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Biomedical subjects

M Roussel

Publications and source records attributed to M Roussel.

At least 37 records · Page 2Linked to original sources

31P magnetic resonance spectroscopy study of phosphocreatine recovery kinetics in skeletal muscle: the issue of intersubject variability.

We have analyzed by (31)P MRS the relationship between kinetic parameters of phosphocreatine (PCr) recovery and end-of-exercise status under conditions of moderate and large acidosis induced by dynamic exercise. Thirteen healthy subjects performed muscular contractions at 0.47 Hz (low frequency, moderate exercise) and 0.85 Hz (high frequency, heavy exercise). The rate constant of PCr resynthesis (k(PCr)) varied greatly among subjects (variation coefficients: 43 vs. 57% for LF vs. HF exercises) and protocols (k(PCr) values: 1.3+/-0.5 min(-1) vs. 0.9+/-0.5 min(-1) for LF vs. HF exercises, P<0.03). The large intersubject variability can be captured into a linear relationship between k(PCr), the amount of PCr consumed ([PCr(2)]) and pH reached at the end of exercise (pH(end)) (k(PCr)=-3.3+0.7 pH(end)-0.03 [PCr(2)]; P=0.0007; r=0.61). This dual relationship illustrates that mitochondrial activity is affected by end-of-exercise metabolic status and allows reliable comparisons between control, diseased and trained muscles. In contrast to k(PCr), the initial rate of PCr recovery and the maximum oxidative capacity were always constant whatever the metabolic conditions of end-of-exercise and can then be additionally used in the identification of dysfunctions in the oxidative metabolic pathway.

Adenosine Diphosphate↗

[Hypoxic-ischemic encephalopathy in the full-term newborn. Contribution of electroencephalography and MRI or computed tomography to its prognostic evaluation. Apropos of 26 cases].

OBJECTIVES: Perinatal asphyxia complicated by hypoxic ischemic brain injury still remains the source of neurological lesions often serious and definitive. A major aim of neonatologists is to appreciate the severity of the hypoxic ischemic brain injury in the first days of life and to evaluate the forecast. The purpose of this work is to establish a relation between clinical signs, EEG, neuroimaging (MRI and CTS) and neuro-development. MATERIALS AND METHODS: 26 neonates from paediatric resuscitation unit (Hospital North, Marseille) were enrolled in a retrospective study since February 1994 to December 1997. All the newborns had at least one anamnestic criteria of perinatal asphyxia, an early electroencephalogram in the first two days of life and another between the third and the seventh day of life, and neuroimaging in the first 15 days of life: CTS in five cases and MRI in 21 cases. RESULTS: There was a good electro-clinic (P: 0.01) and prognostic (P: 0.03) correlation in patients within stage 3 of the "Sarnat classification". In the stage 2, the EEG did not provide valuable information about severity of the injury, and neuroimaging (especially MRI) allowed better prognosis. Diffuse brain injury or lesions of basal ganglia in MRI were associated, independently of clinical settings and EEG tracings, with a poor neurodevelopmental outcome (P: 0.02). The MRI was diagnostic in four cases of congenital encephalopathy complicated with neonatal suffering. CONCLUSION: Our study confirms the interest of the association of clinical settings, EEG tracings and MRI in the diagnosis and the prognostic of the hypoxic-ischemic encephalopathy in term neonate.

Disease Progression↗

Cyclin D1 expression in patients with multiple myeloma.

INTRODUCTION: Chromosomal abnormalities are detected in 50 to 70% of patients with multiple myeloma (MM). By conventional cytogenetic analysis, a t(11;14)(q13;q32) is observed at a frequency of 3 to 14%. MATERIALS AND METHODS: To demonstrate a cyclin D1 expression in MM patients or MM cell lines, 14 patients with multiple myeloma (MM) and nine human multiple myeloma cell lines (HMCL) were screened by a competitive RT-PCR and/or Northern blot analysis for cyclin D1 expression. Furthermore, we screened 10 MM patients with FISH to demonstrate a relationship between the cyclin D1 expression and the presence of the t(11;14). RESULTS: Five HMCL had a cyclin D1 overexpression: three of them had a t(11;14)(q13;q32) and two had extra copies of chromosome 11. A cyclin D1 expression was found at diagnosis in seven out of 14 untreated MM patients (50%). Out of 14 MM patients, FISH studies were performed in 10 patients. A t(11;14) was detected in three out of 10 patients and extra copies of chromosome 11 were found in two additional patients. CONCLUSION: Cyclin D1 expression is a common event in MM patients (50%) and is associated either with a t(11;14)(q13;q32) or extra copies of chromosome 11. The prognostic role of the cyclin D1 expression and the level of this expression, as compared to other B-cell chronic lymphoproliferative disorders such as mantle cell lymphoma or hairy cell leukemia, remains to be determined in the pathogenesis of multiple myeloma.

