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Biomedical subjects

P Maurice

Publications and source records attributed to P Maurice.

At least 109 records · Page 6Linked to original sources

[Incidence of hyperuricemia in atrioventricular block. Systematic study of 158 cases which required implantation of an isotopic cardiac pacemaker].

This is a study of 158 patients in whom the placement of an isotopic cardiac pacemaker was indicated; this procedure was carried out Broussais Hospital between 1970 and 1975. These patients, whose mean age was 39 (84 males, 47 females, 12 young men and 15 young women) were examined for uricaemia, and the levels compared with the mean for control population. The results were as follows: 91% had uricaemia at a level higher than the controls. Of these, 61% had uricaemia above 70 mg/l in the men and youths of over 15 years of age, and above 60 mg/l in the women and 50 mg/l in the adolescents. The highest uric acid levels were found in adults with post-operative atrio-ventricular block following surgical correction of a congenital cardiac abnormality, and also in children and adolescence with block which appeared to be congenital.

Adolescent↗

[Mitral commissurotomy under direct vision. 37 cases].

1 188 mitral commissurotomies were carried out between 1962 and 1976, 37 of them (3.1%) being under direct vision. The two operative deaths (5.4%) occurred early in the series. Longer term follow-up showed that 3 cases died secondarily, and 3 had revision surgery. The main complication was mitral incompetence (51% of operated cases had a systolic murmur). The varying indications and results are presented; these justify a prospective study, but not a recommendation for the systematic adoption of mitral commissurotomy by an open heart technique.

Adult↗

[Arterial pressure changes during exertion in the normal subject].

The exercice electrocardiogram, carried out in 160 normal subjects, has allowed us to witness the physiological mechanisms of adaptation to exercise as a function of age and sex. The relationship between systolic arterial pressure (SAP) and cardiac rate (CR) is very narrow (R = 0.97), and is a linear function. Its slope increases with age in both sexes, and differs significantly in the male and female (P less than 0.001). Systolic pressure is related to the relative cardiac rate (CR%) by the formula SAP = 1.55.CR% + 70.

Adaptation, Physiological↗

[The double ventricular response phenomenon in 2 cases of Wolff-Parkinson-White syndrome].

The authors report two cases of "true" consecutive double ventricular response caused by a single premature atrial stimulation; both were young men with Wolff-Parkinson-White syndrome. In both cases, the presence of a bundle of Kent was confirmed. The phenomenon of double ventricular response arising successively from the bundle of Kent and node-His pathway is rare, being mentioned in only two cases in the literature. It is only found when there is the combination of a good bundle of Kent, fair forward conduction, and a relative ventricle-His retrograde block. Amongst the other mechanisms for double ventricular repsonse, re-entry from branch to branch presents the most difficult differential diagnosis. From our observations, the forward characteristics of the spread through the bundle of His which always procedes the bundle of His which always precedes the second ventricular complex have been confirmed, especially in view of the freat variation in the position of this potential which can easily be explained by variations in intra-nodal conduction. In one of these cases, the atriogram, taken after the second ventriculogram, was provided by retrograde activity in the bundle of Kent.

Adolescent↗

[Evaluation of sino-atrial function using the method of extrasystole induced by constant-relative premature impulses. 1. Method and normal results].

Atrial pacemaking under conditions of relative constancy (40 or 50% of the preceding cycle) enables us to calculate the immediate sino-atrial conduction time (retrograde and antegrade) (SACT). 17 patients were chosen for their normal sino-atrial function under spontaneous changes of the sinus cycle (SC). In each case, a significant inverse linear relationship was found between SACT and the corresponding SC. The mean correlation slope was -0.36 in 10 patients with no post-pacing depression (PPD). The slope was greater in 7 patients with a PPD (-0.89); if this depression is taken into account when the SACT is calculated, the slope decreases. In 5 patients, atropine (1 mg I.V. reduced the mean value of SC, and shortened (constant relative value) the SACT. The mechanisms for the spontaneous and induced variations in the sinus output are discussed; it may be that there are substitute pacemakers within the cells of the sino-artrial node, which are affected by variations in sympathetic or parasympathetic activity or by pacing. In clinical practice, automatism and conduction with the sinus node should be interpreted as inter-related functions, both under normal conditions and after vagal block.

