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Biomedical subjects

G Dreyfus

Publications and source records attributed to G Dreyfus.

At least 109 records · Page 6Linked to original sources

Effect of hydrostatic pressure on the mitochondrial ATP synthase.

The effects of hydrostatic pressure on three different preparations of mitochondrial H+-ATPase were investigated by studies of the hydrolytic activity, of the spectral shift and quantum yield of the intrinsic protein fluorescence, and of filtration chromatography. Both membrane-bound and detergent-solubilized forms of the mitochondrial F0-F1 complex were reversibly inactivated in the pressure range of 600-1800 bar, whereas with soluble F1-ATPase the inactivation was irreversible. Pressure inactivation of soluble F1-ATPase was facilitated by decreasing the protein concentration, indicating that dissociation is an important factor. In the presence of 30% glycerol, soluble F1-ATPase becomes inactivated by pressure in a reversible fashion, recovering the original activity. ATPase activity measured in an aqueous medium returns to the original values when incubated under high pressure in a glycerol-containing medium without substrate and is even enhanced when Mg-ATP is present. ATP hydrolysis returns to 80% of its original value in the case of the F0-F1 complex. Fluorescence studies under pressure revealed a red shift in the spectral distribution of the emission of tyrosine fluorescence of soluble F1-ATPase. A decrease in the quantum yield of intrinsic fluorescence was also observed upon subjection to pressure. The fluorescence intensity decreased monotonically as a function of pressure when the sample was in an aqueous medium, whereas it presented a biphasic behavior in a 30% glycerol medium. Gel filtration studies demonstrated that the hydrodynamic properties of the F1-ATPase are preserved if the enzyme is subjected to pressure in the presence of glycerol but they are modified when the same procedure is performed in an aqueous medium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Mechanical methods of treating refractory cardiac failure].

Mechanical means tend to be used more frequently nowadays for the treatment of congestive heart failure which does not respond to more normal treatment. The indications and limits of such devices, as well as their cost, must be defined. The new problem created by these therapeutic tools is the evolution of the underlying cardiac disease: should it improve the patient will be weaned from the machine, whereas if it worsens heart transplantation would be the only answer. Three types of mechanical support are described. Balloon pumping, and especially intra-aortic balloon pumping, is the technique used most often. It has a true but limited efficacy. Its best indication is cardiogenic shock by left ventricular ischaemia with normal or slightly increased peripheral resistances. Intrapulmonary balloon pumping is occasionally used, but the system can only be set up surgically. Its best indication would seem to be right-sided heart failure by pulmonary hypertension. Circulatory assistance is the second type considered. All types of bypass pumps can be used. The output used is usually less than the patient's theoretical output, the aim being to allow the myocardium to recover. Vascular access for these pumps is either femoral or intrathoracic. An oxygenator may or may not be added to the bypass circuit, and support may be mono- or biventricular. Although the non pulsatile flow has not been shown to be detrimental, this has to be investigated further. The use of these devices is limited by their effects on blood coagulation and pulmonary function. The artificial heart or artificial ventricles are the last devices described.(ABSTRACT TRUNCATED AT 250 WORDS)

Costs and Cost Analysis↗

Clinical comparison of mitral valve replacement using porcine, Starr, and Bjork valves.

The choice of a cardiac prosthesis for mitral valve replacement remains controversial, and thromboembolic complications are still a major cause of morbidity and mortality in patients with mechanical valves. Because of this, permanent anticoagulation with its risks and constraints on daily life is necessary. Bioprostheses, however, are associated with a lower rate of thromboembolic events. Therefore, the need for long-term anticoagulation is minimized. These advantages are counterbalanced by the limited durability of tissue valves. In an effort to give some perspective to this balance, we compared the long-term results of three commonly used mitral valve prostheses. Three hundred patients operated on in the same institution January 1974 to December 1978 form the basis of this evaluation.

Adolescent↗

[Histochemical quantification of muscular ischemia: effect of treatment with naftidrofuryl].

