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Biomedical subjects

C Fournier

Publications and source records attributed to C Fournier.

At least 235 records · Page 13Linked to original sources
PubMed1977

[The action of D-penicillamine on the distribution of T and B-lymphocytes in rheumatoid arthritis].

Comparative study of the numbers of T and B lymphocytes in cases of rheumatoid polyarthritis treated and untreated with D-penicillamine shows that in the untreated subjects the distribution of these two types of lymphocytes is comparable with that in normal subjects and that D-penicillamine does not alter this distribution. This purely quantitative investigation does not rule out the possibility of functional modifications in the cells studied.

Adult↗
PubMed1977

[Electrocardiogram in the "typical angina of effort with normal arteriography" syndrome].

This study related to 163 cases of chest pain with the typical clinical features of angina of effort (AE) selected from a continuous series of patients who had carotid arteriography (CA) for anginal pain. These 163 cases were divided into two groups: a study group (SG) consisting of 44 patients with a normal CA, and a control group (CG) which, when patients with ECG evidence of transmural necrosis had been excluded, consisted of 119 cases of coronary artery stenosis, almost all amounting to more than 75 percent. Among those with typical AE (without ECG evidence of transmural necrosis), the proportion of normal CA was 27 percent. It was reduced to 17 percent when those patients with ECG evidence of transmural necrosis were added to the CG. The clinical features of the pain were noted for the SG and the CG, as well as the incidence of "risk factors". By contrast, the SG contained significantly more young subjects and females than the CG (P less than 0.001). The proportion with normal ECGs at reat was the same in the two groups (32 percent). The proportion of non-ischaemic abnormalities of repolarisation was 32 percent in the SG and 18 percent in the CG. Ischaemic abnormalities of repolarisation were present in 23 percent of cases in the SG, and in 49 percent in the CG (p less than 0.01). The exercise test on a bicycle ergometer was carried out for 16 cases in the SG was positive in 7 (44 percent: one male, six females). Of the 33 tests in the CG, a positive response was obtained in 20 (60 percent: 18 males, 2 females) (NS). 37 percent of patients in the SG showed an abnormality of volume or of left ventricular kinetics on arteriography (5 cases) and/or elevation of the end-diastolic pressure before and after arteriography (9 cases). These findings are not significantly different from those in the CG. 9 patients in the SG were studied for myocardial metabolism under pacing: 2 were found to have abnormalities in lactate production.

Adult↗
PubMed1977

[Long-term results of aortocoronary bypass. 1. Clinical aspects].

Eighty patients undergoing one or several aorto-coronary bypass graft procedures had longterm clinical and arteriographic follow-up (mean follow-up period of two years, extremes 1 and 6 years). The indication fort operation in these patients was unstable angina in 39 (49%), threatened infarction in 16 (20%), Prinzmetal's angina in 8 (10%), and stable but incapacitating angina in 17 (21%). Significant lesions involved the three coronary trunks in 49 cases, two trunks in 25 cases, and one trunk in 6 cases. The longterm clinical results were excellent in 65% of cases, and fair in 26%; the procedure failed in 9% of cases. Angina pectoris either disappeared or improved in 96% of cases. After operation, myocardial infarctions occurred in 11 cases (14%), 7 of which were early and 4 late with a delay of 1 to 4 years. The pre-operative cardiac failure disappeared or decreased in 13 cases out of 16. Finally the quality of the clinical results does not seem to be influenced by the various indications for operation with the exception of Prinzmetal's angina, where the results have been excellent in all cases (8 cases out of 8).

Adult↗
PubMed1977

[Long-term results of aortocoronary bypass. 2 Angiographic aspects].

Follow-up arteriograms carried out between one and six years (mean follow-up period two years) in 80 cases of aorto-coronary bypass graft procedures showed a good correlation between the quality of the clinical results obtained -- as detailed in the first part of this article -- and a larger proportion of patent grafts: 82% of 130 grafts had remained patent, and 94% of patients have all or some of their grafts patent. Late occlusion of the grafts is rare, and does not appear to be influenced by abnormalities of the graft found at early follow-up, these abnormalities being fairly stable. These follow-up have especially shown the good correlation between the quality of the clinical results and the functional status of the coronary network in the long term, a function not only of the permeability of the grafts which have been carried out, but also of the complete or incomplete correction of the lesions of the three coronary trunks. Such a complete procedure which was carried out or could have been carried out in only 30% of the total patients, was then successful in 94% undergoing it. The clinical results should therefore lead us to carry out operations which remove the lesions as completely as possible.

Adult↗
PubMed1976

T lymphocytes in kidney allograft recipients.

The spontaneous sheep erythrocyte (E) rosette test was used on 340 occasions to measure T cell levels in 28 renal allograft recipients. The E rosette counts were reduced by high-dose steroids but usually returned towards normal under maintenance treatment with azathioprine and low-dose prednisone. Unexpectedly, rejection crises were more often associated with a decrease in E rosettes before steroid treatment (12 cases) than with an increase in E rosettes (5 cases). Our results show the need for caution in using the E rosette test and more generally B and T cell markers for monitoring anti-graft immunity in renal allograft recipients.

Azathioprine↗
PubMed1976

Determination of DNA antibodies in normal and pathological sera by a new counterimmunoelectrophoresis method.

A quantitative counter-immunoelectrophoresis technique has been applied to the evaluation of antibodies against native and single-stranded DNA. Anti-DNA antibodies have been found at high dilutions in patients with systematic lupus erythematosus, without correlation with the existence of renal lesions or with the degree of DNA binding assessed by Farr assay. Significant precipitates were also observed at significantly lower dilutions in other pathological situations and in normal subjects, posing the problem of the nature of the precipitates in these cases.

