[The surgical treatment of gastroesophageal reflux in the adult. The results and prospects].
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Esophagogastric Junction↗
Biomedical subjects
L Roy
Publications and source records attributed to L Roy.
Pharmacokinetics of tissue-type plasminogen activator during acute myocardial infarction in men. Effect of a prostacyclin analogue.
BACKGROUND: Coronary reocclusion complicates the thrombolytic therapy of acute myocardial infarction despite the routine use of aspirin. This is consistent with experimental studies demonstrating that multiple agonists, in addition to thromboxane A2, mediate the platelet activation underlying reocclusion. Consequently, a more potent antiplatelet therapy with a broader spectrum of activity than aspirin may be required in this setting. Prostacyclin and its more stable analogue, iloprost, inhibit platelet aggregation to all known agonists and exert an additional effect over aspirin alone. Experiments in animal models have demonstrated, however, that iloprost increases the clearance of tissue-type plasminogen activator (t-PA) and impairs thrombolysis in vivo. This study examines whether a similar interaction occurs in humans. METHODS AND RESULTS: Twelve patients with acute myocardial infarction received t-PA intravenously, 60 mg in the first hour and a maintenance infusion of 13.3 mg/hr for 3 hours. Patients were assigned in a double-blind fashion to iloprost (2 ng/kg/min) or placebo following the initial 90 minutes of the maintenance infusion of t-PA. Iloprost decreased mean arterial blood pressure (-10 +/- 2.9 mm Hg, p less than 0.05) but did not alter heart rate. Steady-state plasma iloprost concentration was 591 +/- 64 pmol/l. At this concentration, iloprost markedly inhibited platelet aggregation in vitro, particularly in the presence of aspirin. Steady-state clearance of t-PA was unchanged by iloprost (454 +/- 65 versus 443 +/- 136 ml/min in controls, p = NS). Furthermore, neither elimination kinetics nor plasma protein binding of t-PA was altered by iloprost. CONCLUSIONS: At plasma levels that exert a potent antiplatelet effect, iloprost did not alter the pharmacokinetics of t-PA in men. Prostacyclin analogues may prove useful as an adjunct to plasminogen activators, particularly in patients at high risk for thrombotic reocclusion.
Acute Disease↗
Double-blind, randomized, controlled trial of fish oil supplements in prevention of recurrence of stenosis after coronary angioplasty.
BACKGROUND: Previous studies suggest that recurrence of coronary stenosis after percutaneous transluminal coronary angioplasty (PTCA) might be prevented with dietary supplements rich in omega-3 fatty acids. The purpose of the present study was to evaluate this hypothesis. In addition, the relation between usual dietary consumption of omega-3 fatty acids and restenosis was assessed. METHODS AND RESULTS: A double-blind, randomized, controlled trial was conducted in which 205 patients undergoing a first PTCA received 15 capsules per day containing 1 g of either fish oil (2.7 g/day of eicosapentaenoic acid, 1.8 g/day of docosahexaenoic acid) or olive oil. The treatment was started 3 weeks before PTCA and continued for 6 months thereafter. Dietary intake was assessed by food frequency questionnaire. At 6 months after PTCA, patients underwent a control angiography. All angiographic lesions were measured by quantitative computer analysis. Four criteria were used to define restenosis. Restenosis occurred less often in the fish oil group (22.0-35.6% depending on the definition) than in the control group (40.0-53.3%). After controlling for other risk factors of restenosis, the association of fish oil supplementation with a lower frequency of restenosis was statistically significant (p = 0.03) for three of four definitions. After adjustment, a dietary intake of omega-3 fatty acids of more than 0.15 g/day was also associated with a lower frequency of restenosis (p less than or equal to 0.03). CONCLUSIONS: This trial documented the protective effect of fish oil supplements on the recurrence of coronary stenosis 6 months after PTCA. The study results suggest that a dietary intervention could be useful in preventing restenosis.
Angioplasty, Balloon, Coronary↗
GTP-dependent membrane fusion during hepatocarcinogenesis and liver regeneration.
Rough microsomes were isolated from homogenates of livers of rats bearing hepatomas as well as from homogenates of livers of rats 24 and 48 h after partial hepatectomy. When incubated in the presence of GTP in a cell-free system to assay membrane fusion these membranes were observed to have a greater capacity (1.4 to 5 fold) for GTP-dependent fusion than homologous membranes from control non-proliferating liver tissue. The enhanced GTP-dependent membrane fusion may reflect changes in membrane properties related to cell proliferation.
Aflatoxin B1↗
Effect of maturation on topographic distribution of bronchoconstrictor responses in large diameter airways of young swine.