Evaluation of degree of muscle ischemia of a limb and its reversibility is a poorly resolved practical problem, and it has not been clarified whether vasodilatory and circulatory spasmolytic substances possess, in addition to an effect of increasing irrigation, any direct action on muscle cell energy metabolism. An experimental study used histochemical techniques to evaluate oxidative enzyme activity of tissues. The compound tetrazolium nitro-blue (NBT), when reduced by tissue dehydrogenases, has the property of producing a dense non-crystalline blue pigment designated "formazan". During muscle ischemia, the time of appearance of this reaction increases with degree of ischemia through the bias of the decrease or disappearance of succinate-dehydrogenases. Transient ischemia of hindpaw, over 3, 6, 9, 12, 15 and 18 hours, was provoked by tourniquet in 49 rats treated with a vasodilator (naftidrofuryl) and 21 untreated (control) rats. Spontaneous revascularization occurred after removal of the tourniquet. Muscles were studied by microsurgical removal of specimens on removal of tourniquet and 1 and 12 hours and 3, 7 and 14 days after its removal (fig. 1 and 2). Times for staining of muscles with tetrazolium were measured and curves of comparative times established (fig. 3 and 4). Histopathologic specimens were also obtained at the same periods (fig. 5, 6, 7). Results of histochemical studies with tetrazolium and with quantitative determination of degree of cellular anoxia showed the action of naftidrofuryl to be related to mitochondrial metabolism of skeletal muscle, specifically for succinate-dehydrogenase. Clinical application in the determination of therapy and of functional prognosis of an ischemic limb is a possibility by the use of the NBT test in vascular surgery.

Animals↗

Left ventricular outflow obstruction after mitral valve repair (Carpentier's technique). Proposed mechanisms of disease.

Left ventricular outflow tract obstruction (LVOTO) after mitral valve repair by Carpentier's technique has been recently reported in the literature. To assess the mechanisms of this phenomenon, we investigated 307 mitral valve repairs performed between July 1985 and December 1986. Incidence of LVOTO related to the mechanism of the mitral insufficiency and to the etiology demonstrates a direct relation to preoperative mitral valve prolapse (posterior leaflet +/- anterior leaflet) of degenerative origin. No LVOTO occurred after rheumatic mitral insufficiency repair regardless of size of the left heart cavities or of the prosthetic ring. Intraoperative and surficial two-dimensional echocardiography, color Doppler methods, and cardiac catheterization were used to investigate the mechanisms leading to LVOTO. Nonspecific modifications induced by reduction in size of the mitral annulus by the prosthetic ring (anterior displacement of the posterior ventricular wall and of the posterior mitral leaflet and narrowing of the mitroaortic angle) are not sufficient to explain the LVOTO. The association of mitral leaflets (composed of excess tissue and opposed to flow by a perpendicular position attributable to a narrow mitroaortic angle) and geometric left ventricular modifications (responsible for the superposition of mitral inflow to ventricular outflow) also qualifies as a mechanism for the induction of LVOTO after mitral surgical repair.

Cardiac Catheterization↗

Activation of Mg-ATP hydrolysis in isolated Rhodospirillum rubrum H+-ATPase.

The effects of lauryl dimethylamine oxide on the Rhodospirillum rubrum H+-ATPase have been studied. This detergent activates Mg2+-dependent ATP hydrolysis in the isolated R. rubrum F0-F1 34-fold, whereas the Ca2+-ATPase activity is only slightly modified. ATPase activation by lauryl dimethylamine oxide enhances the effect on ATP hydrolysis exerted by free Mg2+ ions. Concentrations of free Mg2+ in the range of 0.025 mM favor activation while higher concentrations inhibit ATPase activity by approximately 70%. Steady-state kinetic analysis shows that lauryl dimethylamine oxide induces a complex kinetic behavior for Mg-ATP in the chromatophores, similar to the untreated F0-F1 complex. The initial rate value for Mg-ATP unisite catalysis was found to be 6.3 times higher (3.5 X 10(-3) mol Pi per mol R. rubrum F0-F1 per second) in the presence than in the absence of detergent, where the initial rate was 5.5 X 10(-4) mol Pi per mol R. rubrum F0-F1 per second. These experiments show that lauryl dimethylamine oxide shifts the cation requirement for ATP-hydrolysis of the isolated R. rubrum H+-ATPase from Ca2+ to Mg2+ and that it activates both multisite and unisite catalysis. Results are discussed in relation to the possibility of a regulatory role by Mg2+ ions on ATP hydrolysis expressed through subunit interactions.

