[Association of sclerosing cholangitis and ankylosing spondylitis].
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Cholangitis, Sclerosing↗
Biomedical subjects
E Bertrand
Publications and source records attributed to E Bertrand.
Can hammerhead ribozymes be efficient tools to inactivate gene function?
In order to improve hammerhead ribozyme efficiency and specificity, we have analyzed, both in vitro and in vivo, the activity of a series of ribozyme/substrate combinations that have the same target sequence but differ in the length of the ribozyme/substrate duplex or in their structure, i.e., the total length of the RNA. In vitro, we have found that optimal kcat/Km (at 37 degrees C) is obtained when the ribozyme/substrate duplex has a length of 12 bases, which according to the base composition represents a calculated free energy of binding of -16 kcal/mol. We discuss the importance of this value for ribozyme specificity and present strategies that may improve it. Increasing the length of the duplex from 14 to 17 bases (from -19 to -26 kcal/mol) produces a reduced ribozyme activity which is probably due to a slower rate of product dissociation. In addition, inclusion of either the substrate or the ribozyme in a long transcript produces a reduction (10 fold) of the kcat/Km, probably because of a different accessibility of the target sequence. In vivo, the activity of the trans-acting ribozyme was extremely low and detected in only one case: with a ribozyme/substrate duplex length of 13 bases and with both ribozyme and substrate embedded in short RNAs expressed at a very high level. The similarity of the results obtained in vitro and in vivo indicates that it is possible to use an in vitro system to optimize ribozymes which are to be used in vivo. Satisfactory results were obtained in vivo only with cisacting ribozymes. Altogether these results suggest that the ribozyme/substrate hybridization step is the limiting step in vivo and therefore it is not clear if ribozymes represent an improvement over antisense RNAs.
Base Sequence↗
Intracytoplasmic single sperm injection: preclinical training and first clinical results.
OBJECTIVE: Our purpose was to reduce oocyte damage before clinical application of intracytoplasmic single sperm injection by training on aged unfertilized oocytes. DESIGN: Intracytoplasmic single sperm injection (ICSI) was accomplished by micromanipulation of sperm and oocytes. PATIENTS: Thirty-four patients consented to donate unfertilized aged oocytes to train for ICSI. Forty-four patients suffering from severe male infertility were treated with ICSI. INTERVENTION: Oocytes were inseminated by intracytoplasmic single sperm injection. MAIN OUTCOME MEASURES: Oocyte damage and fertilization and pregnancy rates were the outcome measures. RESULTS: One hundred fifty-one aged unfertilized oocytes were gathered for training of which 121 were injected with a single sperm and 30 without a spermatozoon as a control group for activation. Oocyte damage, initially as high as 40%, was reduced to 15% after 60 oocytes. Normal fertilization (2PN) occurred in 18%, and polyploidy in 4.4%. The cleavage rate was 69%; none of these embryos were transferred. In the control group, seven oocytes were damaged, seven (30%) showed one pronucleus, and one showed two pronuclei. No cleavage was observed in the control group. In the clinical trial, 44 patients (61 cycles) were clinically treated with the same ICSI procedure, including 575 of 721 collected oocytes. Damage was 13%, activation was 11%, normal fertilization was 30%, and 5 (1%) polypoid zygotes were observed. The fertilization rate ranged from 5 to 100%, with a mean of 39.5 +/- 4% (SE). Nine patients had no fertilization (15%). Ninety-six percent of the zygotes cleaved and 47% were at the four-cell stage 45 hr after injection. One hundred twelve embryos were replaced in 48 transfers (2.3 embryos/ET). One live birth, one miscarriage, and eight ongoing pregnancies were obtained (22%/ET). CONCLUSION: Preclinical practice on aged unfertilized oocytes seems useful before starting clinical ICSI, as the high initial oocyte damage can be reduced and subsequent clinical treatment successfully applied.
Cell Survival↗
Gliomatosis cerebri at the 17-year-old girl--correlations of histological, CT and MRI appearance.
The neuropathologic findings are compared with CT scans and MRI in the case of gliomatosis cerebri; a 17-year-old girl died 2 years after the first epileptic seizure and the onset of neurologic signs. CT scans showed two poorly defined, hypodense foci: the major one in the left parietal white matter and the minor one in the right frontal white matter. MRI demonstrated on T2 weighted image bilateral diffuse increased signal intensity changes with focal high signal mass in the right frontal white matter and cortex as well as in the left occipito-temporal white matter and cortex. The brain coronal sections showed widespread and diffuse neoplastic infiltration in both cerebral hemispheres: corpus callosum, basal ganglia, brainstem and cerebellum. In the microscopic examination diffuse gliomatous infiltration was found.
