP 15.0%) containing 500 g of corn per kg; or whole corn (AMEn 13.9 MJ/kg, CP 7.3%) and protein-rich pellets (AMEn 10.3 MJ/kg, CP 22.7%) in equal quantities mixed in the same feeders (loose-mix feeding [LMF] group) or in 2 separate feeders (free-choice feeding [FCF] group). From 89 to 99 d, 72 birds/group were overfed with a mixture containing mainly corn and water and then slaughtered to determine the weight and commercial value of the fatty liver. Feed intake was measured daily. Body weight (BW) was measured at 58, 88, and 99 d of age. From 58 to 88 d, total feed intake of the FCF group was +7% and +9% (+558 g and +672 g) higher than in the groups CON and LMF, respectively (P = 0.005). At 88 d, the BW was higher in the CON group than in the FCF group (4,959 vs. 4,778 g, P < 0.001), the LMF group being intermediate (4,874 g). During the experimental stage, the feed conversion ratio was higher in the FCF group than in the 2 others (+32%, P = 0.024), but the energy intake was similar between the 3 groups (92.6 MJ/duck, P = 0.353).After overfeeding (99 d), the BW (6,593 g), weight (642 g), and commercial grading of fatty liver were similar (P > 0.05) in the 3 groups. The present results suggest that loose-mix feeding during the finishing stage using whole corn is a solution for reducing feed cost.

Effects of replacing corn with sorghum on the performance of overfed mule ducks

The aim of this trial was to study the effects of replacing yellow corn (C) with condensed tannin-free sorghum (S) during the finishing period (F period; age 53 to 79 d) and/or overfeeding period (O period; age 80 to 91 d) on the performance of overfed mule ducks. 192 ducks were divided into 4 groups (48 in each) differing in the cereal (yellow corn or sorghum) included in the diet given during the F and/or the O periods, using a 2 × 2 factorial arrangement of treatments : SS, SC, CS, CC. At the end of the O period, the birds were slaughtered after 10 h of fasting to measure foie gras and magret qualities. Mortality (1%; P > 0.05) and weight gain (2,030 g; P > 0.05) during the O period were similar in the 4 groups. At the end of the O period, birds overfed with sorghum had foie gras that was heavier (723 vs. 694 g in CS+SS vs. CC+SC, respectively; P < 0.05) and less yellow (24.40 vs. 38.59 for b* in CS+SS vs. CC+SC, respectively; P < 0.001) than birds overfed with corn. Fat loss during foie gras cooking was similar in the 4 groups (18%; P > 0.05), but the foie gras was less yellow in birds overfed with sorghum (14.84 vs. 26.01 for b* in CS+SS vs. CC+SC, respectively; P < 0.001). Weight of magret was similar in the 4 groups (491 g, P > 0.05) but the color of the breast muscle and skin of magret was less yellow in birds overfed with sorghum compared with corn (12.26 vs. 12.92 and 13.84 vs. 18.30 in CS+SS vs. CC+SC, respectively; P < 0.001). In conclusion, the replacement of yellow corn with sorghum during finishing and/or overfeeding is possible and useful in a mule duck foie gras production system because it increases foie gras weight without decreasing the weight of magret However, it changes the quality of the products, mainly their color.

Squeeze bottle versus saline spray after endoscopic sinus surgery for chronic rhinosinusitis: a pilot multicentre trial

BACKGROUND

There is a need for controlled trials to guide the perioperative management of patients undergoing endoscopic sinus surgery (ESS). The authors performed a pilot multicenter trial to compare two types of saline delivery devices in this population.

METHODS

Patients were randomized to high volume saline irrigation with a squeeze bottle and low volume saline spray after ESS in patients with chronic rhinosinusitis (CRS). Surgeons were blinded to treatment, and one-month postoperative scores for sinonasal outcomes [Sinonasal Outcome Test-22 (SNOT-22)] scale, nasal and sinus symptom score (NSS), and perioperative sinus endoscopy (POSE) scale were compared with preoperative scores.

RESULTS

Nine centers provided data for 86 patients. All three outcomes measures improved significantly for both groups. Saline spray: SNOT-22 48.8 versus. 23.7, treatment effect 25.1 (95% confidence interval [CI], 17.9-32.2), POSE 21.1 versus. 8.4, treatment effect 12.7 (95% CI, 9.2-16.1), and NSS 8.2 versus 5.0, treatment effect 3.1 (95% CI, 1.4-4.9) pre- and postoperatively, respectively (all p < 0.0001). Squeeze bottle: SNOT-22 49.5 versus 23.6, treatment effect 25.9 (95% CI, 20.3-31.6), POSE 18.6 versus 9.2, treatment effect 9.3, (95% CI 6.7-12.0), and NSS 9.0 versus 5.7, treatment effect 3.3 (95% CI, 2.3-4.3) pre- and postoperatively, respectively (all p < 0.0001). Analysis of variance did not identify a difference between the two treatment groups. Subgroup analysis based on preoperative disease severity did not change the nonassociation of saline bottle with outcome measures. Post hoc sample size calculation determined that 176 patients is required to detect an 8.9-point difference in SNOT-22 scores.