Adenosine Triphosphate↗

Structural and functional differences in H+-ATPases with native and reconstituted inhibitor protein.

Anti F1 antibodies that react with the alpha and beta subunits of the mitochondrial F0-F1 ATPase complex do not interfere with the natural inhibitor protein-ATPase interaction as revealed by inhibitor peptide titration curves. Submitochondrial particles with endogenous or added bound inhibitor protein show differences in immunoprecipitation. Submitochondrial particles which are partially depleted of inhibitor protein gave the same immunoprecipitation curve as the Mg-ATP particle. Anti F1 antibodies induce differential effects in ATP hydrolysis and ATP-Pi exchange. ATP hydrolysis is stimulated in Mg-ATP particles to 200%, while inhibitor depleted and inhibitor reconstituted particles are inhibited by the presence of the antibodies. ATP-Pi exchange is stimulated in inhibitor reconstituted particles and inhibited in Mg-ATP and inhibitor depleted particles. These results suggest that the inhibitor protein when endogenously bound confers a different conformation to the F1-ATPase than that of the F1 ATPase with added bound inhibitor protein.

Adenosine Triphosphate↗

Mitochondrial H+-ATPase activation by an amine oxide detergent.

Lauryl dimethylamine oxide activates ATP hydrolysis by the mitochondrial H+-ATPase. Activation is observed in systems with a high content of inhibitor protein as described by Pullman and Monroy (Pullman, M.E., and Monroy, G.C. (1963) J. Biol. Chem. 238, 3762-3769), i.e. Mg-ATP submitochondrial particles and a Triton X-100-solubilized H+-ATPase from the same particles. Detergent activation of ATP hydrolysis is also present in inhibitor-reconstituted systems, i.e. submitochondrial particles, Triton extracts, and soluble F1-ATPase. In submitochondrial particles depleted of inhibitor protein, lauryl dimethylamine oxide induced a biphasic response which is characterized by a drop-in activity induced by relatively low concentrations of LDAO; at higher concentrations the detergent activates to an extent never greater than the initial activity. In inhibitor protein-depleted oligomycin-sensitive Triton extracts, lauryl dimethylamine oxide stimulates ATP hydrolysis to very high values (30 mumol min-1 mg-1). These findings suggest that in addition to the inhibitor protein ATP hydrolysis is controlled by other subunit interactions.

Adenosine Triphosphate↗

[Compressive hemopericardium of the right atrium after cardiac surgery].

Between June 1983 and September 1984, 3 patients operated for mitral valve disease presented with acute right heart failure due to right atrial compression. Emergency echocardiography did not show pericardial separation around the ventricles but in the apical 4 chamber view severe right atrial compression by an extracardiac mass was observed. Emergency surgery was performed in all three cases to evacuate a localised haemopericardium despite the absence of pericardial fusion. These cases of acute right ventricular failure underline the importance of multiplying the number of echocardiographic views in order to detect localised pericardial effusion. The diagnosis should be made as soon as possible as clinical deterioration may be rapid despite effusions of small volume. The main differential diagnoses are right atrial thrombosis and acute postoperative pulmonary embolism. In these cases of localised tamponade, the clinical signs are the result of vena caval compression or extrinsic compression of the tricuspid orifice. The preferential localisation of the haemopericardium around the right atrium is difficult to explain. It is probably related to the low pressures in this region. The echocardiographic appearances of this condition have been established allowing reliable diagnosis.

Adolescent↗

[Low molecular weight heparin in extracorporeal circulation. 1st clinical applications].

The haemorrhagic complications inherent to the use of heparin during cardiac surgery led us, after a pilot experimental study, to try out a low molecular weight heparin (LMWH), PK 10169, which has weaker haemorrhagic effects in vitro. Our initial experience was confined to 23 patients with differing pathologies, undergoing cardiopulmonary bypass lasting 30 to 165 minutes. The modes of injection of YK 10169 varied according to the results, especially with respect to the limitation of peaks of anti-Xa activity; 8 patients were given one bolus intravenous injection, 9 were given a bolus injection and a continuous infusion, and 6 were only given the continuous infusion. Biological monitoring of anticoagulation was based on anti-Xa activity. Analysis of the biological results showed that the principal feature was the partial correction, and occasionally the non-correction of anti-Xa activity by protamine sulphate, with no correlation between this anti-Xa activity and postoperative bleeding. The authors report cases of severe postoperative bleeding despite the supposed theoretical and experimental weakly haemorrhagic properties of LMWH, and also discuss the inefficacy of protamine sulphate. The indications for LMWH for cardiopulmonary bypass which were retained, were the rare cases of heparin-induced thrombocytopaenia. In conclusion, it is possible to use LMWH during cardiac surgery but we do not advise using it routinely as its theoretical advantages are not confirmed in practice.

