Blood conservation techniques for cardiac surgery: a survey of French centres

A survey resulting from a partnership between CECEC (Centre d'Etudes en Circulation Extra-Corporelle) and Laboratoires Hoechst, France was carried out amongst all French adult cardiac surgery centres. The aim of this study was to investigate the various strategies used to decrease blood loss during open-heart surgery. Due to an exceptionally high response rate, we are able to report the current practice of French cardiac centres which account for 75% of open-heart adult surgery. The three most interesting strategies for blood conservation appear to be haemodilution, blood salvage from the extracorporeal circuit and previously deposited autologous blood transfusion, yet the three methods which are predominantly used are haemodilution (92.7%), aprotinin therapy (87.8%) and blood salvage from the extracorporeal circuit (82.9%).     

Induction of single- and double-strand breaks in plasmid DNA by 100-1500 eV electrons

PURPOSE: To investigate the induction of DNA strand breaks by electrons with energies ranging from 0.1 to 1.5 keV. MATERIALS AND METHODS: Dry supercoiled plasmid DNA was irradiated with electrons of energies ranging from 0.1 to 1.5 keV and the results were compared with those obtained by gamma-irradiation of the same plasmid in solution. For electron irradiation, the plasmid was deposited on a gold substrate under a controlled atmosphere to minimize contamination of the DNA film. Electron bombardments were performed under ultra-high vacuum conditions (UHV 10(-9) torr). DNA damage was detected by gel electrophoresis followed by quantitation of the DNA bands by fluorescence or by hybridization with a radioactive probe. RESULTS: Electrons with energies from 0.1 to 1.5 keV induced single, double and multiple double-strand breaks in supercoiled plasmid DNA. For equal doses, we observed a marked increase in the efficiency of induction of double- and multiple-strand breaks in supercoiled DNA as a function of electron energy. In contrast to gamma-irradiation, the formation of small DNA fragments by electrons did not seem to be related to the production of the linear form of the plasmid. CONCLUSIONS: Electrons within the energy; range of the secondary electrons generated by high-energy ionizing radiation induce single, double and multiple double-strand breaks in DNA. Problems associated with low-energy electron irradiation experiments and dose calculations in thin films are also discussed.     

Noninvasive in vivo magnetic resonance imaging of injury-induced neointima formation in the carotid artery of the apolipoprotein-E null mouse

Mice deficient in apolipoprotein-E (apoE) experience severe hypercholesterolemia, are prone to atherosclerosis, and recently have emerged as a powerful tool in the study of plaque formation. In this study, we developed magnetic resonance (MR) imaging methods to detect the progression of atherosclerosis noninvasively in a mouse model of arterial injury. Four 14-week-old apoE-deficient mice were imaged 5 weeks after beginning an atherogenic Western diet and 4 weeks after wire denudation injury of the left common carotid artery (LCCA). Information from several images was combined into high-information content images using methods previously developed. The image resolution was 47 x 47 x 750 microm(3). We acquired T1-, T2-, and proton density (PD)-weighted images (TR/TE 650/14, 2000/60, and 2000/14 msec, respectively). Each 8-bit image was placed in a separate color channel to produce a 24-bit color image (red = T1, green = PD, and blue = T2). The composite image created contrast between different tissue types that was superior to that of any single image and revealed significant luminal narrowing of the LCCA, but not the uninjured RCCA. MR images were compared with corresponding histopathology cross sections and luminal area measurements from each method correlated(r2= 0.61). Atherosclerotic luminal narrowing was successfully detected through MR imaging in a mouse model of arterial injury that is small, reproduces quickly, and lends itself to genetic analysis and manipulation.     

p53 and Bax implication in NMDA induced-apoptosis in mouse hippocampus

Seven days after in vivo intrahippocampal administration of NMDA, 3'-OH DNA fragmentations and Bax protein expression were detected in hippocampal neurons of p53+/+ but not p53-/- transgenic mice. Interestingly, neurons showing pycnosis, an early apoptotic phenomena, were present in all genotypes. These results confirm that apoptotic 3'OH DNA fragmentations and Bax protein induction during NMDA-induced apoptosis in adult hippocampal neurons are p53 dependent.     

Frequency of serological markers of rheumatoid arthritis in patients with IgA anti‐β2 glycoprotein I antibodies

AimTo determine the frequency of serological markers of RA in patients with anti‐β2 glycoprotein I antibodies (aβ2GPI) of IgA isotype.Material and MethodsA retrospective study was conducted on 67 patients with aβ2GPI‐IgA. Ninety healthy blood donors (HBD) were used as a control group. IgG anti‐cyclic citrullinated peptides antibodies (CCP‐Ab) and rheumatoid factors (RF) IgG, IgA, and IgM were detected by enzyme‐linked immunosorbent assay (ELISA).ResultsSeventeen patients and eight HBD had CCP‐Ab and/or RF (25.4% vs. 8.9%, p = 0.005, CI 95% [14.95; 35.79], odds ratio = 3.5). The frequency of CCP‐Ab was significantly higher in patients than in healthy subjects (14.9% vs. 3.3%, p = 0.009). IgA isotype of RF was significantly higher in patients than in controls (7.5% vs. 0%, p = 0.02). In male patients, CCP‐Ab and/or RF were more frequent than in healthy male subjects (37.5% vs. 11.8%, p = 0.02). In patients, no correlation was found between the levels of aβ2GPI‐IgA and CCP‐Ab (r = 0.082, p = 0.51). There was no correlation between the level aβ2GPI‐IgA and the level of the isotypes of RF (IgG, IgA, and IgM) in patients (r = 0.1, p = 0.37; r = 0.17, p = 0.17 and r = 0.07, p = 0.59 respectively).ConclusionFrequencies of CCP‐Ab and RF are high in patients with aβ2GPI‐IgA suggesting that these patients are susceptible to developing RA.     

Transvaginal hydrolaparoscopy: practices in French teaching hospitals

STUDY OBJECTIVE: To examine transvaginal hydrolaparoscopy (THL) practices in French tertiary care centers. DESIGN: Prospective longitudinal study (Canadian Task Force classification III). SETTING: University hospital in France. PARTICIPANTS: Gynecology and obstetrics departments of all 48 French teaching hospitals. INTERVENTIONS: Practice of THL using a 8-item questionnaire. MEASUREMENTS AND MAIN RESULTS: Main outcome measure was practice, indications, and complications of THL in French tertiary care centers. Between October 2005 and March 2006, the departments were sent an 8-item questionnaire on the use of diagnostic and operative THL. In all, 38 (79%) hospitals completed the questionnaire. THL was or is still used in 20 (53%) departments. The main reason given by the 18 departments that never used THL was that it was "less informative than laparoscopy." Only 8 (40%) of 20 departments with experience of THL continued to use the procedure routinely. The main reason given for abandoning THL was its limited operative potential. Among the 8 departments that continued to use THL, 6 used operative THL (mainly for ovarian drilling). Among the 30 departments that answered the item on the likely future place of THL, only 6 (20%) considered that THL would continue to be performed. CONCLUSION: Few French teaching hospitals routinely use THL. Further data on THL, and especially its cost effectiveness, are needed to clarify its place to evaluate female fertility.