La Société de Biologie de Strasbourg : 100 ans au service de la science et de la société

Founded in 1919, the Society of Biology of Strasbourg (SBS) is a learned society whose purpose is the dissemination and promotion of scientific knowledge in biology. Subsidiary of the Society of Biology, the SBS celebrated its Centenary on Wednesday, the 16th of October 2019 on the Strasbourg University campus and at the Strasbourg City Hall. This day allowed retracing the various milestones of the SBS, through its main strengths, its difficulties and its permanent goal to meet scientific and societal challenges. The common thread of this day was the transmission of knowledge related to the past, the present, but also the future. At the start of the 21st century, the SBS must continue to reinvent itself to pursue its objective of transmitting scientific knowledge in biology and beyond. Scientific talks performed by senior scientists and former SBS thesis prizes awardees, a round table, and informal discussions reflected the history and the dynamism of the SBS association. All SBS Centennial participants have set the first milestone for the SBS Bicentennial.

[History of the Strasbourg Society of Biology]

The Society of Biology of Strasbourg (SBS) is a learned society that was created in 1919 based on the model of the Society of Biology of which it is a subsidiary. Like its Parisian colleague, SBS aims at diffusing and promoting scientific knowledge in biology. To achieve this goal, SBS initiated since its creation a dialogue interface between researchers in biology and physicians, and more recently with other scientific disciplines, industry and the civil society. At the dawn of its first century, the Society of Biology of Strasbourg must continue to reinvent itself to pursue its development and to fulfil its mission of sharing scientific knowledge. This work continues in strong collaboration with our partners that share with SBS the willingness to foster excellence in biological research in Strasbourg, its region and beyond.

[Birth of the "Social Security" in Alsace-Lorraine]

For a long time healthy and socially disabled people have been helped by caritative institutions, primarily religious ones, with only occasional involvement of the state. The problem was raised by the economic revolution in the XIXth century, with particular emphasis on the highly industrialized countries, such as Alsace and Lorraine. The development of public healthcare, as well as the help to socially disabled people in these two areas (particularly in the spinning factories of Mulhouse, the iron works and the coal-mines of Moselle) have undoubtedly come before and lead to the social laws that were promulgated between 1883 and 1889 by Bismark and then in France after 1919.

[Pulmonary toxicity of oxygen]

Recent progress in artificial ventilation procedures sheds doubt on the toxicity of oxygen in the lung. Histological studies of the lung by light and electron microscopy were made in rats exposed to 100% oxygen at 1 ATA in spontaneous ventilation. The results are compared with the lesions observed in 19 human patients suffering from acute respiratory distress syndrome and with the data on retinopathy of prematurity. This study suggests to keep in mind that oxygen may, as well as infections or baro-traumatic factors, be involved in causing or aggravating lung fibrosis. The complexity of the mechanisms of this action is emphasized. The production of highly reactive free radicals is one of the essential factors of this aggression. These elements illustrate the value of further studies on ways of preventing these changes, especially using appropriate antioxidant molecules.

[Joseph-Alexis Stoltz (1803-1896), dean of the two Faculties]

Life and works of Joseph-Alexis Stoltz, gynecologist and obstetrician Professor at the Strasbourg Ecole de Medecine, then dean in the same town Faculte de Medecine (1867-1872) and after in Nancy (1872-1879). With Adolphe Wurtz, dean of Paris Faculte de Medecine, Edmond Simonin, director of Nancy Ecole de Medecine, and Jules Simon, Minister of the Instruction Publique he brought to a successful conclusion, in 1872, the transfer of the Faculte de Medecine from Strasbourg to Nancy

[Perinatal maternal emergencies]

