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Biomedical subjects

A Bloch

Publications and source records attributed to A Bloch.

At least 127 records · Page 7Linked to original sources

[Drug therapy of unstable angina].

Medical prognosis of unstable angina looks better to-day than was previously thought. Medical treatment includes bed rest in an intensive care unit, antianginal drugs and sedatives. The main antianginal drugs are nitrates (intravenous, percutaneous and oral), beta-blockers, calcium antagonists and amiodarone. Treatment and follow-up of 53 consecutive patients hospitalized at the Geneva Medical Intensive Care Unit are reviewed. Medical treatment serves to decrease or suppress myocardial ischemia in most cases. Coronary arteriography can then be performed on an elective basis and followed, if necessary, by coronary by-pass grafting. Rare failures of medical therapy form the only indication for emergency coronary arteriography and surgery.

Adrenergic beta-Antagonists↗

Synthesis and biological effects of acyclic pyrimidine nucleoside analogues.

A series of nucleoside analogues has been prepared, wherein the cyclic carbohydrate moiety is replaced by aliphatic side chains attached to cytosine, thymine, uracil, and 5-fluorouracil. The 1-[(2-hydroxyethoxy)methyl] derivatives of these heterocycles were synthesized by reacting the silylated bases with 2-(chloromethoxy)ethyl benzoate, followed by removal of the protecting groups with methanolic ammonia. The hydroxy groups of a number of these derivatives was subsequently replaced by an azido, amino, or carbamoyloxy moiety. The 1-(2-oxo-3-butyl) and 1-(2-oxo-3-nonyl) derivatives of cytosine were also prepared, their synthesis being accomplished by condensation of the silylated heterocycle with the appropriate alpha-halo ketone. At 10(-4) M concentrations, the newly prepared compounds were inactive against leukemia L-1210 cells in culture. However, a number of the agents inhibited the in vitro growth of Escherichia coli K-12, the most potent among these, 1-[(2-hydroxyethoxy)methyl]-5-fluorouracil being active at an IC50 of 1.2 micro M. This compound was equally active in preventing the growth of a 5-fluorouracil resistant strain of E. coli. Some of the analogues were also found to selectively interfere with herpes simplex virus replication in vitro. None of the cytosine derivatives tested served as either substrates or inhibitors of human liver cytosine nucleoside deaminase.

Animals↗

[Interauricular communication and mitral prolapse. An echocardiographic and angiographic study].

The association of atrial septal defect (ASD) and mitral valve prolapse (MVP) is well known but its precise incidence has not yet been established. Most previous publications have only been angiographic studies and the diagnostic criteria of MVP were, therefore, controversial. In this study, 61 consecutive patients, adults and children, underwent M mode echocardiography and cardiac catheterisation with cineangiography. In the adult group echocardiographic MVP was observed in one of 23 patients with secundum ASD. These findings were confirmed on angiography in addition, four other cases were observed in patients without systolic clicks or pansystolic or late systolic murmurs. MVP was observed in four out of 27 children with secundum ASD on M mode echocardiography and all cases were confirmed at angiography. In contrast to the adult group, no additional cases were demonstrated. Three out of 11 patients with ostium primum defects had MVP at echo and/or angiography, a finding which was probably related to the common atrioventricular canal. Follow-up echocardiography 6 weeks after surgical repair of ASD showed persistent but less marked MVP in all cases. Echocardiographic evidence of MVP was therefore demonstrated in 5 out of 50 patients (10%) with secundum ASD. It was more common in children (15%) than in adults (4%). These results differ from those previously published, probably because of differences in method (use of echo and angiography), diagnostic criteria, size of atrial shunt and the incidence of associated mitral regurgitation. The prevalence of MVP in patients with ASD may have been overestimated in previous publications.

Adolescent↗

Biological and biochemical effects of 2'-azido-2'-deoxyarabinofuranosylcytosine on human tumor cells in vitro.