CONCLUSION

In this pilot multicenter trial examining patients with chronic rhinosinusitis undergoing ESS, both squeeze bottle and saline spray showed significant improvement in SNOT-22, POSE, and NSS scores at one-month postoperatively. Because the study was nonpowered, we cannot rule out a potential difference between the two treatment groups.

The influence of choice feeding and cereal type (corn or triticale) during the finishing period on performance of mule ducks

The aim of this trial was to study the influence of choice feeding and cereal type (corn or triticale) during the finishing period on performance of ducks. In total, 624 one-day-old male mule ducks (Cairina moschata × Anas platyrhynchos) were divided into 3 groups differing in the diet they received between 56 and 84 d of age: a commercial complete pelleted diet (control group; AMEn 12.1 MJ/kg, CP 15%), or corn whole seeds (AMEn 14.4 MJ/kg, CP 7.3%) and protein-rich pellets (AMEn 9.9 MJ/kg, CP 22.7%) in 2 separated feeders [choice feeding with corn (CFC) group]; or triticale whole seeds (AMEn 13.0 MJ/kg, CP 10.5%) and protein-rich pellets (AMEn 11.2 MJ/kg, CP 19.5%) in 2 separated feeders [choice feeding with triticale (CFT) group]. From 85 to 96 d, 96 birds/group were overfed with corn. Feed intake (complete pellets or cereal and protein-rich pellets) per pen was measured at 60, 62, 65, 69, 78, and 84 d of age. Body weight and body traits were measured at 56 to 84 d of age. Over the entire period, from 56 to 84 d, the feed intake of the CFC group was 7% lower than the control group, and 5% lower than that in the CFT group (P = 0.002). Whatever the diet tested, at 56 and 84 d of age, the BW (4,099 and 4,779 g, P = 0.42 and P = 0.35, respectively) and the carcass traits (P > 0.05) of ducks were similar in the 3 groups. During and after overfeeding, the performances of the ducks were also similar (P > 0.05). The present results suggest that CFC during the finishing period is a solution to reduce the cost of diet destined to ducks. Indeed, using locally grown grains could reduce the economic and environmental impacts of duck feeding, reducing the transportation and crushing processes.

Effect of topical corticosteroids on allergic airway inflammation and disease severity in obstructive sleep apnoea

BACKGROUND

The incidence of sleep-related breathing disorders is correlated with lower and upper airway inflammatory diseases, such as asthma and allergic rhinitis. We hypothesized that corticosteroids treatment would lead to a greater reduction in disease severity in obstructive sleep apnoea syndrome (OSAS) patients with concomitant allergic rhinitis vs. non-allergic OSAS patients by reducing the level of inflammation in upper airway tissues.

OBJECTIVE

This study was performed to determine whether treatment with intranasal corticosteroids could reduce upper airway inflammation and improve sleep parameters in obstructive sleep apnoea syndrome patients with or without concomitant allergic rhinitis.

METHODS

Obstructive sleep apnoea syndrome patients with (n = 34) or without (n = 21) documented allergic rhinitis voluntarily enrolled in the study and were assessed at baseline and after corticosteroids treatment for 10-12 weeks. Sleep studies were performed and biopsies were obtained from the inferior turbinate, nasopharynx, and uvula. The apnoea-hypopnoea index, sleep quality, and level of daytime alertness were determined, and immunocytochemistry was used to phenotype tissue inflammation.

RESULTS

Standard sleep indices improved following treatment in the entire cohort of obstructive sleep apnoea syndrome patients, with greater improvement seen in the allergic rhinitis group. Allergic rhinitis patients demonstrated significantly improved O2 saturation and a lower supine apnoea-hypopnoea index score after corticosteroid treatment; similar improvements were not seen in the non-allergic rhinitis group. Eosinophilia was detected at all three sites in the allergic rhinitis group, but not in the non-allergic rhinitis group. Following treatment, fewer eosinophils and CD4 lymphocytes were documented at all three biopsy sites in the allergic group; the reduction in inflammation was less apparent in the non-allergic rhinitis group.

CONCLUSION

This study has provided important molecular and clinical evidence regarding the ability of corticosteroids to reduce upper airway inflammation and improve obstructive sleep apnoea syndrome morbidity patients with concomitant allergic rhinitis.

