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Biomedical subjects

H Milon

Publications and source records attributed to H Milon.

At least 109 records · Page 6Linked to original sources
PubMed1983

[The limits of the medical treatment of angina pectoris].

The limitations of medical treatment in angina pectoris depend on its efficacity and indications. 1. Efficacity of medical treatment.--Anti-anginal drugs are able to relieve anginal pain in at least 3/4 of cases. However, the ability of medical measures (diet, exercise, stopping smoking, hypolipidemic drugs, antihypertensive drugs, anticoagulants, platelet anti-aggregants, antiarrhythmics, inotropic agents, vasodilators and diuretics) to prevent coronary atherosclerosis delay its progression and prevent its complications--so increasing the life expectancy of coronary patients--remains very uncertain. 2. Frontiers and judications of medical treatment.--Coronary patients with few or no symptoms appear to be best suited for long-term anti-anginal treatment with long acting nitrate derivatives and/or betablockers. The ability of the latter group to increase the life expectancy of all coronary patients remains to be shown. The limits of the indications of medical treatment are more difficult to define either by purely subjective criteria (incapacitating angina after trials of anti-anginal drugs at adapted doses) or by "objective" criteria (ergometry, coronary angiography).

Adrenergic beta-Antagonists↗
PubMed1983

[Correlations between coronary and ventricular angiography and the exercise test after myocardial infarction].

The aim of this study to assess the predictive value of exercise stress testing (ET) compared with coronary angiography-left ventriculography (CLV) in 102 patients undergoing physical rehabilitation (PH) after myocardial infarction (MI). The ET was optimised in its performance by the PH and in its interpretation by the selection of the parameters according to the site of MI. In anterior MI, angina (30%) and ischemic ST depression outside the acute period (35%) had little predictive value of multivessel disease which was demonstrated in 40% of cases; on the other hand, ST elevation in the same area as MI (65%) had an 88% predictive value for severe LV impairment which was found in 66% of cases. In inferior MI, ischemic ST depression (75%) more than angina (27%) was of greater predictive value (82%) for multivessel disease which was demonstrated in 59% of cases. The sensitivity was 97% and the specificity 64%; the LAD artery was diseased in 48% of cases. LV function was preserved in 63% of cases, but ET was not useful in the prediction of this parameter. In all cases of MI, the absence of ST changes predicted single vessel disease in 94%; ventricular arrhythmias (5%) stopped the patients reaching a discriminative exercise level but indicated poor LV function. The extreme values of heart rate and double product improved the correlations between ET and CLV. Therefore, ET may provide some of the information of CLV before the usual evolutive criteria and may help avoid this investigation in patients with favourable results, especially with inferior infarction. Although it has no absolute value, systematic ET is justified after MI as it enables the most severe cases to be distinguished from the most benign.

Adult↗
PubMed1982

Pharmacological investigation on the role of dopamine in the rat locus coeruleus.

The role of dopamine (DA) in the rat locus coeruleus (LC) was investigated by determining the levels of 3,4-dihydroxyphenylacetic acid (DOPAC), DA and noradrenaline (NA) in the LC after pharmacological treatments by pargyline, haloperidol, 6-hydroxydopamine (6-OHDA) and desmethylimipramine (DMI). The DA, DOPAC and NA contents of the LC were determined by high pressure liquid chromatography. Fifteen days after 6-OHDA, the DOPAC and NA levels were reduced by 60%, but they remained constant after 6-OHDA + DMI. Pargyline provoked highly significant increases in DA and NA but reduced DOPAC to non-measurable amounts. haloperidol caused a 54% decrease in the DOPAC levels. Pargyline and haloperidol administered to rats having received 6-OHDA + DMI 15 days before, caused similar effects on DA, DOPAC and NA levels as those in non-treated rats. It is suggested that DOPAC is mainly located in noradrenergic neurons, thus eliminating the possibility of a significant DA cell body population in the rat LC.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1982

[The renin-angiotensin system and the sympathetic nervous system in essential hypertension].

In 112 patients with essential hypertension (HTA), free of any therapeutic and receiving the standard ward, a significant inverse relationship was found between age and plasma renin activity (PRA) and plasma aldosterone (PA), measured in the supine and upright position. Urinary epinephrine and norepinephrine were not related with age. When dividing the patients in 4 different age groups, it appeared that those younger than 30 years exhibited a significantly higher PRA and PA values and a higher frequency of borderline hypertension (45 p. 100) than the older ones (12 p. 100). So as to determine the characteristics associated with borderline HTA, it was necessary to eliminate the influence of age. This was achieved by comparing two groups of carefully age-matched patients, one with borderline HTA and the other with stable HTA. The only significant difference found was a significantly more marked increase in PRA in response to orthostatism, in patients with borderline HTA. Since renin responses to an orthostatic stress are largely mediated by renal nerves, this result suggest that borderline HTA could be associated with an increased reactivity of the sympathetic nervous system.

