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Biomedical subjects

M Laville

Publications and source records attributed to M Laville.

At least 199 records · Page 11Linked to original sources
PubMed1986

[Course of renal function in malignant hypertension. Effect of treatment. Study of 30 cases followed for 5 to 18 years].

Renal insufficiency is the most frequent complication of malignant hypertension (MHT). The initiation of effective hypotensive treatment is generally followed by a rapid improvement of renal functions, but the long-term evolution has been only rarely studied. A group of 30 patients was retrospectively selected on the following criteria: Malignant hypertension: mean DBP 138 +/- 20 mmHg, hypertensive retinopathy stage III-IV; Early renal insufficiency: mean Inulin clearance (CIN) 66 +/- 26 ml/min, mean PAH clearance (CPAH) 364 +/- 161 ml/min; Clinical and functional follow-up ranging from 5 to 18 years. Among these patients, two groups were defined according to the quality of BP control: good or fair responders (GR) with a DBP always less than 110 mmHg, poor responders (PR) with a DBP occasionally greater than or equal to 110 mmHg. The results show in the two groups an improvement of CIN at 3 years, followed by a stabilization then a decrease after the 6th year. However the early improvement is significantly lower in PR. Despite similar initial values (GR = 54.7 +/- 31.3; PR = 51.4 +/- 13.2), CIN remains always lower in PR (at 9 years = GR 72.4 +/- 30.6; PR 56.0 +/- 19.8). During the first 3 years, CPAH increases in GR, whereas it decreases in PR, resulting in significantly different values at 3 years. At 9 years, CPAH remains improved in GR (329.1 +/- 109.3 vs 281.7 +/- 173.8 initially) but decreased in PR (256.0 +/- 166.9 vs 307.3 +/- 119.5 initially). The parallel improvement of CIN and CPAH in GR confirms a favorable effect of BP control on early vascular lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Obstructive anuria with non-dilated cavities].

Four patients with no evidence of acute functional or organic renal failure suddenly developed anuria. Repeated ultrasonographic exploration failed to show any dilatation of the urinary tract. After 4, 5, 7 and 34 days of anuria respectively, an obstacle was detected, located and identified by ultrasonically guided antegrade pyelography, which led to immediate urine derivation by percutaneous nephrostomy. Three of these patients were cured by percutaneous techniques alone. These 4 cases represent a small but not negligible part of a series of 74 patients with obstructive anuria, 70 of whom had dilated renal cavities. They throw doubt not on the reliability of ultrasonography, but on the idea that all obstacles are associated with dilatation upstream. They also confirm that opacification of the urinary tract is the only way of making sure that an obstacle is present. Antegrade pyelography gives excellent contrast images and can be used as first stage of a percutaneous nephrostomy. The other diagnostic methods are fraught with a high proportion of inadequacy or failure.

Acute Kidney Injury↗
PubMed1985

[Insulinoma today].

Explore the source record for details and available documents.

Adenoma, Islet Cell↗
PubMed1985

Dephosphorylation of L-pyruvate kinase during rat liver hepatocyte isolation.

In isolated rat liver cells, the inhibition of L-pyruvate kinase (L-PK) by a cyclic AMP-dependent phosphorylation mechanism is involved in the hormonal control of glycolysis and gluconeogenesis. The aim of this study was to ascertain whether or not the in vivo phosphorylation state of the enzyme was maintained during the liver perfusion used to prepare isolated liver cells. When the L-PK phosphorylation state was studied indirectly in liver extracts by kinetic measurement, it was found that, during the perfusion, the S0.5 of phosphoenol pyruvate (PEP) for L-PK was decreased in a time-dependent manner from 1 +/- 0.08 to 0.64 +/- 0.1 mM (P less than 0.01) and 0.58 +/- 0.06 mM in liver cells. This shift was prevented only by the addition of glucagon to the perfusion medium. The extent of phosphorylation of L-PK was also estimated by incubation of the liver extract with [gamma-32P]ATP, protein kinase, and cyclic AMP, and measurement of 32Pi incorporated in L-PK by specific immunoprecipitation. In liver extracts removed at the beginning of the perfusion, 0.4 mol Pi/mol L-PK was incorporated and there was no stimulation by cyclic AMP. In contrast, in the liver extracts removed after 30 min of perfusion, cyclic AMP stimulated 32P incorporation two to threefold, and 1.6 mol Pi/mol L-PK was incorporated. These data suggest that L-PK was activated by a dephosphorylation mechanism during rat liver perfusion. This phenomenon could be involved in the classical inactivation of gluconeogenesis observed in the perfused rat liver model.

