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Biomedical subjects

A Simon

Publications and source records attributed to A Simon.

At least 433 records · Page 24Linked to original sources
PubMed1986

[Essential arterial hypertension: a strategy for the use of antihypertensive drugs].

Mild to moderate essential arterial hypertension affects almost 15 p. 100 of middle-aged adults in the general population. Although its individual vascular complications are few, it constitutes a problem of public health since a large number of patients implies a large number of complications in the population. Hypotensive therapy has proved capable of preventing mechanical complications of vascular rupture, but epidemiological studies have not yet demonstrated that it reduces the frequency of atherosclerosis of the coronary arteries and, probably, of other arteries at risk. A more detailed physiopathological approach to the vascular system in hypertensive patients therefore is necessary, notably to investigate the interactions between arterial hypertension, atherosclerosis and antihypertensive drugs. Meanwhile, the therapeutic strategy remains empirical, its principal goal being the degree of fall in blood pressure. The large number of drugs currently prescribed as first-choice treatment (diuretics, beta-blockers, calcium antagonists, angiotensin converting enzyme inhibitors) has complicated the conventional treatment by successive prescription of drugs with additive effects and has paved the way for a new therapeutic approach involving substitution and trying to find, for each individual patient, one or two effective drugs.

Adult↗
PubMed1986

Fetal activity in premature rupture of membranes.

Fetal movement (FM) counts by mothers with premature rupture of membranes (PROM) may be helpful in estimating fetal well being, provided FM assessment is not altered by the reduced amniotic fluid. It is possible that the decreased uterine volume restricts fetal movements, though the closer contact of the fetus to the uterine wall may enhance maternal perception of even weak FM. The present study compared maternally perceived FM in 41 cases of PROM to 120 uncomplicated pregnancies. No significant differences in FM counts were detected between the two groups at any of the gestational ages. Fetal movement counts by mothers with PROM, therefore, can assist fetal surveillance as is the case in pregnancies with intact membranes.

Female↗
PubMed1986

Anencephaly and the nature of fetal response to vibroacoustic stimulation.

The fetal response to vibroacoustic stimulation has been used in recent years as a measure of well being. Vibroacoustic stimulation theoretically may evoke both tactile and auditory responses in the fetus. In clinical practice, it is important to distinguish which type of response is actually activated. An answer may be suggested through observation of two anencephalic fetuses who demonstrated no response to such stimulation. Neuroanatomic considerations are discussed that suggest which auditory mechanisms are involved in the fetal response to vibroacoustic stimulation.

Acoustic Stimulation↗
PubMed1986

Isosorbide dinitrate and pulsatile arterial haemodynamic variables in hypertension.

The effect of a sustained-release oral isosorbide dinitrate (ISDN) preparation on cerebral and forearm circulation was determined in 16 patients with mild to moderate essential hypertension. Measurements were made by pulsed Doppler velocimetry in the common carotid and the brachial arteries. Pulse wave velocity of the forearm was simultaneously recorded by means of strain gauge arterial mechanography allowing non-invasive evaluation of compliance and characteristic impedance of the brachial artery. Four hours after ISDN ingestion, the patients exhibited a significant decrease in blood pressure without a change in heart rate. An increase in carotid and brachial artery diameter was shown whereas blood flow increased only in the forearm. Resistance decreased significantly in both carotid and brachial vascular beds but only in the brachial vascular bed was the baseline resistance directly correlated with the change in brachial bed resistance. Concerning pulsatile large artery parameters, pulse wave velocity and characteristic impedance diminished, and brachial artery compliance increased significantly. The tangential tension of carotid and brachial arteries did not change. An increase in plasma renin activity was observed and related to the vasodilating effect on small arteries of the brachial vascular bed. This study showed that the antihypertensive effects of ISDN were accompanied by a strong vasodilatory action on small and large arteries and by an improvement in the pulsatile behaviour of large arteries.

Adult↗
PubMed1986

The sulphoxide moiety of substituted benzimidazoles is essential for inhibition of parietal cell K+/H+-ATPase.