Adolescent↗
Visualization of the interaction of a regulatory protein with RNA in vivo.
We have adapted to RNA molecules the ligation-mediated polymerase chain reaction (LMPCR) procedure of genomic sequencing [Mueller, P. R. & Wold, B. (1989) Science 246, 780-786]. This new procedure, the reverse ligation-mediated PCR (RLPCR), is sufficiently sensitive to allow "in vivo" footprinting of minor RNA species. It is based on the ligation of an RNA linker of known sequence to every 5' end resulting from the cleavage of total cellular RNA. Target RNA molecules are specifically reverse-transcribed and the resulting products are amplified by PCR. The localization of the initial 5' ends is ultimately determined on a sequencing gel. To demonstrate the validity of this strategy, we have used RNase T1 treatment of permeabilized cells and RLPCR and have detected in vivo iron-depletion-dependent footprints on two iron-responsive elements of the transferrin receptor mRNA.
Base Sequence↗
A highly sensitive method for mapping the 5' termini of mRNAs.
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Base Sequence↗
Abnormal sperm-mucus penetration test predicts low in vitro fertilization ability of apparently normal semen.
OBJECTIVE: To investigate whether Kremer's sperm-mucus penetration test may predict sperm fertilizing ability in IVF. DESIGN: Kremer's test was prospectively performed on semen samples used for 66 consecutive IVF trials and compared with the fertilization rates and fertilization failure rates observed. RESULTS: Fertilization rates were significantly reduced in cases of abnormal Kremer's test (42% versus 51%; n = 745 oocytes with a statistically insignificant increase in fertilization failure rates (21% versus 10%; n = 66 trials). For abnormal semen, fertilization rates (39% versus 39%; n = 208 oocytes) and fertilization failure rates (20% versus 28%; n = 17 trials) were similar regardless of Kremer's test result. For normal semen, an abnormal Kremer's test implied a significant decrease in fertilization rates (44% versus 54%; n = 537 oocytes) with a statistically insignificant increase in fertilization failure rates (21% versus 6%; n = 49 trials). CONCLUSIONS: Abnormal Kremer's test results identify patients with a decreased in vitro fertilizing ability despite apparently normal semen samples and a group with very low fertilizing failure risk in case of normal semen samples and normal Kremer's test. Kremer's test does not add any predictive value to sperm analysis in the case of abnormal semen samples. These observations point out the importance of the male factor in fertilization failure even in the case of normal semen analysis.
Cervix Mucus↗
[Comparison of hospital prevalence of rheumatic heart diseases and acute rheumatic arthritis in France and Africa].
This study reports the results of a multicentre enquiry performed in France in 1990 which included 41,242 adults hospitalised in Cardiology Units, 33,907 children hospitalised in Pediatric departments and 8,868 soldiers. A comparative enquiry was also carried out in North Africa (Tunis) and West Africa (Abidjan, Ouagadougou). The results of the French arm of the enquiry showed that rheumatic heart disease (RHD) has become very rare in adults (3.1% of all cardiac disease) and that it tends to occur in older subjects (average 54.4 years of age). There is practically no RHD in young adults. This decreased prevalence of RHD is confirmed in children in whom this diagnosis represents only 0.04% of cases of all cardiac disease--of which 87.5% are of extra-European origin. In contrast, there is a high frequency of RHD in Tunisia (29.3%) and West Africa (13.2% in Abidjan and 13% in Ouagadougou). The disease remains active as is shown by the age of affected adults in Africa (average 21 and 27 years of age). The results also show a reduction to a very low prevalence of acute rheumatic fever in French pediatric departments (0.005%). The authors discuss the reasons for the persistence of endemic infection in Africa: virulence of the streptococcus, predisposing factors (HLA group?), geographic factors and, above all, socioeconomic factors and difficulties in obtaining treatment and prophylaxis. A movement of international cooperation is suggested in order to combat RHD in Africa, especially with regards to its prevention in childhood.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
[Coronary disease with normal coronarography in the black Africans: epidemiological and clinical data in 31 cases. Role of abnormal hemoglobins].
