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Biomedical subjects

A Fournier

Publications and source records attributed to A Fournier.

At least 433 records · Page 24Linked to original sources
PubMed1989

Phorbol ester induces differential membrane-association of protein kinase C subspecies in human platelets.

Human platelets contained proteins which cross-reacted with antisera specific for brain protein kinase C-alpha and -beta. When platelets were incubated with 12-O-tetradecanoylphorbol-13-acetate there was a rapid accumulation of protein kinase C-alpha in the particulate fraction associated with a loss of this subspecies from the soluble fraction. No particulate accumulation or soluble loss of protein kinase C-beta could be detected when platelets were incubated with the phorbol ester.

Blood Platelets↗
PubMed1989

Can tegumental morphology be used as a taxonomic criterion between Schistosoma haematobium, S. intercalatum, and S. bovis?

A comparative study of the evolution in time of the tegumental morphology of male adult Schistosoma haematobium from Niger, S. intercalatum from Cameroon and Zaire, and S. bovis from Spain and Sudan was carried out with scanning electron microscopy. Interindividual, interstrain, and interspecies variations are pointed out. The value of the morphological criterion (tegument with or without spines) is discussed. The tegumental morphology can be used for the identification of schistosome species showing strong phyletic affinities under precise experimental conditions. In the present work, this criterion permits the characterization of strains of S. bovis from Sudan and Spain.

Animals↗
PubMed1989

Pulmonary artery to the left atrium fistula as an unusual cause of cyanosis in the newborn.

A fistula between the pulmonary artery (PA) and the left atrium (LA) is a rare form of congenital heart disease, 34 cases having been described in the literature, all from the right pulmonary artery (RPA). Only six cases were diagnosed in the newborn period. We report such a case, diagnosed at 1 day of age by Doppler echocardiography, with an unusual site of the fistula.

Cyanosis↗
PubMed1989

Low-molecular-weight heparin Fraxiparin in chronic hemodialysis. A dose-finding study.

A two-step dose-ranging study was undertaken with CY216 (Fraxiparin) in 8 patients on 7 sessions each. The different doses were administered each time as a single bolus injection at the start of hemodialysis without heparinized priming nor further administration during the 4-hour session. In the first step, the clinical efficacy of 4 different doses of Fraxiparin was compared with that of standard heparin on the percentage of sessions free of clot formation in the extracorporeal circulation (ECC). Safety was evaluated by the compression time for hemostasis at the puncture sites. The second step was a randomized comparison of 3 Fraxiparin dosages. In addition to the clinical assessment of efficacy, the following biological parameters were measured: fibrinopeptide A (FPA), anti-Xa (AXa) activity calibrated against Fraxiparin, thrombin time (TT), activated partial thromboplastin time, blood counts, hemoglobin, hematocrit, plasma creatinine and urea, and residual blood volume in the dialyzer. A 'standard' dosage of 10,000 AXa Institut Choay units of Fraxiparin was shown to prevent clot formation in the ECC. It resulted in a marked increase in TT, without any lengthening of the puncture site compression time. After 4 h, AXa and FPA levels in the venous line were related to the doses used (p less than 0.05). After 48 h AXa activity was very low. Dialysance and tolerance were excellent. Thus, a single dose of Fraxiparin unrelated to body weight and not determined by the measurement of the whole-blood activated clotting time appeared to be a safe and effective means for preventing fibrin formation in 4-hour dialysis sessions.

Adult↗
PubMed1989

Use of Permcath (Quinton) catheter in uraemic patients in whom the creation of conventional vascular access for haemodialysis is difficult.

