[Surgical problems in the treatment of mitral valve insufficiency of ischemic origin].
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Coronary Disease↗
Biomedical subjects
C Perret
Publications and source records attributed to C Perret.
[Barotrauma and decompression illness: diagnosis and adjuvant medical treatment in recompression].
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Barotrauma↗
[Vasopressin in acute myocardial infarct: clinical implications].
Since current data on vasopressin (AVP) secretion during the early phase of myocardial infarction is not extensive, plasma AVP was measured in 26 patients with acute myocardial infarction. Twelve had an increased AVP concentration (23.2 +/- 7.0 pg/ml; mean +/- SEM) whereas 14 had an AVP level less than 3 pg/ml (1.96 +/- 0.14 pg/ml). The patients with AVP greater than 3 pg/ml had higher heart rate and plasma osmolality than those with AVP less than 3 pg/ml. Blood pressure values were the same in both groups of patients. There was no difference in peak CPK and iso CPK activities between the two groups. Seven patients with AVP greater than 3 pg/ml died within the next few days, while only 1 patient with AVP less than pg/ml died. It thus appears that increased AVP concentration during acute myocardial infarction is associated with a poor prognosis. Whether it is a cause or a consequence of an unfavourable course of myocardial infarction remains to be determined.
Adult↗
Molecular cloning of the avian beta-nerve growth factor gene: transcription in brain.
A chicken gene cross-hybridizing with a murine beta-nerve growth factor (beta NGF) cDNA probe was identified by Southern blot analysis and isolated from a genomic DNA library. The DNA sequence coding for the putative mature beta NGF protein was determined, providing direct evidence for the existence in birds of a neurotrophic factor sharing a high degree of sequence homology with mammalian beta NGF. In addition this gene is shown to be transcriptionally active in adult avian brain as demonstrated by Northern blot analysis.
Animals↗
[Prevention of acute renal insufficiency due to nontraumatic rhabdomyolysis].
Nine patients with nontraumatic rhabdomyolysis underwent preventive treatment for acute renal failure (ARF) (vascular filling, furosemide, dopamine, Na bicarbonate, allopurinol). Four patients developed functional azotemia and 4 others ARF with conserved diuresis and normalization of renal function without substitutive treatment. Only one patient remained oligoanuric and needed hemodialysis for 3 weeks. Comparing these 3 groups it appears that the severity of the renal impairment is due on one hand to the extent of the muscular lysis and on the other to early commencement of preventive treatment.
Acute Kidney Injury↗
[Fulminant gram-negative (CDC-dysgonic-fermenter 2) septicemia in a splenectomized patient].
In a 43-year-old woman admitted because of fever and high cardiac output shock, disseminated intravascular coagulation with purpura was present. The peripheral blood smear revealed the presence of intraleukocytic elongated bacilli, but growth of bacteria (further identified as DF2) in the blood cultures was detected only two weeks after admission. Despite intensive therapy with hemodynamic and respiratory support, associated with broad spectrum antibiotherapy, the patient died on the third day of hospitalisation. The past medical history of the patient revealed splenectomy for Hodgkin's disease 4 years previously, but no recent dog bite.
Adult↗
Evidence of rhythmic inhibitory synaptic influences in hindlimb motoneurons during fictive locomotion in the thalamic cat.
Intracellular recordings of various motoneurons of proximal hindlimb muscles were performed on thalamic paralyzed cats, during fictive locomotion that was either spontaneous or evoked by stimulation of the subthalamic region. In motoneurons innervating sartorius (medialis and lateralis), vasti (intermedius, medialis and lateralis) and anterior biceps-semimembranous, one depolarization occurred in each locomotor cycle, alternating with a phase of repolarization that was synchronous with the activation of the antagonistic muscle nerve. This latter phase could be decreased or reversed by intracellular injection of chloride ions or current, revealing the presence of inhibitory inputs onto motoneurons. The pattern of membrane potential variations was more complex in motoneurons of rectus femoris and posterior biceps-semitendinosus muscles, but phases of chloride dependent inhibition were nevertheless identified, mainly during the sartorius nerve activation in the case of rectus femoris, and during the vasti and anterior biceps-semimembranosus nerve activations in the case of posterior biceps-semitendinosus. These inhibitory influences were shown to be controlled by the level of activity in exteroceptive afferents. The characteristics of the excitatory and inhibitory inputs to the hindlimb motoneurons identified here are discussed in relation with the organization of the central pattern generator for locomotion.
Animals↗
In situ detection of vitamin D-induced calcium-binding protein (9-kDa CaBP) messenger RNA in rat duodenum.
