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J Vedel

Publications and source records attributed to J Vedel.

At least 19 recordsLinked to original sources
PubMed1992

Flow cytometry analysis of adhesion molecules on human Langerhans cells.

The Langerhans cell (LC) migrates between the epidermis and the regional lymph nodes to present antigens. This migration pattern requires the expression of a changing repertoire of cell-surface molecules. In this work, we have investigated the expression of the adhesion molecules CD 11/CD 18 and CD 58 on LCs. Human epidermal cell suspensions were enriched in LCs (mean enrichment 75%) using a two-step technique including a Ficoll-Hypaque gradient followed by Fc receptor panning with IgG-coated sheep erythrocytes. The number of cells obtained per experiment was 750,000 (extremes 280,000-1,800,000), and the following antibodies were tested on fresh suspensions and/or after 48 hours in culture: BB3 (antithyroglobulin negative control IgG2a), OKT6 (anti CD1a, Ortho), anti HLA-DR (Becton-Dickinson), MHM 24 (anti CD 11a, leukocyte typing workshop n(0)3), MO1 and 44 (anti CD 11b, leukocyte typing workshop n(0)3), anti CD 11c (Immunotech), 60.3 and MHM 23 (anti CD 18, leukocyte typing workshop n(0)2), TS2/9.1.1 (anti CD 58, leukocyte typing workshop n(0)3). We found that amongst CD 11 subunits, only CD 11c was expressed in fresh suspensions, but was weaker than CD 18, and disappeared with culture. CD 58 was not detected in fresh suspensions but appeared after 2 days of culture, confirming earlier work. Thus the LC exhibits cell surface characteristics similar to tissue macrophages (CD 18 and CD 11c) prior to culture. The expression of CD 58 after culture is in accordance with the interaction of LC with CD2 bearing T-lymphocytes during antigen presentation in peripheral lymph-nodes.

Antigens, CD↗
PubMed1988

Atrial septal defect with cyanosis without pulmonary hypertension or anomalous systemic venous drainage to the left atrium.

A case of a 29-year-old patient with cyanosis due to a right-to-left shunt is reported. This patient presented an atrial septal defect within the oval fossa and an anomalous left superior caval vein. The direction of this shunt is explained by the anatomical relationship between the oval fossa and the dilated coronary sinus, draining venous blood into the left atrium across the atrial septal defect. Cyanosis disappeared after surgical correction of the defect.

Adult↗
PubMed1984

[Coronary involvement in Takayasu's disease. Apropos of 3 cases, of which 2 were surgically treated, and review of the literature].

Coronary arteries like other branches of the aorta may be involved in Takayasu's disease. This complication is not rare (7% of cases) but appears to be relatively unappreciated. Three new cases are reported of main coronary artery disease, two of which were treated by coronary bypass surgery. A review of the literature of 1 130 cases of Takayasu's disease revealed 86 cases with coronary involvement, 33 of which were confirmed anatomically and 15 by coronary arteriography. The clinical manifestations, angina and/or myocardial infarction, were present in 5% and 3% respectively, of patients with Takayasu's disease. They may be the first sign of the disease and, in some cases, the only symptomatic arterial localisation. The coronary lesions are either ostial, a direct complication of the aortic disease, or on a main vessel, usually proximal. Histological studies show typical changes of stenosing inflammatory panarteritis involving mainly the media and adventitia. Thrombosis and secondary atheromatous plaques may be observed. Aneurysms are rare. Apart from cases with typical ostial lesions, the coronary angiographic appearances are not specific, but some features are suggestive of the diagnosis; the occurrence in young women; the presence of associated peripheral arterial lesions, their localisation and grouping; their radiological and/or histological characteristics. The spontaneous prognosis of these proximal lesions is usually poor and justifies surgical revascularisation by coronary bypass. Six patients, including two in this series, have been treated surgically. The associated aortic lesions may pose special technical problems which we discussed. The relatively high incidence of coronary involvement in Takayasu's disease and its often unexpected revelation by myocardial infarction or sudden death, suggest that coronary arteriography should be undertaken more often during investigation of the arterial lesions of these patients. Takayasu's disease should figure prominently amongst the causes of coronary artery disease in young women.