The perinatal period (from the 28th week of pregnancy to the 28th day after delivery) is a short but special period which endangers the mother's and child's life. There has been no elective statistical assessment of this period but surveys conducted in western countries show that most of the maternal emergencies requiring admission to an intensive care unit are actually those of the perinatal period; some are specific of pregnancy: gravidic toxemia, delivery hemorrhage, acute fatty liver of pregnancy; others such as septic or embolic shock, cardiomyopathy, are found also in non-pregnant women but are favored by pregnancy. Among the numerous eventualities it was necessary to take a selection: ours results from three sorts of considerations: i) the severity of some of these perinatal emergencies: preeclampsia, eclampsia, Hellp syndrome, subcapsula hepatic rupture, septic or hemorrhagic shock are among the most serious ones; ii) the high frequency of some of them: post partum hemorrhage is, in France, the first cause of maternal mortality and the second cause of maternal morbidity whereas infection which can bring a septic shock is found to complicate one to eight per cent of the deliveries; iii) several emergency conditions raise pathophysiological problems which are still not entirely solved, for instance, gravidic toxemia, acute fatty liver of pregnancy, amniotic embolism. They will be especially studied here. Maternal perinatal emergencies remain a major public health problem. It is a necessity to realize the importance of the stakes, to encourage a team spirit, to combine the abilities of obstetricians, intensive care physicians, anaesthesists, echographists, biologists, so that this race against time can be won.

Muscle regeneration after exercise-induced myoglobinuria: an electron microscopic study

Muscle regeneration was studied by light and electron microscopy in a case of exercise-induced acute myoglobinuria in a young patient with carnitine-palmityl-transferase deficiency. Various stages of regeneration existed in the foci of necrosis scattered throughout apparently normal muscle. Activated satellite cells, myoblasts and myotubes were found, some of them containing myofibrils. Among the cells accumulating in the necrotic fibres, some apparently contained surviving myonuclei. In some fibres of normal size, developing myofibrils were abundant. Surviving myonuclei may be of significance in the reaction of muscle cells after injury.

[Duodenal perforations by the hooks of a Kimray-Greenfield filter]

A case is reported of a duodenal perforation by a Kimray-Greenfield filter hook in a 66-year-old female patient. This device had been inserted four years before, after a pulmonary embolism. The patient presented with epigastric pain, vomiting and extracellular dehydration with renal failure. A plain abdominal film showed the filter to be tilted 15 degrees to the left, with an opening 28 mm wide. Various investigations were carried out, none of which providing a satisfactory diagnosis. Steroid treatment (1 mg.kg-1 x day-1 of prednisone) was started before admission to intensive care. Only at that time gastroduodenoscopy showed on of the filter's hooks jutting through the duodenal wall. This perforation was located in the posterior wall of the third part of the duodenum, and was associated with an ulcer of the mucosa facing this hook. The diagnosis was confirmed by an abdominal CT scan. The hook was cut and the perforation sealed off during a first laparotomy. Twenty-six days later, the patient developed intestinal obstruction due to a haematoma of the jejunal wall. She later had a cerebrovascular accident, with status epilepticus and deep coma. She died four months after her admission. The late complications of vena caval filters are discussed. The position of these devices should be regularly checked by a plain abdominal film. Abdominal CT scanning is a useful investigation for the diagnosis of intra and extravascular complications.

Vascular and myofibrillar lesions in acute myoglobinuria associated with carnitine-palmityl-transferase deficiency

A case of severe exercise-induced myoglobinuria in a 14-year-old boy suffering from a carnitine-palmityl-transferase (CPT) defect is reported. Biopsies of the forearm muscle were examined using light and electron microscopy in the acute and recovery phases of the illness. The first biopsy showed the presence of scattered foci of necrosis where necrotic fibres with occasional disruptions of the basal lamina were seen around injured capillaries. Various degrees of damage and different stages of evolution were found in these foci, which also contained regenerating muscle fibres. In the second biopsy, performed 2 weeks later, most of the fibres displayed a normal structure. Necrosis was no longer present. However, in some areas perivascular fibrosis was prominent, the fibres were small and irregularly shaped, and their nuclei often centrally located. These data strongly suggest that circulatory disorders and ischaemia, brought about by premature acute metabolic imbalance, could be involved in the development of exercise-induced myolysis observed in CPT deficiency. The risk of fibrous cardiomyopathy in these patients is pointed out.

