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Biomedical subjects

J Lintermans

Publications and source records attributed to J Lintermans.

At least 19 recordsLinked to original sources
PubMed1995

Early balloon dilatation of the pulmonary valve in infants with tetralogy of Fallot. Risks and benefits.

BACKGROUND: Balloon dilatation, an established treatment for pulmonary valve stenosis, remains a controversial procedure in tetralogy of Fallot. METHODS AND RESULTS: Balloon dilatation of the pulmonary valve was performed in 19 infants with tetralogy of Fallot. Its effects on the severity of cyanosis, the growth of the pulmonary valve and pulmonary arteries, and the need for transannular patching were evaluated. Clinical, echographic, angiographic, hemodynamic, and operative data were analyzed. The procedure was safe in all, without significant complications. After balloon dilatation, systemic oxygen saturation increased from a mean value of 79% to 90%. This increase proved to be short-lasting in 4 patients, who required surgery before the age of 6 months. Balloon dilatation increased pulmonary annulus size in each case, from a mean value of 4.9 to 6.9 mm (P < .001). This gain in size remained stable over time, with a mean Z score of -4.8 SD before dilatation, -3.1 SD immediately after the procedure, and -2.7 SD at preoperative catheterization (P < .001). Pulmonary artery dimensions remained unchanged immediately after balloon dilatation but increased at follow-up from a Z score mean value of -2.5 to -0.06 SD and from -2.2 to 0.04 SD for right and left pulmonary arteries, respectively (P < .001). At the time of corrective surgery, the pulmonary annulus was considered large enough to avoid a transannular patch in 69% of the infants. This represented a 30% to 40% reduction in the need for a transannular patch compared with the incidence of transannular patch expected before balloon dilatation. CONCLUSIONS: Pulmonary valve dilatation in infants with tetralogy of Fallot is a relatively safe procedure and appears to produce adequate palliation in most patients. It allowed the growth of the pulmonary annulus and of the pulmonary arteries, resulting in a mean gain of 2 SD for those structures.

Cardiac Catheterization↗
PubMed1994

[Percutaneous embolization of a pulmonary arteriovenous fistula in a child].

BACKGROUND: Pulmonary arteriovenous fistula is a rare vascular abnormality in children that is usually treated by lobectomy. This report describes a case that was improved by coil embolization. CASE REPORT: A thoracic X-ray was routinely taken before amygdalectomy in a 6 year-old girl. It showed a consolidation area in the left superior lobe that persisted despite treatment with erythromycin for 3 weeks. Bronchoscopy was normal, but study of blood gases showed a refractory hypoxemia with moderate cyanosis and hemoglobin at 16.2 g/dl. Right-heart catheterization and angiography showed a pulmonary arteriovenous fistula that was treated by coil embolization. A control investigation 3 months later showed normal arterial oxygen saturation, hemoglobin at 14.5 g/dl and reduced pulmonary condensation. CONCLUSION: Pulmonary arteriovenous fistula may show few symptoms. Coil embolization appears to be a useful initial non-aggressive treatment.

Arteriovenous Fistula↗
PubMed1993

Morphometrical quantification of brain edema related to experimental multiple micro-infarcts in mice: assessment of neurotropin effect.

Cerebral micro-infarcts were induced in mice by injecting a standardized suspension of latex microbeads into one internal carotid artery. The animals were sacrificed after either 2 or 4 days. The importance of the lesions induced in each brain was morphometrically quantified on stratified samples of microscopic serial sections, whereas edema was evaluated in the same sections by comparing the section area of the injected hemisphere with that of the non-injected side. Lesion density and brain edema were found to significantly correlate. Neurotropin, an inhibitor of kinin release, was curatively administered twice a day to 20 experimental animals which were compared to 20 saline-treated counterparts. In the neurotropin-injected mice, after 4 days the global amount of cerebral edema was significantly smaller than that of the controls and the slope of the lesion/edema regression line was reduced, indicating a lower amount of edema for a given lesion. These findings support the theory that the kallikrein-kinin system plays a major role in the development of the vasogenic late phase of ischemic brain edema.

Analgesics↗
PubMed1990

Action of neurotropin on cold-induced pain in normal volunteers: a double-blind placebo study.