We have previously described the molecular cloning of a cDNA fragment synthesized from rat duodenal mRNA coding for a 9000-dalton vitamin D-induced calcium-binding protein (9-kDa CaBP) (3). We now report the use of this cloned cDNA to study the cytological distribution of 9-kDa CaBP mRNA in rat duodenum by in situ hybridization. Tissue sections, fixed in ethanol:acetic acid, were hybridized to the 3H-cDNA probe and processed for autoradiography. The specificity of the CaBP mRNA-DNA hybrid formation was checked using 3H-labeled plasmid pBR322 DNA as a control probe. 9k-Da CaBP mRNA, visualized by silver grains, was found only in the absorptive epithelial cells, and the concentration was greater in the cells at the villous tips than in those of the crypts. The 9k-Da CaBP mRNA was observed mainly in the cytoplasm of the columnar cells and less frequently in the nucleus. Labeling was not seen in the brush border and goblet cells. The submucosa, with Brunner's glands and muscularis, also showed no specific 9-kDa CaBP mRNA concentration. This demonstration of 9-kDa CaBP gene activity in the columnar cells of the rat duodenum illustrates the usefulness of in situ hybridization for characterization of specific cells involved in the expression of 1,25(OH)2 D3 activity.
Animals↗
Distribution of vitamin D-dependent calcium-binding protein messenger ribonucleic acid in rat placenta and duodenum.
The vitamin D-dependent calcium-binding protein (CaBP), cholecalcin or calbindin, is one of the best documented molecular expressions of 1,25-dihydroxyvitamin D, the hormonal metabolite of vitamin D. In this report, DNA/RNA hybridization assays have been used to examine cholecalcin (CaBP) mRNA production in the placenta and duodenum of 21-day pregnant rats. A cloned CaBP cDNA which codes for the rat intestinal 9000 mol wt cholecalcin (9KCaBP) was radiolabeled and used in hybridization assays to explore 1) the size and relative quantities of CaBP mRNA extractable from placenta and duodenum by molecular hybridization, and 2) the localization and quantification, by in situ hybridization histochemistry, of CaBP mRNA in specific cells in rat placenta and duodenum. Northern hybridization studies show that the [32P]cDNA sequence hybridizes to a single 500- to 600-nucleotide species in the placenta as in the duodenum and, therefore, demonstrate identical 9KCaBP mRNA processing in both tissues. Dot blot hybridization studies show that the concentration of 9KCaBP mRNA was greatest in the duodenum, while that of the inner (fetal) placenta was about 50% the duodenal level. Considerably less CaBP mRNA was found in the outer (maternal) placenta. The observed differences in 9KCaBP mRNA levels correlate well with the in vivo variations in 9KCaBP concentrations. In situ hybridization histochemistry using [3H]cDNA reveals that 9KCaBP mRNA visualized by silver grains was concentrated in the inner placenta over the cytoplasm of syncytial cells in the trophoblastic epithelium of the labyrinth and much less frequently in the cells of the outer placenta. In the duodenum, 9KCaBP mRNA was found only in the absorptive epithelial cells from the crypt region to the upper part of the villi. The silver grains were distributed throughout the cytoplasm of the columnar cells; they were densest in the perinuclear region and rarest in the nuclear region. The concentration was greater in the cells at the villous tips than in those of the crypts. This difference in 9KCaBP mRNA levels correlates well with the distribution of the protein itself along the villi. CaBP mRNA quantities detected by hybridization histochemistry showed greater labeling in the syncytial cells of the trophoblastic epithelium of the labyrinth than in the absorptive epithelial cells of the upper part of the villi (200% less), indicating accumulation of CaBP mRNA at a greater rate in the trophoblastic epithelium than in the absorptive epithelial cells. These results indicate that in the rat, 9KCaBP is synthesized in both the absorptive cells of the duodenum and the cells of the trophoblastic epithelium of the placenta.
Animals↗
[Treatment of dilated cardiomyopathies. Recent findings].
The drug therapy of decompensated cardiac insufficiency in dilated cardiomyopathies is based, still today, on the association of digitalis and diuretics, even though doubts had been expressed about the long term efficacy of glycosides. In the search for an ideal inotropic agent, several molecules recently synthesized are being investigated. The results obtained are not entirely satisfactory, either because the functional advantage is finally exhausted, or because of the frequency of side effects. Among the vasodilators, inhibitors of the conversion enzyme give better results by producing a substantial and lasting improvement of the ventricle performance, without tachyphylaxis or sympathetic compensation phenomenon. In some patients,the use of Beta-blockers could be beneficial, but the definitive proof is not yet furnished and the results are inconsistent.