Adolescent↗

Porphyrin content of the cysticercus of Taenia solium.

The strong red fluorescence of the cysticercus of Taenia solium depends on the presence of several porphyrins in the vesicular fluid of the parasite: probably protoporphyrin IX, coproporphyin I or III, and 2 decarboxylated porphyrins intermediate between uroporphyrin and coproporphyrin. Cyst porphyrins associated to form conglomerates of high molecular weight that dissociated in acid solutions and were not antigenic themselves nor associated with antigenic molecules. An appreciable fraction of the porphyrins was capable of undergoing oxidation and reduction, indicating that some of the porphyrins were complexed with metal ions. The metabolic basis for the accumulation of porphyrins is unknown. Preliminary results suggest that conditions deleterious to the cysticercus cause release of porphyrins so that the appearance of porphyrins in the cerebrospinal fluid of neurocysticercotic patients may prove useful in monitoring therapeutic attacks on the parasite.

Animals↗

Regulation of the Pi-ATP exchange and hydrolytic reactions in F0-F1 reconstituted liposomes.

The regulation of ATP hydrolysis and Pi-ATP exchange reactions by ATP, ADP, Mg2+, and phosphate was studied in liposomes containing F0-F1 obtained from bovine heart submitochondrial particles by solubilization with lauryl dimethylamino oxide as described previously (Dreyfus, G., Celis, H., and Ramirez, J. (1984) Anal. Biochem. 142, 215-220). A simultaneous analysis of ATP hydrolysis and the Pi-ATP exchange reactions showed that the ratio of hydrolysis/exchange is close to one when the ATP concentration is in the lower micromolar range. In this preparation ADP stimulates the Pi-ATP exchange reaction and depresses ATP hydrolysis. The exchange reaction is almost abolished when ADP is removed from the medium by an ATP-regenerating system. Mg2+ in millimolar concentrations stimulates Pi-ATP exchange, and at the same time decreases ATP hydrolysis; accordingly, the hydrolysis/exchange ratio depends on the concentration of Mg2+. Inorganic phosphate also controls this ratio, a lower ratio being observed at high phosphate concentrations. The Pi-ATP exchange reaction, but not ATP hydrolysis, depends on the concentration of medium phosphate. These results indicate that the kinetic characteristics of this F0-F1 preparation are modified by Mg2+, ATP, and phosphate.

Adenosine Diphosphate↗

Reversibility of muscular ischemia: a histochemical quantification by the nitroblue tetrazolium (NBT) test.

The degree of muscular ischemia and its reversibility can be quantified in the early stages. This histochemical enzymatic study utilized Nitroblue tetrazolium (NBT) which when reduced by tissue dehydrogenase produces a blue pigment: "formazan." Seventy Wistar rats were subjected to transient hindlimb ischemia by means of a tourniquet for 3, 6, 9, 12, 15 and 18 hours, followed by reperfusion. Microsurgical muscle biopsies were obtained in each rat at 1 and 12 hours, and 3, 7, 14 days after reperfusion. Time increased in muscle staining demonstrated a succino-dehydrogenase deficit confirmed by clinical and histopathological follow-up. NBT staining time was 2 minutes (+/- 8 sec.) in the control group, between 2 and 6 minutes in the reversible ischemia group (rats with 3 and 6 hours of tourniquet), and more than 9 minutes (+/- 14 sec.) in the irreversible ischemia group (animals with more than 9 hours of tourniquet). In vascular surgery and in limb reimplantation this protocol is a practical method of evaluating cytoplasmic enzymatic activity and the status of myofibrillar oxidation in the early phases of ischemic injury, before histologic changes are clearly delineated.

Animals↗