Adult↗

[Evaluation of sino-atrial function using the method of extrasystole induced by constant-relative premature impulses. 2. Application in 50 normal and abnormal studies].

The total immediate sino-atrial conduction time (SACT) as calculated by constant relative pacing, 40 or 50% of the immediate sinus cycle (SC), normally varies inversely with the SC. 50 patients were investigated by this method. In 38 patients without sino-atrial block (SAB) on the surface ECG, it was found that the mean slope of correlation between SACT and SC varied with the shape of the curve of Strauss and with the presence or absence of a post-pacing depression. The smallest slope was found in the group in which the curve of Strauss was horizontal in zone II, and in which there was no depression. In the groups with a rising zone II, comparative use of pacing with a fixed relationship in milliseconds suggested a phenomenon of decreasing retrograde conduction. In cases with sinus arrhythmia and a Strauss curve with scattered coordinates, the relationship between SACT and SC was maintained. 1st degree right-sided SAB should therefore be defined as a function of the immediate SC. In 12 other patients with SAB on the surface ECG, the immediate SACT was greatly lengthened so as to be immeasurable, and bore no relationship to the SC.

Adolescent↗

[Continous electrocardiography recording in coronary insufficiency. Diagnostic value].

The accuracy of continuous 24 hour recordings (Holter's method) in the diagnosis of coronary insufficiency has been studied in 115 patients, by comparison with coronary arteriography. The technique was highly specific, but only fairly sensitive under the conditions of the study, because of the relative inactivity of the patients or the absence symptoms during the recording. It has allowed us to detect certain painfree or relatively painless forms of myocardial ischaemia which may be severe, and to have a clearer understanding of the effect of treatment. Comparison with the exercise electrocardiogram has shown inconsistencies due to the limitations of the two techniques. Holter's method is a particularly simple way of detecting coronary insufficiency, and is most useful when exercise tests are impossible or contraindicated.

Adult↗

[Characteristics of nucleic acids excreted by non-stimulated normal human lymphocytes].

Unstimulated human blood lymphocytes have been shown to release in vitro a complex containing DNA and RNA. These nucleic acids are composed of newly synthesized material and appear to be released according to a homeostatic mechanism. Extracellular synthesis of the released DNA has been demonstrated by using a nearest neighbor analysis technique. The characteristics of the extracellular nucleic acids have been investigated biochemically and by electron microscopy.

DNA↗

[Subvalvular aortic stenosis, dysmorphic familial syndrome and peripheral muscular disease].

Two related cases are reported, those of two sisters aged 7 and 13, who had an aortic subvalvular stenosis in the form of a fibro-muscular channel, associated with mitral incompetence, a triangular facies with a pointed chin, pinched lips, a divergent squint, hypertelorism, a mask-like face, normal intelligence, and a peripheral muscular disorder with arthrogriposis. The description of such a combination of malformations is original, and this is discussed.

Abnormalities, Multiple↗

[Arrhythmias following closure of atrial septal defects. Apropos of 300 cases].

In a series of 300 cases whose atrial septal defects were closed (268 with ostium secundum, 27 with ostium primum, and 5 cases with both), arrhythmias were found in 60%. These were usually slow supraventricular arrhythmias caused by substitution (51%), and less commonly rapid supraventricular arrhythmias (27%), extra-systoles (16%), disorders of atrio-ventricular conduction of second and third degree and disorders of the auricle (6%). Conduction disorders were significantly more common (p less than 0.001) after closure of ostium primum (37%) than after closure of an ostium secundum (4.5%). Arrhythmias are most common during the first week (56%), and are usually of the slow type, and during the three succeeding weeks are markedly less frequent (31%) with a higher proportion (p less than 0.001) of the rapid type. No one anatomical type of ASD was complicated with arrhythmia more than the others. The slow type of arrhythmias occurred in the high ASDs, and the fast type especially amongst elderly patients. Longterm follow-up showed arrhythmias in 28% of patients with an ostium secundum defect. The factors influencing arrhythmias were age, cardiac enlargement, and the mean pulmonary arterial pressure. Arrhythmias were just as common in cases with a small shunt.

Adolescent↗