Effects of substituting yellow corn for sorghum in geese diets on magret and foie gras quality

The aim of this trial was to study the effects of substitution of yellow corn with sorghum during the growing-finishing (G period), overfeeding (O period), or both periods on magret and foie gras quality in geese. In total, 260 ganders were divided into 4 groups (65 birds in each) differing in the cereal (yellow corn or sorghum) included in the diet given during the G and the O periods, using a 2 × 2 factorial arrangement of treatments. The groups differed in the nature of the cereal in the diet offered to birds between 44 and 104 d of age (G period: a diet containing 500 g of sorghum/kg (SS and SC groups) or a diet containing 500 g of yellow corn/kg (CS and CC groups). The groups differed also in the diet offered to birds between 105 and 120 d of age (O period): 967 g of yellow corn/kg (SC and CC groups) or 965 g of sorghum/kg (SS and CS groups). At the end of the O period, the birds were slaughtered after 10 h of fasting to measure foie gras and breast muscle weight, color, and chemical composition. The mortality in the SC group was higher (P < 0.05) than in the other 3 groups (14.29 vs. 3.58%, average of the 3 groups). After overfeeding, birds fed with sorghum had foie gras that were heavier 984 vs. 885 g, in CS+SS vs. CC+SC groups, respectively; P < 0.001) and less yellow (18.03 vs. 23.97 for b*, in CS+SS vs. CC+SC groups, respectively, P < 0.001) than birds fed with corn. The substitution of yellow corn with sorghum during the G and O periods (SS group) increased the weight of the foie gras, but altered its color to a paler yellow. In contrast, a substitution during the G period only (SC group) resulted in increased mortality during the O period.

Endoscopic endonasal resection of the odontoid process as a standalone decompressive procedure for basilar invagination in Chiari type I malformation

BACKGROUND

The expanded endonasal approach of the cranio-cervical junction provides comfortable working space while avoiding some of the disadvantages of the transoral route. We report a purely endonasal endoscopic resection of the odontoid process for basilar invagination in a patient with a Chiari type I malformation, without posterior decompression or fusion.

CASE REPORT

A 54-year-old female patient presented with cranial nerve and brainstem deficits. CT and MRI showed a Chiari type I malformation and compression of the medulla by basilar invagination of the odontoid process. The tip of the latter was displaced up to the bulbo-pontine sulcus. The odontoid process was resected via the expanded endoscopic endonasal approach, without additional posterior decompression or fusion. The post-operative course was uneventful, including the absence of velopharyngeal insufficiency. Neurological deficits regressed rapidly. The preoperative cervical pain virtually disappeared. At 9 months follow-up, the patient had normal activity with minimal residual neurological deficits. Post-op dynamic radiography and CT showed stability of the cranio-cervical junction.

CONCLUSION

Decompression of the bulbomedullary junction by purely endoscopic transnasal resection of the odontoid process is well tolerated and efficient. Immediate stabilization is not mandatory in all cases of congenital causes of basilar invagination.

Thermal and structural behavior of anhydrous milk fat. 2. Crystalline forms obtained by slow cooling

The crystallization behavior of milk fat has been examined on slow cooling at 0.1 degrees C/min from 50 to -15 degrees C, to determine the variations of triacylglycerol organizations as a function of temperature. The experiments have been conducted with an instrument allowing coupled X-ray diffraction (XRD) at both small and wide angles and high-sensitivity differential scanning calorimetry (DSC) recordings from the same sample by taking advantage of the high-energy flux of a synchrotron. On slow cooling, milk fat triacylglycerols sequentially crystallize in four different lamellar structures with double-chain length of 41.5, 48.3, and 39.2 A and a triple-chain length of 62.2 A stackings. Simultaneous wide-angle XRD has shown that initial nucleation occurs in a packing of beta' type at about 24 degrees C. For temperature < 13 degrees C, triacylglycerols crystallize in an hexagonal subcell of alpha type, leading to the coexistence of the beta' + alpha polymorphic forms, which is recorded until -15 degrees C. Thermal analysis allowed to correlate the formation of the different crystalline species monitored by XRDT (XRD as a function of temperature) to the exothermal events recorded simultaneously by differential scanning calorimetry. The evolution of the species formed during crystallization was also monitored on heating at 2 degrees C/min. The absence of polymorphic evolution on heating, as well as the high final melting point observed, about 40 to 41 degrees C, confirmed that cooling at 0.1 degrees C/min leads to quasi equilibrium.

Thermal and Structural Behavior of Milk Fat. 1. Unstable Species of Anhydrous Milk Fat

The thermal and structural behavior of anhydrous milk fat (AMF) was studied by a technique that allowed simultaneous time-resolved synchrotron X-ray diffraction as a function of temperature (XRDT) and high sensitivity differential scanning calorimetry (DSC) to be carried out in the same apparatus from the same sample. In this paper (the first of a series), the less stable crystalline structures made by triacylglycerols (TG) of bulk AMF after its liquid quenching down to -8 degrees C are addressed The coexistence of two lamellar structures characterized by sharp long spacing reflections corresponding to well-defined 3L (70 A) and 2L (47 A) longitudinal stackings but broad short spacing lines related to poorly ordered hexagonal (alpha) lateral packing is shown for the first time, The bilayered structure was very unstable, since it disappeared during a 20-min isothermal recording. Simultaneous DSC and X-ray monitoring of AMF heating in the range -8, +50 degrees C at a rate of 2 degrees C/min allows the same sample to be followed on the evolution of these unstable forms to more stable varieties. The 3L stacking transforms into a new 2L crystalline structure characterized by broad LS reflections corresponding to a ill-defined 2L (37 A) longitudinal stacking but a more compact orthorhombic (beta') lateral packing. A delimitation of the domains of existence of the crystalline structures resulted from the comparison of detailed analysis of the evolutions of positions, intensities, and widths of X-ray peaks as a function of temperature to microcalorimetry recording.