2-azido-2'-deoxyarabinofuranosylcytosine (Cytarazid), recently synthesized, was found to inhibit the in vitro growth of several human cell lines by 50% at concentrations ranging from 0.06 to 0.2 microM and to prevent the replication of herpes simplex virus types 1 and 2 by 98% at 50 microM. As determined with HeLa cells, the inhibition of cell growth was partially prevented by 2'-deoxycytidine (dCyd) and cytidine but not by uridine or thymidine. Cytarazid proved resistant to deamination by human cytidine/dCyd deaminases purified from acute myelocytic leukemia blast cells and from liver, a property reflected in the inability of tetrahydrouridine to enhance the cytotoxicity of the compound. Cytarazid served as a substrate for cytoplasmic dCyd kinase partially purified from human peripheral chronic lymphocytic leukemia blast cells. At a concentration of 0.4 mM, the nucleoside analog was phosphorylated 2.6 times more effectively by this enzyme than was dCyd, the Km for Cytarazid being 250 microM. In intact HeLa cells, the triphosphate derivative of Cytarazid was the major drug metabolite formed. In these cells, the analog interfered with the incorporation of radiolabeled thymidine into DNA at a concentration and a time interval at which the incorporation of uridine into RNA and amino acids into protein was not inhibited, suggesting that interference with DNA synthesis is a primary drug effect. Further analysis showed that Cytarazid triphosphate interferes with DNA synthesis in intact HeLa cell nuclei and that it inhibits both the alpha- and beta-DNA polymerases purified from HeLa cells in a manner competitive with deoxycytidine triphosphate, with Ki's of 0.6 and 0.7 microM, respectively. Cytarazid triphosphate was not able to replace deoxycytidine triphosphate for the synthesis of DNA in either intact nuclei or in cell-free preparations; but, in the cell-free assay system, the compound was found to interfere with primer-template activity.

Biotransformation↗

[Myocardial infarction and meteorology].

The authors have investigated retrospectively over two years (1977-1978) a possible relationship between daily admissions for myocardial infarction at the University Cantonal Hospital, Geneva, and the weather. Statistical analysis of 963 emergency patients (572 with patent myocardial infarction and 391 with possible infarction at the admission center) shows that this correlation exists. One weather feature, the warm front, has been identified during which there is a significant increase in the number of coronary cases admitted. This weather situation appears to be a contributory factor in triggering a coronary accident.

Humans↗

[M-mode and two-dimensional echocardiography in evaluating mitral stenosis before and after commissurotomy].

A first group of 51 patients with pure or predominant mitral stenosis underwent M-mode (M) and two-dimensional (2D) echocardiography and cardiac catheterization (cath). After elimination of 3 incomplete cases, the series consists of 48 patients. 20 later underwent surgery. Quantitative correlations between M and cath are poor (r = 0.34, p less than 0.05); however, correlations between 2D and cath were excellent (r = 0.89, p less than 0.001). There were 4 major discrepancies between 2D and cath: 3 of these patients were operated upon and surgery confirmed 2D mitral valve area in all of them. 2D had served to diagnose all 6 cases of mitral calcifications seen at surgery; however, M provided 1 false negative and 5 false positive results with regard to diagnosis of calcifications. A second group consisted of 18 patients who had undergone mitral commissurotomy, 8 of these had a pre- and postoperative echocardiography. 10 also underwent postoperative cath. M appeared to be unable to predict correctly the presence or absence of a recurrence of mitral stenosis. Quantitative correlations between diastolic slope and mitral valve area at cath were poor. However, excellent correlations were found between 2D and cath, showing that 2D also serves to measure mitral valve area after commissurotomy.

Calcinosis↗

[Atrial septum defect: comparison of pre-and postsurgery echocardiographic data in adults and children].

Echocardiographic data in 13 adults and 17 children before and after surgical closure of an atrial septum defect are compared. Before surgery the enddiastolic dimension of the right ventricle was bigger in children than in adults. Septal motion was paradoxal or abnormal in 92% of adults and 65% of children (NS). Two weeks after surgery the right ventricle had decreased similarly in adults and in children, but often remained dilated. Septal motion was normal in 25% of adults and 76% of children (p less than 0.01). Four months after surgery, the right ventricle dimension was unchanged; septal motion was normal in all children but only in 50% of adults (p less than 0.005). This remaining abnormal septal motion after surgery may be explicable by the long-standing presence before surgery of a major shunt inducing chronic disturbances of right ventricular compliance.

Adolescent↗

[Hemodynamics monitoring: correlations of clinical and invasive methods].