During the last 4 years, the Permcath Quinton double-lumen silicone catheter was inserted into the internal jugular vein of 57 uraemic patients with difficulty for creating conventional vascular access for haemodialysis. In 4 patients, with definitive contraindication of conventional vascular access, this catheter still permits haemodialysis after a duration of 8-25 months. In 25 further patients with terminal uraemia, but poor vein system, it allowed the maturation of an arteriovenous fistula after 2-14 months of use. In 17 patients already on chronic haemodialysis, but who lost abruptly their vascular access (15 grafts and 2 arteriovenous fistulae), it allowed a new arteriovenous fistula to mature in 16 cases after a mean duration of 7.3 +/- months. In 5 patients with short life expectancy because of neoplasia, it allowed to dialyse them until their death which occurred after 6.5 +/- 2.2 months. In 6 patients with acute renal failure and haemostasis problems, it allowed to perform not only dialysis, but also plasmapheresis in 3 and parenteral nutrition in 3 other cases. The complications were the following: sepsis (n = 3); episodes of hypocoagulability due to inadvertent injection of heparin stored in the lumen (n = 2), thrombosis of the lumen (n = 3), and insufficient flow (n = 6). In no case these complications prevented continuation of haemodialysis. The catheter had to be removed in 2 cases because of septis and in 1 case because of insufficient flow. In 3 cases the catheter had to be replaced because of thrombosis and in 1 case because of laceration. These complication rates are, however, fewer than those reported in the literature for arteriovenous shunts or rigid subclavian and femoral catheters. The Permcath catheter seems, therefore to be the method of choice for immediated vascular access in patients in whom the creation of conventional vascular access is difficult.

Adolescent↗
PubMed1989

[Arrhythmia disorders after repair of ventricular septal defects. Comparison of atrial and ventricular approaches].

Post-operative disorders of conduction and of ventricular and supraventricular excitability were studied in 50 patients operated upon for ventricular septal defect (VSD). The VSD was approached by right ventriculotomy in 29 patients aged 4.4 +/- 3.1 years at surgery and 15.1 +/- 6.5 years at evaluation. The VSD was closed by the atrial route in 21 patients aged 6.6 +/- 3.9 years at surgery and 12.1 +/- 6.8 years at evaluation. Complete right bundle branch block (CRBB) was significantly more frequent in patients who underwent ventriculotomy (62 p. 100 vs 33 p. 100, p less than 0.05), but 2 late complete atrioventricular blocks were observed in patients in whom the atrial route was used. 34 p. 100 of the patients with ventriculotomy and 26.5 p. 100 of those without ventriculotomy had significant ventricular arrhythmias on Holter recordings (greater than or equal to Lown's grade 2, p = NS). The occurrence of ventricular arrhythmias in the patient population as a whole increased significantly with age at surgery and age at evaluation (p less than 0.05); this increase was also noted in each group (p = 0.06). Pre-operative right ventricular systolic pressure, severity of intraventricular disorders of conduction or duration of extracorporeal circulation and aortic clamping had no influence on the occurrence of ventricular arrhythmias. Disorders of supraventricular excitability were found in 1 patient who had ventriculotomy and in 2 patients whose VSD was corrected by the atrial route. No sinus dysfunction was observed. It is concluded that the ventricular approach of VSD significantly increases the occurrence of post-operative CRBB.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗
PubMed1989

Hemodialysis in the treatment of lactic acidosis in diabetics treated by metformin: a study of metformin elimination.

The aim of this study was to determine the characteristics of metformin elimination by dialysis. For this purpose we report the kinetic parameters during dialysis and the metformin clearance (i.e. dialysance) in four patients presenting with lactic acidosis which occurred on metformin therapy. We also studied metformin elimination in two chronically hemodialyzed diabetic patients inadvertently maintained on metformin therapy and in two chronically hemodialyzed non-diabetic patients who took a single dose of metformin before a dialysis session. Analysis of plasma concentration-time curves showed a biphasic pattern of metformin - elimination, according to a two-compartment model. We demonstrate that metformin may be removed even after reaching an equilibrium between blood and dialysate levels in a recirculating system, suggesting a storage of metformin in a deep compartment with a gradient of concentration between this compartment and the blood. Lastly, metformin dialysance appears satisfactory (68 ml/min) even in the case of relatively low blood flow; this value reached 170 ml/min under good hemodynamic conditions. In conclusion, hemodialysis efficiently removes metformin and corrects metabolic acidosis in patients with metformin-induced lactic acidosis.

Acidosis, Lactic↗
PubMed1989

Prevention of osteitis fibrosa, aluminium bone disease and soft-tissue calcification in dialysis patients: a long-term comparison of moderate doses of oral calcium +/- Mg(OH)2 vs Al(OH)3 +/- 1 alpha OH vitamin D3.

