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Biomedical subjects

H Bricaud

Publications and source records attributed to H Bricaud.

At least 55 records · Page 3Linked to original sources

Soluble fibrinogen derivatives generated by thrombin: affinity for elastin.

When human citrated plasma is dialysed against a phosphate buffer containing Ca++, citrate anions are removed, thrombin is generated and soluble fibrinogen derivatives (fibrin monomers and/or soluble fibrin polymers) are formed. These derivatives are able to combine with human or bovine elastin to form a very stable addition product or adduct. The formation of the adduct is dependent on time, Ca++ and thrombin concentrations.

Animals↗

Deoxyribosyl exchange reactions leading to the in vivo generation and regeneration of the antiviral agents (E)-5-(2-bromovinyl)-2'-deoxyuridine, 5-ethyl-2'-deoxyuridine and 5-(2-chloroethyl)-2'-deoxyuridine.

In the rat, the highly potent anti-herpes drug (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVdUrd) is rapidly converted to its base (E)-5-(2-bromovinyl)uracil (BVUra) through the action of pyrimidine nucleoside phosphorylases. However, BVdUrd can be regenerated or even generated de novo from BVUra by a pentosyl transfer reaction upon the administration of 2'-deoxythymidine (dThd), 2'-deoxyuridine (dUrd) or 5-ethyl-2'-deoxyuridine (EtdUrd). The antiherpetic drugs EtdUrd and 5-(2-chloroethyl)-2'-deoxyuridine (ClEtdUrd) can also be regenerated or generated de novo from their respective bases 5-ethyluracil (EtUra) and 5-(2-chloroethyl)uracil (ClEtUra), by a pentosyl transfer mediated by the administration of dThd or dUrd as deoxyribosyl donor. The generation or regeneration of BVdUrd, EtdUrd and ClEtdUrd from their bases (BVUra, EtUra and ClEtUra, respectively) is readily achieved because the latter have long half-lifes. Thus, the active anti-herpes drugs can be (re)generated repeatedly after a single administration of these nucleosides or their bases, followed by repeated administrations of dUrd.

Animals↗

Quantitative frame by frame analysis of regional contraction and lengthening on left ventricular cineangiograms: application to the study of normal left ventricles and left ventricles with mitral valve prolapse.

This work attempted to study the segmental wall motion on left ventriculograms, in terms of segmental shortening, velocity of segmental shortening, and temporal sequences of various events in systole as well as in diastole. The ability of such a method to characterize patterns of normal regional wall motion and to detect mild abnormalities such as isolated asynchronisms, was tested on two groups of patients. Group I included 25 patients presenting evidence of a normal left ventricle (LV) after left heart catheterization. Group II consisted of 21 patients suffering from an isolated pure idiopathic mitral valve prolapse (MVP), with no mitral insufficiency and with an unaffected global LV function. In all patients left ventriculography was filmed in the right anterior oblique view at a rate of 50 frames/s. For each patient a cycle was chosen, distant from any premature beat, with acceptably contrasted outlines, and a quantitative frame by frame study of the motion of 10 segments was performed using a semiautomated method derived from the Stanford method. In the control group (Group I), analysis of the segmental motion by means of this method demonstrates a mild nonuniformity of the normal wall motion. This is principally marked by a stronger and faster contraction in anterolateral segments (segments 7, 8, 9) and by a shorter duration of the contraction in this region. In contrast the MVP group (Group II), exhibited a frank asynergy of the anterolateral region occurring from end systole to early diastole.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Comparison of fibrinolytic treatment with interruption of the inferior caval vein in the prevention of pulmonary embolism.

The procedure of interruption of the inferior caval vein is designed to prevent pulmonary embolism, but its effectiveness has yet to be compared with thrombolytic therapy. Sixty patients hospitalized for pulmonary embolism and proximal deep vein thrombosis were divided into two groups of 31 and 29 patients, respectively. The patients were selected because of persistent venous thrombosis in the inferior caval, iliac or femoral veins. The patients in the first group (mean age 53.2 years) were treated by interruption of the inferior caval vein. The second group of patients (mean age 57) received only fibrinolytic treatment. From those patients having caval venous interruption due to peri-operative myocardial infarction 1 died and 3 others presented pulmonary embolism (massive in two cases). No patients treated by fibrinolysis suffered from pulmonary embolism. Five patients died of cancer, 2 having had caval interruption, as opposed to only 2 having fibrinolysis. Eight patients undergoing surgery had a severe functional handicap. This study demonstrated a high recurrence of pulmonary embolism in patients with persistent venous thrombosis who were treated by interruption of the inferior caval vein. These patients also had a high morbidity. Fibrinolytic treatment (even in the presence of persistent venous thrombosis) appeared to be more effective in avoiding recurrence of pulmonary embolism.