Adult↗
PubMed1981

[Tricuspid valve replacement by Hancock's prosthesis].

The medium term results of tricuspid valve replacement with the Hancock bioprosthesis are reported. Twenty eight patients underwent tricuspid valve replacement with this prosthesis between December 1974 and January 1978: mitral valve replacement with a Starr-Edwards or Cooley-Cutter prosthesis was associated in all cases and aortic valve replacement with a Björk-Shiley prosthesis in 11 cases. Follow-up at an average of 36,2 months after operation examined functional status, cardiac size and haemodynamics (in 12 patients). Three patients died in the immediate postoperative period and four others died later: the number of survivors was greater in the triple valve replacement (9/11) than in the double valve replacement group (12/17) but the difference was not statistically significant. Of the 23 surviving patients (average follow-up of 36,2 +/- 9,6 months), 17 were classified in functional Classes I or II of the NYHA classification. All patients had been Class III or IV before operation. The cardiothoracic ratio did not decrease significantly in patients undergoing triple valve replacement. Control cardiac catheterisation showed a significant increase in cardiac index (2,53 +/- 0,11 1/mn/m2, compared to 1,87 +/- 0,35 1/mn/m2 before operation; p less than 0,001) without significant reduction in pulmonary artery or right atrial pressures. The resting gradient across the Hancock bioprosthesis was not related to the size of the prosthesis (No 29-30: 2,17 +/- 2,57 mm Hg; No 31-33: 2,78 +/- 3,53 mm Hg) or with the quality of the functional result. However, on exercise, the gradient across the prosthesis was high, reaching an average of 10,3 +/- 5,2 mm Hg). The operative mortality of tricuspid valve replacement is relatively bioprosthesis associated with mitral and/or aortic valve replacement is relatively bioprosthesis associated with mitral and/or aortic valve replacement is relatively low (about 10%) and could be an argument in favour of broadening the indications for tricuspid valve replacement as resting tricuspid function with a bioprosthesis is satisfactory. However, the stenotic effects on exercise and the uncertainty over the long-term outcome of bioprostheses suggest that surgery should be limited to severe tricuspid stenoses and/or major tricuspid regurgitation organic or functional uncontrolled by digitalis and diuretic therapy.

Adult↗
PubMed1980

Brain catecholamines and sleep states in offspring of caffeine-treated rats.

Caffeine was administered in the diet to rats throughout gestation. In the 2 consecutive untreated generations, an increase of parodoxical sleep was observed at maturity. In the 1st generation, the dopamine level was markedly reduced in the locus coeruleus, wheras that of noradrenaline remained constant. The effect was less pronounced in the 2nd generation.

Animals↗
PubMed1980

Effect of caffeine on rat offspring from treated dams.

Pregnant Sprague-Dawley rats were given caffeine at 1.0, 0.5 and 0.25 g/kg diet during gestation and lactation. At birth, half of the pups from control and treated rats at each dose level were exchanged and cross fostered. Two litters were produced by each animal from each of the experimental groups. Caffeine at dietary concentrations of 0.5 and 0.25 g/kg throughout gestation and lactation had no significant effect on birth weight, litter size or development. There was also no effect at these doses following treatment during either gestation alone, or lactation alone. At 1.0 g/kg there was a slight reduction of birth weight, as well as a trend towards lower weight gain in litters from dams fed the test diet throughout gestation and lactation.

Animals↗
PubMed1980

[Long-term course of patients with myocardial infarction and bundle branch block].

The long-term outcome of myocardial infarction (MI) with bundle branch block (BBB) was studied retrospectively by a direct questionnaire and a registry enquiry in order to define the prognostic significance of data obtained during hospitalisation and to discuss the possible indications of permanent pacing in these patients. Out of 2 720 acute MI hospitalised between October 1969 and April 1977, 231 and BBB (unknown before infarction): 58 right, 53 left and 120 bilateral BBB. 113 patients survived the acute phase of MI and 111 patients were followed up for 72 +/- 24 months: 80 patients died, and 30 survive - a global survival rate of only 13% at 6 years. The post-admission mortality rate was not related to the type of BBB or the site of infarction. It was significantly higher in patients with previous myocardial infarction and in a sub group of patients without advanced AV block in the acute phase who had severe cardiac failure (Classes III and IV, Killip). The hospital mortality was higher in patients with advanced AV block in the acute stage (62,5% compared to 45,9%) in patients without advanced AV block, p < 0,025. On the other hand, the post-admission mortality was not significantly different in these two sub groups (77,8% compared to 69,8% : NS). Stokes-Adams syncope was rarely authentified in the post-admission course of the patients. An increased risk of secondary sudden death directly related to a conduction defect has not been proved. The indications for permanent pacing therefore remain uncertain. They should not be widened further than the indications for permanent pacing in chronic degenerative block.

