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Biomedical subjects

G van Melle

Publications and source records attributed to G van Melle.

At least 73 records · Page 4Linked to original sources

[Lausanne study of retinoblastoma, 1986-90: deletion of esterase D locus in a collective of 128 patients].

Activity and phenotype of red blood cell esterase D were systematically determined in a population of 128 retinoblastoma patients from 99 families and compared to 158 controls, in order to detect a chromosome 13q14 deletion. Among these patients 12 were healthy carriers and 116 affected carriers of a mutant allele of the retinoblastoma susceptibility gene (110 retinoblastoma, 5 retinoma, 1 phtisis bulbi). 4 patients were found to have decreased ESD levels in connection with 13q14 deletion which was confirmed by chromosome analysis. The data presented here suggest that ESD quantification has a high specificity and sensitivity for the detection of homogenous chromosome 13 deletions in retinoblastoma patients.

Carboxylesterase↗

Prognostic value of serum proteins synthesized by breast carcinoma cells.

Several breast carcinoma cell lines or explants of such tumors, as well as examples of lactating or dysplastic breast tissue, synthesized three serum proteins (alpha 2-Zn-glycoprotein, alpha 1-antichymotrypsin, and alpha-lipoprotein) in vitro. These proteins were detected by immunoperoxidase techniques in 126 breast carcinomas that had been evaluated clinically for more than six years. Alpha-2-Zn-glycoprotein was present in 58% of the carcinomas, whereas alpha 1-antichymotrypsin was seen in 55% and alpha-lipoprotein in 52%. These markers showed a relationship with clinical outcome. Alpha-1-antichymotrypsin and alpha-lipoprotein were unfavorable determinants, whereas alpha 2-Zn-glycoprotein was detected in lesions with a favorable evolution. Taken individually, these markers have similar but rather weak associations with five-year survival rates; roughly 20% of patients in the "favorable" group died, compared with 33% in the "unfavorable" group. Alpha-2-Zn-glycoprotein in grade 1 tumors was a marker with marginally favorable significance, but alpha 1-antichymotrypsin significantly worsened the prognosis of grade 2 and 3 tumors. Furthermore, stratification of patients according to the number of positive unfavorable markers yielded striking results. Eight percent of patients with none of the unfavorable markers were dead at five years, compared with 55% of those whose lesions expressed three unfavorable markers.

Biomarkers, Tumor↗

[Cardiac sources of cerebral embolism and infarction: results of the Lausanne register for cerebrovascular accidents].

We studied 305 patients with a first stroke and a potential cardiac source of embolism (PCSE), on the basis of the Lausanne Stroke Registry. We have compared these patients with 1006 patients with stroke but without PCSE, admitted into the Registry during the same period, in order to assess the potential role of PCSE and the coexistence of other causes of stroke. Analysis of the various types of PCSE suggests that some neurologic characteristics are more frequent in patients with than without PCSE (infarcts of the posterior division of middle cerebral artery with Wernicke's aphasia and lateral hemianopia; maximal neurologic deficit at onset; haemorrhagic infarcts).

Arrhythmias, Cardiac↗

Primitive megalencephaly in children: natural history, medium term prognosis with special reference to external hydrocephalus.

We studied 74 children with primitive megalencephaly retrospectively with attention directed to familial megalencephaly, birth history, enlarged pericerebral subarachnoid space (SAS) (idiopathic external hydrocephalus), head and statural growth dynamics, developmental and school prognosis, morphological findings and development of subdural haematoma. In the megalencephalic children, no significant differences were found between those with normal or those with enlarged pericerebral SAS. Out of 62, 31 children (50%) were already megalencephalic at birth. Of 74, 37 children (50%) showed variable degrees of developmental delay which in 18 was transient. Eight out of 74 were mentally retarded. Of 52 children at school age, 42 attend normal schools and 10, of whom 7 are mentally retarded, attend special schools. Three children showed subdural haematoma resulting from apparently minor trauma or occurring spontaneously. We suggest that idiopathic external hydrocephalus represents a variant of primitive megalencephaly with transient increase of intracranial pressure and that it could predispose to the development of idiopathic (spontaneous or non-traumatic) subdural haematoma.

Brain↗

[Organ donation for transplantation. Survey of opinions of physicians and paramedics in the province of Vaud].

In 1987, two media campaigns were organized in Switzerland to promote donor cards. The purpose of this study was to test their impact on the medical community. Questionnaires were sent to qualified practitioners, doctors in training and intensive care nurses. It is concluded that the campaigns for organ donation must be repeated and that their quality can be improved. It is however more urgent to improve the level of knowledge among doctors and other health professionals.

