Interleukin 9–induced In Vivo Expansion of the B-1 Lymphocyte Population

The activity of interleukin (IL)-9 on B cells was analyzed in vivo using transgenic mice that constitutively express this cytokine. These mice show an increase in both baseline and antigen-specific immunoglobulin concentrations for all isotypes tested. Analysis of B cell populations showed a specific expansion of Mac-1+ B-1 cells in the peritoneal and pleuropericardial cavities, and in the blood of IL-9 transgenic mice. In normal mice, the IL-9 receptor was found to be expressed by CD5+ as well as CD5− B-1 cells, and repeated injections of IL-9 resulted in accumulation of B-1 cells in the peritoneal cavity, as observed in transgenic animals. Unlike other mouse models, such as IL-5 transgenic mice, in which expansion of the B-1 population is associated with high levels of autoantibodies, IL-9 did not stimulate the production of autoantibodies in vivo, and most of the expanded cells were found to belong to the B-1b subset (IgM+Mac-1+CD5−). In addition, we found that these IL-9–expanded B-1b cells do not share the well-documented antibromelain-treated red blood cell specificity of CD5+ B-1a cells. The increase of antigen-specific antibody concentration in immunized mice suggests that these B-1 cells are directly or indirectly involved in antibody responses in IL-9 transgenic mice

Perforation œsophagienne consécutive à une manœuvre de Heimlich

La manœuvre de Heimlich est une technique qui permet de dégager les voies respiratoires obstruées par un corps étranger et, ainsi, de sauver une vie. Cependant, dans de rares cas, cette manœuvre peut induire des complications potentiellement mortelles. Parmi celles-ci, on retrouve quelques cas exceptionnels de rupture œsophagienne. En raison du taux élevé de mortalité de ce type de pathologie et de l’importance d’une prise en charge multidisciplinaire rapide, il est essentiel que cette entité clinique soit connue par les médecins pour qu’ils puissent l’intégrer à leur diagnostic différentiel.[Esophageal perforation as a consequence of the Heimlich maneuvre] The Heimlich maneuver is a technique designed to clear the airways obstructed by a foreign body, which is able to save life. In rare cases, however, this maneuver can lead to life-threatening complications. Among these undesirable effects figure a few exceptional cases of esophageal rupture. Esophageal perforation is an extremely rare complication of the Heimlich maneuver. Due to this pathology’s high mortality rate and its requirement of rapid multidisciplinary management, it is essential that this clinical entity be known by physicians and be incorporated into their differential diagnosis

Procédure de PCI simple.... mais suivie de multiples complications : à propos d'un cas et revue d'une littérature abondante

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Pneumopericardium: A Rare Complication of Antireflux Surgery

Pneumopericardium is a rare clinical entity, occurring in the setting of thoracic trauma, malignancies, or mechanical ventilation. Very few cases report pneumopericardium as a complication of gastrointestinal tract surgery. Signs and symptoms may be frustrating, ranging from asymptomatic to chest pain, sepsis, hemodynamic instability, pericarditis, or even cardiac tamponade. Clinical pathognomonic signs of pneumopericardium include pericardial metallic tinkling friction rub and mill wheel murmur. Diagnostic work-up includes electrocardiogram, chest radiography, and, computed tomography imaging. A gastro pericardial fistula should be considered a rare differential diagnosis for acute chest pain in patients with a history of gastroesophageal surgery. Rapid recognition and treatment avoid life-threatening complications. The successful outcome of gastro pericardial fistula treatment depends on both emergency and definitive surgical management. The survival rate with conservative management is poor.We present the case of a 78-year-old patient suffering from pneumopericardium and pericardial infusion, due to a fibrotic fistula between the Nissen’s valve, occurring 10 years after redo antireflux surgery. Treatment included broad-spectrum antibiotics, and emergency surgery for pericardial drainage, biopsy of the valve’s defect, suture, and omentoplasty

Pneumopericardium: A Rare Complication of Antireflux Surgery

Pneumopericardium is a rare clinical entity, occurring in the setting of thoracic trauma, malignancies, or mechanical ventilation. Very few cases report pneumopericardium as a complication of gastrointestinal tract surgery. Signs and symptoms may be frustrating, ranging from asymptomatic to chest pain, sepsis, hemodynamic instability, pericarditis, or even cardiac tamponade. Clinical pathognomonic signs of pneumopericardium include pericardial metallic tinkling friction rub and mill wheel murmur. Diagnostic workup includes electrocardiogram, chest radiography, and, computed tomography imaging. A gastro pericardial fi stula should be considered a rare diff erential diagnosis for acute chest pain in patients with a history of gastroesophageal surgery. Rapid recognition and treatment avoid life-threatening complications. The successful outcome of gastro pericardial fi stula treatment depends on both emergency and defi nitive surgical management. The survival rate with conservative management is poor. We present the case of a 78-year-old patient suff ering from pneumopericardium and pericardial infusion, due to a fi brotic fi stula between the Nissen’s valve, occurring 10 years after redo antirefl ux surgery. Treatment included broad-spectrum antibiotics, and emergency surgery for pericardial drainage, biopsy of the valve’s defect, suture, and omentoplasty