Biomedical subjects
Publications and source records attributed to J F Morin.
HLA-antigens of 80 patients with recurrent ocular herpes simplex infection were compared to a control population. HLA-B5 antigen was significantly more common in the first group. Several hypothesis are discussed in order to explain a relationship between recurrent ocular herpes simplex infection and HLA-antigens.
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The study of 30,279 adult sera, most issued from Finistère, detected 334 monoclonal gammapathies. The analysis of the results discloses that monoclonal gammapathies appear more frequently in this district (Finistère) than in Paris' one and that their repartition is not homogeneous. Two areas seem to be more particularly affected: one in the north-east, where IgG paraproteins are particularly frequent and the other in southwest, more particularly touched by IgM. The role of a genetic tendency could be backed by a discovery of numerous cases of monoclonal gammapathies occuring in families, and the high rate occuring between "half brother and sisters", but the case study of three couples would be more in favor of an environmental stimulus.
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A comparison of the short and long term outcome in two groups of patients admitted to hospital during the acute phase of their first myocardial infarction, an anterior group (123 cases) and a posterior group (147 cases) has produced the following results:--an immediate mortality which was significantly higher (identical cause of death) in the anterior infarct group (22.8%) than in the posterior infarct group (11.6%): p less than 0.02;--a very similar long term mortality (5 to 6% per year) in the two groups (the main causes for which cannot be equated) despite the fact that the initial destruction of muscle was usually greater when the infarct had been anterior. These results seem to lead to the following conclusion: a better overall prognosis seems to be related to efforts to limit the extent of an infarct, especially when it is anteriorly situated; sometime after the infarct, it is also linked to the improvement in vascularity of the regions which are not involved, especially in cases of posterior necrosis.
Myocardial infarction (MI), (and especially anteriorly situated necrosis) was complicated by complete branch block (CBB) in 9.7% of cases (45 patients out of 462). A comparison of the short- and long-term outcome in two groups of patients (group A: 45 cases of MI complicated by CBB; group B: 45 cases of MI with no atrio-ventricular or intra-ventricular conduction defects) showed that there was a much bigger immediate mortality in group A, which was not changed by temporary cardiac pacemaking, and depended on the extent of myocardial destruction. A study of the long-term outcome showed that there were more deaths in group A (recurrence of MI, intractable cardiac failure). However, the incidence of sudden death was equal in the two groups (group A 15%, group B 13%), and there was no obvious explanation in the absence of electrocardiographic tracings. Therefore this study lends no support to the argument which favours prophylactic implantation of a cardiac pacemaker during the course of MI complicated by CBB.
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We have studied by using HLA system, 200 people, without filiation but having the same geographic origine (Finistère). The results have been compared with those measured for Parisian and Basque population. A significantly decrease of antigen A29, B18 and BW16 frequency have been observed in the population from Finistere. But, antigen B8 and B27 seems to be more frequent than in population from Paris. A linkage desequilibrium is described for A1-B8 and A3-B7 haplotypes as in population from Paris, but the desequilibrium for A11-B5 seens to be characteristic of population from Finistere.
Age and circumstances of menopause (natural or artificial) are detailed in 104 cases of recent myocardial infarction (MI). The results of this study with statistical analysis show no correlation between the age at menopause and the age at onset of MI; so for this study, an early menopause, cannot be considered, whatever circumstances, as a risk factor for coronary heart disease.
The mean length of the LCA found by pathological (or angiographic) methods is fairly constant. This exclusively anatomical study shows no significant relationship between the length of the LCA and stenotic atherosclerosis in the LCA or the heart weight or a dominant left circumflex coronary artery or a complete His left bundle-branch block.
From an anatomical point of view, the various elements which seem to individualize myocardial infarctions complicated by rupture are: a limited increase in the volume of the heart; a propensity for the rupture to follow the first infarction of a previously healthy cardiac muscle; a myocardial necrosis of sometimes small extension with clear limits and a destruction of the muscle so severe as to amount in two thirds of the cases to a variable parietal dissection; a lesser extension and diffusion of coronary stenosis; an ever-present and totally occlusive coronary thrombosis; an insignificant or absent substitutive circulation. Those strictly anatomical facts can be reason to extend the indications of a very early direct myocardial revascularization (almost a third of all cardiac ruptures occur within 24 hours) or to contemplate an infarctectomy after the eighth hour (the necroses are usually of a moderate size and well deliminated) if it appears possible to draw the "clinical profile" of those patients prone to cardiac rupture or to read the signs that may announce the likelihood of this dreadful complication.
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The over-estimate of plasma volume noted at the time of the substitution of iodine 131 labeled human serum albumin by indium 113m transferrin, probably results from a defective fastening of the radionucleide on the binding protein and not at all from a particular behavior of this last one as it has often been admitted.
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A study of the distribution of the various risk factors for coronary artery disease as a function of the age and sex of a homogenous population of 316 patients has brought to light the following findings: -- These was found to be a greater incidence (statistically significant) of hypertension disorders of glucose metabolism obesity and hypercholesterolaemia in the females, and of tobacco consumption (cigarettes) and, to a lesser extent, of hypertriglyceridaemia and of gout in the males; -- The females who 'tot up' risk factors have their myocardial infarction at a greater age than the males -- The risk factor which separates the two sexes in the consumption of cigarette tobacco. These findings agree with those already in the literature.
Fifty five anatomo-clinical cases of patients who died of a recent myocardial infarction were divided into two groups according to existence of a complete block of one of the branches of the bundle of His, which occured at the same time as the myocardial necrosis: group A: 14 cases comprising 13 complete right blocks and only one complete left block, or absence of intraventricular conduction disorders: group B: 41 cases. The macroscopic anatomical study separated the two groups: in group A there was a very high frequency of healed posterior infarction, extensive recent anterior infraction, transeptal through the anterior and upper half of the interventricular septum by occlusion of the anterior interventricular artery in its proximal segment, above the origin of the second anterior septal artery, associated to severe stenosing lesions of the other coronary trunks, in particular the right coronary artery.
The results of a radioisotopic exploration are not independant of the physical characteristics of the tracer used. Thus in the measurement of cardiac output index by external detection, the substitution of 131I fastened on the human serum albumine by 99mTc fastened on red cells introduces a systematic average error of +20% whose origin is double. Because of the plasma or red cell kind of the tracer, the average error done on the volume is, in 130 measurements, 26% whereas that which results from the difference of photon energy is -6%. Only this last error affects the measurement of the cardiac output and, by that time, it is demonstrated that a direct determination of the cardiac output index by STEWART-HAMILTON'S relation is impossible.