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Biomedical subjects

L Boyer

Publications and source records attributed to L Boyer.

11 recordsLinked to original sources

Increased avidity of mutant IgM antibodies caused by the absence of COOH-terminal glycosylation of the mu H chain.

We have previously described the isolation of two hybridoma variants secreting higher avidity IgM (D5 and 7F5), starting from the E11 hybridoma cell line, which produces an antibody specific for the A Ag of the ABO blood group system. In order to explain at the molecular level this increased reactivity, cDNA encoding the H and L chains of the E11, D5, and 7F5 mAb were cloned and sequenced. Comparison of the nucleotide sequences showed a single point mutation in each of the two mAb produced by the hybridoma variants. The mutations were both located in the H chain C region and caused a Ser to Phe substitution at position 565 in the D5 mAb and a Asn to Tyr substitution at position 563 in the 7F5 mAb. Both substitutions modified the consensus glycosylation sequence (Asn-X-Ser/Thr) located in the tail piece of the secretory mu-chain. The absence of glycosylation at this site was confirmed by CNBr cleavage of the [14C]mannose-labeled mAb. The two single point mutations were solely responsible for the increased avidity of the antibodies, as confirmed by site-directed mutagenesis of the E11 mu-chain and serologic analysis of the mutated E11 antibodies. We conclude that the absence of glycosylation at Asn 563 is responsible for the increased avidity of the mutant, possibly by altering the quaternary structure of the IgM polymer. To our knowledge, this is the first report that point mutations in the H chain C region can influence the reactivity of IgM mAb.

Amino Acid Sequence

[Traumatic rupture of the aortic isthmus revealed by acute obstruction of the descending thoracic aorta].

A traumatic transection of the upper descending thoracic aorta, undiagnosed, was complicated on the tenth day by an acute obstruction of the descending thoracic aorta. The upper body hypertension resulted in generalised convulsions and cardiac failure with pulmonary oedema. The lower body ischemia resulted in paraplegia, acute ischemia of the lower limbs, liver failure and anuria. An emergency revascularisation of the lower body was achieved by axillary-bifemoral bypass. The improvement of the clinical status allowed complete repair of the aortic transection two days after the extra-anatomic revascularisation. This case emphasizes the severity of the cases with impaired blood flow to the lower body and the benefit of the extra-anatomic bypass in pathology of the upper descending thoracic aorta when complete repair of the aortic transection is associated with an extremely high risk.

Acute Disease

[Mediastinal hemangiopericytoma. Apropos of a case].

The authors report a new case of hemangiopericytoma in an elderly man. An asymptomatic mediastinal mass was found on a routine chest film. C.T. guided fine-needle biopsy was diagnostic. These rare lesions are clinically and radiologically aspecific and require pathologic proof. The value of percutaneous biopsy before therapeutic decision is emphasized.

Aged

[Revascularization of occluded renal arteries. A case].

After recent treatment with an angiotensin converting enzyme inhibitor, a 62-year old woman with diabetes, hyperlipidemia and hypertension was admitted for oliguric acute renal failure due to bilateral renal artery lesions (right stenosis and left thrombosis). Hemodialysis was instituted. Percutaneous transluminal angioplasty (PTA) of the right renal artery did not improve the patient's condition, whereas left renal PTA, three weeks after admission, restored diuresis and renal function, allowing hemodialysis to be discontinued. This case underlines the capacity of functional recovery after late recanalization of a totally occluded renal artery. The best outcome predictor is the development of a collateral circulation and the visualization of distal renal arteries at arteriography. The kidney can be recanalized by surgery or PTA.

Angioplasty, Balloon

[Percutaneous recanalization of renal arterial occlusion. Apropos of a case].

Percutaneous recanalization of a left occluded renal artery has been performed 10 days after percutaneous transluminal angioplasty of a controlateral renal stenosis. Improvement of the renal function is keeping normal 8 months after, although hypertension control is not very well. 26 case-reports have been found. These preliminary results are encouraging and suggest that this technique should be used against severe hypertension, especially if the kidney is functionnaly solitary, to avoid dialysis in patients with increased operative risk.

Acute Kidney Injury

[Reducing diet].

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Adult

A student-run course in interprofessional relations.

The topic of working relationships among health professionals is one which has long been neglected in professional school curricula. During the winter of 1976 students from four health professions--medicine, nursing, occupational therapy, and physical therapy--initiated a course designed to improve their knowledge of one another's training and skills, with the larger aim of preparing themselves to work in health care teams. The nine weekly meetings are described in terms of their content and students' reactions. In the discussion the underlying themes of legal responsibilities and of sex-roles as factors in health care team functioning are identified. Suggestions are made about format and techniques that seem to be useful for courses of this type.

Education, Medical, Undergraduate

A different summer.

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Delivery of Health Care