[Two years' experience teaching medical ethics in a hospital clinic course]

Ethics problems arise from conflict of values: a physician has to take charge of his patients, but advances of sciences and technics make such conflicts more and more frequent. Their solution cannot be left to a mere improvization. Medical ethics have to be taught. In Strasbourg, we have elected to teach compulsory medical ethics in the course of compulsory hospital training, for five mornings running, to groups of ten fifth-year medical students, the place being different each day. Fifteen departments including five specialties, internal medicine, intensive care, pediatrics, gynecology-obstetrics, geriatrics, are involved in this experience. The training takes place near the patient bed in the presence of a medical teacher. Communication and multi-disciplinarity are the characteristics. The teaching is done with the purpose of bringing about reflection in the students, of proposing methods for the discovering and the approach of ethics problems, of leading the students up to the enlightenment of their own scale of evaluation. A few previous lectures about history of ethics through different philosophical systems, about social, economical and cultural implications, are given for basic formation of the students. This teaching experience interests students and teachers greatly. The first ones have the opportunity to perceive a new dimension of medical responsibility, the second ones appreciate this form of recovered fellowship.

Pulsed field gel electrophoresis as a new epidemiological tool for monitoring methicillin-resistant Staphylococcus aureus in an intensive care unit

Pulsed field gel electrophoresis (PFGE) of bacterial DNA was used in a 1-month epidemiological study of methicillin-resistant Staphylococcus aureus (MRSA) in a 15-bed Intensive Care Unit (ICU). Patient and hospital staff carriage as well as distribution of MRSA in the ICU environment were investigated, and a total of 3802 samples produced 175 isolates. The stability and the reproducibility of the PFGE method were satisfactory. Moreover, the plasmid content of the strains so far examined had no influence on the PFGE profiles of the MRSA strains. The polymorphic profiles observed also account for the use of this method as an epidemiological tool for investigating MRSA. Among 30 patients who stayed more than 4 days in the unit, PFGE analysis showed 11 episodes of colonization in nine patients, whereas lysotyping and plasmid DNA analysis demonstrated only eight and seven such episodes in the same patients, respectively. The combination of PFGE with lysotyping and plasmid analysis may provide a greater discriminatory capacity between MRSA isolates.

[Acute verapamil poisoning. 6 cases. Review of the literature]

Six cases of acute verapamil poisoning are reported. The dose ingested ranged between 1.2 and 9.6 g. In all cases other drugs had also been ingested and especially betablockers in two cases. Symptomatology included a cardiogenic shock in two cases and an atrioventricular block in four cases. A hemodynamic study in one case showed a cardiogenic shock with increased systemic vascular resistances. The treatment of cardiogenic shock included artificial ventilation, several vasopressors and inotropic agents and cardiac pacing in one case. All patients recovered without sequelae. A toxicokinetic study performed in two cases showed plasma half lives of 7.9 and 13.2 hours, total body clearances of 425 and 298 ml/min. Only 2 to 4.2 per cent of the dose ingested were eliminated in urine. These results confirm the severity of verapamil overdose and the efficacy of symptomatic treatment by inotropic agents. The high rate of spontaneous elimination by hepatic metabolism does not justify drug removal by extra-corporeal methods.