Adult↗

Spontaneous coronary artery dissection: case report and evidence for a defect in collagen metabolism.

Spontaneous coronary artery dissection is a rare disease with a higher prevalence in women, especially in the post-partum state. In one case, we attempted to relate this pathology to a disorder in collagen metabolism. A 32-year-old woman presented two episodes of myocardial infarction, 2 and 4 months after delivery which were shown to be due to two consecutive coronary artery dissections on coronary angiogram. Collagen metabolism was investigated in skin fibroblast cultures derived from the patient, and in control fibroblast cultures. After protein labelling in culture, total protein and collagen synthesis were determined. Quantification of procollagen synthesized in cell cultures and their rate of conversion into collagen were determined both in the culture media and a cell layer extract by DEAE cellulose chromatography. The results showed a reduced total collagen synthesis in the cultures of the patient in comparison with control cultures. The ratio between type I and III procollagen was not altered. The rate of conversion of procollagen into collagen was higher in the pathological cultures than in control cultures. Impaired collagen synthesis due perhaps to a change in hormonal equilibrium in the post-partum state might therefore have been responsible for coronary artery dissection.

Adult↗

Study of the electrophysiologic properties of clonidine administered intravenously.

A few cases of sinus node dysfunction (SND) and AV block (AVB) were described with clonidine therapy. The aim of this study is to evaluate the electrophysiologic properties of clonidine in volunteers with normal electrophysiologic data. Twenty-eight subjects were investigated by endocavitary techniques. The following parameters were measured before and 20 min after intravenous administration of clonidine: systolic and diastolic blood pressure (BP); sinus cycle (SC); PA, AH, and HV intervals; effective (ERP) and functional (FRP) refractory period of right atria (RA); AV node (AVN); His Purkinje system (HP); right ventricle (RV); corrected sinus node recovery time (SNRT); and sinoatrial conduction time (SACT). Blood pressure was reduced from 149/89 to 115/74 mm Hg. Sinus cycle was prolonged by 71 ms (p less than 0.01), corrected SNRT by 81 ms (p less than 0.05), and FRP of AVN by 16 ms (p less than 0.05). SND was more marked when initial SC was longer. Atrioventricular node depression was more marked when the PR interval was longer and when subject was older. Electrophysiologic effects of clonidine are similar to those of beta-blockers. The tensional effects are more marked than electrophysiologic effects. Clonidine in the high risk subject (age, bradycardia, long PR) may be cautiously dosed. Drug association with digitalis antiarrhythmic drugs, beta-blockers, and calcium antagonists may be avoided.

Adult↗

A new method for evaluating the effect of antiarrhythmic drugs on atrioventricular nodal conduction.

Electrophysiological variables were studied in 19 patients before and after one of three commonly used antiarrhythmic agents. The pacing rate at which alternating Wenckebach periods appeared in eight patients was significantly reduced by intravenous digoxin (0.01 mg/kg body weight). The atrioventricular nodal conduction time (A-H interval) and Wenckebach point were not significantly altered by digoxin. Intravenous propranolol (0.1 mg/kg body weight) in four patients did not affect the A-H interval, but it reduced the pacing rates at which the Wenckebach point and alternating Wenckebach periods occurred. Intravenous disopyramide (2 mg/kg body weight) significantly increased the pacing rate required to produce alternating Wenckebach periods but did not significantly alter the other indicators of atrioventricular conduction in seven patients. It is concluded that the pacing rate required to produce alternating Wenckebach periodicity may be a useful and sensitive variable in the evaluation of the effect of antiarrhythmic agents on atrioventricular nodal conduction.

Adult↗

[Prevalence, significance and prognosis of ventricular arrhythmia in 236 cases of dilated myocardiopathy].

The prevalence on ECG, Holter monitoring and stress testing and the prognosis of ventricular arrhythmias were assessed in 236 patients with dilated cardiomyopathy (DCM). This diagnosis was confirmed by haemodynamic and coronary angiographic criteria in 218 cases. Analysis of ECG recordings confirmed the high incidence of ventricular extrasystoles (VES) which were observed in 56% of cases, with doublets in 28% and salvoes in 5% of cases. Sustained VT was observed in 5 cases before the diagnosis was established and in 9 cases during follow-up. Ventricular fibrillation was documented in 8 patients without overt cardiac failure. Holter monitoring over 24 hours (N = 76) showed less than 30 VES per hour in 32% of cases, greater than 100 per hour in 36% of cases, predominantly diurnal in 36% of cases, doublets in 40% of cases and salvoes in 15% of cases. A significant correlation was observed (p less than 0.01) between repetitive activity and the frequency of VES. Exercise stress testing (N = 113) showed aggravation of the ventricular arrhythmia in 28% cases. Of the 72 clinical and paraclinical variables that were analysed, the group of patients with VES and doublets on ECG had lower left ventricular ejection fractions and higher pulmonary pressures. Eighty patients died of cardiac causes during follow-up of 38.8 +/- 27 months. Taking into account the haemodynamic differences, the presence of doublets on the ECG was a poor prognostic factor in subjects with ejection fractions greater than 40% (p less than 0.06); this was even more significant when greater than 50% (p less than 0.027).(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗

[Correlations between vectorcardiographic data and effect of myocardial infarction on global and regional left ventricular function].