Cardiac failure is the main in-hospital cause of death in acute myocardial infarction. The present review demonstrates the possibilities and advantages of invasive monitoring. The Swan-Ganz catheter offers the possibility of measuring cardiac pressures, particularly pulmonary wedge pressure, cardiac O2 saturations and cardiac output. The main indications are severe left heart failure, right heart failure, complicated myocardial infarction, severe hypovolemia and vasodilator therapy.

Blood Pressure↗

Synthesis, biologic effects, and biochemical properties of some 2'-azido- and 2'-amino-2'-deoxyarabinofuranosyl pyrimidines and purines.

Various 2'-azido- and 2'-aminoarabinofuranosyl purine and pyrimidine nucleosides have been synthesized. Among these, the derivatives of cytosine and of adenine inhibit the growth of some tumor cell lines in vitro and in vivo. 2'-Azidoarabinofuranosyl cytosine also interferes with the replication of herpes simplex virus types I and II. Whereas 2'-azidoara-C is resistant to deamination by a partially purified CdR deaminase from KB cells, the adenine derivatives are substrates for aminohydrolases partially purified from calf and mouse intestines. Both azido- and aminoara-C are phosphorylated by partially purified CdR kinases from leukemia L1210 and from human AML blast cells. The accumulated data encourage exploration of the clinical utility of the more potent of these analogues.

Animals↗

[Interventricular septum. Angiographic and echocardiographic correlations].

The diastolic thickness of the interventricular septum was measured by echocardiography and by biventricular angiography in 48 patients (40 male, 8 female) with age ranging between 15 and 67 years (average 44.4 years). These patients were classified in four groups according to clinical and paraclinical parameters:--normal subjects (29 cases),--patients with concentric hypertrophy (5 cases),--patients with asymmetrical septal hypertrophy without obstruction (4 cases),--patients with hypertrophic cardiomyopathy with obstruction under basal conditions or under stress (10 cases). Biventricular cineangiography was performed in 70 degrees left anterior oblique projection after measuring the intracavitary pressures. Analysis was performed by projecting the film and reproducing one or several diastolic frames on paper. Septal thickness was measured at the two levels suggested by Redwood. The septum was then divided into 5 parts and the thickness measured at the corresponding 4 levels. The values obtained were then corrected for magnification artefact. Qualitative comparison of the results obtained by echocardiography and angiocardiography showed a good correlation in 35 cases (73%) and less significant correlations in the other 13 cases (27%). The poorest correlations were observed in the groups of patients with concentric or asymmetrical hypertrophy without obstruction. Of these 13 cases, angiography confirmed the clinical diagnosis in 6 cases. In the remaining 2 cases, echocardiography and angiocardiography gave divergent diagnoses which also differed from the clinical diagnosis. The quantitative correlations between the echocardiographical and angiocardiographic measurements of diastolic septal thickness were quite satisfactory in most patients. The correlation improved when the echocardiographical measurement was compared to an average of the 4 angiographical measurements; (R = 0,74; p < 0.001). The correlation was poorer in groups 2 and 3 in patients with concentric or asymmetrical hypertrophy without obstruction. The disadvantages and limitations of these two methods are discussed. Possible ambiguity in the identification of segments of the septum measured by the two methods may be a significant factor especially in cases of asymmetrical hypertrophy.

Adolescent↗

[M-mode and two dimensional echocardiography for evaluation of mitral stenosis (author's transl)].

M-mode and two-dimensional echocardiography (echo) were performed in 51 patients with pure or predominant mitral stenosis. Echocardiographic assessment of the severity of the stenosis was compared to the results of cardiac catheterization (cath); surgical evaluation of the mitral valve area was also obtained in 20 patients. M-mode is an excellent method for the diagnosis of mitral stenosis. However two-dimensional echo is much better for the assessment of its severity; in the present study correlations with cardiac catheterization have been excellent (r = 0.89, p less than 0.001). Major disagreement between echo and cath were found in 4 patients; 3 of them have been operated on and surgery has confirmed the echo results in all 3. Two-dimensional echo has also allowed correct prediction in the presence of mitral calcifications in 6 of the operated patients, whereas several false positive and negative diagnosis was made on M-mode. Two-dimensional echocardiography is therefore an excellent non-invasive technique for the diagnosis of mitral stenosis, measurement of mitral valve area and identification of mitral calcifications.

Adult↗