Local synthesis of epsilon germline gene transcripts, IL-4, and IL-13 in allergic nasal mucosa after ex vivo allergen exposure

BACKGROUND

The production of epsilon germline gene transcripts (Iepsilon(+)/Cepsilon(+) RNA) precedes class switch recombination to IgE and is induced by IL-4 and/or IL-13. Although Iepsilon and Cepsilon RNA(+) B cells have been identified within nasal tissue after in vivo allergen exposure, suggesting local germline transcription, whether these were resident or infiltrating B lymphocytes was not clear.

OBJECTIVE

We sought to examine whether B cells resident to the nasal mucosa undergo epsilon germline transcription.

METHODS

Nasal mucosal biopsy specimens were obtained from asymptomatic patients with seasonal allergic rhinitis and exposed to allergen ex vivo. Using immunocytochemistry, B lymphocytes were enumerated; with in situ hybridization, the number of cells expressing Iepsilon, Cepsilon, IL-4, and IL-13 messenger (m)RNA(+) cells was examined.

RESULTS

Tissue cultured in medium containing specific allergen exhibited significantly more Iepsilon and Cepsilon RNA(+) cells compared with medium alone (P <.05). IL-4 and IL-13 mRNA synthesis also resulted from ex vivo allergen exposure; there were significantly more cells expressing transcripts for these cytokines within allergic nasal mucosal tissue cultured with allergen than medium alone (P <.05). Within allergen-stimulated tissue obtained from allergic patients, 30% of total B cells were Iepsilon RNA(+), and the majority of IL-4 and IL-13 mRNA(+) cells were T cells (68% and 44%, respectively) and mast cells (32% and 19%, respectively).

CONCLUSION

These results demonstrate that the nasal mucosa is a site of epsilon germline gene transcription and suggest that local T cell and mast cell production of IL-4 and IL-13 may regulate this event.

Upregulation of the transcription factor GATA-3 in upper airway mucosa after in vivo and in vitro allergen challenge

BACKGROUND

Allergic rhinitis is a complex upper airways disorder characterized by the infiltration of eosinophils and T(H2)-type T lymphocytes. GATA-3 is a novel transcription factor recently shown to regulate IL-5 and, possibly, IL-4 gene expression. We previously reported that GATA-3 is increased within the bronchial mucosa of allergic asthmatic subjects compared with control subjects.

OBJECTIVE

In the present study we set out to determine whether there is also an increased number of cells expressing GATA-3 messenger (m)RNA within the nasal mucosa of patients with allergic rhinitis.

METHODS

Inferior turbinate biopsy specimens were obtained from patients with allergic rhinitis and nonatopic control subjects before and after local allergen provocation in vivo. To assess the contribution of resident cells expressing GATA-3 mRNA, we also performed isolated explant studies in which nasal mucosal tissue from subjects with allergic rhinitis and nonatopic control subjects was cultured in allergen-treated medium. The presence of mRNA coding for GATA-3, IL-5, IL-4, IL-13, and GM-CSF was assessed by using in situ hybridization.

RESULTS

The number of GATA-3 mRNA(+) cells was increased after local allergen provocation in vivo (increase in GATA-3 mRNA(+) cells [mean +/- SEM]: subjects with allergic rhinitis, 11.3 +/- 8.7; control subjects, 1.2 +/- 4.1; P <.05) and in explanted nasal mucosa in vitro (subjects with allergic rhinitis, 10. 2 +/- 3.8; control subjects, 2.7 +/- 4.4; P <.05). The gene expression of GATA-3 was significantly correlated to the numbers of IL-5 (r = 0.87) and GM-CSF (r = 0.79) mRNA(+) cells but not with IL-4 or IL-13 mRNA(+) cells.

CONCLUSION

In summary, the expression of the transcription factor GATA-3 was increased after allergen challenge, and this was evident in the absence of de novo inflammatory cell recruitment. GATA-3 may be a potential target in the treatment of allergic diseases, such as rhinitis.

The influence of semantic context on initial eye landing sites in words

To determine the role of ongoing processing on eye guidance in reading, two studies examined the effects of semantic context on the eyes' initial landing position in words of different levels of processing difficulty. Results from both studies clearly indicate a shift of the initial fixation location towards the end of the words for words that can be predicted from a prior semantic context. However, shifts occur only in high-frequency words and with prior fixations close to the beginning of the target word. These results suggest that ongoing perceptual and linguistic processes can affect the decision of where to send the eyes next in reading. They are explained in terms of the easiness of processing associated with the target words when located in parafoveal vision. It is concluded that two critical factors might help observing effects of linguistic variables on initial landing sites, namely, the frequency of the target word and the position where the eyes are launched from as regards to the beginning of the target word. Results also provide evidence for an early locus of semantic context effects in reading.