The antisecretory action of the benzimidazole sulphoxide derivative B 823-10, 2[(4-methoxy-3-methyl-2-pyridylmethyl)-sulphinyl]- 5-trifluoromethyl(1H)-benzimidazole, was compared with the effect of the corresponding sulphide B 823-08 in several in vivo and in vitro and in vitro test systems. The sulphide B 823-08 and the sulphoxide B 823-10 were found to be equipotent in the Shay rat. The sulphide was found to inhibit H+ secretion in intact rabbit gastric glands and enriched guinea-pig parietal cells with lower potency than the corresponding sulphoxide. The relative potency in antisecretory activity (sulphide/sulphoxide) decreased in the following rank order: Shay rat: gastric glands: parietal cells. Purified K+/H+-ATPase was not blocked by the sulphide, whereas the sulphoxide inhibited the overall as well as the partial reactions of this enzyme. In all in vitro systems tested, inhibition of H+ secretion and enzyme activity by the sulphoxide, but not by the sulphide, was antagonized by SH-compounds such as dithiothreitol. It is concluded that in vivo sulphoxidation of the sulphide plays an important role in acid inhibition. In vitro an additional inhibitory mechanism of the sulphide has to be considered.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1986

Computed tomography prior to surgery for ovarian carcinoma.

The value of investigation of patients with ovarian carcinoma by preoperative computed tomography scan was evaluated in all the patients operated on during the last 2 years; 22 patients were included in this study and evaluated. In 11 patients the scan was performed prior to the primary surgery and in the other 11 patients before second look following chemotherapy. CT scan was found to be highly sensitive in detecting ascites, pelvic wall extension and spread or involvement of the uterus. Peritoneal and omental spread was detected in only half of the patients before primary surgery. Prior to second look operation CT scan was effective in excluding liver metastasis, ascites, paraaortic lymph node enlargement, pelvic wall extension and pelvic residual tumour. Generally, CT scan failed to detect peritoneal and omental spread. It is an important tool for preoperative evaluation of the extension of the disease and planning of surgery, but still, the final staging deserves explorative laparotomy.

Altretamine↗
PubMed1986

Intrapartum vibroacoustic stimulation in cases of normal and abnormal fetal heart rate patterns.

The fetal heart rate (FHR) response to a vibroacoustic stimulation was studied in 100 women during active labor. Three types of FHR responses were noted: acceleration, tachycardia of duration longer than 2 min, and combined acceleration-deceleration response. The last type was significantly more common in labors with abnormal FHR tracings. All fetuses demonstrating FHR response to the stimulation, including those with abnormal FHR tracings, had good outcome. The vibroacoustic stimulation is easily performed, noninvasive, and has no contraindications. Its possible application as an intrapartum test of fetal well-being awaits further clinical confirmation.

Acoustic Stimulation↗
PubMed1986

Fetal activity in pregnancies complicated by rheumatic heart disease.

Severe cardiac disease in pregnancy may be complicated by reduced placental perfusion and subsequent fetal deprivation. In the present study we have evaluated one fetal parameter that may thus be affected, namely fetal activity. The study group included patients with rheumatic heart disease: 36 women with mild and 5 with severe disease. Each counted fetal movements 3 times a day and from this the daily fetal movement recording was calculated. One hundred and twenty women with normal pregnancies were the controls. The mild cases had fetal activity which was similar to that of the controls. The severe cases had reduced fetal activity, which was significant statistically at 29 to 32 weeks of gestation. Three in the severe disease group had marked decrease of fetal movements on admission to hospital. A return to normal fetal activity was observed following improvement of the maternal cardiac state. As was previously suggested for other high and low risk pregnancies, the maternal perception and counting of fetal movements may aid the fetal surveillance of patients with rheumatic heart disease.

Female↗
PubMed1986

Cytomegaly in benign ovarian cysts.

We report two cases of benign ovarian cysts that revealed cytomegaly of the epithelial lining cells. One case was a large solitary luteinized follicle cyst of pregnancy and puerperium. The other case was an endometrial cyst. Changes in the cells included marked pleomorphism and hyperchromasia of the nuclei, large amounts of cytoplasm, and lack of mitotic figures. We ascribed these cellular features to hormonal effects and stress the importance of recognizing such changes and differentiating them from malignancy.

Adult↗
PubMed1985

The effect of estradiol on human myelomonocytic cells. 1. Enhancement of colony formation.