Bone Marrow↗

Gender modulates the energy cost of muscle contraction in untrained healthy subjects. A 31P magnetic resonance spectroscopy analysis.

The forearm flexor muscles of 56 untrained volunteers (26 women and 30 men) were examined by 31P magnetic resonance spectroscopy, during a rest-exercise-recovery protocol, in order to document the impact of gender on muscle energetics. Absolute concentrations of high-energy phosphate compounds, intracellular pH and rates of aerobic and anaerobic ATP production were calculated. An inverse correlation was found between body mass index (BMI) and power output in women but not in men. After correcting for power output and BMI, the measured energy cost of contraction was twice larger for women than for men. This increase was also reflected in larger ATP production from aerobic and anaerobic pathways. This higher energy cost might be explained in part by differences in local muscle mass, a higher impact of fatness, but also by a reduced metabolic efficiency of muscle fibers in untrained women.

Adenosine Triphosphate↗

Differential desensitization of human delta-opioid receptors by peptide and alkaloid agonists.

The efficacy of different opioid agonists to induce acute desensitization of the human delta-opioid receptor-mediated inhibition of cAMP accumulation was investigated in the neuroblastoma cell line SK-N-BE, which endogenously expresses these receptors. While etorphine, a non-selective alkaloid agonist, caused 50% desensitization after a 30-min incubation, the same treatment in the presence of the selective peptide agonists, DPDPE ([D-Pen2,D-Pen5]enkephalin) and deltorphin I (Tyr-D-Ala-Phe-Asp-Val-Val-Gly), almost totally desensitized the delta-opioid receptor-mediated inhibition of adenylyl cyclase. When SK-N-BE cells were prechallenged either with alkaloid or peptide agonist, we observed a cross-desensitization that was less marked when cells were pretreated with peptide agonists and then challenged with etorphine. Taken together, these results demonstrate that human delta-opioid receptors are differentially desensitized by alkaloid and peptide agonists.

Adenylyl Cyclase Inhibitors↗

Can cerebrovascular microemboli induce cognitive impairment in patients with prosthetic heart valves?

Doppler ultrasonography can be used to detect the presence of emboli in the cerebral arterial circulation. Emboli can be produced by different sources and can be of different nature: solid elements as thrombi, platelet aggregates or atheromatous material, or gaseous when they are produced during the decompression phase of diving or during extracorporeal circulation (ECC) procedures. A more recent source of emboli has been found in the mechanical prostheic heart valves (MHV). The emboli generated by MHV are likely of gaseous nature and are found in the middle cerebral artery blood flow at a variable rate, where they are detected by transcranial Doppler sonography. The mechanism of production of these microbubbles may be related to the rapid leaflet motion especially at closure when very high local pressure gradients appear, which may be able to provoke a release of the disolved blood gas. Solid element emboli constitute a major cause of cerebrovascular disease and particularly stroke. Conversely, gaseous emboli coming from ECC or MHV are considered as clinically silent. Nevertheless, cognitive alterations have been reported after ECC. As the MHV carriers are chronically submitted to embolic events, it can be assumed that cognitive impairments may occur also in these patients. A preliminary study was designed to inpatients attention and memory in patients with normally functioning MHV and microemboli, with biological prosthesis and in normal subjects. In the two groups of patients, episodic memory was significantly altered relatively to the control group. In the MHV carriers group, a significant decrease in working memory performance was observed relatively to the two other groups. These results confirm a long term effect of the microembolization occuring during ECC and point out the effect of the chronic exposition to microemboli.

Bioprosthesis↗

Microemboli in cerebral circulation and alteration of cognitive abilities in patients with mechanical prosthetic heart valves.

BACKGROUND AND PURPOSE: It has been shown previously that cerebral microemboli may occur frequently in patients with a normal mechanical heart valve (MHV) without prior history of stroke. Some arguments strongly suggest that these microemboli have a gaseous origin. In other circumstances such as extracorporeal circulation or decompression in divers, it has been demonstrated that cerebral microbubbles could lead to some deterioration in cognitive functions. Therefore, we have studied attention and memory, which are among the most impaired cognitive functions as demonstrated in previous studies, in patients with an MHV. METHODS: Three groups of 12 volunteers each were composed of patients with an MHV and embolic signals in the cerebral circulation (group 1), patients with biological prostheses (group 2), and healthy subjects (group 3). Groups were carefully matched for age and verbal intellectual abilities. For each group, a transcranial Doppler examination was performed and a set of cognitive tests assessing sustained and selective attention and episodic and working memory was administered. RESULTS: The mean embolic rate was 29 per hour in patients with an MHV. No embolus was detected in the other 2 groups. Episodic memory was significantly modified in both groups 1 and 2 compared with the control group for tasks that required high-processing resources. Working memory performance was significantly decreased in MHV patients. No between-groups differences were observed for the other parameters. CONCLUSIONS: Alteration of episodic memory can be attributed to a long-term effect of the surgical procedure. Deterioration of working memory can be related to the presence of cerebral microemboli in MHV patients.