Attitude of Health Personnel↗

Substrate- and alkali-metal-ion-induced pK shifts in intestinal brush-border sucrase, according to the three-protons model.

To define adequately enzyme activation/inhibition mechanisms as a function of pH, it is necessary to characterize the effector-induced pK shifts on both the free enzyme and on the enzyme-substrate complex. On the basis of our recent three-protons model for sucrase [Vasseur, van Melle, Frangne & Alvarado (1988) Biochem. J. 251, 667-675], we show how the 'fundamental' pK values, deduced from the classical double-logarithmic transformations, are insufficient to generate the required information. This insufficiency derives from the fact that, for sucrase, the acid ionization constant, K1, is a molecular constant that involves complex, V-type plus K-type, activatory and inhibitory kinetic effects. As a consequence, substrate-induced pK shifts cannot be interpreted correctly only by using the fundamental pK approach, because an unequal number of key protons is involved, depending on whether the free enzyme or the enzyme-substrate complex is considered. We demonstrate how this problem can be solved by using the 'theoretical' pK values, derived from the reciprocals of the Michaelis pH functions, i.e. Cha's fractional concentration factors. The procedure we propose, which is general, has the advantage of yielding all the macroscopic pK values for any given model, as calculated from the microscopic pK values. Furthermore, it permits predicting pK shifts as a function of [S] and/or [A] (where S is the substrate and A is the allosteric modifier), an objective that cannot be attained by using the double-logarithmic plot approach. Finally, we describe the relation existing between the fundamental and the theoretical pK values.

Animals↗

A method for writing enzyme rate equations: application to the estimation of the number and size of key proton families.

We develop a method to derive the rate equation for enzyme models that include pH-dependent activation. Our presentation is based on a kinetic model recently described for sucrase, the three-key-proton model of Vasseur and coworkers, which considers the existence, in the acid ionization reaction, of two functionally distinct prototropic groups, respectively responsible for either V-type or K-type kinetic effects. In contrast, as concerns the basic ionization reaction, the model conforms to classical concepts of pH-dependent activation, whereby a single proton participates in either V-type or K-type effects but not in both at the same time. Enzymes with more than three key protons have been described, indicating that, rather than isolated protons, groups of protons should be considered, and therefore the model can be better described as a three-proton-family model, where a proton family is defined as one or several protons that are gained or lost as a block and perform the same kinetic function. The resulting model is treated here as a useful framework upon which other models can be built. To facilitate the writing of the rate equations, we define two new entities: (1) intralevel coefficients, which describe the various combinations of the enzyme with either the substrate(s), the allosteric effector(s), or both at a given protonation level, and (2) interlevel coefficients, which describe the interplay between the various protonation levels. The resulting rate equation can be used in a global fit procedure permitting in a single computer run the estimation of (1) the entire set of dissociation and microscopic ionization constants of the model, (2) the number and kinetic function of proton families characterizing the enzyme under consideration, and (3) the number of key protons constituting each family, which is derived from the derivatives of the kinetic parameters, Vm/Km, Vm, and Km.

Enzymes↗

[Differentiation of a normal population and of a cohort of patients presenting with a history of idiopathic thromboembolism as identified with fibrinolytic tests].

To identify persons at risk for development of thromboembolic disease, fibrinolytic and blood coagulation parameters of normal controls (n = 40) and patients (n = 40) have been compared. Four fibrinolytic parameters, i.e. fibrinolytic activity at rest (FAr), fibrinolytic response after 10 minutes of venous occlusion (delta FA10'), and resting antigenic levels of the plasmatic inhibitor of the plasminogen activators (PAI-1) and of urokinase (u-PA), showed significant differences between the two study groups. The separate and combined discriminant analysis of FAr and delta FA10' values revealed that individuals with FAr below 0.63 UI/ml or a delta FA10' below 0.98 UI/ml are at risk for development of thromboembolic disease.

Adult↗

Prevention of gram-negative shock and death in surgical patients by antibody to endotoxin core glycolipid.

The prophylactic effect of antibody to endotoxin core glycolipid was studied in surgical patients at high risk of gram-negative infection. At randomisation (on admission to intensive care unit), every 5 days thereafter, and at onset of septic shock, patients received plasma taken from donors before (control) or after immunisation with Escherichia coli J5, a mutant with only core determinants in its endotoxin. Gram-negative shock occurred in 15 of 136 controls and 6 of 126 J5 antibody recipients and related deaths in 9 of 136 and 2 of 126, respectively. J5 antibody was most effective in abdominal surgery patients, in whom shock occurred in 13 of 83 controls and 2 of 71 antibody recipients. Although antibody prophylaxis did not lower the infection rate, it prevented the serious consequences of gram-negative infections and thus improved the overall prognosis.