The object of this study was to identify vector-cardiographic parameters (VCG) dependant on the size of myocardial infarction and its consequences on segmental left ventricular wall motion. Forty-five patients were selected for study after a complete haemodynamic investigation including quantitative analysis of LV wall motion. They were divided into three groups: Group I, comprising 15 normal control subjects; Group II, comprising 16 patients with abnormal LV wall motion related to anterior wall infarction due to a solitary lesion of the left anterior descending artery; Group III, comprising 14 patients with abnormal LV wall motion related either to posterior wall infarction or inferior wall infarction due to a solitary lesion of the right coronary or left circumflex arteries. Segmental wall motion was analysed by a semi-automatic programme derived from the Standford method. This programme detects the number of pathological segments in a ventricle and their shortening, and also determines a coefficient of severity of the abnormal zone. The VCG was performed according to Frank's principle and exploited using the computerised Arnaud RUBEL system. The characteristics of the instantaneous vectors were determined every 10 ms up to 60 ms: X, Y and 2 coordinates, amplitude, azimuth and elevation. These coordinates were compared with the segmental wall motion in every patient. There was a close correlation between LV regional wall motion abnormalities and the deflection of the initial vectors (during the first 40 ms) in the horizontal and frontal planes. A ROC statistical analysis showed that VCG was an excellent method of detecting abnormal LV wall motion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Mitral valve prolapse and pectus excavatum. Expressions of connective tissue dystrophy?].

Pectus excavatum is a common malformation in diseases of elastic tissue (Marfan, Ehlers-Danlos...). When observed apparently alone it may represent a minor form of dystrophy, implying the same risk of a cardiac lesion. Abnormalities of the thoracic skeleton and echocardiographic mitral valve prolapse is a well established association, suggesting a common disorder of connective tissue. However, there is no absolute proof that this is a statistically significant association. Histological connective tissue changes relating these two markers have yet to be found. Clinical and echocardiographic examinations and skin biopsies were performed in 17 patients with pectus excavatum. Mitral valve prolapse was detected in 65% of cases (associated in 1 out of 3 cases with tricuspid valve prolapse). In 53% of cases electron microscopy showed abnormal skin collagen and elastin. Collagen abnormalities were twice as common as those of elastin and could be associated. Mixed changes of thinning of elastin and collagen fibres of irregular calibre were particularly suggestive. Pectus excavatum would therefore seem to be the expression of a minor form of dystrophy of collagen and elastin tissues and a clinical marker of possible mitral valve prolapse.

Adult↗

Comparative study of the efficacy and tolerance of capozide and moduretic administered in a single daily dose for the treatment of chronic moderate arterial hypertension.

A comparative study was made of the effects of a new therapeutic agent consisting of 50 mg captopril and 25 mg hydrochlorothiazide (Capozide) with an already existing agent Moduretic (50 mg hydrochlorothiazide and 5 mg amiloride). In the Capozide group (32 patients), 20 achieved normal blood pressure, 8 responded but were not brought under control, and 3 were non-responders. In the Moduretic group (31 patients), 17 achieved normal blood pressure, 10 were partially controlled and 4 were non-responders. Moduretic appeared to be most effective in patients previously untreated or who had been taking only one drug, while Capozide controlled patients who had been taking 1 or 2 antihypertensive drugs which had been either ineffective or poorly tolerated. The long-acting effect of a single dose of Capozide was demonstrated by blood pressure measurements taken at least 10 hours later. Both drugs were generally well tolerated and no significant changes were observed in the laboratory measurements. The combination of an angiotensin converting enzyme inhibitor with a diuretic proved more effective than single agents in lowering raised blood pressure. We therefore conclude that Capozide is an effective alternative to traditional medication in the treatment of moderate hypertension.

Adolescent↗

[Fibrinolytic treatment of 28 thromboses of valve prostheses. A biological study].

We carried out a series of laboratory investigation in 28 patients with prosthetic valve thrombosis (17 mitral and 11 aortic). The diagnosis was confirmed by TM and bidimensional echocardiograms and by cineradiography. The treatment consisted of UK (4,500 IU/kg/hour for 12 hours) and/or SK (initial loading dose of 500,000 IU, then 150,000 IU/hour for 10 hours). We measured fibrinogen, degradation products of fibrinogen-fibrin, plasminogen and antiplasmin. Two dimensional electrophoresis against anti-fibrinogen, anti-fragment-D and anti-fragment-E were employed for some samples. After thrombolytic therapy (SK: 18; UK: 7; SK-UK: 2; UK-SK: 1) complete clot removal was obtained in 21 cases (successful: group S), partial removal in 4 cases (improvement: group A) and failure in 3 cases (failure: group E). 3 patients died. Biochemical effects can be seen in group S and in group A. There were no changes in group E.