The analgesic action of neurotropin, a biological compound widely used in Japan with a record of very limited side-effects, was tested in 8 Caucasian normal volunteers. For the pain test, the subjects were requested to immerse the right hand in ice-cold water and to report the appearance of the following sensations: pain threshold (PThr) and tolerance to pain (PTol). Pain sensitivity range (PSR) was calculated by difference between PThr and PTol expressed in s from beginning of immersion. Neurotropin tablets or an indistinguishable inert placebo were administered according to a randomized double-blind cross-over design and their influence in the pain test was investigated during 2 daily sessions. The effects of both treatments were assessed by calculating the difference between initial and post-medication values for each pain response parameter. Under placebo the means of all effects were found to be negative, reflecting the appearance of hyperalgesia under repetitive pain conditions, with neurotropin, the effects on PTol and PSR were positive and significantly different from those of placebo. These results are discussed in terms of possible mechanisms of action: neurotropin analgesic activity could be linked to its kinin release-inhibiting properties or to a reduction in vaso-constriction and hyperalgesia related to an effect on catecholamines.

Adult↗
PubMed1989

Psychological effects of Neurotropin in man under normal conditions and after sleep deprivation: a double-blind placebo study.

Psychological effects of Neurotropin--a widely used analgesic in Japan--have been evaluated in a double blind cross-over study on volunteers belonging to the nursing staff of a hospital under sleep deprivation or not. Each subject was asked to record his feelings by self-assessment on scales registering the following states: fatigue-/rest+, mental stress-/relaxation+, cold sensation-/comfort+, dissatisfaction-/satisfaction+. Neurotropin was shown to be devoid of demonstrable psychological effects in the subjects under normal sleeping conditions. After sleep deprivation, Neurotropin globally determined significantly more psychological evolutions towards positives+ and less towards negative- mood than inactive placebo. From the self-assessed feelings, euphoria was unaffected, whereas Neurotropin significantly reduced fatigue and improved relaxation and comfort. These results are compared with the observations made on animals submitted to Specific Alternation of Rhythm in Temperature (SART) where Neurotropin relieves such symptoms as hyperalgesia. This model for experimental pain study corresponds to a depletion of brain serotonin and catecholamines. The effects of Neurotropin on exhausted volunteers could, as in the SART model, be due to an inhibition of monoaminergic depletion. The relevance of this finding to some association of chronic pain and psychogenic factors is to be considered.

Adult↗
PubMed1988

[Congenital heart diseases and obstructive pulmonary vascular diseases in Down's syndrome. Apropos of 142 children with trisomy 21].

Trisomy 21 accounts for 3 p. 100 of reasons for admission to the Paediatric Cardiology unit of the St Luc University Clinics, Brussels. In a series of 142 cardiac children with trisomy 21 evaluated by catheterization between 1969 and 1987, 54 p. 100 of the cardiac malformations observed consisted of persistent common atrioventricular canal (complete in 45 p. 100 of the cases). The other heart diseases were ventricular septal defect (23 p. 100), atrial septal defect of the ostium secundum type (10 p. 100) and tetralogy of Fallot (9 p. 100). In 40 p. 100 of the patients other cardiovascular abnormalities were associated with these predominant intracardiac shunts. These findings were in agreement with those usually reported in the literature. At the time of investigation (mean age 24 months), pulmonary vascular resistance had already reached a pathological level in 88 p. 100 of the cases. Oxygen tests only slightly improved these results, which suggested that the conditions were favourable to the early development of a pulmonary obstructive vascular disease in Down's syndrome, thus darkening the prognosis of congenital heart disease in mongoloid children. In this series to overall mortality rate of corrective surgery was 23 p. 100. The risk was maximum in infants aged less than 3 months with severe and rapidly symptomatic lesions. The outcome in patients successfully operated upon was satisfactory, with benign residual lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗
PubMed1987

Long-term follow-up of the Senning operation for transposition of the great arteries in children under 3 months of age.

Twenty-six patients aged 6 days to 3 months (mean 57 days) underwent a Senning procedure for transposition of the great arteries. Twenty-two had intact ventricular septum and four had a small ventricular septal defect. They were followed up for 1 month to 8 years (mean 4 years). There were no late deaths. At late examination, 25 patients were asymptomatic and there was no clinical or echographic evidence of caval or pulmonary venous obstruction. Growth was normal in all but two patients. Neurologic assessment was abnormal in eight patients. The electrocardiogram showed sinus rhythm in 22 patients and asymptomatic arrhythmias in four. Twenty-three patients underwent cardiac catheterization and angiographic studies 2 to 72 months postoperatively (mean 15 months), which demonstrated effective left and right atrial contraction. An atrial shunt was noted in one patient and a ventricular shunt in one. Two infants (8%) had a residual left ventricular outflow tract obstruction (gradients of 26 and 37 mm Hg). Two had mild superior vena caval obstruction (gradients of 4 and 5 mm Hg). We conclude that the Senning procedure can be performed in early infancy with good results and a low incidence of late complications.