Since 1980, moderately large doses of oral calcium (80 +/- 35 mmol/day as CaCO3 +/- calcium polystyrene sulphonate), in association if necessary with Mg(OH)2 (2.5 +/- 1 g/day), with a reduction in the dialysate Mg concentrations from 0.75 to 0.375 mmol/24 h, have replaced A1(OH)3 as phosphate binders in our centre. A1(OH)3 was previously given to our haemodialysis patients in association with small doses of Ca CO3 (less than or equal to 3 g/day) and if necessary with 1 alpha OH vitamin D3. To compare the long-term efficacy of this new approach with the former one in the prevention of renal osteodystrophy and soft-tissue calcification, 32 current patients were selected on the basis of at least 24 months of treatment in our centre and availability of a yearly bone survey (profile of lumbar spine and anteroposterior view of the pelvis, shoulders and hands). A group of 30 patients treated before 1980 were then selected on the same criteria and matched for age, sex, and duration on dialysis. Linear calcifications of the anterior and posterior walls of the aorta in front of L2, L3, L4 and on the lateral walls of the iliac and femoral arteries were measured and the para-articular calcifications and subperiosteal resorptions of the hands evaluated. The initial extent and the subsequent increase of the ocular and para-articular calcification were comparable in the two groups. Plasma alkaline phosphatase was stable in the normal range in both groups, as was plasma concentration of calcium. Plasma phosphate was slightly elevated (1.7 mmol/l) but stable and comparable in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum↗
PubMed1989

Structure-activity profile of calcitonin gene-related peptide in peripheral and brain tissues. Evidence for receptor multiplicity.

The radioligand binding characteristics and in vitro biological activities of human calcitonin gene-related peptide (hCGRP) homologs, analogs and fragments have been tested in a variety of preparations in order to determine the structural requirements of the calcitonin gene-related peptide (CGRP) receptor. The ligand selectivity profile observed in this study suggests that [125I] hCGRP binding sites present in rat brain and spleen are similar. The high affinity of the analogs [Cys(ACM)2.7]hCGRP and cyclo2.7 [Asp2, Lys7]hCGRP indicates that the disulfide bridge between positions 2 and 7 is not essential for the binding of the ligand to the CGRP receptor. On the other hand, the lack of affinity of various N-terminal fragments in the binding assays demonstrates the importance of amino acids 9-37 in maintaining appropriate receptor recognition. The existence of CGRP receptor subtypes is supported by data obtained in various in vitro bioassays. For example, the linear analog, [Cys(ACM)2.7]hCGRP, which retained high potency in the rat vas deferens bioassay displayed no agonistic activity in the right and left guinea pig atrial preparations. Additionally, the C-terminal fragment hCGRP 12-37 possessed some antagonist properties in atrial but not vas deferens preparations. Thus, it appears that it is possible to differentiate between CGRP receptor subtypes on the basis of differential agonistic (e.g.[Cys(ACM)2.7]hCGRP) and antagonistic (e.g., hCGRP 12-37) potencies in various isolated tissues. Moreover, the weak but significant antagonistic properties of hCGRP 12-37 may be most useful in order to design more potent CGRP receptor antagonists.

Animals↗
PubMed1989

[Sequential study of the plasmatic atrial natriuretic factor and the urinary excretion of an ouabain displacing factor and of dopamine in normotensive pregnant women before and after labor].

Estimation of urinary excretion of a ouabain displacing factor (ODF) and dopamine was carried out immediately before delivery, 7 days and 70-90 days after delivery in 12 normotensive pregnant women. Simultaneous estimation of plasma 99-126 atrial natriuretic factor (ANF), plasma renin activity (PRA) and plasma aldosterone were also undertaken. The data were compared with those obtained in a non pregnant normotensive group of women (n = 14) and a group of pregnant normotensive women in the early third trimester (n = 14). Urinary ODF and dopamine were significantly higher in the early third trimester when compared with non pregnant women but immediately before delivery, ODF excretion had fallen below non pregnant values and dopamine excretion had dropped to control values. Both remained low after delivery. Plasma ANF was higher in pregnant women when compared with non pregnant controls and remained high just before delivery and 7 and 70-90 days after delivery. PRA and plasma aldosterone were higher during pregnancy and had fallen to non pregnant values 7 days post-partum. It is concluded that there is considerable discrepancy in the evolution of natriuretic and antinatriuretic factors before and after delivery and that the drop of PRA and aldosterone by 7 days post-partum, contrasting with the unchanged high values of ANF, may contribute to negative sodium balance after delivery.

Adult↗