Aged↗

Understanding nursing resources in intensive care: a case study.

OBJECTIVE: We describe the use of a measurement of nursing acuity in an ICU based on data from an integrated clinical and financial information system to shed light on the problem of a perceived change in the work of the unit. SETTING: A surgical-neurosurgical ICU in a teaching hospital with more than 800 beds. DESIGN: Changes in the work of nursing, defined by nursing acuity and by case mix and use of ancillary services in this unit for an 18-month period, were reviewed. RESULTS: The caseload was unpredictable. The lack of a systematic pattern of use of hospital resources burdened the nurses. CONCLUSION: For the first time at this institution, timely clinical and financial information has been brought together in an understandable format that can be used to explain trends and variances, to plan for the future, and to manage for cost and quality. The model for information management described here might serve other hospitals as well.

Connecticut↗

DNA-binding and transcriptional activation properties of the EWS-FLI-1 fusion protein resulting from the t(11;22) translocation in Ewing sarcoma.

The 5' half of the EWS gene has recently been described to be fused to the 3' regions of genes encoding the DNA-binding domain of several transcriptional regulators, including ATF1, FLI-1, and ERG, in several human tumors. The most frequent occurrence of this situation results from the t(11;22)(q24;q12) chromosome translocation specific for Ewing sarcoma (ES) and related tumors which joins EWS sequences to the 3' half of FLI-1, which encodes a member of the Ets family of transcriptional regulators. We show here that this chimeric gene encodes an EWS-FLI-1 nuclear protein which binds DNA with the same sequence specificity as the wild-type parental FLI-1 protein. We further show that EWS-FLI-1 is an efficient sequence-specific transcriptional activator of model promoters containing FLI-1 (Ets)-binding sites, a property which is strictly dependent on the presence of its EWS domain. Comparison of the properties of the N-terminal activation domain of FLI-1 to those of the EWS domain of the fusion protein indicates that EWS-FLI-1 has altered transcriptional activation properties compared with FLI-1. These results suggest that EWS-FLI-1 contributes to the transformed phenotype of ES tumor cells by inducing the deregulated and/or unscheduled activation of genes normally responsive to FLI-1 or to other close members of the Ets family. ES and related tumors are characterized by an elevated level of c-myc expression. We show that EWS-FLI-1 is a transactivator of the c-myc promoter, suggesting that upregulation of c-myc expression is under control of EWS-FLI-1.

Amino Acid Sequence↗

Reoperative coronary artery bypass surgery. Improved preservation of myocardial function with retrograde cardioplegia.

BACKGROUND: Cardiac-related mortality remains high for reoperative coronary artery bypass graft surgery (rCABG) compared with first-time surgery (fCABG). Retrograde cardioplegia (RC) has been suggested but not proven to improve the results for rCABG. METHODS AND RESULTS: We therefore reviewed the records of 240 consecutive patients who had undergone rCABG at our institution since 1988. The interval to reoperation was 9.1 +/- 4.2 years (mean +/- SD), with a range from 0.2 to 18 years. Only 46% of grafts were patent at the time of rCABG. The incision to cardiopulmonary bypass (CPB), incision to cross-clamp (XCL), and XCL per graft time intervals were significantly prolonged compared with 100 consecutive fCABG patients operated on during the same time period. Blood utilization was also significantly increased in rCABG compared with fCABG patients. Overall operative mortality was 5.8% and 0% for rCABG and fCABG patients, respectively (P < .05). High-risk criteria (emergency surgery, angina at rest requiring intravenous nitroglycerin or intra-aortic balloon pump [IABP] support [urgent surgery], recent [<21 days] myocardial infarction, or ejection fraction < 30%) were noted in 136 rCABG patients (57%) and 28 fCABG patients (28%) (P < .001). Profound postoperative myocardial dysfunction (postoperative IABP dependence) occurred in only one of 104 low-risk patients (1%), compared with 14 of 136 high-risk patients (10%) (P < .005). Operative mortality was noted in 13 high-risk patients (9.5%) compared with one low-risk patient (1%) (P < .005). RC was used in 80 patients without complication. Postoperative IABP dependence developed in only 2 of 53 high-risk/RC patients (3.8%) compared with 12 of 83 high-risk/non-RC patients (14.5%) (P < .05). At follow-up, rCABG and fCABG patients enjoyed similar symptomatic improvement. CONCLUSIONS: We conclude that retrograde cardioplegia, possibly by minimizing the increased ischemia associated with rCABG, improves the results of rCABG, specifically in regard to preventing profound myocardial dysfunction in high-risk patients.