Prognosis and prediction of response to surgery in allergic patients with chronic sinusitis

BACKGROUND

Chronic rhinosinusitis (CRS) occurs frequently in patients with atopy, but little is known of the prognosis after surgery and of factors that may predict a poor outcome.

OBJECTIVE

Our purpose was to assess the long-term prognosis in atopic patients with CRS who undergo surgery and whether certain immune markers could predict a worse prognosis in this setting.

METHODS

Fifteen patients with diffuse involvement of the sinuses on computed tomographic (CT) scan but without nasal polyposis underwent ethmoidectomy with middle meatotomy for CRS when it was clinically indicated. All patients had a biopsy of the inferior turbinate and of the most inflamed areas of the maxillary and ethmoid sinuses at the time of surgery. Follow-up was performed by video endoscopy and by assessment of 2 chronic sinusitis questionnaires at 0, 6, and 24 months postoperatively. The number of lymphocyte subsets (CD3, CD4, CD8), mast cells and eosinophils, and cells expressing IL-4 and IL-5 messenger RNA (mRNA) in all 3 biopsy sites at the time of surgery were compared with the clinical response after surgery.

RESULTS

Seven patients had persistent improvement after surgery, with a decrease in pain, rhinorrhea, or nasal obstruction and a decrease in the need for medication. Eight patients were unchanged or worsened after surgery with disabling rhinorrhea and repeated sinusitis. We found no difference in the number of inflammatory cells, lymphocyte subsets, or IL-4 mRNA-positive cells in the sinus mucosa between responders and nonresponders. However, an increased number of cells expressing IL-5 mRNA was found in the ethmoid sinus at the time of surgery in patients who did not respond to the surgical intervention (P =.007).

CONCLUSION

More than 50% of patients with perennial rhinitis and CRS do not improve after surgery, a response that may be predicted by more cells expressing IL-5 mRNA in the ethmoid sinuses. The increased number of cells expressing IL-5 mRNA may have the potential to be used as a marker for prediction of the response to surgery. The worsening of symptoms in some patients with CRS after sinus surgery could be a result of the disturbance of the anatomy of the sinuses and exposure to the environmental allergens.

Evidence for local eosinophil differentiation within allergic nasal mucosa: inhibition with soluble IL-5 receptor

Eosinophil differentiation occurs within the bone marrow in response to eosinopoietic cytokines, particularly IL-5. Recently, however, eosinophil precursors (CD34/IL-5Ralpha+ cells) and IL-5 mRNA+ cells have been identified within the lungs of asthmatics, indicating that a population of eosinophils may differentiate in situ. In this report, we examined the presence of eosinophil precursors within allergic nasal mucosa and examined whether they undergo local differentiation following ex vivo stimulation. We cultured human nasal mucosa obtained from individuals with seasonal allergic rhinitis with either specific allergen, recombinant human IL-5 (rhIL-5), or allergen + soluble IL-5Ralpha (sIL-5Ralpha), shown to antagonize IL-5 function. Simultaneous immunocytochemistry and in situ hybridization demonstrated that there were fewer cells coexpressing CD34 immunoreactivity and IL-5Ralpha mRNA following culture with allergen or rhIL-5, compared with medium alone. Immunostaining revealed that the number of major basic protein (MBP) immunoreactive cells (eosinophils) was higher within tissue stimulated with allergen or rhIL-5, compared with unstimulated tissue. In situ hybridization detected an increase in IL-5 mRNA+ cells in sections from tissue cultured with allergen, compared with medium alone. These effects were not observed in tissue cultured with a combination of allergen and sIL-5Ralpha. Colocalization analysis indicated this expression to be mainly, but not exclusively, T cell (44%) and eosinophil (10%) derived. Our findings suggest that a subset of eosinophils may differentiate locally within allergic nasal mucosa, in what appears to be a highly IL-5-dependent fashion, and imply that this process might be regulated in vivo by endogenous production of sIL-5Ralpha.