Animals↗
PubMed1985

[Retroperitoneal fibrosis and generalized scleroderma].

A Raynaud's phenomenon was observed in a 72 year-old man affected by progressive systemic sclerosis. Few months later, the patient was readmitted to the Hospital because of acute renal failure, and a retroperitoneal fibrosis was first suspected on the basis of typical urinary tract alterations, and subsequently confirmed at the post-mortem examination. Such association does not appear fortuitous on histological data, but it has been rarely described. HLA B27 antigen is not always present. Symptomatic therapy includes association between prednisone and percutaneous nephrostomy.

Aged↗
PubMed1985

[Survival of patients in acute renal failure: effect of nutrition and its associated complications].

A retrospective study of 150 patients with acute renal failure (ARF) was conducted to assess the influence of both protein and caloric intake and non-renal complications on the prognosis, as well as the predictive value of plasma protein levels. The majority of ARF had occurred in medical or surgical settings (46% and 32.7%, respectively). Nutritional data were available from 94 patients, fed either by parenteral or enteral routes, or both. The mean caloric intake was higher (29 kcal/kg/day) in patients who recovered than in those who did not (24 kcal/kg/day, p less than 0.01). A caloric intake above 35 kcal/kg/day resulted in an improved survival, independently of either patients' age or non-renal complications. Serum prealbumin and transferrin levels were higher in surviving patients than in those who died, 0.25 vs 0.16 g/l (p less than 0.001) and 1.7 vs 1.4 g/l (p less than 0.01), respectively. Nutritional support in ARF could be adapted according to the variations of these serum markers. Its influence on survival should be assessed with regard to the associated prognosis factors.

Acute Kidney Injury↗
PubMed1984

[Urinary sediment in acute renal insufficiency. Diagnostic and prognostic value of phase-contrast microscopic examination].

Living cells from the urinary tract can be examined by phase-contrast microscopy in a pellet obtained by centrifugation of 10 ml of freshly voided urine. Once these cells have been identified and classified according to their sources, their respective proportions can be evaluated, thus providing some information on the renal structures affected. Urine sediment examination was performed in 60 cases of acute renal failure in order to determine the relationship between the abnormalities encountered and the clinical or histological diagnosis. An abnormal sediment was always associated with parenchymal acute renal failure. Cellular debris and casts were abundant in acute tubular necrosis and less numerous in toxic acute renal failure than in failure resulting from shock. The finding of deformed erythrocytes was strongly suggestive of glomerular nephropathy, a diagnosis which was confirmed by renal biopsy in almost every case.

Acute Kidney Injury↗
PubMed1984

Glucose metabolism in experimental hyperthyroidism: intact in vivo sensitivity to insulin with abnormal binding and increased glucose turnover.