Bacterial Infections↗

[Drugs and general medicine. Study of the profile of prescriptions and requests of the patients].

744 prescriptions written by a general practitioner are analyzed. It emerges that out of 1759 drugs prescribed, 13.5% are considered to have been directly demanded by the patient. This demand, which approaches 30% in women over 65, chiefly relates to hypnotics and tranquillizers. It involves a rise of 13% in pharmaceutical costs if the physician yields to the demands. In this study an average of 2.4 drugs were given per prescription and the average prescription cost is 47.65 Swiss francs. The scope of such demand should be taken into consideration more often when studying drug consumption in general and prescribing patterns in particular.

Adolescent↗

Unilateral occipital infarction: evaluation of the risks of developing bilateral loss of vision.

Fifty-eight patients with a unilateral infarction in the superficial area supplied by a posterior cerebral artery were followed (mean: 39.6 months). Thirteen (22.4%) developed cortical blindness associated with a delayed contralateral occipital infarction. Advanced age, general vascular risk, a history of strokes, Sylvian border-zone extension of the initial infarct, and an absence of improvement of initial visual field defects were strongly associated with spread to the other side. The lack of visual field improvement most accurately predicted a high risk of cortical blindness. A careful follow-up and controlled medical therapy is particularly indicated in these patients.

Adult↗

[Comparative study of a new package insert for benzodiazepines adapted for patients].

A standardized, patient-oriented package insert for benzodiazepines has been compared with four package inserts printed by manufacturers for these drugs. The leaflets were submitted to 222 hospitalized patients randomly allocated to two groups; 108 received a manufacturer's notice and 114 the standardized notice. The patients were interviewed two or three days later and found the standardized notice more comprehensible than those of the manufacturers. Two independent experts assessed the adequacy of the notices and also found the standardized notice more appropriate for patients. The patients answered a questionnaire about the effects of the drugs and the precautions while using them. Those who had read the standardized notice were significantly better informed than those who had read manufacturers' notices. However, the level of understanding varied largely from one item to another, and depended on the level of education and age.

Age Factors↗

Single-site uptake of neutral amino acids into guinea-pig intestinal rings.

1. A kinetic analysis of amino acid influx into guinea-pig small intestinal rings has been performed in an attempt to ascertain whether one or more transport sites for these substrates exists in the luminal membrane of the enterocyte. 2. No indirect correction for uptake into the extracellular space was applied, but it was assumed in the analysis that the total uptake included a diffusion term. This procedure was vindicated by the results obtained. 3. All analyses were performed by non-linear regression techniques. In many experiments, both substrate and inhibitor concentrations were varied within the same experiment, thus giving rise to three-dimensional diagrams describing transport processes. 4. All results pointed to the existence of a single transport agency shared by all amino acids tested. The kinetic constants, Km and Vmax, were independent of the concentration range used for their estimation; such behaviour would not be expected if several sites with different kinetic constants were available for transport. The value of KD, the constant describing the diffusive component of uptake, was the same when estimated from the uptake of an amino acid alone or when determined as the asymptote of the curve describing the inhibition of this uptake by an analogue. Finally, the Ki for an amino acid when used as an inhibitor was identical to its Km when used as substrate. This property was maintained even when the most disparate pair of amino acids, threonine and isoleucine, was examined.

Amino Acids↗

Variability of the nucleolar organizer activity in human lymphocytes via Ag-staining.

Chromosomes with Ag staining that varies from one metaphase to the other can be distinguished from those with an Ag-staining that is the same in all metaphases. The intercellular variation of an Ag-NOR can be attributed to many different factors. Whatever the importance of technical factors, they do not seem to account for the large variations in Ag-staining which were observed for each ac. This suggests the existence of a natural intercellular variability of the NOR's activity. The variation of the Ag-stainability of a given NOR, the diversity of Ag-stainings observed on the ten ac of one individual and the differences that exist between individuals raise the question of the existence of a compensation of activity between nucleolar organizers. The study, for each individual, of the mean sum of staining per metaphase reveals that this value is not absolutely constant from one individual to another; in the carriers of Robertsonian fusions it is smaller than in chromosomally normal individuals. The analysis of the transmission shows that inactive NORs remain inactive and that active NORs present a variation in the activity from one generation to the next.

Adult↗