Search PubMed⌕ Search

Biomedical subjects

E Bertrand

Publications and source records attributed to E Bertrand.

At least 127 records · Page 7Linked to original sources
PubMed1985

[Anatomo-clinical forms of left endomyocardial fibrosis. Study of 22 surgically treated cases].

The authors studied 22 patients with operated left sided endomyocardial fibrosis (EMF). Twenty patients had pure left sided and 2 bilateral (mainly right sided) EMF. The mean age of the patients was 14 years (range 7-51 years). Three clinico-pathological forms of the disease were identified: obliterating, diffuse and limited. The mechanism of associated mitral regurgitation was papillary muscle and/or posterior leaflet involvement. The anterior mitral leaflet was not affected in any of these cases. Echocardiographic diagnosis was possible in 18 cases by M mode recording showing M-shaped septal wall motion. The diagnosis was made in 5 out of 13 patients by 2D echocardiography. This method was satisfactory in the obliterating form of the disease but direct visualisation of the fibrosis in the diffuse and limited forms was very difficult. Catheter studies showed severe pulmonary hypertension in all cases. The presence of a dip-plateau pressure recording was inconstant and was only observed in the obliterating and diffuse forms of EMF. Angiocardiography was characteristic in the obliterating and diffuse forms and enabled an accurate anatomical diagnosis before surgery. The diagnosis of the limited form was difficult and could only be suspected in cases of mitral regurgitation associated with right ventricular EMF or in the presence of parietal recesses. This surgical series does not include cases of EMF limited to the ventricular apex without mitral regurgitation or adiastole, treated medically.

Adolescent↗
PubMed1985

[Pulmonary artery aneurysms in patent ductus arteriosus].

Two cases of pulmonary artery aneurysm are reported in patients with persistent ductus arteriosus (PDA). The first was a mycotic aneurysm complicating staphylococcal pneumonia; the other was a calcific aneurysm of the right pulmonary artery. The mycotic origin was confirmed in the first case. The aetiological roles of pulmonary hypertension and previous endocarditis are discussed in the second case. Based on these two observations, the authors analyse the aetiology and evolution of mycotic aneurysms and review the therapeutic problems posed by their association with PDA.

Adolescent↗
PubMed1984

[Early coronary atherosclerosis in a malignant pheochromocytoma. Apropos of a case].

An observation of adrenergic myocarditis with clinical and electrical signs of coronary failure is reported. The patient had electrical and enzymatic manifestations of acute anteroseptal necrosis, complicated at the acute stage by complete atrioventricular block and fatal vasoplegic circulatory collapse. Post-mortem examination showed obstructive atherosclerosis of the anterior interventricular artery without anatomic signs of infarction. Pathogenesis of this coronary failure is discussed. In this case, functional coronary insufficiency produced by catecholamine release was associated with coronary atherosclerosis.

Adrenal Gland Neoplasms↗
PubMed1984

Influence of histone hyperacetylation on nucleosomal particles as visualized by electron microscopy.

Recently, Bode et al. [J. Bode, M. Gómez-Lira, and H. Schröter (1983) Eur. J. Biochem. 130, 437-445] have observed that monomeric nucleosomal particles from butyrate-treated Namalva lymphoma cells display a distinct heterogeneity in their mobilities on a nondenaturing 4% polyacrylamide gel. They have proposed that histone hyperacetylation induces a conformational change in monomers that can be modulated by the presence of HMG 14/17. The electron microscopic analyses presented here support these proposals.

Acetylation↗
PubMed1984

Right ventricular dysfunction after endocardiectomy for right ventricular endomyocardial fibrosis.

Early right ventricular failure following a large endocardiectomy in right endomyocardial fibrosis (EMF) is reported. This diagnosis was confirmed upon echocardiography by the presence of a dilated right ventricle, and hemodynamically (upon postoperative control catheterization) by the presence of right ventricular diastolic dysfunction. The role of the endocardiectomy and of the pericardium in the genesis of this ventricular dysfunction are discussed in the light of this case which was documented by a hemodynamic study and surgically confirmed.

Adolescent↗
PubMed1984

[Echocardiographic, angiographic and hemodynamic development of surgically treated endomyocardial fibrosis].

The echocardiographic, angiographic and haemodynamic evolution of endomyocardial fibrosis (EMF) was assessed in 19 patients: 8 patients with isolated right sided EMF, 3 with predominantly right-sided EMF, and 8 with isolated left sided EMF with mitral regurgitation. Echocardiographic controls were preformed in 16 patients, on average 11.3 months after surgery; angiographic and haemodynamic controls were preformed in 14 patients, on average 14 months after surgery. In isolated or predominantly right-sided EMF, echocardiographic abnormalities of septal motion (paradoxal) disappeared. Although the volume of the right heart chambers decreased, they remained dilated. The syndrome of adiastole disappeared in patients operated early. In left EMF with mitral regurgitation, the M-shaped motion of the septum regressed in the 4 cases in which this abnormality was observed preoperatively. The size of the left heart chambers decreased on post-operative echo and angiographic studies. Left ventricular function returned to normal after surgery. The author underline the differences between right and left-sided EMF with mitral regurgitation. In right-sided EMF the evolution is that of adiastole and surgery should be preformed early because the right ventricular reserve is small. In left-sided EMF with mitral regurgitation, the evolution is that of a valvular lesion with a good postoperative result.