Comparison of inflammatory cell profile and Th2 cytokine expression in the ethmoid sinuses, maxillary sinuses, and turbinates of atopic subjects with chronic sinusitis

Chronic sinusitis is a common disease characterized by persistent inflammation of the sinus mucosa. This study was undertaken to investigate immunopathologic findings in biopsy specimens from the ethmoid sinuses, maxillary sinuses, and inferior nasal turbinates of 14 allergic subjects with chronic sinusitis. The composition of the inflammatory infiltrate in the three tissue sites was examined by immunocytochemistry with anti-CD3 (total T cells), anti-CD4 (helper T cells), anti-CD8 (suppressor T cells), anti-MBP (eosinophils), antitryptase (mast cells), and antichymase (mast cells) antibodies. These revealed a significant increase in the T-cell helper/suppressor ratio and eosinophils in the ethmoid sinus mucosa compared with those in the maxillary sinus mucosa and the inferior turbinate. Eosinophil numbers were also higher in the maxillary sinus than in the inferior turbinate. Mast cells were present in significantly higher numbers in the ethmoid sinus and inferior turbinate biopsy sections than in the maxillary sinus. With antisense, radiolabeled riboprobes, we used in situ hybridization to examine the expression of interleukin-4 and interleukin-5 transcripts. The density of cells expressing interleukin-4 transcripts was significantly higher in the inferior turbinate biopsy sections than in those from the ethmoid and maxillary sinuses. In addition, the number of interleukin-4 mRNA-positive cells was higher in the ethmoid than in the maxillary sinus mucosa. The density of interleukin-5 mRNA-positive cells was significantly higher in the ethmoid and maxillary sinuses than in the inferior turbinate. The results of this study indicate (1) a more intense inflammatory response in the ethmoid sinus than in the maxillary sinus and inferior turbinate in allergic chronic sinusitis and (2) different inflammatory responses in the upper airways that are dependent on the anatomic site. These findings have potential implications in the design of new therapeutic interventions for allergic chronic sinusitis.

Interleukin-6 expression in chronic sinusitis: colocalization of gene transcripts to eosinophils, macrophages, T lymphocytes, and mast cells

Chronic sinusitis in allergic (ACS) and nonallergic (NCS) patients is characterized by persistent inflammation and subepithelial fibrosis of the sinus mucosa. The inflammatory infiltrate is rich in T lymphocytes, monocyte/macrophages, plasma cells, and eosinophils. Th2-type cytokines are thought to regulate inflammatory cell recruitment, activation, survival, and the release of tissue-damaging mediators. Interleukin-6 is a proinflammatory Th2-type cytokine that stimulates fibroblast proliferation and collagen synthesis. Expression of interleukin-6 has been reported in pulmonary fibrosis and a number of other conditions associated with fibrotic tissue changes. In vitro studies have indicated that interleukin-6 is produced by macrophages, T cells, eosinophils, mast cells, and other cell types. Here we examined interleukin-6 messenger RNA and immunoreactivity in the sinus epithelium and subepithelium of subjects with ACS and NCS by in situ hybridization and immunocytochemistry, performed on sinus biopsy and polyp sections obtained from patients. Nasal turbinate biopsy specimens from normal volunteers were used as controls. Interleukin-6 messenger RNA and immunoreactivity were expressed by a significantly greater proportion of epithelial and subepithelial cells in ACS and NCS subjects than in normal controls. There was no difference in epithelial or subepithelial interleukin-6 expression between ACS and NCS patients. Colocalization studies revealed that macrophages, T cells, eosinophils, and mast cells are sources of interleukin-6 messenger RNA in ACS and NCS. The numbers of interleukin-6 messenger RNA-positive cells coexpressing immunoreactivity for the mast-cell marker were significantly greater in ACS than in NCS subjects. The results of this study suggest a role for interleukin-6 in the inflammatory response of chronic sinusitis.

Eotaxin mRNA and protein expression in chronic sinusitis and allergen-induced nasal responses in seasonal allergic rhinitis

Eotaxin is an eosinophil-specific chemokine associated with the recruitment of eosinophils to the site of allergic inflammation. The aims of this study were to determine the expression of eotaxin in nasal biopsies from allergic and nonallergic individuals with chronic severe sinusitis, and to examine whether the expression of this chemokine is upregulated following allergen challenge in the nasal mucosa of patients with allergic rhinitis. We also undertook to phenotype of inflammatory cells within the submucosa expressing eotaxin mRNA. Nasal turbinate tissue from 16 individuals with allergic or nonallergic chronic sinusitis and 10 normal controls were examined for the presence of eotaxin mRNA and immunoreactivity by in situ hybridization and immunocytochemistry. The numbers of cells expressing eotaxin mRNA were also determined after either allergen or diluent challenge in atopic subjects with a history of allergic rhinitis. There was a constitutive expression of eotaxin-immunoreactivity and the presence of eotaxin mRNA-positive cells in nasal biopsies from normal individuals. Compared with normal controls, the numbers of cells expressing eotaxin mRNA and protein were significantly increased in both allergic and nonallergic sinusitis (P < 0.001). Eotaxin mRNA was expressed by nasal epithelial cells and primarily colocalized to CD68-positive macrophages within the subepithelium. In subjects with allergic rhinitis, allergen challenge markedly increased the numbers of cells expressing eotaxin mRNA and immunoreactivity in the epithelial and subepithelial cell layers (P < 0.05). This could be largely attributed to a local increase in eotaxin production within the nasal tissues. The results of this study demonstrate the constitutive expression of eotaxin and show that the numbers of cells expressing eotaxin mRNA are increased within the epithelial and subepithelial layers of the nasal mucosa in individuals with chronic sinusitis. Furthermore, allergen challenge of the nasal mucosa in atopic subjects results in a local upregulation of eotaxin expression. These data suggest a potential role for this chemokine in the pathogenesis of allergic and nonallergic eosinophilic inflammation characterizing chronic sinusitis and allergic rhinitis.