Coronary Artery Bypass↗

[A rare cause of hypercalcemia: familial hypocalciuric hypercalcemia].

BACKGROUND: Familial hypocalciuric hypercalcemia is a rare disease with autosomal dominant transmission. Its basic defect is unknown and it requires no treatment. CASE REPORT: A 4 month-old girl was admitted for unexplained crying. She was found to have hypercalcemia (2.8 mmol/l) and later values of blood calcium were 3, 3.1 and 3 mmol/l. The serum free ionic calcium level was also elevated. The serum concentrations of protein, phosphorus, magnesium and the alkaline phosphatase activity were all normal. Serum concentrations of 25-(OH)-D3, 1.25-(OH)-2-D3 and PTH were also normal. The urinary calcium/creatinine ratio was normal and the urinary calcium excretion was 1.08 mg/kg/d. Screening of family members showed hypercalcemia in the father (2.8 mmol/l) and a brother aged 7 years (2.9 mmol/l). Short-term treatment with disodium etidronate lowered the serum calcium level to normal, but hypercalcemia reappeared once the treatment was discontinued. CONCLUSIONS: This asymptomatic familial hypercalcemia has the characteristics of familial hypocalciuric hypercalcemia. There was no associated endocrine disorder. Screening of family members is worthwhile.

Calcium↗

[Health effects of chronic exposure to tobacco smoke on a non-smoker population].

A study devised to evaluate the effects of chronic exposure to tobacco smoke on the health of a population of non-smokers was conducted in a prison. Fourteen volunteers among male, non-smoking prisoners in good health and without history of lung disease were put for thirty days in a cell that was already occupied by three smokers. These subjects were examined on arrival and on the 30th day of their imprisonment. The examination included filling a questionnaire concerning daily habits and food, respiratory function tests, measurement of CO in the expired air, measurement of nicotine, cotinine, thiocyanates and cadmium concentrations in blood and in urine, and measurement of mutagenic substances excreted. The purpose of the study was to detect possible changes in the variables tested between the first and last days of confinement. No significant difference could be demonstrated within this lapse of time. These results are in agreement with the data available in the literature. In the present state of our knowledge, it is difficult to find evidence of a biological impact, notably on the concentrations of the specific indicators nicotine and cotinine, in subjects passively exposed to tobacco smoke.

Adult↗

Production and characterization of human monoclonal antibodies against core protein p25 and transmembrane glycoprotein gp41 of HIV-1.

With a view to obtaining human monoclonal antibodies against HIV-1 antigens we used the Epstein-Barr virus immortalization technique to induce lymphoblastoid cell lines from peripheral blood lymphocytes of 10 people who were seropositive for HIV-1 and had no clinical symptoms. A number of polyclonal lines were obtained which synthesized antibodies against most of the major proteins and glycoproteins of HIV-1. Three stable clones were characterized for class, secretion characteristics and specificity. Two of these clones produce antibodies which react with gp41, and the third reacts with p25. One of the anti-gp41 antibodies was found to have neutralizing activity.

Amino Acid Sequence↗

[Benign hypertrophic gastritis associated with cytomegalovirus infection].

A new case of benign hypertrophic gastritis associated with cytomegalovirus infection in a 7 year-old boy is reported. The main symptoms were complete digestive intolerance and protein loss, resulting in major hypoalbuminemia and anasarca. The alpha-1-antitrypsin clearance was very increased. Diagnosis was established by upper gastrointestinal x-rays which displayed important thickening of the gastric rugae, and by endoscopic examination with biopsy. A cytomegalovirus infection attested by seroconversion and viruria probably played a role in its origin. Symptomatic treatment and albumin infusions led to recovery within one month. In the last 25 years, 31 cases of benign hypertrophic gastritis have been reported. Vomiting is the main symptom with abdominal pain and G-I bleeding. The protein loss is constant, often severe. In most cases, the disease recedes within a few weeks, unlike the adults' Ménétrier disease which proves to be chronic and severe. The cause remains unknown. In 11 cases, a cytomegalovirus infection was reported and, so, is probably not fortuitous.

Child↗