Adolescent↗
PubMed1984

[Conservative valve surgery in endomyocardial fibrosis. Apropos of 8 cases among 46 surgically treated patients].

The authors report their experience of conservative valvular surgery in endomyocardial fibrosis (EMF) (8 cases among 46 surgical cases). These patients were divided into 3 groups: Group I: bilateral EMF predominating on the left side with associated tricuspid involvement (n: 3). Group II: bilateral EMF predominating on the right side with moderate associated mitral involvement (n: 3). Group III: unilateral EMF with massive mitral insufficiency, (n: 2). At surgery, on the side of the conserved valve, the patients had a transvalvular endocardectomy (n: 3) and a valvuloplasty either tricuspid (n: 3) or mitral (n: 5). The results of the valvuloplasty were satisfactory. Two patients died in the post-operative period. Their death was unrelated with the conservative procedure. The authors study the literature concerning the cases of valvular conservative surgery in EMF (n: 4) and define the conditions under which this surgery can be done. They report 2 original cases of pure left sided limited EMF with massive mitral insufficiency successfully treated by a valvuloplasty.

Adolescent↗
PubMed1984

[Acute bilharzial cor pulmonale due to Schistosoma mansoni].

The authors report a cause of acute cor pulmonale caused by Schistosoma mansoni bilharziosis. The clinical feature was a collapse with right ventricular failure following a delivery. The hemodynamic exploration showed a pre-capillary and supra-systemic pulmonary hypertension. The histopathologic study in post-mortem showed pulmonary lesions of fibrosis endarteritis with granulomatosis reaction round many eggs of Schistosoma mansoni. The authors discuss the frequency of various anatomic lesions (20, 30%), hemodynamic (20%) and clinical (2,5%) of the pulmonary bilharziosis. They recall the anatomical and histological mechanisms of the pulmonary artery hypertension in this disease. They emphasize the originality of this observation which is due to its super acute character and its Schistosoma mansoni bilharziosis etiology whereas pulmonary demonstrations are usually due to Schistosoma haematobium.

Acute Disease↗
PubMed1984

[Endomyocardial fibrosis or fibroplastic endocarditis. Indications and results of surgical treatment].

Endocardial fibrosis is most common in tropical regions where it affects young subjects. Fibroplastic endocarditis appears to be the same condition, seen in temperate countries. Fibrosis of the endocardium is the common lesion which initially involves the endocardium and not the myocardium. These lesions result in a restrictive and a valvular syndrome. The author recalls the signs of the right-sided, left-sided and bilateral forms of the disease. The signs in common to all forms are early diastolic endocardial vibration, arrhythmias and conduction disturbances and the possibility of endocardial calcifications. The disease progresses towards death within 3, 4 or 5 years after the discovery of the condition. Medical treatment is effective initially. Surgical treatment improves the prognosis, as demonstrated by the comparative study conducted in Abidjan between 30 operated patients and 31 non-operated patients. The most favourable forms are the isolated left-sided forms. However, surgery is indicated in all forms whenever there are signs of a restrictive syndrome or a moderate to severe mitral incompetence. The only definitive contra-indication at the present time is the presence of recurrent ascites with hepatic fibrosis.

Adolescent↗
PubMed1983

Endomyocardial fibrosis masquerading as rheumatic mitral incompetence. A report of six surgical cases.

This report presents six cases (among 43 surgical cases) of left ventricular EMF presenting as pure mitral insufficiency without any echocardiographic or hemodynamic signs of left ventricular EMF (except apical diverticulum in two cases). Five of these cases were diagnosed at operation, and the sixth was diagnosed on the basis of a characteristic right ventricular angiogram. At operation a fibrotic lesion localized to the level of the anteropapillary muscle, with severe mitral insufficiency, was found. Five patients underwent successful mitral valve replacement and one a successful conservative mitral valve procedure. Postoperative angiograms, done in two patients, showed a normal contour of the left ventricle. A review of the literature did not reveal any previous descriptions of this type of limited left ventricular EMF, mimicking rheumatic mitral insufficiency. In our surgical experience, we have encountered three types of left ventricular EMF: obliterative, extensive, and limited. We emphasize EMF as a possible cause of mitral insufficiency in African children.

Adolescent↗
PubMed1983

[Superior bullous retinal detachment: value of the intravitreous injection of sulfur hexafluoride].