Human monocyte chemoattractant protein (MCP)-4 is a novel CC chemokine with activities on monocytes, eosinophils, and basophils induced in allergic and nonallergic inflammation that signals through the CC chemokine receptors (CCR)-2 and -3

The chemokines are a large family of cytokines that regulate the complex and precise recruitment of immune cells into inflammatory foci. To fully appreciate their role in the pathogenesis of human diseases, the entire spectrum of chemokines, their receptors, their cellular targets, and mechanisms of regulation need to be delineated. Using eotaxin as a probe, we isolated a cDNA for a novel human beta (or CC) chemokine that, based on its biological and structural features, we have named monocyte chemoattractant protein (MCP)-4. Purified recombinant MCP-4 protein was a potent chemoattractant for monocytes and eosinophils and stimulated histamine release from basophils. MCP-4 induced a calcium flux in HEK-293 cells transfected with the monocyte selective MCP-1 receptor (CCR-2B) and the eosinophil selective eotaxin receptor (CCR-3), but not in the more widely expressed CCR-1 or CCR-5. This novel chemokine is expressed in TNF-alpha and IL-1 activated epithelial and endothelial cells in vitro, and in the epithelial mucosa of patients with both Th2-type allergic and Th1-type nonallergic sinusitis. Furthermore, both IFN-gamma and IL-4, products of Th1 and Th2 cells, respectively, synergized with TNF-alpha and IL-1 in inducing MCP-4 mRNA accumulation. These properties of MCP-4 offer a molecular explanation for the observed accumulation of monocytes, eosinophils and basophils in both Th1- and Th2-type immune responses.

Human monocyte chemoattractant protein (MCP)-4 is a novel CC chemokine with activities on monocytes, eosinophils, and basophils induced in allergic and nonallergic inflammation that signals through the CC chemokine receptors (CCR)-2 and -3

The chemokines are a large family of cytokines that regulate the complex and precise recruitment of immune cells into inflammatory foci. To fully appreciate their role in the pathogenesis of human diseases, the entire spectrum of chemokines, their receptors, their cellular targets, and mechanisms of regulation need to be delineated. Using eotaxin as a probe, we isolated a cDNA for a novel human beta (or CC) chemokine that, based on its biological and structural features, we have named monocyte chemoattractant protein (MCP)-4. Purified recombinant MCP-4 protein was a potent chemoattractant for monocytes and eosinophils and stimulated histamine release from basophils. MCP-4 induced a calcium flux in HEK-293 cells transfected with the monocyte selective MCP-1 receptor (CCR-2B) and the eosinophil selective eotaxin receptor (CCR-3), but not in the more widely expressed CCR-1 or CCR-5. This novel chemokine is expressed in TNF-alpha and IL-1 activated epithelial and endothelial cells in vitro, and in the epithelial mucosa of patients with both Th2-type allergic and Th1-type nonallergic sinusitis. Furthermore, both IFN-gamma and IL-4, products of Th1 and Th2 cells, respectively, synergized with TNF-alpha and IL-1 in inducing MCP-4 mRNA accumulation. These properties of MCP-4 offer a molecular explanation for the observed accumulation of monocytes, eosinophils and basophils in both Th1- and Th2-type immune responses.

Pulsatile tinnitus and dural arteriovenous fistula of the transverse sinus

A case of dural arteriovenous fistula of the transverse and sigmoid sinus presenting with a pulsatile tinnitus is described. On the basis of this demonstrative case, we review the clinical presentation, pathogenesis, diagnostic imaging and principles of treatment of this disease. Emphasis is put on the importance of careful diagnostic evaluation because of potential cerebrovascular complications associated with dural fistulas.

Effect of clentiazem on lipid profile, lipoprotein composition and aortic fatty streaks in cholesterol-fed rabbits

Numerous experimental studies have reported that common antihypertensive drugs such as diuretics, beta-blockers, and methyldopa have adverse effects on plasma lipids and lipoproteins. The present study was designed to define the effect of clentiazem (10 mg/kg/day) an antihypertensive drug, on hyperlipidemia in rabbits on a cholesterol-rich diet (1%) for 12 weeks. Compared with controls, clentiazem treated rabbits had lower plasma concentrations of triglycerides (55%), total cholesterol (24%), free cholesterol (27%), esterified cholesterol (23%) and phospholipids (24%). The decrease in cholesterol was accounted for by a reduction of VLDL-cholesterol (13%), IDL-cholesterol (24%) and primarily LDL-cholesterol (45%). Neither HDL-cholesterol nor chemical composition of VLDL, IDL, LDL and HDL was altered. When the aortic atherosclerotic involvement was evaluated by computerized planimetry, a 24% reduction of lesions was noted in clentiazem treated animals (P less than 0.05). Similarly, cholesterol content extracted from aortic wall was decreased. Our data therefore demonstrated that clentiazem is a potential antiatherosclerotic agent capable of decreasing plasma lipids and atherogenic lipoproteins as well as aortic fatty streaks.

