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Biomedical subjects

H Merle

Publications and source records attributed to H Merle.

63 records · Page 4Linked to original sources
PubMed1976

[Atrial flutter with an audible atrial sound (author's transl)].

In a case of rheumatic valve disease atrial sounds could be heard and recorded on the phonocardiogram during atrial flutter at a rate of 260/min and an atrioventricular block of 3:1 and 5:1. The atrial flutter sounds were also recorded in the apex-cardiogram and as a slight but rapid motion of the anterior mitral valve leaflet in the echocardiogram. These atrial sounds were recorded both in systole and diastole and disappeared after cardiac failure had been treated and sinus rhythm restored. This case and 19 others reported in the medical literature indicate that for atrial sounds to become audible requires high-grade atrioventricular block and increased atrial contractions with increased ventricular filling. The sounds have been proven to originate in the atrium, the characteristics of the sound being similar to those of an opening snap.

Atrial Flutter↗
PubMed1976

[Changes in hemodynamics and contractility during supraventricular tachycardias and after electrical or aprindin-induced termination (author's transl)].

Alterations of hemodynamics and contractility were studied in 6 patients in whom two consecutive runs of supraventricular tachycardias (SVT) were electrically induced. Following initiation there was an abrupt decrease of arterial blood pressure, left ventricular systolic pressure, dp/dtmax, cardiac index and stroke work index (SWI). These parameters -- with the exception of SWI -- increased in the course of the SVT, however, control values were not reached. Mean pulmonary artery pressure steadily increased and remained on an elevated level until the tachycardia was stopped. When the SVT was electrically terminated, there was a transient overshoot of mean arterial and left ventricular systolic pressure, while mean pulmonary artery pressure slowly returned to control values. When the tachycardia was stopped by i.v. infusion of N-)diethylamino-3-propyl)-N-phenyl-indanamine-2 (aprindin, Amidonal) -- started at the 7th minute -- there was no statistically significant difference, neither during the SVT nor after cessation as compared to the values of the first run. Only mean pulmonary artery pressure remained at a higher level after SVT was stopped. It may, therefore, be concluded that in patients with otherwise normal hearts aprindin applied in a dosage sufficient to stop the SVT, does not exhibit noteworthy inotropic side effects.

Adult↗
PubMedDate not supplied

Sicca syndrome and HTLV-I-associated myelopathy/tropical spastic paraparesis.

PURPOSE: The objective of this study is to describe the clinical and immunological aspects observed in patients with both human T-cell lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis and ocular dryness. METHODS: In 15 such patients, clinical and biological examinations completed with a biopsy of secondary salivary glands were performed to assess the etiology of the ocular dryness. RESULTS: Histological study of the biopsy specimens indicated that 80% of the patients had grade 3 or grade 4 lesions, according to the Chisholm scale. Polyclonal hypergammaglobulinemia was found in 60% of patients and lymphocytic alveolitis in 80%. Three patients had past medical history of chronic uveitis. CONCLUSIONS: All findings in these patients were compatible with Sjögren's syndrome; however, no immunological disorders characteristic of the syndrome were found. Tests for antinuclear antibodies and rheumatoid factor proved negative in all cases.

Adult↗
PubMedDate not supplied

Visual phenotype of multiple sclerosis in the Afro-Caribbean population and the influence of migration to metropolitan France.

PURPOSE: To describe the visual phenotype of multiple sclerosis (MS) in the Afro-Caribbean population living in Martinique (French West Indies) and to specify the influence of the migration to metropolitan France on ocular impairment. DESIGN: Prospective consecutive observational case series. METHODS: A complete ophthalmologic examination was performed. PARTICIPANTS: A total of 112 patients of Afro-Caribbean origin with MS satisfying McDonald's diagnostic criteria, divided into 53 cases (47.3%), the non-migrant patients (group NM), who had never left the Caribbean basin, and 59 cases (52.7%), the migrant patients (group M), who had lived in metropolitan France for at least 1 year before age 15. RESULTS: MS first manifested as an impairment of the optic nerve in 41 cases (36.6%): 25 cases (47.1%) in group NM and 16 cases (27.1%) in group M. Visual function was recovered in 13/25 cases (52%) in group NM compared to 13/16 cases (81%) in group M. Two-thirds of patients presented with a clinical ocular impairment, which was bilateral in 58.5% of cases in group NM. Fourteen cases (12.5%) met the criteria of neuromyelitis optica, nine cases (17%) in group NM and five cases (8.5%) in group M. In group NM, when the initial visual attack did not regress, the visual Expanded Disability Status Scale (EDSS) score was 5+/-1.5 ; 75% of patients had monocular blindness and 50% binocular. CONCLUSIONS: In the non-migrants (group NM), MS manifested more frequently with an optical neuropathy, the ocular impairment was more severe, and corresponded to neuromyelitis optica in 17% of the cases; a visual presentation and the absence of complete recovery from the first attack represented a factor of poor prognosis. This series is the largest description of the visual phenotype of MS in patients of African origin. The results confirm the preferential impairment of the optic nerve in the black population in the course of the disease. The migration towards an area of high prevalence of MS influences the visual phenotype in terms of a lower incidence and less severe prognosis of ocular impairment.

Adult↗
PubMedDate not supplied

Isolated conjunctival ulcerations as the first sign of Behçet's disease.

PURPOSE: To report an unusual incident of isolated conjunctival ulcerations which preceded all other signs of Behçet's disease. METHODS: Description of a 34-year-old woman of West Indian origin with an unremarkable medical history presenting with bilateral bulbar conjunctival ulcerations. RESULTS: The authors noted the presence of a diffuse bilateral conjunctival hyperemia which was more pronounced at the temporal bulbar conjunctiva of the right eye and the nasal conjunctiva of the left eye, each having one ulceration. The rest of the ophthalmologic examination was normal. One month later, the appearance of buccogenital aphthosis led to the diagnosis of Behçet's disease. CONCLUSIONS: This observation is unusual, as the conjunctival ulcerations are isolated and precede the onset of all other symptoms of Behçet's disease. Conjunctival ulcerations are rarely seen with Behçet's disease, but are characteristic enough to be included among the diagnostic criteria.

Adult↗
PubMedDate not supplied

[Isolated ocular melanosis. Apropos of a case].

A case of an eighteen month child with ocular melanocytosis is reported. The authors describe clinicopathological features of the affection. Ocular melanocytosis is a neural crest disorder more frequently found in pigmented populations. Differential diagnosis are naevus of Ota, blue sclera disease and scleritis. The risk of malignant degeneration especially in caucasian people explain that patient should be followed-up at regular intervals.

Black People↗