Cardiac Catheterization↗
PubMed1984

Myxomatous degeneration of the mitral valve in a child with Turner syndrome and partial anomalous pulmonary venous return.

This a report of myxomatous mitral valve degeneration in a child with Turner syndrome. The diagnosis was first suspected at 7 months of age. At 5 years of age, ultrasonic and angio-cardiographic confirmation prompted a successful mitral valve replacement with a Starr prosthesis. The child also had partial anomalous pulmonary venous return and a dysplastic right kidney. The child has remained well for 4 years after surgery.

Diagnosis, Differential↗
PubMed1984

[Severe hypertrophic myocardiopathy in newborn infants. Intra-erythrocyte calcium and the effect of lidoflazine, a calcium-channel inhibitor. Apropos of 2 cases].

Two cases of severe hypertrophic obstructive cardiomyopathy in the neonate are reported. The first case was poorly tolerated because of predominant stenosis of the right ventricular outflow tract causing right to left shunting through a patent foramen ovale. The second case presented with severe syncope at 6 weeks of age. The first patient was treated with propranolol without any success. Regression of the clinical and electrocardiographic signs was obtained in both cases with lidoflazine, within a few weeks. Red blood cell calcium concentrations were abnormally high in both patients before treatment and returned to normal levels with clinical and echocardiographic improvement. Abnormal accumulation of intracellular calcium in the myocardium is a possible mechanism of this cardiomyopathy. The relation between this type of accumulation and the effects of catecholamine discharge are recalled. The possible initiating role of an enzymatic abnormality of calcium entry is discussed: the chaotic geometric alignment of the myocardial fibres, characteristic of this type of hypertrophy, would therefore be a secondary phenomenon. Once constituted, the hypertrophy would then become irreversible. However, it may be possible to reverse it in the neonate by calcium antagonists as suggested by these two cases.

Calcium↗
PubMed1983

[Mitral valve replacement in an infant with disseminated lupus erythematosus and Libman-Sacks endocarditis].

The authors report a case of Libman-Sacks endocarditis of the posterior mitral leaflet in a child treated for disseminated lupus erythematosus for 8 years. Mitral valve replacement was performed. Libman-Sacks vegetations are hardly ever recognised in vivo and have never been previously reported in a child. The incidence of this cardiac complication of lupus erythematosus is probably higher than indicated in the literature. Attentive cardiac examination and systematic echocardiography should be part of routine follow-up of patients with disseminated lupus erythematosus.

Child↗
PubMed1982

[Autoradiographic demonstration of the passage of vincamin through the blood-brain barrier].

Autoradiographies of the brain and of the cerebellum were performed in 8-month old rats after intraperitoneal injection of 3H-labelled vincamine. Only those samples that were processed by freezedrying or by freezesubstitution gave interpretable results. Some specifically labelled cells were found in the molecular layer of the cerebellar cortex as well as in the internal granular and in the deeper layers of the cerebral cortex. they did not belong to the vascular system. It was concluded that vincamine or its metabolites crosses the blood-brain barrier. Any attempt to explain a possible action of the substance on the brain function should thus also consider the cellular components of the central nervous system and not only the haemodynamics of the cerebral circulation.

Animals↗
PubMed1980

[Bacterial endocarditis and echocardiography].

The authors present a case of enterococcal bacterial endocarditis in which a high degree of correlation was found between the echocardiographic findings and the anatomical lesions found at autopsy. They review the value of echocardiography as a simple non-invasive technique in the diagnosis and assessment of bacterial endocarditis.

Echocardiography↗
PubMed1979

Autoradiographic evidence for passage of vincamine through the blood-brain barrier.

Autoradiographies of the brain and of the cerebellum were performed in 8-month old rats intraperitoneal injection of 3H-labelled vincamine. Only those samples that were processed by freeze-drying or by freeze-substitution gave interpretable results. Some specifically labeled cells were found in the molecular layer of the cerebellar cortex as well as in the internal granular and in the deeper layers of the cerebral cortex. They did not belong to the vascular system. It was concluded that vincamine or its metabolites crosses the blood-brain barrier. Any attempt to explain a possible action of the substance on the brain function should thus also consider the cellular components of the central nervous system and not only the haemodynamics of the cerebral circulation.

Animals↗