Extracranial and intracranial meningiomas

Meningiomas constitute about 18% of primary intracranial tumors, and they are rarely observed in patients under 30 years of age. In this study, we present the case of a 17-year-old patient who was first seen for a right cervical mass. Further investigation revealed that a meningioma of the posterior cranial fossa had invaded the temporal bone, the infratemporal fossa and the right parapharyngeal region and was at the origin of that cervical mass. This intra- and extracranial meningioma was completely resected in two stages with very satisfactory results. We have reviewed the literature pertaining to the extracranial extensions of meningiomas originating in the posterior fossa.

[Human basophil degranulation test in the diagnosis and prevention of peranesthetic anaphylactoid complications]

The human basophil degranulation test (HBDT) studies the allergic response of effector cells. In this work, it was used in the diagnosis of anaphylactoid reactions during anaesthesia. Thirteen patients having had an anaphylactoid shock during general anaesthesia were investigated. An HBDT was performed with every suspected drug used during the anaesthesia. Ten patients had a positive HBDT and in five cases the drug involved was suxamethonium. In one case, the IgE-dependency of the accident was asserted by the ability of the plasma to sensitize in vitro alien basophils. These sensitized basophils degranulated in the presence of Althesin and suxamethonium. Passive sensitization was abolished when using plasma heated for 2 h at 56 degrees C. Two patients had a negative HBDT to 11 drugs tested. To assess the validity of these results, and to rule out unspecific degranulation, thirteen control patients who were to undergo general anaesthesia were investigated. HBDT was performed immediately before anaesthesia in a double-blind method with every drug to be used during the anaesthesia. The twelve patients who had a negative HBDT to every drug had an uneventful anaesthesia. One patient had a positive test to thiopentone and displayed bronchospasm and generalized urticaria during the anaesthesia. In conclusion, the HBDT appears to be a reliable test in the diagnosis of anaphylactoid reactions during anaesthesia.

Pulsatile tinnitus and fibromuscular dysplasia of the internal carotid

Carotid fibromuscular dysplasia (FMD-C), a stenosing angiopathy, is frequently associated with pulsatile tinnitus. This study reports two patients, initially presenting with pulsatile tinnitus, who proved to have FMD-C. Symptoms such as tinnitus, vertigo, hemicrania, and cervicofacial hypo-esthesia might bring such a patient under an otolaryngologist's management. The paper discusses the physiopathology of the symptoms encountered with FMD-C. It is suggested that the sympathetic plexus is implicated in the manifestations of the disorder. A surgical therapeutic approach is suggested to achieve satisfactory symptomatic control.

[Peridural analgesia with 0.375 percent bupivacaine in labor with dystocia]

For dystoctic deliveries peridural analgesia with bupivacaine 0.25% was compared with bupivacaine 0.375%, without adrenalin. Shortening of the delivery time in cases of stagnation of dilatation, was obtained with bupivacaine 0.375%: 181 mn in the average instead of 276 mn with bupivacaine 0.25% (p = 0.05). In the case of a cervical spasm, there was release of the contraction with return of a normal dilatation leading to a shorter labour: 188 mn in the average against 340 mn (p = 0.02) with the 0.25% solution. Apgar scores were similar in both series.

[Primary-purpose peridural analgesia in labor induction]

21 parturients, showing in most of cases either high blood pressure badly controlled or a "real" out of date term, have undergone a peridural analgesia of first intention in labour induction. All these patients were considered to be uninducable according to Bishop score. After an injection of adrenalinized bupivacaïne, either 0.25% or 0.375% rupture depending on state of cervix of membranes occurred in most cases 6 hours after peridural analgesia. The mean between onset of analgesia and delivery was 17 h and the mean time between induction with ocytocin to birth 5 h 37 min. 16 parturients gave birth per vaginam, 9 of which spontaneously 5 have undergone caesarian section because of a non lack of dilatation or foetal distress. Children at birth, at the 2nd and the 24th hour were all healthy.

[Laryngeal histoplasmosis due to "Histoplasma duboisii" (author's transl)]

Primitive detection of the Histoplasma duboisii accompanied with proteiform manifestations, is rare in the superior air ways. Its localisation at the larynx level is an exception and makes the very interest of our following reported observation. In front of this hard diagnostic, only the pathogenic agent visualisation gives evidence. Among serological techniques, immuno-fluorescence and E.L.I.S.A. are very helpful. Therapeutic possibilities have been improved by Miconazole which both associates efficiency and inocuity.