The authors studied 31 cases of coronary artery disease with normal or minimally diseases coronary arteries in black Africans, 29.8% of 104 coronary patients undergoing coronary angiography in this series. These 31 cases comprised 16 cases of infarction, 10 cases of angina, 3 ventricular aneurysms and 2 cases of silent ischemia in diabetic patients. Twenty-five patients were men (80.6%). There were 6 women (19.3%) two of whom presented in the post-partum period. The average age of these patients was 45 years (males: 47.7 years; females: 41.8 years). The following risk factors were noted: smoking (60%), hypertension (25.8%), obesity (29%), diabetes (12.9%), serum cholesterol (average 2.15 g/l), serum triglycerides (average 1.25 g/l). The risk index per patient was 1.29. In comparison with coronary patients with angiographic coronary lesions (n = 73), the patients with normal angiography were significantly younger, comprised more females and had fewer risk factors (especially hypertension and diabetes), though this was not statistically significant. The prevalence of inaugural infarction was 81.2% in the cases of infarction with normal coronary arteries. These infarcts may be complicated by ventricular aneurysm formation. Spontaneous spasm was observed in 3 out of 31 patients (9.6%) at coronary angiography. A provocative test was performed in only 2 cases and 1 was positive. This deserves further study and may have therapeutic implications. The authors emphasise the high incidence of hemoglobin S or C traits (57.1%). These heterozygotic hemoglobinopathies could be a risk factor in these coronary patients with normal coronary angiography.
Adult↗
[Spontaneous coronary artery dissection: apropos of a case with associated spasm and regression of the dissection].
The authors report the case of a 34 year old woman with postpartum myocardial infarction due to spontaneous coronary dissection of the distal circumflex artery. A spontaneously regressive spasm of the right coronary artery was also observed. The outcome with heparin, glyceryl trinitrate and calcium antagonist therapy was favourable. Over one year later, coronary angiography showed total resolution of the dissection and a large aneurysm of the inferior and septal walls of the left ventricle. This case is an example of post-partum spontaneous coronary dissection, in a particular vascular context. There are, however, other causes of spontaneous coronary artery dissection (atherosclerosis, eosinophilic syndrome...). Spasm may aggravate the consequences of coronary artery dissection and cause worse myocardial damage. The medical treatment, especially with regards to thrombolytic therapy, requires further codification.
Adult↗
[Coronary disease in black Africans].
Coronary artery disease remains rare (6% of all cardiovascular disease) in black Africa despite its progression in recent years. Infarcts in black Africans have similar characteristics to those seen in Western countries in patients aged under 40, notably regarding the frequency of infarcts as the first manifestation of the disease, the small number of stenoses and the incidence (18%) of patients with normal coronary arteriography (spasm? thrombosis?). Risk factors are the same as in Western countries, but the hemoglobin S or C trait could be a predisposing factor. The long-term outcome of infarcts is severe because of notable myocardial sequelae of imprecise origin: delayed hospitalisation and absence of thrombolysis? absence of angioplasty? socio-economic problems and lack of health education.
Adult↗
Comparative auto-controlled study between swim-up and Percoll preparation of fresh semen samples for in-vitro fertilization.
This study compared swim-up and Percoll preparation of fresh semen samples for in-vitro fertilization. Sixty trials of in-vitro fertilization (IVF), 38 with normal semen and 22 with abnormal semen, comprising 734 oocytes were included in the study. Each semen sample was prepared by both a swim-up technique and a simplified discontinuous (50%, 70%, 90%) Percoll gradient. The oocytes for each trial were distributed at random between the two sperm preparations and incubated with the same number of motile spermatozoa. Percoll gradient preparation produced a significantly higher final concentration of spermatozoa than swim-up preparation (mean +/- SEM: 6.6 +/- 1.5 x 10(6)/ml versus 1.9 +/- 0.2 x 10(6)/ml; P less than 0.01) but a significantly lower sperm motility (69 +/- 2% versus 94 +/- 1%; P less than 0.001) and a lower number of normal forms (55 +/- 2% versus 64 +/- 2%; P less than 0.01). The ability of the Percoll gradient method to extract motile spermatozoa was higher than that of the swim-up technique (20 +/- 15.6% versus 0.8 +/- 13.6%). Nevertheless, the rates of fertilization (61%), fertilization failure (18%) and polyspermia (9%), embryo quality evaluated by mean embryo scores (3.8 +/- 0.3) and the mean number of spare embryos frozen per trial (1.4 +/- 0.3) were strictly identical in both groups. The 24 pregnancies (including three from frozen--thawed embryos) obtained in these 60 trials (40% per oocyte retrieval) could not be separated according to the sperm preparation method, as embryos from both groups were replaced together.(ABSTRACT TRUNCATED AT 250 WORDS)
Cell Separation↗
Rheumatic heart disease in Africa.
Rheumatic heart disease continues to be relatively common in many parts of Africa, predominantly affecting young people. Special attention should be given to its prevention by the inexpensive methods that have proved effective elsewhere, and to this end assistance should be provided by the international community.
Adolescent↗
[Coronary disease in black Africans: epidemiology, risk factors, clinical symptomatology and coronarography, evolution].