Acute mercury chloride intoxication. Effects of hemodialysis and plasma exchange on mercury kinetic

A 27 year-old man developed after ingestion of mercury chloride, 6 g, a hypovolemic shock, an acute renal failure and a necrosis of the stomach which required a total gastrectomy. The anuria did not improve and required 42 hemodialyses. Subsequent evolution showed numerous complications and the patient died on the 91st day. On admission mercury plasma concentration was 5 mg/L and decreased slowly with an apparent half-life of 226 hours. Hemodialyses were ineffective for mercury elimination: mercury clearances varied between -10 and + 1.5 ml/min. Seventeen mg of mercury were removed by six plasma exchanges: the mercury clearance was mean 17.3 ml/min. Among the extracorporeal elimination methods, plasma exchange appears to be the most efficient for inorganic mercury and it could be usefull in association with chelation therapy at the early phase of the intoxication.

[Hepatitis secondary to a gold salt overdose]

The authors report the case of a 51-year-old woman who developed cholestatic and cytolytic hepatitis after an overdose of sodium aurothiopropanol sulfonate 1.1 g, namely 300 mg gold metal. Liver biopsy demonstrated cholestasis, centrolobular steatosis and portal fibrosis. Electron microscopy showed abundant lipo-pigments in the hepatic and cellular cells, as well as myelinic bodies. Gold analysis by atomic absorption spectroscopy showed a level of 22.76 micrograms per ml in the plasma and a level of 2.16 micrograms per g in the liver. Chelating agents increased the urinary gold excretion, but were without effect on the course of hepatitis. Dimercaptopropanol seemed to favor the occurrence of other gold salt side-effects and penicillamine increased the hepatic cytolysis. The patient recovered without sequelae.

[Immunoallergic intravascular hemolysis and tubulointerstitial nephritis due to penicillin G]

A 51-year old woman treated with high doses of penicillin G developed acute intravascular haemolysis and tubulointerstitial nephritis. Immunological investigations showed circulating immune complexes, decreased C3 and C4 components of complement, IgG deposits in the renal interstitium, positive direct Coombs test with anti-IgG sera and complement and circulating anti-penicillin antibodies demonstrated by indirect antiglobulin tests and IgG RAST. Plasma haemoglobin and anti-penicillin antibodies could be removed by an early exsanguino-transfusion. These findings suggest that the nephritis was due to immune complexes and the haemolysis, to a combined hapten-type and immune complex mechanism.

[Acute poisoning by inhalation of metallic vapors]

Seven cases of acute intoxications by inhalation of metallic vapors are reported. The metals involved were zinc in three cases, tin in one case and mercury in three cases. The severity of the respiratory symptoms was dependent from the inhalated metal. The inhalation of zinc or tin vapors produced an acute limited pneumonitis. A lesional pulmonary oedema and acute interstitial fibrosis with lethal outcome was observed in two cases of intoxication by mercury vapors. The treatment by dimercaptopropanol used in mercury intoxications, increased urinary mercury excretion, but did not improve the pulmonary symptoms.

[The pulmonary toxicity of mercury vapors in the rat]

Rats have been exposed for periods of 120 to 240 minutes to an atmosphere containing 6 +/- 0.7 mg per cu.m mercury vapor. All rats developed an acute respiratory distress which lead to death within 2 to 210 hours (mean 53.5 h). Microscopical examination of the lungs showed an oedema rich in fibrin, an epithelial necrosis, hyaline membranes and in two cases an interstitial fibrosis. Mercury levels in the lungs ranged between 0.5 and 9.37 micrograms per gramme wet weight. The activity of pulmonary superoxide dismutase was decreased to 1.57 +/- 0.66 micrograms per mg of soluble proteins, compared with the level of 5.01 +/- 0.76 micrograms per mg in control rats. This study confirm the pulmonary toxicity of mercury vapors observed in human intoxication.

Acute voluntary intoxication by ricin

1 A 21-year-old student ingested thirty ricin seeds in a suicidal attempt, some of which were masticated. Three hours later he developed severe diarrhoea with vomiting and abdominal cramps, followed by extracellular dehydration and circulatory collapse. 2 Biological changes included haemoconcentration. He recovered following symptomatic treatment by infusion of saline and glucose solutions. 3 Ricin was quantified by a radioimmunologic method using Iodine 125, and showed that only a small part of the ricin contained in the seeds was absorbed.