The characteristics of the dose response of insulin on the glucose turnover rate and erythrocyte insulin binding parameters were determined in five normal men before and during experimentally induced hyperthyroidism [L-T4 (2 micrograms kg-1 day-1) for 4 weeks with additional L-T3 (1 microgram kg-1 day-1) for the following 3 weeks]. Hyperthyroidism was characterized by significant rises in T3 from 1.92 +/- 0.17 (+/- SEM) to 3.66 +/- 0.17 nmol/liter (P less than 0.01) and resting metabolic rate from 39 +/- 0.7 to 48 +/- 1 watt/m2 (P less than 0.001). While the subjects received a diet adapted to the metabolic rate, blood glucose rose from 3.8 +/- 0.07 to 4.46 +/- 0.11 mmol/liter (P less than 0.05) without a significant change in plasma insulin. During the insulin dose-response study, glucose infusion rates were unaltered by hyperthyroidism, and neither the maximum effect nor the sensitivity to insulin was altered. Glucose turnover rate, measured using [6,6-2H2]glucose as tracer, was determined in the basal state and during the 0.4 mU kg-1 min-1 insulin infusion. In the basal state, it was significantly increased by hyperthyroidism (control, 2.3 +/- 0.1; hyperthyroidism, 3.7 +/- 0.1 mg kg-1 min-1). During the insulin infusion, hepatic glucose production was totally suppressed before T4 and T3 treatment, but was 0.96 +/- 0.39 mg kg-1 min-1 during T4 and T3 treatment. A marked decrease in the insulin binding affinity to erythrocytes was found without a change in the insulin receptor number. In conclusion, glucose metabolism in experimental hyperthyroidism is characterized by 1) increases in basal glucose production and utilization; 2) antagonism between the effect of insulin and hyperthyroidism at the hepatic level; and 3) lack of peripheral insulin resistance in spite of marked alteration in erythrocyte insulin binding affinity.

Adult↗
PubMed1984

Specific adsorption of circulating antibodies by extracorporeal plasma perfusions over antigen coated collagen flat-membranes: applications to systemic lupus erythematosus.

A new biocompatible collagen membrane, chemically activated in order to bind several antigens such as albumin or DNA, was successfully used to perform extracorporeal immunoadsorptions (IA) in vivo. First, immunoadsorbent devices composed of albumin-coated membranes, in a multilayer arrangement, were able to remove a large amount of anti-albumin antibodies from dogs actively immunized against heterologous albumin, during a single hemoperfusion. Second, DNA-coated membranes, in the same disposition, were used in 5 SLE-patients for serial plasma perfusions, which resulted in a significant decrease of anti-DNA antibodies (DNA-Ab) and immune complexes in serum. As previously observed in dogs, IA were sometimes followed by a rebound of DNA-Ab levels, which occurred either between successive IA (fast rebound) or 2 weeks after the series of IA, only in patients receiving the lowest steroid dosages. The main factors involved in such a rebound are probably a reequilibration of the antibody pool between the intra- and extravascular spaces, for the "fast" component of this rebound, and a de novo antibody synthesis induced by antibody removal only. Indeed, the hypothesis of a direct stimulation by either antigen release or contact between lymphocytes and antigen linked on the membrane, were ruled out by the results of in vitro studies and of plasma perfusion alone. These results support the usefulness of antigen-coated collagen membranes for in vivo IA, which represent a new approach to the treatment of autoantibody mediated diseases and to the investigation of the factors governing antibody synthesis.

Adolescent↗
PubMed1983

Aortic occlusion by a balloon catheter: a method to induce hind limb rigidity in rats.

Post-ischaemic spinal extensor or flexor rigidity can be induced in different species by clamping or ligature of the descending aorta after thoracotomy or laparotomy. A similar motor deficit can also be induced by an intraluminal aortic occlusion produced by inflation of a balloon attached to the tip of a catheter inserted via the femoral artery. This method is easy to perform and avoids all the possible complications of thoracotomy or laparotomy. In rats the occlusion time for obtaining the maximum percentage of animals exhibiting a permanent hind limb extensor (62.5%) or flexor (12.5%) rigidity was 15-16 minutes. A marked depression of hind limb sensory perception accompanied this rigidity but there were no urinary, bowel or skin disturbances. The unilateral femoral ligation following the catheterization did not induce a difference in muscle tone between both hind limbs. The present procedure which is simpler than other published procedures might thus serve as a useful animal model for spastic paraplegia.

Animals↗
PubMed1983

Improvement of cadaveric renal allograft survival by thoracic duct drainage: relation with T-lymphocyte subset modifications assessed by flow-cytometry.