Bundle-Branch Block↗
PubMed1979

Caffeine determination in rat plasma. A comparative study of micromethods.

Confronted with the need for a sensitive (1 mg/1), specific and reproducible (less than 5%) method for the determination of caffeine in small plasma samples (10-50 microliter) of small laboratory animals, two existing methods, radioactive labelling and gas chromatography, were adapted. The first step, common to both methods, is chloroform extraction, followed by either gas-chromatographic analysis or radioactivity measurement. These methods were compared by using a common internal standard, labelled caffeine, measured before and after the extraction step. The initial requirements were fulfilled and the correlation of the results proved to be excellent. The methods can be extended to animals other than the rat, and to organs or biological fluids other than plasma. The very small amount of plasma needed for the determination allows pharmacokinetic studies to be conducted in small laboratory animals. Further, by combining the two methods it is possible to perform rather complex investigations, such as evaluating the extent of caffeine metabolism and, at the same time, determining levels in the case of chromic administration.

Animals↗
PubMed1979

[Coronary lesions due to aortic valve disease. II -- Results and indications of aortocoronary bypass surgery].

454 cases of aortic valve replacement were studied: 217 had no significant coronary artery disease, 197 had associated aorto-coronary bypass surgery and 40 coronary artery disease without revascularization surgery:-- The early mortality in the three groups was 5.5%, 21% and 12.5% respectively, the only statistically significant difference being between the first two groups. -- The coronary artery disease was signigicantly more severe in the group which underwent associated aorto-coronary bypass surgery. The early mortality was significantly raised in the group without bypass surgery in cases with severe coronary artery disease (28%) and in the group with bypass surgery with unsuitable coronary artery lesions (35.5%). On the other hand, the long term survival and functional capacity of patients who underwent associated bypass surgery approached that of the non-coronary patients. Combined aortic valve replacement and coronary bypass surgery should therefore be continued in selected cases.

Aortic Valve Insufficiency↗
PubMed1979

[Comparison of hospitalized hypertensive patients and those consulting in a specialized unit. Initial clinical state and patient compliance].

This study is based on a series of 1919 hypertensive patients examined consecutively either in hospital or in the out patient clinic between 1969 and 1977 and reviewed in February 1977 by a postal questionnaire. The initial presentation of in-patients and out-patients differed very significantly in the same specialised department: the patients hospitalised were seen at a more advanced stage of their hypertensive illness. Neither group was truly representative of the general population of hypertensive patients. The percentage of patient compliance was only slightly lower in the out-patients. The mortality rate observed did not differ significantly from the expected mortality rate in out-patients; despite treatment it remained over 200% greater in the hospitalised group. It would seem desirable to develop out-patient rather than in-patient hospital facilities for the treatment of hypertension, despite the foreseeable practical difficulties.

Adult↗
PubMed1979

Hexobarbital blood levels and effects on EEG in the presence and absence of caffeine.

The interaction of caffeine and hexobarbital in the rat with spinal cord transection was studied. Duration of hexobarbital effect on the brain was taken as the time from the injection of hexobarbital (i.v.) to the return of pre-injection cortical voltage. Hexobarbital distribution and elimination was estimated by application of a two-compartmental model to values for blood hexobarbital concentration (determined by a direct gas chromatographic method after extraction). Caffeine caused a shift in the dose-response curve for hexobarbital but no changes in hexobarbital distribution and elimination. Results are interpreted on the basis of a central interaction of caffeine with hexobarbital at a brain receptor level.

Animals↗
PubMed1979

[Relationship of sodium intake and arterial hypertension. Contribution of geographical epidemiology (author's transl)].

1. In 28 populations over the world, are available both mean daily sodium intake and trend of the means of blood pressure in adulthood (in order to compute the slope of linear regression of pressure over age). In both sexes, the sodium intake is very significantly correlated with systolic and diastolic slopes, with systolic and diastolic pressures at age 50, and with systolic pressure at age 20. 2. In limited geographic areas, hypertension appears to be always more prevalent in the communities having the larger sodium intake. 3. Low salt intake communities are always primitive. The positive trend of blood pressure with larger salt intake might be also attributed to acculturation process, body weight increase, and diminution of potassium intake. 4. The data now available lead to advise, as soon as possible in life, a prevention of hypertension based upon reduction of sodium intake and increase of vegetable potassium intake.

Adult↗