Adolescent↗
PubMed1983

[Evaluation of the response to the ajmaline test in the diagnosis of paroxysmal atrioventricular blocks].

Between October 1973 and December 1981, 31 symptomatic patients who underwent pacemaker therapy on the results of a positive Ajmaline test alone, showing infrahisian AV block, were followed up clinically and electrocardiographically. The mean follow up from the date of implantation was 30 months. Two groups of patients were identified according to the results of electrophysiological investigations and clinical and electrocardiographic follow-up: --group I: 13 patients with either infrahisian AV block or an HV interval greater than or equal to 120 ms after Ajmaline; --group II: 18 patients with an HV interval less than 120 ms after Ajmaline. During follow-up, the 5 AV blocks observed out of the 7 documented at inhibition of the pacemaker and the only two cases of deterioration of the intraventricular conduction during sinus rhythm occurred in Group I. The only discriminating variable between the two groups before the implantation of a pacemaker was the response to the Ajmaline test. The difference of the results of the electrical outcome between the two groups was statistically significant (p less than 0,03). During the same study period this critical value was observed in 49 other patients with a basal HV greater than or equal to 70 ms. In this group, 20 developed infrahisian AV block after Ajmaline, 26 had a HV interval greater than or equal to 120 ms and only 3 cases had HV intervals of 100 ms. These results suggest that a HV interval greater than or equal to 120 ms after Ajmaline has the same significance as infrahisian block produced by the drug.

Aged↗
PubMed1979

[Permanent intra-hisian atrioventricular block induced during right intraventricular exploration].

A 47 year old patient underwent endocavitary electrophysiological investigation for recurrent syncopal episodes occuring three years after an inaugural enterior myocardial infarction. Syncopal ventricular tachycardia was induced during the investigation when the bipolar catheter was in contact with the Bundle of His and several external electric shocks were required for its reduction. During cardioversion a complete intra-hisian atrio venticular block was observed and remained permanently although the values of the conduction intervals had previously been normal. This complication of defibrillation is thought to be the result of an induction phenomenon.

Bundle of His↗
PubMed1978

[Recurrent ventricular tachycardia and parchment right ventricle in the adult. Anatomical and clinical report of 2 cases].

Two patients, aged 52 and 55 years, were admitted to hospital for attacks of recurrent ventricular tachycardia for which preventive treatment was difficult. The crises were of one type, with left-sided delay. The findings on clinical examination, electrocardiography, haemodynamic and arteriographic investigation and at post-mortem were those of the parchment right ventricle syndrome of the adult. Electrophysiological investigation in the 2 cases indicated that a re-entry mechanism underlay the attacks of tachycardia. Late activation of the pulmonary infundibulum was responsible for a post-excitation potential on the surface and intra-cavitary leads. Mapping carried out during ventricular tachycardia in one case demonstrated the pathway for re-entry at the level of the pulmonary infundibulum.

Electrophysiology↗
PubMed1978

Modern concepts of ventricular tachycardia. The value of electrocardiological investigations and delayed potentials in ventricular tachycardia of ischemic and nonischemic etiology (31 operated cases).

Concepts on ventricular tachycardia (VT) have markedly changed in the last 10 yr, with the help of sophisticated electrophysiological methods of study. The importance of the reentry phenomenon in the mechanism of the arrhythmias has been pointed out by stimulation procedures. Epicardial mapping allowed the localization of the abnormal zone where delayed impulses could allow reentry. Surgical techniques have been developed from these observations, to prevent reentrant VT in some refractory cases.

Action Potentials↗
PubMed1977

[Current indications of coronary arteriography in coronary artery disease (with the exception of acute myocardial infarction) (author's transl)].