The study of the epidemiological data (published since 1952) seems to show an increasing frequency of the coronary disease for 15 last years. But this incidence seems to reach a stable level about 6 to 7% of the cardiovascular diseases at the Abidjan Institute of Cardiology; and 3.17% in a study in 13 countries but without coronarography (except at the Abidjan Institute). The study of the risk factors show that they are the same ones than in Europa. The risk index in Black Africa was 2.1 to 2.7 risk factor patient. These numbers are lesser than the risk index noted in France (3.6 in coronary patients and 1.9 in non-coronary subjects). The signs of the disease show that myocardial infarctions were frequent (48.8%) and often were the first manifestations of the coronary disease (40%). Angina pectoris was observed in 32.2%, an ischemic cardiomyopathy in 6.6% and a ventricular aneurysm in 6.6%. A silent ischemia was observed in 5.5% among at risk diabetic patients. The in-hospital mortality after myocardial infarction was 15% and was the same in European and African patients. But the mortality in Africans was greater than in Europeans the next years. Coronarography showed that 18.8% of the patients with coronary disease had normal coronary arteries. The arteries were also normal in 19.9% of the patients examined after an infarction. These high percentages can be related to coronary arterial spasms or to recanalized thrombosis. A spontaneous spasm was observed in 6.6% of the patients (a provoked coronary arterial spasm was not studied. The coronary arterial lesion was an one artery disease in 38.8% of the coronary patients and 50% of the patients with infarction. The stenosis were frequently proximal (82.6%) and the anterior descending artery was interested in 45.6%. Ventricular aneurysms were observed in 56.6% and the ejection fraction was lower than 0.50 in 63.3%. These data permit to compare the myocardial infarction of Blacks with the myocardial infarction of the young occidental men. We can think that thrombolysis or angioplasty would be very useful but they are often impossible in the Black African conditions.
Africa↗
[Acute thrombosis of the brachial artery and beta-thalassemia-sickle cell anemia].
The authors report about one case of left branchial arterial thrombosis in a 6-year-old child with thalassemia-sickle cell disease. In their opinion, although this hemoglobinopathy usually causes microthrombosis, its existence at the same time as that of the brachial thrombosis does not seem to be a coincidence. The actual origin of this disease remains to be found, as well as the role that thrombocytosis may play. The authors emphasize the relative rarity of thrombolytic arterial diseases in African Negroes and advise practitioners to recognize them, because their diagnosis, often established late in our climates, has severe consequences.
Acute Disease↗
[Education of patients taking antivitamin K].
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Anticoagulants↗
[Development of echocardiographic and Doppler parameters after orthotopic cardiac transplantation, except during rejection periods].
The aim of this study was to evaluate spontaneous changes of Doppler and echocardiographic parameters of cardiac transplants in the absence of rejection. Based on 258 recordings representing the follow up of 30 patients after orthotopic cardiac transplantation in the absence of histological signs of rejection on biopsy within 24 hours, we tried to define: the evolution of these parameters from the first postoperative week to after the 30th month (average 12 months); the Doppler echocardiographic values of "normal" transplants: the values observed one year after surgery were compared with a control group age-matched to the donors.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Transposition of the great vessels in western Africa. Apropos of 17 cases observed at the Institute of Cardiology in Abidjan].
During the last 10 years, 17 children with transposition of the great arteries (TGA) were admitted to the Cardiology Institute of Abidjan: 1 case between March 1978 and December 1985, 16 cases between January 1986 and December 1989. The average age was 58 days (range 5 to 270 days) at the first consultation, and 90 days (5 to 270 days) at the time of admission. The diagnosis was confirmed by echocardiography and hemodynamic investigation in 12 cases. There were 9 simple forms of TGA, 7 with ventricular septal defects (VSD) and 1 with VSD and pulmonary stenosis. Two children were taken back by their parents before any treatment was given. A Rashkind atrial septostomy was carried out in 11 children which increased aortic oxygen saturation from 35 +/- 18 percent to 57 +/- 19 percent; there were 3 unsuccessful procedures in children aged 2, 3 and 5 months with 2 deaths. Five patients later underwent surgical correction by a Senning procedure in 4 cases and anatomical correction in 1 case with VSD. All are well after an average 15 months follow-up (1 to 48 months). One of the 8 children awaiting surgery died. Therefore, TGA is not a rare abnormality in Black Africa; it represents 2 percent of the 887 cases of congenital heart disease observed during the same period. The inadequacy of means of diagnosis is certainly the cause of the relatively low incidence of this malformation, of the considerable delay in under specialist care and, as a consequence, of the greater difficulties in treatment, especially with regards to atrial septostomy.(ABSTRACT TRUNCATED AT 250 WORDS)
Angiocardiography↗