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Biomedical subjects

J Leonetti

Publications and source records attributed to J Leonetti.

At least 19 recordsLinked to original sources
PubMed1991

[Ischemic clinical forms of hypertrophic cardiomyopathies: differential diagnosis with myocardial infarction. Apropos of 15 cases].

This study reports 15 cases of ischaemic clinical forms of hypertrophic cardiomyopathy (HCM). In this retrospective study over a 3 year period, 15 patients with HCM presented with clinical and electrocardiographic signs simulating unstable angina (N = 5) or myocardial infarction (N = 10). All patients had chest pain lasting at least 20 minutes with pseudo-ischaemic ECG changes. Two patients were given thrombolytic therapy. The clinical and enzymatic outcome and results of complementary investigations (including coronary angiography) confirmed the absence of coronary artery disease. The diagnostic of HCM was made by echocardiography. These cases were all apparently primary forms of HCM without intraventricular pressure gradient under basal conditions. Three of the patients were known cases of HCM but the condition was diagnosed after the ischaemic presentation in the other cases. Eight of them had however been considered to have had coronary insufficiency for an average of 5 years. The clinical presentation of HCM represents a difficult differential diagnostic problem with myocardial infarction. Echocardiography is of little help in distinguishing the 2 diseases as septal hypokinesis is often observed in HCM. The clinical course usually reestablishes the diagnosis within a few hours but the delay is often too long in this situation of therapeutic emergency and the indications of thrombolysis may be wrongly posed. Although there is no available formal means of distinguishing the two conditions, this study underlines that this clinical form of HCM is not rare and that the diagnosis should be keep in mind with the other differential diagnoses of myocardial infarction.

Adult↗
PubMed1978

Treatment of venous thrombosis and pulmonary embolism by streptokinase.

We applied the standard treatment with streptokinase to 52 cases of deep venous thrombosis and 35 cases pulmonary embolism. Angiography demonstrated total lysis of the clot 22 times, partial lysis 42 times, and no lysis 23 times. The absence of lysis was more frequent in venous clots than in pulmonary clots. Early treatment was more effective, achieving complete lysis in 21 of 22 cases. Nevertheless, in deep venous thrombosis, late treatment can result in partial lysis and set an important venous junction free. With the standard treatment, the biologic controls showed good lysis in 75% of the cases, insufficient lysis in 15%, and no lysis in 10%. The extent of the thrombosis is an important point. The clot was totally lysed in 9 of 10 cases of localized deep venous thrombosis. In patients with pulmonary embolism, about 30% of the obstructed surface is cleared. Nevertheless, in such cases we must take into consideration not only the nonperfused pulmonary area, but also the venous starting point of the clot.

Adult↗
PubMed1978

[Streptokinase in the treatment of deep venous thrombosis and pulmonary embolism].

Fifty-two deep venous thromboses and 35 pulmonary emboli were treated by Streptokinase administered in accordance with a standard protocol. Radiological examinations revealed total lysis of clots in 22 cases, partial lysis in 42 and failure in 23. The latter more commonly involved venous clots than pulmonary emboli. Early treatment was more effective (21 total lyses out of 22) than late treatment. However, in venous thrombosis, late treatment may give partial lysis and free important venous junctions. With standard treatment, lysis was biologically correct in 70 p. 100 of cases. It was inadequate in 20 p 100 of cases and nil in 10 p. 100 of cases. The results could thus have been improved by treatment established and adjusted in the light of laboratory results. The extent of the thrombosis played an important role. Total lysis was obtained in 9 out of 10 cases of localised deep venous thrombosis. In pulmonary embolism there was an average gain of approximately 30 p. 100 in obstructed surface area. However, in these latter cases, it is important to take into account not only the pulmonary surface area obstructed but also the origin of the clots.

Adult↗
PubMed1977

[Alcoholic cardiomyopathies (author's transl)].