Thoracic duct drainage (TDD) with reinfusion of cell-free lymph was performed in 118 prospective recipients within four months before transplantation. TDD was unsuccessful in 27 patients (A); it yielded 1-19 X 10(9) lymphocytes in 25 cases (B) and 20-185 X -10(9) in 66 cases (C). The incidence of acute rejection episodes and the requirement for early post-transplant dialysis were lower in C than in A. Six patients were studied for T-lymphocyte subsets, using monoclonal antibodies from OKT series and a monomorphic and HLA-DR (BL2) raised in our laboratory. During TDD peripheral blood lymphocyte (PBL) counts decreased and the percentage of BL2 cells increased. Simultaneously, typical small PBL were replaced by large less differentiated cells slightly labelled by OKT3, some of them bearing both OKT4 and OKT8 markers. The larger the depletion, the earlier the emergence of immature T-cells. In lymph fluid, lymphocyte counts decreased later than in blood, the proportion of T8+ cells lacking Fc receptors increased with time. Changes in B patients were less than in C. These results support the hypothesis that T-cell subset modifications represent the main immunological change accounting for better allograft prognosis.

Antibodies, Monoclonal↗
PubMed1981

[Frequency and significance of circulating immune complexes in polyradiculoneuritis (author's transl)].

Circulating immune complexes (CIC) were systematically looked for in 27 patients admitted to an intensive care unit for polyradiculoneuritis. The technique used involved precipitation by polyethylene-glycol of complexed immunoglobulins after binding with 125I-Clq. CICs were present in 21 patients. A longitudinal study was performed in 17 of these, including 6 treated by plasmapheresis. The curves obtained since the onset of clinical symptoms suggest diphasic variations in CIC levels during the course of the disease, independently of plasmapheresis. There was no significant correlation between the rise in CIC and complement activation, concomitant viral infection or severity of the neurological condition. In the present state of our knowledge, a possible role of CICs in the genesis of polyradiculoneuritic lesions can neither be confirmed nor excluded.

Adult↗
PubMedDate not supplied

Peroxisome proliferator activated receptor-gamma, leptin and tumor necrosis factor-alpha mRNA expression during very low calorie diet in subcutaneous adipose tissue in obese women.

BACKGROUND: PPAR gamma, leptin and TNF alpha are three major factors that play a key role in influencing adipocyte differentiation and both adipose tissue function and metabolism. However, the regulation of these three genes during a dynamic period of weight loss is unknown. We therefore investigated the concomitant regulation of the mRNA expression of PPAR gamma, leptin and TNF alpha in adipose tissue during a 21-day very low calorie diet (VLCD) in 12 non-diabetic obese women. METHODS: The mRNA levels of PPAR gamma, leptin and TNF alpha were quantified by quantitative RT-competitive PCR in abdominal subcutaneous adipose tissue before and during VLCD (940 kcal/day). RESULTS: VLCD induced weight loss (approximately 6 kg) and improved insulin sensitivity. Simultaneously, VLCD induced the reduction in the adipose tissue mRNA abundances of PPAR gamma (-13%, p < 0.05) and of leptin (-58%, p < 0.005), whereas TNF alpha mRNA levels increased (+78%, p < 0.005). PPAR gamma and leptin mRNA levels were correlated before (r = 0.778, p < 0.01) and after VLCD (r = 0.797, p < 0.01). Serum HDL-cholesterol concentrations were positively associated with PPAR gamma (r = 0.696, p < 0.03) and leptin (r = 0.806, p < 0.01) mRNA levels. CONCLUSIONS: The increase in TNF alpha mRNA levels suggested that a local increased expression of this cytokine in adipose tissue might play a role in the control of the fat mass during weight loss. PPAR gamma and leptin mRNA levels were positively associated both before and after VLCD, suggesting that common regulatory mechanism(s) might control their expression. More strikingly, we found strong positive correlations between circulating HDL-cholesterol and both PPAR gamma and leptin mRNA levels, suggesting the existence of physiological links between circulating lipoprotein metabolism and adipose tissue function.

Abdomen↗