E Fornaris's scientific contributions

Bronchial challenges were effected with carbachol in 76 subjects who were candidates for a scuba diving group. Bronchial reactivity was assessed through airway resistance and forced expiratory volume in 1 sec (FEV1) measurements. Medical interrogation had revealed symptoms of recent (RA) or ancient (AA) asthma, or allergic rhinitis (AL). Nearly half of the subjects (47%) presented bronchial hyperresponsiveness (BHR), which was much more frequent in the RA group, but whose strength did not depend on clinical presentation. Prevalence of BHR was fairly high (36%) in the AL group. BHR constituted a contraindication to scuba diving because it may promote pulmonary barotrauma.

The mechanism and its effects on the bone mass are discussed. The bone disorders of spacemen show the necessity of physical constraints. The intensive physical exercise can increase disturbances in the bone remodeling. But the hormonal disorders (amenorrhea, oligomenorrhea) which are made by intensive and top level physical activities, increase indirectly the bone remodeling and decrease the bone mass. The effects of a moderate physical activity are more discussed. Nevertheless, an increasing of the bone mass peak is admitted. In the adult and postmenopausal women, the data are more uncertain and discussed. But, an adapted moderate regular physical activity for each people authorizes certainly a bone gain. It is favorable to prevent osteoporosis, its fractures and reduce the social cost.

Low back pains are very frequent in athletes by microtraumatisms and sudden efforts. The prolapse of the nucleus pulposus is created. After the failure of correct medical treatment, some new technics give good results: chemonucleolysis, trans-cutaneous nucleotomy, microdiscectomy. These techniques permit a faster and more active return to effort. The choice must be perfect: clinical examination and imagery manage this advance.

Forty nine patients suffering from respiratory disorders underwent an exercise test carried out on a bicycle ergometer (n = 45) or by walking rapidly on flat or inclined ground (n = 4). The respiratory restrictions on effort were correlated with a degree of dyspnoea (stages 1 to 4) established by a questionnaire. The analysis of the effort test had consequences of practical importance: in effect, in this study, nearly half the patients benefited from advice orientated in particular towards the level of activity which would be suitable for them, and to reduction in their weight.

Effectiveness and tolerance of ketoprofen in sustained-release tablets (Bi-Profenid 150 mg) were investigated in a double blind trial in 44 athletes who had recently sprained an ankle. Patients were given either 300 mg Bi-Profenid or 400 mg oxyphenbutazone daily for seven days. Treatment regimens were assigned at random. Results were assessed as excellent or good in 85% of patients given Bi-Profenid and 50% of those given oxyphenbutazone. Spontaneous pain resolved in 19 patients receiving Bi-Profenid and in 6 under oxyphenbutazone. Decrease in pain upon physical examination and in articular circumference was significantly greater with Bi-Profenid as compared with oxyphenbutazone. The chance of rapidly resuming sport was better with Bi-Profenid. Tolerance was excellent in 68.2% of patients with Bi-Profenid and 59% of those with oxyphenbutazone. This investigation thus emphasizes the value of Bi-Profenid in sport pathology.

The composition of the bronchial branches of the vagus nerves was studied in cats using light and electron microscopy. In order to determine the number and the diameter of fibers in the afferent and the efferent components, a unilateral efferent vagotomy was performed. The myelinated and the non-myelinated fibers were counted from the total nerve area and the endoneural area of each one was measured by means of a computer. Composition of "afferent" bronchial nerves (after degeneration following the efferent vagotomy) was compared to that of "entire" nerves. The main results are: (1) efferent fibers represent about 40% of the "entire" bronchial nerve; (2) non-myelinated fibers constitute more than 90% of the total population of the "entire" nerves as well as of the efferent component; (3) the density of myelinated and non-myelinated fibers (i.e. their number per surface unit) was similar in all nerves. However, there were discrepancies between diameter histograms established from different areas of a section. This feature seems to be due to preferential compartmentalization by Schwann cell envelopment of fibers having comparable diameter. This "packing effect" was observed in both efferent and afferent components.

Changes in lung mechanics were measured during hypoxia (FIO2 = 0.10 during 5 min) in spontaneously breathing anesthetized rabbits. In intact animals, hypoxia induced scattered variations in total lung resistance (RL) (decrease, increase or no alteration) and dynamic lung compliance (CL), whereas in carotid body denervated animals it was accompanied by an almost constant decrease in RL (-12%); but if a subsequent vagotomy was performed, there was no significant variation in RL. In animals which had been only vagotomized, CL decreased significantly during hypoxia (-23%) without any associated change in RL. So, the arterial chemoreceptor mediated bronchoconstrictor effects due to hypoxia could be normally masked by the dilator effects (metabolic and/or sympathetic) on the airways.

In anaesthetized dogs, medullary pyramid stimulation produces a decrease of myocardial contractility. The peak of the first derivative of the left ventricular pressure (dP/dt max) was used to assess myocardial contractility; this index is independent of afterload. Medullary pyramid stimulation produces a decrease of dP/dt max and of the maximal left ventricular pressure (L.V.P. max) also, after bilateral vagotomy. But the same stimulation induces only a decrease of L.V.P. max after inhibiting beta-adrenergic efferences and bilateral vagotomy. Just as corticopyramidal fibres inhibiting alpha-adrenergic vascular tone, one does consider the existence of corticopyramidal fibres inhibiting beta-adrenergic efferences to myocardium.