In 108 patients suffering from congestive type cardiomyopathy, there were 42 alcoholics and 66 non-alcoholics. Comparisons between the two groups were made on the basis of clinical data, paraclinical investigations and prognosis. It was possible to distinguish an alcoholic cardiomyopathy which differs from primary cardiomyopathies by the greater severity of the clinical picture and a gloomier prognosis.

Adolescent↗
PubMed1977

Cyclic AMP and ultrastructural organization of the nerve cell nucleus: stimulation of nuclear microtubules and microfilaments assembly in sympathetic neurons.

As we have previously shown for electrical stimulation, in vivo cyclic AMP analogues and theophylline induce an increase (up to 8.5-fold) in the frequency of microtubular-microfilamentous inclusions in the nucleus of sympathetic neurons. These drugs, like electrical stimulation, do not modify the ultrastructural organization of such inclusions, which is briefly reviewed in the present study with the help of tilting experiments. Such data consistent with our previous opinion that microtubules and microfilaments are normal nuclear constituents of these nerve cells, their frequency being related to physiological activity. Moreover, our results may now be discussed in terms of the relationship between these nuclear inclusions and the physiological modulation of transmission through the sympathetic ganglion. Finally, as recently demonstrated in the cytoplasm, the present study shows for the first time that cyclic AMP promotes the assembly of microtubules and microfilaments in the nuclear compartment.

Animals↗
PubMed1976

[Venous signs at the acute stage of pulmonary embolism].

The authors have carried out phlebograms on 50 patients with recent pulmonary emboli. In the majority of cases (44 out of 50) they found thrombosis in the veins of the lower limbs: in 35 cases, these were situated proximally, ending in the femoro-ilio-caval segment; in 9 cases they were confined to the suropopliteal veins. These facts have led us to modify our treatment plan for pulmonary embolism. Thrombolytic treatment seems to be justified in cases where the prebitis is high up, even if the pulmonary embolus is benign. Heparin is reserved for those cases of benign pulmonary emboli which are secondary to suro-popliteal phlebitis. The question of interrupting the inferior vena cava must bed ecided in the light of the phlebograms.

Acute Disease↗
PubMed1976

[Development of pulmonary embolism].

The authors have made a study of the fate of 118 patients with pulmonary embolism. The mortality (21.8%) is related not only to the embolus itself (especially to the recurrent types) but also to the condition of the affected area. Recurrence is common (34%), serious (9 deaths out of 25), and early (during the first three months.). No treatment or inadequate treatment are the main causes. Treatment works effectively on the pulmonary circulation, which becomes reestablished in the majority of cases, but it carries the risk of a high incidence of haemorrhage (29%) which is severe (2 deaths and 10 tranfusions of more than one litre of blood). In the long term, the prognosis is linked to the developments in the lower limbs, in which there is a progressive failure of venous drainage (46 cases out of 57), even in cases in which there was no local sign of phlebitis at the time of the original embolus.

Adult↗
PubMed1975

[Mechanism of the appearance of nuclear inclusions with microfilaments and microtubules in sympathetic neurons. Influence of dibutyryl-adenosine 3'-5' monophosphate and theophylline].

As we have shown previously the nucleus of sympathetic neurons contains microtubules and microfilaments giving rise to highly organized inclusions. Present in vivo experiments on cat stellate ganglia have shown that dibutyryl cyclic AMP and theophyllin induce an increase of their frequency (up to 8.5 fold). These and earlier observations lead us to conclude that cyclic AMP mediates the process of nuclear microtubules and microfilaments assembly from preformed protein subunits.

Animals↗
PubMedDate not supplied

[Influence of dibutyryl cyclic AMP and theophylline on the frequency of nuclear microtubules and microfilaments of sympathetic neurons].

In vivo dibutyryl cyclic AMP and theophylline, as does electrical stimulation, increase the frequency of nuclear microtubules and microfilaments in neurons of cat stellate ganglia. These and previous results lead us to conclude that cyclic AMP mediates the process of assembly of these two structural components from preformed protein subunits and thus triggers the formation of highly organized nuclear inclusions corresponding to the so-called intranuclear rodlets of light microscopy.

Animals↗