2,2'-Dipyridyl↗
[The special case of right ventricular infarct. Physiopathologic study].
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Cardiac Catheterization↗
[Mechanical recanalization and dilatation of coronary arteries in the acute stage of myocardial infarction].
The time between coronary artery occlusion and reperfusion remains the decisive factor for myocardial function in acute myocardial infarction. Of 110 patients admitted to hospital less than 3 hours after the onset of chest pain, 83 underwent intracoronary thrombolysis with streptokinase or urokinase. 27 patients underwent mechanical recanalization with the aid of a steerable guide wire (Schneider 0.014") followed by transluminal angioplasty of the residual stenosis. 70 of 83 patients (84%) were recanalized by intracoronary streptokinase perfusion within 45 +/- 10 minutes. By mechanical recanalization the occluded artery could be recanalized in 27 patients within 6 +/- 1 minutes. During the same session transluminal angioplasty was performed while the affected coronary artery was perfused for 20 minutes with 20,000-50,000 U streptokinase. 2 patients died after intracoronary thrombolysis (2.4%) and 1 patient died after mechanical recanalization (3.7%). 25 of 26 survivors of the mechanical recanalization group were discharged after bicycle stress testing, and 1 patient underwent a coronary bypass operation. In the intracoronary thrombolysis group, 4 patients presented with reobstruction of the affected vessel within 24 hours of the intervention (4.8%). Of the remaining 66 patients. 20 underwent transluminal coronary angioplasty (285), 16 coronary bypass (22%) and 30 received drug therapy (43%). Left ventricular injection fraction, measured 24 hours after treatment, was 63 +/- 10% in the mechanical recanalization group and 53 +/- 9% in the intracoronary thrombolysis group.
Adult↗
[Myocardial involvement in nontraumatic rhabdomyolysis following an opiate overdose].
Eight young addicts developed rhabdomyolysis as a complication of heroin overdose. ECG, plasma enzyme time activity curves and thallium myocardial scintigraphy were highly suggestive of a myocardial lesion associated with rhabdomyolysis. Such changes were particularly striking in 3 patients with acute left ventricular failure, as shown by a hemodynamic investigation (3 patients) and by echocardiography (1 patient). All patients recovered but myocardial scintigraphy and ECG remained abnormal for a period ranging from 8 months to 3 years following the acute episode. Although associated metabolic changes may play a role in myocardial dysfunction, the most likely mechanism appears to be a direct toxic effect of heroin on cardiac muscle.
Adult↗
Cholecalcin (a 9-kDa cholecalciferol-induced calcium-binding protein) messenger RNA. Distribution and induction by calcitriol in the rat digestive tract.
In view of the possible physiological importance of the 9-kDa cholecalcin (a 9000-Mr cholecalciferol-induced calcium-binding protein) in the intestinal transport of calcium in mammals, the gene expression of this protein has been analysed. Its regulation in the digestive tract of the growing rat by calcitriol (1,25-dihydroxycholecalciferol) was studied using a specific cloned [32P]cDNA to 9-kDa cholecalcin. Northern hybridisation studies show that the cDNA sequence hybridises to a single 500-600-nucleotide species throughout the digestive tract and therefore demonstrate identical 9-kDa-cholecalcin mRNA processing in the whole of the intestine and caecum. The highest concentrations of cholecalcin mRNA occur in the duodenum, proximal jejunum and caecum. The observed differences in 9-kDa-cholecalcin mRNA levels correlate well with both the in vivo variations in cholecalcin itself and with the known intestinal sites of calcium absorption. The whole intestine is able to respond to exogenous calcitriol but the response of the distal intestine and caecum, as measured by the increase in cholecalcin mRNA and corresponding protein, was proportionally higher than in the duodenum. The rapid production of fully functional cholecalcin mRNA, which was detectable as early as 1 h after a single dose of calcitriol to vitamin-D-deficient rats, provides convincing evidence that calcitriol increases 9-kDa cholecalcin production by increasing cholecalcin gene expression at the transcriptional level.
Animals↗
Characterisation of rat 9-kDa cholecalcin (CaBP) messenger RNA using a complementary DNA. Absence of homology with 28-kDa cholecalcin mRNA.