We studied the effect of maturation on the topographic distribution of airway constriction in Generations 0 (trachea) through 6 in fourteen 2-wk-old swine (2ws) and sixteen 10-wk-old swine (10ws) in vivo and in excised airways from seven 2ws and seven 10ws in vitro. Animals were anesthetized with chloralose-urethane and received beta-adrenergic blockade and vagotomy prior to generation of random-order, dose-response curves with i.v. methacholine (MCh) and histamine (His) or serotonin (5HT) given intravenously. Lung resistance (RL) was measured, and airway diameter was assessed by tantalum bronchograms obtained at functional residual capacity for each dose of agonist. Baseline RL was substantially greater in 2ws (48 to 62 cm H2O/L/s) than in 10ws (9 to 11 cm H2O/L/s; p less than 0.001 for all groups). Intravenous infusion of 10(-6) mol/kg MCh caused a 416 +/- 110% increase in RL in 2 ws and a 314 +/- 32% increase in RL in 10 ws (p = NS); airway diameter (Daw) decreased by 10 +/- 1% (Generation 2) to 27 +/- 4% (Generation 6) in 2ws and from 8 +/- 2 (Generation 2) to 17 +/- 4% in 10ws. Intravenous infusion of 10(-6) mol/kg His caused a 513 +/- 85% increase in RL in 2ws and a 276 +/- 17% increase in RL in 10 ws (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Age Factors↗
[Use of pectin in the treatment of hypoglycemic dumping syndrome].
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Adult↗
Diagnosis of rubella virus infections. I. A comparison between Vero and BHK-21 cells for the detection of specific IgG and IgM antibodies by immunofluorescence.
Vero cells were more suitable then BHK-21 cells for the detection of rubella-specific IgG antibodies because the nonspecific fluorescence was minimal. However, BHK-21 cells were found more sensitive than Vero cells for the detection of rubella-specific IgM antibodies.
Adult↗
Diagnosis of rubella virus infections. II. A comparison between incident and transmitted light fluorescence for the detection of specific IgM antibodies.
The fluorescence obtained with an incident light system is higher than that obtained with a transmitted light system. Examination time is reduced and the strain on the eyes, after long periods, is reduced. However, the results are the same whatever the system used.
Animals↗
[Blount's disease: a review of 8 cases (author's transl)].
The authors have reviewed eight cases of infantile tibia vara. All were treated operatively. Five patients were young children (less than 5 years old); they were treated by a single osteotomy into valgus and lateral rotation. Three children were older at the time of surgery. The deformity recurred in all of them and a second operation was required of elevation of the lateral tibial plateau and lateral epiplysiodesis. The authors emphasise the need for early correction of deformity to produce better mechanical function of the knee and balanced epiphyseal growth.
Age Factors↗
Effects of a fish oil supplement on blood pressure and serum lipids in patients treated for coronary artery disease.
OBJECTIVE: The purpose of this study was to evaluate the effects of a concentrate of fish oil on blood pressure and serum lipids in patients treated for coronary artery disease. DESIGN: One hundred and twenty-five patients were randomly assigned to receive 15 g/day MaxEPA (4.5 g eicosapentaenoic and docosahexaenoic acids) or olive oil. Blood pressure and serum lipids were measured at enrollment and six months thereafter. MAIN RESULTS: As an important proportion of antihypertensive or antianginal drug users stopped their usual medication during the trial, blood pressure increased in both groups. The increase in systolic blood pressure was less in the fish oil group than in the control group (P = 0.002). Serum triglyceride levels decreased markedly in the fish oil group while they remained constant in the control group (P = 0.0001). Fish oil supplementation had no effect on total cholesterol and only marginal independent influence on high density lipoprotein and low density lipoprotein cholesterol levels. CONCLUSIONS: In conclusion, fish oil supplementation has a beneficial effect on blood pressure and serum triglycerides in patients treated for coronary artery disease.
Antihypertensive Agents↗
[A retrospective study on the use of preoperative percutaneous drainage in uncomplicated obstructive jaundice].
This study concerns a retrospective analysis of the use of preoperative percutaneous biliary drainage in the treatment of obstructive jaundice complicated or not by cholangitis. From 1980 to 1987, 87 patients were selected; among these, only those with bilirubin greater than 5 mg% and an overt indication to surgery were included in the study. It was so possible to match two relatively homogeneous populations, e.g. patients submitted to preoperative drainage vs patients not drained. According to our experience, a preoperative percutaneous biliary drainage does not affect postoperative mortality, incidence of immediate postoperative complications and length of hospitalisation. These results are probably linked to a predominant use of the drainage in absence of infectious complications.
Cholestasis↗
Untreated scoliosis in the adult.
Untreated scoliosis affects the quality of life and is a disabling disease in the adult. Most patients can expect back pain, particularly after the age of 30, and one in 4 may be disabled by it. The majority of adults are embarassed by their deformity. Women, in particular, are less likely to marry. Surgical treatment of the adult is difficult and hazardous, and is associated with socioeconomic problems not encountered in the adolescent. Scoliosis should be treated definitively before the end of the period of growth.
Adolescent↗