Cyclic changes were observed in the content of blood monocytes during the menstrual cycle of normal women. Elevated blood monocytes were found during the ovulation period as well as in other conditions which are associated with increased blood estradiol (E2). To understand the possible association between E2 and monocytosis, we analysed the in vitro effect of E2 on the development of myelomonocytic colonies in culture. E2 in physiological concentrations was found to increase the number of colonies developed from peripheral blood mononuclear cells (PBM) of both females and males. The optimal concentration for the augmenting effect on males' PBM was lower than that for females. Mononuclear cells derived from cord blood, which yielded much higher numbers of colonies than adult PBM, also responded to the stimulatory effect of E2. Estrone and estriol were less effective than E2 in adult PBM. In contrast, progesterone, diethylstilbestrol and testosterone did not affect the number of colonies at the range of physiological concentrations tested. The anti-estrogen Tamoxifen did not inhibit the stimulatory effect of E2. The augmenting effect of E2 on monomyelocytic colony formation may explain at least in part the increase in blood monocyte content of women with high E2 as well as other phenomena of macrophage and granulocyte changes associated with the menstrual cycle.

Adult↗
PubMed1985

Development of macrophage and granulocyte colonies from human peripheral blood.

The presence of macrophage and granulocyte progenitor cells in the human peripheral blood enabled the establishment of colonies from this accessible tissue and obviated the need for bone marrow to achieve this task. We have developed a method of obtaining reproducible growth of macrophage/granulocyte colonies from human peripheral blood. Colonies of macrophages and granulocytes were obtained by plating peripheral blood mononuclear cells (PBM) in methylcellulose containing medium in the presence of medium conditioned by nonstimulated PBM (CM). At early stages of colony growth both macrophage and granulocyte colonies were detected while following 20-25 days in culture all colonies tested revealed monocyte-macrophage morphology. To obtain higher numbers of colonies, we tested different cell sources, different CM preparations and the effect of steroid hormones on colony development. We found that the mononuclear cells obtained from cord blood (CB) or from some patients with inflammatory bowel disease yielded much higher numbers of colonies than PBM from normal individuals. Colony development from these two sources did not depend on an external source of colony stimulating factor (CSF) but was augmented as a result of CSF supplementation. CM obtained from CB mononuclear cells as well as supernatants from some human monoblastic cell lines were similar in their CSF activity to CM from normal PBM and made possible the development of macrophage/granulocyte colonies. Higher numbers of colonies were induced by including physiological concentrations of estradiol in the culture medium, in the absence of external sources of CSF. The system described above enabled the analysis of cloned macrophages and their circulating progenitor cells as well as the assay of different preparations of CSF.

Adolescent↗
PubMed1985

Pulsed Doppler evaluation of diameter, blood velocity and blood flow of common carotid artery in sustained essential hypertension.

Diameter, blood flow velocity, and volumic flow of the common carotid artery were measured in 38 patients with sustained essential hypertension and compared with those of 38 age-matched normal subjects. Both hypertensive and control subjects were classified according to age into those younger and those older than 45 years. For the determinations, a pulsed Doppler velocimeter with an adjustable range-gated time system and a double transducer probe was used. In the younger group, the diameter of the common carotid artery had a similar value in hypertensive patients (0.639 +/- 0.014 cm) and in controls (0.651 +/- 0.015). The same level of blood flow velocity in hypertensive patients (19.7 +/- 0.9 cm/s) and in controls (21.2 +/- 0.9 cm/s) was observed. Therefore, the volumic flow was equal in the common carotid artery of the hypertensive patients (385 +/- 20 ml/min) and of the normotensive subjects (410 +/- 23 ml/min). In the older group, blood flow velocity was reduced in the common carotid artery of the hypertensive patients (19.4 +/- 1.0 cm/s vs. 15.6 +/- 0.6 cm/s; p less than 0.01), but the diameter was unchanged (0.653 +/- 0.018 cm in hypertensive patients and 0.665 +/- 0.018 cm in controls). Thus, there was a significant reduction of volumic blood flow in common carotid artery of the hypertensive patients over 45 years (321 +/- 14 ml/min). A negative relationship was observed between common carotid artery blood flow and age in elderly hypertensive patients (r = -0.42; p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Fetal movements in hypertensive pregnancies.

The maternally perceived fetal movements counts of 273 hypertensive patients were compared to normal controls and their degree of fetal activity was related to perinatal outcome. Pregnancy induced hypertension was associated with fetal activity which was significantly lower than controls at the beginning of the third trimester and significantly higher at term. In cases of chronic hypertension patients, 8 had cessation or marked reduction of fetal movements to less than 4 in 12 hours, and all had poor fetal outcome. The remaining 265 hypertensive patients had a 92% incidence of good fetal outcome. Markedly reduced fetal movements in hypertensive patients are highly suggestive of fetal distress and following verification by additional tests the appropriate clinical measures should be undertaken.

Female↗