[Letter: New method of opacification of the inferior vena cava].
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Biomedical subjects
Publications and source records attributed to J Leonetti.
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The authors have carried out phlebograms on 50 patients with recent pulmonary emboli. In the majority of cases (44 out of 50) they found thrombosis in the veins of the lower limbs: in 35 cases, these were situated proximally, ending in the femoro-ilio-caval segment; in 9 cases they were confined to the suropopliteal veins. These facts have led us to modify our treatment plan for pulmonary embolism. Thrombolytic treatment seems to be justified in cases where the prebitis is high up, even if the pulmonary embolus is benign. Heparin is reserved for those cases of benign pulmonary emboli which are secondary to suro-popliteal phlebitis. The question of interrupting the inferior vena cava must bed ecided in the light of the phlebograms.
The authors have made a study of the fate of 118 patients with pulmonary embolism. The mortality (21.8%) is related not only to the embolus itself (especially to the recurrent types) but also to the condition of the affected area. Recurrence is common (34%), serious (9 deaths out of 25), and early (during the first three months.). No treatment or inadequate treatment are the main causes. Treatment works effectively on the pulmonary circulation, which becomes reestablished in the majority of cases, but it carries the risk of a high incidence of haemorrhage (29%) which is severe (2 deaths and 10 tranfusions of more than one litre of blood). In the long term, the prognosis is linked to the developments in the lower limbs, in which there is a progressive failure of venous drainage (46 cases out of 57), even in cases in which there was no local sign of phlebitis at the time of the original embolus.
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As we have shown previously the nucleus of sympathetic neurons contains microtubules and microfilaments giving rise to highly organized inclusions. Present in vivo experiments on cat stellate ganglia have shown that dibutyryl cyclic AMP and theophyllin induce an increase of their frequency (up to 8.5 fold). These and earlier observations lead us to conclude that cyclic AMP mediates the process of nuclear microtubules and microfilaments assembly from preformed protein subunits.
In vivo dibutyryl cyclic AMP and theophylline, as does electrical stimulation, increase the frequency of nuclear microtubules and microfilaments in neurons of cat stellate ganglia. These and previous results lead us to conclude that cyclic AMP mediates the process of assembly of these two structural components from preformed protein subunits and thus triggers the formation of highly organized nuclear inclusions corresponding to the so-called intranuclear rodlets of light microscopy.
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