Antibodies↗
PubMed1976

[Anatomic study of early failures of aortocoronary venous bypass].

A post-mortem study of 10 patients who died soon after an aorto-coronary by-pass procedure (16 grafts) showed that 5 grafts were blocked by recent thrombus (31%) in 5 patients, 3 of whom had infarcts as a result. It seems that the two main causative factors of early thrombosis were: -the wider calibre of the saphenous graft; the ratio of the circumference of the graft to the circumference of the coronary artery at the site of anastomosis is greater when there is a graft thrombosis (5.6/1 +/- 2.2) than when the graft is permeable (2.3/1 +/- 1.1) (p less than 0.01); -stenosing atherosclerosis of the artieal tree beyond the anastamosis. Changes in the endothelium of the vein, especially those caused by suturing, could equally well play a part in thrombus formation. Certain other factors, such as an insufficiently large graft ostium into the aorta, and poor outflow in the distal arterial bed, or an insufficiently large territory of supply belonging to the artery which has been bypassed, may also influence the degree of myocardial revascularisation brought about by the operation. A by-pass procedure requires a vein graft with a reasonably small diameter which matches, if at all possible, that of the coronary artery, and a good flow in the distal arterial bed, which must be confirmed at operation.

Adult↗
PubMed1975

Regulation of theta-antigen expression by agents altering cyclic AMP level and by thymic factor.

Thymic factor, cyclic AMP, and products increasing its cellular level, such as Prostaglandin E1, induce the appearance of the theta-antigen on T-cell precursors whether assessed by a rossette-inhibition assay or a cytotoxic assay after cell fractionation on BSA discontinuous gradiet. Synergism has been demonstrated between cyclic AMPT and TF for that effect. Conversely, decrease of theta expression has been obtained by altering cyclic AMP level in theta-positive cells either increasing it by dibutyryl cAMP treatment or decreasing it by indomethacin treatment. Finally, these data suggest the involvement of cyclic AMP in the regulation of theta expression under thymic hormone control.

Acetylcholine↗
PubMed1975

[Long-term course of nonoperated tricuspid insufficiency following surgical correction of mitral and mitro-aortic valve diseases].

This study concerns 120 patients with tricuspid incompetence (TI) combined with mitral or mitral-aortic valve disease. This first part is devoted to the 48 patients TI of whom was not corrected, and the long-term course (average 40 months) after mitral-aortic lesions correction was analysed. Assessment of the degree of TI at operation differed markedly from its pre-operative clinical assessment; surgical findings agreed with the clinical estimations in 10 of 12 cases of TI considered to be negligible, but only in 4 of 24 cases with a TI considered as intense clinically. The long-term unfavourable courses (TI with persistent right ventricular failure) were more common in the group of TI considered intense clinically (59%) than in the TI considered clinically as negligible (23%). Assessment by the surgeon during operation of the degree of TI seemed a less accurate element of valuation of the long-term prognosis. The mean pulmonary artery pressure measured at operation did not have, in the patients studied, a significant influence on the long-terme course after mitral-aortic valve correction. On the contrary, the results were less favourable in the group of patients whose TI was old-standing and in the group of patients with a cardio-thoracic ration higher than 0.65. It seems therefore legitimate to recommend correction of both the cases of TI considered to be intense by the surgeon, and those considered to be intense clinically, even if the surgeon finds them to be negligible. This attitude is the more justified the older the TI and the larger the heart enlargement.

Aortic Valve↗
PubMed1975

[Long-term course of tricuspid insufficiency operated during the surgical correction of mitral and mitro-aortic valve diseases].

This study concerns 120 patients with tricuspid incompetence (TI) combined with mitral or mitral-aortic valve disease. This second part is devoted to the 72 patients whose TI was corrected together with the mitral-aortic valve lesions, and the long-term post-operative course (average 40 months) was analysed. The results were correlated with pre-operatice clinical intensity of the TI: un unfavourable course (persistent TI and right ventricular failure) was noted in 56% of the cases of TI judged to be intense and in 29% only of the cases of TI judged to be clinically negligible (p is less than 0.5). The course varied according to the mode of tricuspid valve repair with a good long-term result in 37% of the 30 cases with Kay's annuloplasty, 62% of the 26 prosthetic valve replacements and 69% of the 13 cases treated by Carpentier's annuloplasty. This latter technique seems to represent the most efficient means of correction for TI, when the anatomical lesions allow for it. In the group of the patients studied, the course is independent from the degree of heart enlargement and from the pulmonary artery pressure level before operation.

Aortic Valve↗
PubMed1975

Comparison of angiographic aspects and anatomical lesions of coronary arteries.

The coronary angiograms of 32 patients were compared with the anatomical lesions found during the postmortem examinations which were done early after the X-ray examination. The angiographic and anatomical data coincided in 81.6 per cent of all the coronary artery segments studied. The best coincidence was observed for the right coronary artery and the less accurate for the left coronary trunk (nevertheless, with 77 per cent good correlations). On the whole, the observer tends to underestimate the severity of the stenoses involving the large trunks (left coronary trunk and anterior descending artery) and to overestimate the involvement of the distal segments, especially if their size is small. Habitually, the errors noted are insufficient to modify the therapeutic attitude. Rarely, on the anterior descending artery, they have led to the performance of an uneccessary aorta-to-coronary by-pass (1 case) or to an unjustified conservative attitude (2 cases). Equally, over-estimation of a distal bed to a left circumflex artery was responsible for an abusive contra-indication (1 case). Thus, if on the whole coronary angiography is a fiable examination, it is necessary to resort to new incidences to improve its results.

Coronary Disease↗