15 cases of superior bullous hemi-retinal detachment were repaired during a 16-month period, with a post-operative follow-up of 3-19 months. Intravitreal injection of 0,75-1,5 cc of pure sulfur hexafluoride (SF 6) was performed in 9 cases. The indications for injection at the end of the procedure were: 1) absence of chorioretinal contact in spite of an indentation in the correct position; 2) fishmouth configuration of the retinal break; 3) presence of radial folds over an indentation parallel to the limbus. Only two out of patients required a second operation, due to the development of proliferative vitreoretinopathy. One case was unsuccessful because of a redetachment secondary to massive periretinal proliferation. No complication was observed with the injection of SF 6. In particular, ocular hypertension was avoided by controlling the amount of gas used, always inferior to 2 cc, and postoperative treatment with acetazolamide and topical timolol. The intraocular injection of SF 6 appears to be useful contribution to the surgical treatment of superior bullous hemi-retinal detachment, allowing effective and durable internal tamponade, while avoiding prolonged bedrest.

Absorption↗
PubMed1982

Endomyocardial fibrosis: early and late results of surgery in 20 patients.

Twenty patients with endomyocardial fibrosis (EMF), the largest series reported to date, were operated upon between June, 1978, and June, 1980. Eleven were male and nine female, ranging in age from 6 to 23 years (mean 13.3 years). There were seven cases of right ventricular (RVEMF), six of left ventricular (LVEMF), and seven cases of bilateral EMF. All patients underwent endocardiectomy and atrioventricular valve replacement with a xenograft. Four patients had an additional valvular annuloplasty. There were four postoperative deaths (all bilateral EMF): two from low cardiac output and one each from hepatic failure and cerebral malaria. There was one late death from serum hepatitis. The other patients had a relatively difficult postoperative course, but none of the 20 patients atrioventricular block. The longest follow-up of the 15 survivors is 28 months (mean 16.7 months). All patients are symptom free. Three take digitalis and/or diuretics. Ten have been recatheterized from 6 months to 1 year after operation. Intracardiac pressures, the ventricular cineangiogram, liver, and heart size returned to normal in patients with LVEMF; in RVEMF, despite clinical improvement, most of these parameters remained abnormal. Of special interest were (1) our recognitions of an early type of LVEMF and (2) our surgical preservation of a thin juxta-annular rim of fibrosis in the right ventricle to avoid atrioventricular block. Operation is indicated in all patients with LVEMF, despite greater risk. Early intervention is advised in RVEMF to avoid irreversible liver damage and cardiac enlargement.

Adolescent↗
PubMed1981

A genetic approach to the geography of hypertension : examination of Na+ - K+ cotransport in Ivory Coast Africans.

Outward Na+ - K+ cotransport in erythrocytes from essential hypertensive Caucasian subjects was found to be excessively low (Co -) compared to normotensives (Co +) carefully selected for their negative family history of hypertension. Since the frequency of essential hypertension varies widely among different populations and is particularly high in certain coloured peoples, we compared erythrocyte Na+ - K+ cotransport in normotensive and hypertensive subjects in Paris (France) and in Abidjan (Ivory Coast) to seen whether defective cotransport was related to high blood pressure in the African group as well. Of the 66 French unselected normotensives investigated, 26 (39%) were Co - whereas 14 of the 18 Ivory Coast unselected normotensives (79%) were Co -. 64 (80%) of the 80 essential hypertensives examined in France were Co -, but the proportion of Co - subjects among the Ivory Coast hypertensives was even higher. In addition, both hypertensives and normotensives in the African groups often had undetectable outward Na+ effluxes, a rare finding in the French subjects. We suggest that the high incidence of abnormal Na+ - K+ cotransport in the Ivory Coast series may reflect a genetic propensity to hypertension in this population, and that consequently, Na+ - K+ erythrocyte cotransport measurements might prove useful in defining geographic variations in hypertension.

Adolescent↗
PubMed1981

[Determination of normal pressure in 15756 African school children from 11 to 18 years old in the Ivory Coast. Comparative study of an African group and an European group].

Blood pressure readings of 15756 coloured African schoolchildren aged between 11 and 18 years old were studied. The measurements were casual readings. The study group was not perfectly representative of the school population. However, from the practical point of view, the data may be used in the whole Ivory Coast school population in the 11 to 18 years age range. The distribution of the average readings with respect to age and sex is indicated on Table II. Abnormally high blood pressure was defined as readings greater than the average BP + 2 standard deviations, to the nearest 0,5 cm Hg (to take the practical problems of BP measurement into account). Under these conditions, all boys and girls between 11 and 18 years of age with BP greater than or equal to 150/90 (except boys of 17-18 years of age for whom the limit was 155/95) were considered to be hypertensive. According to these criteria the prevalence of hypertension in coloured African schoolchildren was: -systolic hypertension: 4,86% boys and 4,03% girls; -diastolic hypertension: 4,20% boys and 5,09% girls; -systolic or diastolic hypertension: 6,77% boys and 7,54% girls; -systolic and diastolic hypertension: 2,29% boys and 1,57% girls. In fact, these would be children "at risk" rather than hypertensive. The true number of hypertensive children would only become apparent on follow-up. A comparison with coloured African and white European schoolchildren in the same schools in Abidjan showed that the average BP readings and prevalence of hypertension was higher in the coloured population but the difference was not always statistically significant. The small number of European children made comparison difficult. The data obtained was compared to previously reported series but it was difficult to draw conclusions because of differences in methodology.

Adolescent↗