The rat possesses two cholecalciferol-induced calcium-binding proteins, the cholecalcins (CaBP). The 9-kDa CaBP is mainly concentrated in the duodenum while 28-kDa CaBP is located in the kidney and cerebellum. The mRNA encoding 9-kDa CaBP has been characterised using the cloned cDNA, pC109, synthesised from rat duodenal 9-kDa CaBP mRNA [Desplan et al. (1983) J. Biol. Chem. 258, 13502-13505]. Nucleotide sequence analysis of this cDNA shows the presence of two stop codons, TGA and TAG, at positions 207 and 271, respectively, of the 3' untranslated region. The cDNA-hybridised mRNA, isolated from rat duodenum, directs the cell-free synthesis of two proteins precipitable by antisera to 9-kDa intestinal CaBP. A major protein comigrates with 9-kDa CaBP whereas a minor product corresponds to a protein which is larger by 2000 Da. The minor protein appears to result from read-through of the 'leaky' UGA stop signal. No protein band which was immunoprecipitable with 28-kDa CaBP antiserum was detected when cDNA-hybridized mRNA from rat kidney and cerebellum was translated in a cell-free system. Northern blots show that the cDNA pC109 sequence hybridizes to a homogeneous mRNA species 500-600 nucleotides long from rat duodenum. Larger mRNA species encoding 28-kDa CaBP are undetectable in rat kidney and cerebellum even under low stringency conditions. All these findings demonstrate that there is no cross-hybridisation between 9-kDa and 28-kDa CaBP mRNAs. Southern blot analysis of rat genomic DNA, that shows only one homologous 9-kDa gene, is consistent with these findings. Thus, all our data indicate that there are distinct genes coding for each rat cholecalcin.
Animals↗
[Acute myocardial dysfunction in meningococcal septicemia].
A progressive myocardial dysfunction is known to occur in prolonged septic shock. The cases of two patients with acute meningococcal infection and Waterhouse-Friderichsen syndrome are reported. Hemodynamic measurements showed, in the early stage, the classical picture of hyperdynamic septic shock, with increased cardiac output and low systemic vascular resistances. However, rapidly progressive cardiac failure then occurred, with high filling pressures and low cardiac output. One patient went into irreversible shock. In the other the administration of inotropic agents was beneficial, with a slow but progressive improvement in left ventricular function over several weeks. Acute myocarditis has been frequently observed in patients with meningococcal infections. It is suggested that the acute myocardial failure observed in those circumstances is caused by the myocarditis.
Acute Disease↗
[Hemodynamic and respiratory effects of phentolamine in pulmonary hypertension secondary to chronic obstructive syndrome].
The hemodynamic and respiratory effects of phentolamine i.v. (15-30 mg/h) on pulmonary hypertension following chronic obstructive pulmonary disease (COPD) have been studied in 13 patients under stable conditions. Phentolamine produced a significant reduction in mean pulmonary arterial pressure, right and left ventricular filling pressures and right ventricular stroke work index. Cardiac index and oxygen delivery increased significantly. Individual analysis showed that in 7 patients the driving pressure decreased across the pulmonary circulation with concomitant increase in cardiac output, suggesting a direct vasodilating effect of phentolamine on the pulmonary circulation. Pulmonary gas exchange did not change significantly. In conclusion, in patients with pulmonary hypertension following COPD phentolamine given i.v. may have beneficial effects on right ventricular function and peripheral oxygen delivery without detrimental effect on gas exchange.
Aged↗
[Epidemic listeriosis. Report of 25 cases in 15 months at the Vaud University Hospital Center].
25 cases (14 adults, 11 neonates) of Listeria monocytogenes infection were observed during a 15-month period (1983/1984) at the University Medical Center (CHUV) in Lausanne (Switzerland), in contrast to a mean of only 3 cases per year during the period 1974-1982. Eleven of 14 adults had neuromeningeal disease (3 meningitis, 7 meningoencephalitis, 1 encephalitis), and 3 patients had septicemia, two of whom were pregnant women. Among 8 adults with CNS parenchymal infection, 6 had involvement of the brainstem (rhombencephalitis), none of whom had an underlying disease characteristically predisposing to L. monocytogenes infection. Prominent clinical features in all patients with neuromeningeal disease included altered consciousness, headache and fever, and in 7 out of 8 patients with parenchymal CNS involvement an influenza-like illness was present prior to the development of neurological symptoms. Among the neuromeningeal cases the mortality rate was 45% (5 of 11), and 4 out of 6 survivors had severe neurological sequelae. During this 15-month period L. monocytogenes had become the leading cause of adult bacterial meningitis in this hospital. This is the first report on epidemic listeriosis in Switzerland, although sporadic cases have been described for 20 years. In contrast to previous years, analysis of the seasonal variation of the cases shows a peak of L. monocytogenes infections during the winter months of 1983/84. The high incidence of human listeriosis was not associated with an increase in animal cases. The human cases were uniformly distributed over the area, apparently in relation to population density.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