Haemodynamic studies in eight cases of acute colchicine poisoning

1 The authors performed haemodynamic studies in 8 cases of colchicine poisoning. The doses absorbed ranged between 9 and 160 mg (mean dose 39 mg). THe haemodynamic study was performed between the 6th and 72nd h after intoxication, before and after plasma infusion (370 ml over a period of 20 minutes). 2 Four patients had severe shock with decreased cardiac index (CI) and increased sytsemic vascular resistance (SVR). Four patients had a hyperkinetic state with increased CI and decreased SVR. The four patients with cardiac failure died, the others recovered. 3 Haemodynamic study of acute colchicine poisoning is of therapeutic and prognostic interest. Hypovolaemia is always present. An initial decrease of cardiac performance is an index of severity with a lethal outcome.

[Pulmonary edema caused by heroin. Hemodynamic study of 2 cases]

The authors report two cases of heroin induced pulmonary edema. In both cases the severity of respiratory failure, attested by a deep hypoxemia (paO2 28 and 32 mmHg) and a metabolic and respiratory acidosis (pH 7.07 and 7.14) imposed an artificial ventilation with positive end expiratory pressure (PEEP). Hemodynamic study revealed a noncardiogenic edema. In both cases, a cardiac insufficiency was also present : in the first case it's etiology remained unclear, in the second it was a complication of hyperkalemia.

[Acute nadoxolol poisoning. A multicentric study of 35 cases]

Between 1976 and 1980, 35 cases of nadoxolol poisoning were collected from french antipoison centers. Acute intoxication was voluntary (50%) or accidental (50%). The ingested dose ranged between 0,25 and 22,5 g. Clinical symptoms appeared three hours after ingestion and consisted of cardio-vascular disorders which were present in 10 patients: bradycardia (7 cases), cardiogenic shock (6 cases), intraventricular block (5 cases), increase of P.R. interval (4 cases) and Q.T. interval (3 cases). The toxic dose in otherwise healthy adults was 5 g. The treatment consisted of gastric lavage and correction of cardiovascular disorders with sodium lactate (4 cases) or dopamine (1 case). All the patients recovered.

[Acute voluntary or accidental disopyramide poisoning. A multicentric study of 106 cases (author's transl)]

Between 1972 and 1978, 106 case-records of disopyramide poisoning were collected from French anti-poison center. Acute intoxication was voluntary in 90% of the cases and occurred in young adults. Clinical symptoms appeared early and consisted mostly of cardiovascular disorders, which were present in 60 patients: cardiogenic shock (24 cases), circulatory arrest (17 cases), atrio-ventricular block (21 cases), intraventricular block (24 cases) and severe ventricular arrhythmia (12 cases). The toxic dose in otherwise healthy adults was 1,5 g and the mortality rate was high (12,2%). An analysis of therapeutic measures and outcome indicated that the best treatment consists of early gastric lavage, cardiorespiratory manoeuvres, electric heart stimulation, administration of sodium lactate in cases with intraventricular conduction disturbances and isoprenaline in cases with cardiogenic shock.

[Usefulness of micro-organism counts in positive haemocultures (author's transl)]

In patients with positive haemoculture counting the number of micro-organisms per ml of blood can be of interest for both diagnosis and prognosis. Contamination is practically excluded when values exceed 20 organisms/ml, and bacteraemia when they exceed 500 organisms/ml. Generally, the higher the count the greater the likelihood of septicaemia. Values lower than 2 organisms/ml correspond in most cases to Gram-negative infections. Excluding the latter, which carry a high lethal risk, the mortality rate in septicaemia increases with the number of micro-organisms in the blood.