Adult↗

Sulmazole effects on mechanical performance of hypoxic and reoxygenated isolated mammalian myocardium.

The present study intended to investigate the effects of 2-[2-methoxy-4-(methylsulfinyl)phenyl]-3H-imidazo[4,5-b]pyridine (sulmazole, AR-L 115 BS) on mechanical performance of rat myocardial fibers under hypoxia, and subsequent reoxygenation. Because of a possible caffeine-like mechanism of action of sulmazole similar experiments were performed with theophylline and the results compared. 1. Under normoxic conditions, sulmazole and theophylline displayed a positive inotropic action with acceleration of relaxation at small concentrations (sulmazole: 6.4 mumol l-1; theophylline 7.35 mumol l-1). Increasing doses led to a negative inotropic effect with slackened relaxation and loss of its load sensitivity (up to 390 mumol l-1 for sulmazole; up to 350 mumol-1 for theophylline). In agreement with other reports, the dose-effect curve was shifted towards low concentrations. 2. During ischemic crisis, therapeutic doses of sulmazole (6 mumol l-1) and theophylline (7 mumol l-1) induced no additional depression of contractility and protected relaxation. During subsequent reoxygenation, better recovery of contractility was observed without any very significant improvement of relaxation. 3. During reoxygenation beyond 120 mumol l-1, increasing doses of sulmazole depressed contractility. An additional depressive effect on mechanical performance was observed during hypoxia only for the highest dose (390 mumol-1).

Animals↗

Effect of (E)-5-(2-bromovinyl)uracil on the catabolism and antitumor activity of 5-fluorouracil in rats and leukemic mice.

In contrast to thymine and 5-fluorouracil (FUra) which were cleared from the bloodstream within 2-4 h after their i.p. administration (200 mumol/kg) to rat, (E)-5-(2-bromovinyl)uracil (BVUra) maintained a concentration of 50-70 microM for at least 6 h and was still present in the plasma 24 h after its administration. In vitro experiments with rat liver extracts indicated that BVUra was not a substrate but an inhibitor for the reductive step in pyrimidine degradation catalyzed by dihydrothymine dehydrogenase. Kinetic and dialysis experiments suggested that BVUra was an irreversible inhibitor of this enzyme. The binding of BVUra to the enzyme depended on the presence of reduced nicotinamide adenine dinucleotide phosphate in the reaction mixture. Dihydrothymine dehydrogenase activity was also inhibited in the dialysed 105,000 X g supernatant fraction of livers from rats that had previously been treated with BVUra. Such inhibitory effects also occurred in vivo; previous administration of BVUra increased the plasma half-lives of thymine and FUra by 10- and 5-fold and their area under the curve by 9- and 8-fold, respectively. The effect of BVUra on the antitumor activity of FUra was evaluated in DBA/2 mice inoculated with 10(6) P388 leukemia cells. The mean survival times for the control and FUra-treated mice (5 mg/kg at 1, 3, 5, and 7 days after tumor cell inoculation) were 9.7 and 12.4 days, respectively. When BVUra (200 mumol/kg) was administered 1 h before each injection of FUra, the mean survival time was extended to 17.1 days. BVUra alone did not affect the mean survival time. When the dose of FUra was increased to 20 mg/kg, the mean survival time was 15.3 days; upon a preceding injection of BVUra the mean survival time decreased to 9.2 days. The latter effect probably resulted from an increased toxicity of FUra. Similar results were obtained if FUra was replaced by 5-fluoro-2'-deoxyuridine and BVUra by (E)-5-(2-bromovinyl)-2'-deoxyuridine. The enhancement of both the antitumor and toxic effects of FUra by BVUra were most probably due to an inhibition of FUra degradation, since, like in rats, BVUra increased the plasma half-life of FUra in DBA/2 mice. Hence BVUra appears to be an interesting compound, increasing the potency of FUra by decreasing its degradation.

Animals↗

Magnesium enhances human pancreatic elastase digestion of 125I-labeled elastin.

The effect of some divalent cations, especially Mg++, on elastinolysis by porcine or human pancreatic elastase has been determined using 125Iodine-labeled elastin as substrate. Elastin degradation was significantly increased in the presence of 10(-3) M Mg++. If elastin was pre-incubated with 0.5 (w/v) Triton, there was a further increase in elastinolysis to 2.6 times the original rate.

Animals↗