[Acute post-operative peritonitis in gastro-enterological surgery. Opinion of the intensive care unit (author's transl)]

Acute purulent post-operative peritonitis is highly severe and difficult to diagnose. Six symptoms have a real prognostic value: shock, acute renal insufficiency, respiratory failure, jaundice, acidosis and septicaemia. If more than three of these signs of severity coexist, the mortality rate reaches nearly 100%. A patient with evidence of acute diffuse post-operative peritonitis must be operated on after a short preoperative treatment to restore a situation altered by shock, renal failure and pulmonary edema. Antibiotic agent alone, though necessary, cannot bring recovery. The maintenance of high nutritional intake for excess caloric expenditure is essential. The effects of the early decision of a surgical reintervention are studied in 27 patients with only two recoveries.

Light and electron microscopic study of ear cartilage in a case of relapsing polychondritis evolving under corticoid treatment

Light and electron microscope studies of the ear cartilage in a patient with relapsing polychondritis (RP) under corticoid treatment are reported. Unilateral auricular deformation evolved without inflammatory epidoses and the lesions consisted mainly of marginal erosions filled with fine collagen fibrils and containing degenerating perichondrial cells in their basal parts. Degenerative cells were scattered throughout the perichondrium, but cartilage erosions only occurred when numerous cells were affected in a same area. Cartilage outside the eroded zones did not seem to be modified. Cartilage lesions thus appear to be a result of a chondrocyte renewal defect leading to loss of proteoglycans and elastic fibers, with only collagen remaining. These data suggest that inflammation is probably not the initial pathogenic process responsible for cartilage injury in RP, but that a metabolic defect in perichondrial cells might be involved.

[Immunoallergic acute haemolysis, thrombocytopaenia and acute renal insufficiency due to treatment with catechines (author's transl)]

The authors report the case of a 25-year-old patient who during discontinuous treatment with a venotropic agent containing catechines suffered from intravascular haemolysis, thrombocytopaenia and acute renal failure, the course of which was favourable with treatment by haemodialysis. Renal biopsy revealed lesions of acute tubulonephritis with a slight interstitial reaction but without immune deposits. The demonstration in the serum and on the red cells of the patient of anti-catechine antibodies confirmed the immunoallergic nature of the haemolysis. The existence of crossed allergy with another venotropic agent, leucocyanide, led to suspicion of the localisation of the antigenic site on the 3-4 dihydroxyphenyl portion of the catechine molecule.

Acute interstitial pulmonary fibrosis. Comparative light and electron microscopic study of 19 cases. Pathogenic and therapeutic implications

Comparative light and electron microscopic studies of the lung were performed in 19 cases of diffuse acute interstitial fibrosis with various etiologies. Our observations emphasize the relation between hyaline membranes (HM) and the evolution of fibrosis. HM formation is due to fibrinous exudates and epithelial necrosis. This phenomenon recurs during the evolution of the disease and appears to be responsible for new waves of fibrosis. Its pathogenesis (humoral or neurovascular ...) remains hypothetical. Modifications of the alveolar epithelium consecutive to septal fibrosis can be clearly distinguished from "fibrinoid necrosis" -type lesions, which results in HM. The formation of HM is accompanied by fibroblastic stimulation which proceeds in spite of epithelial regeneration. The exact stimulus for the proliferation and collagen hypersecretion of fibroblasts remains to be determined. The use, in association with corticosteroid treatment, of a structural analogue of L lysine, acexamic acid, to impede collagenesis reveals encouraging perspectives for improved therapy.

[Inappropriate secretion of anti-diuretic hormone in a case of intermittent acute porphyria (author's transl)]

The authors report the case of a patient who presented, during two exacerbations of intermittent acute porphyria, a grave psychiatric syndrome secondary to severe hyponatraemia. The later was due to inappropriate secretion of anti-diuretic hormone confirmed by laboratory tests and the stimation of anti-diuretic activity in the urine. The course was favourable under the effects of symptomatic treatment including sodium supplements and fluid restriction. The anti-diuretic syndrome disappeared on each occasion without sequelae at the time of regression of the exacerbation of porphyria.