The indications of coronary arteriography have multiplied in recent years. Therapeutic indications have followed knowledge of the good results of revascularisation surgery. Initially limited to severe stable angina improved little or not at all by major anti-angina agents, they have been extended, in the view of many, to include various types of unstable angina where, in addition to the symptomatic improvement obtained, an attempt is made to decrease the incidence of myocardial infarction and of long term mortality. Indications relative to determination of the extent of disease may be preventive: the fear of severe coronary lesions on the basis of effort test results, the fear of a second infarction immediately following a primary lesion, or as a virtually routine examination in young individuals in order to better assess the degree of disease and to guide treatment. Diagnostic indication should be rare.

Angina Pectoris, Variant↗
PubMed1976

[Atrioventricular conduction by a bundle of Kent discovered after a surgical A.V.B].

The case is reported of an 8 year old child who had a 1/1 atrio-ventricular conduction by the bundle of Kent after accidental surgical division of the bundle of His; this "accessory" pathway conducted satisfactorily over a period of 12 years. At the age of 20, the patient had a complete conduction block of the bundle of Kent, causing a complete atrio-ventricular block; this indicated the definitive insertion of a pacemaker.

Bundle of His↗
PubMed1976

[Epicardial scintigraphy in 4 cases of ventricular tachycardia caused by reentry of blood after myocardial infarct. Origin of the tachycardia and surgical approach].

110 point cartography was carried out over the ventricular pericardium during sinus rhythm (SR) and during ventricular tachycardia (VT) in four patients whose infarctions were 15 days, 4 months, 4 years and 7 years previously, and in whom electrocardiographic investigation had suggested a ventricular reentry phenomenon. The macroscopical appearances of the heart at operation suggested that the infarct was situated along the left side in two cases, and in or along the septum in two others. Cartography in sinus rhythm showed that the onset of ventricular activity was compatable with a site of origin in the node/bundle of His. Cartography during VT showed up the epicentre of the abnormal impulses which were always situated outside the exit points and dependent upon the node/bundle of His system as demonstrated by cartography in sinus rhythm. Moreover, in at least two cases this was found to lie outside the infarcted area, in portions of the myocardium which could be considered as healthy. In one case it was found to lie along the anterior interventricular groove, facing the septal infarct. In two cases the arrhythmia will not recur, one having achieved this status bu simple ventriculotomy. The failures are reported in relation to the extent of the lesion anatomically, which may cause disorientation of the surgical approach, and make the results difficult to interpret.

Aged↗
PubMed1976

[Epicardial scintigraphy in 4 cases of ventricular tachycardia caused by reentry of blood after myocardial infarct. Study of intra-ventricular conduction disorders in sinus rhythm and in tachycardia, and their relations to anatomical data].

Ventricular pericardial cartography in sinus rhythm (SR) and during ventricular tachycardia (VT) in four cases of myocardial infarction has yielded additional information in the study of conduction disorders in myocardial ischaemia: 1. The significant slowing of activity in SR as well as in VT is demonstrated by this direct method. It is associated with a diminution in amplitude of the pericardial potentials in the zones affected by the ischaemia; 2. Cartography during VT accentuates or reveals disorders of conduction which are slight or latent in SR; 3. Disorders of intra-ventricular conduction are found to be related either to segmental blocks on the branches of the bundle of His, or as focal blocks (peri-infarct block) on the left side, whose nature can be shown up even during VT; 4. Secondary activation of the myocardial fiber found to be related either to segmental blocks on the bundle of His during VT is demonstrated.

Arrhythmia, Sinus↗
PubMed1976

[Course and prognostic factors of unstable angina. Apropos of 100 cases].

The immediate and medium term (3 years) of unstable angors was specified by the study of 100 hospitalized patients. The cases selection was based on the existence of angina pain which had appeared or reappeared less than a month before, during more than fifteen minutes and/or repeated, which were more and more frequent, less and less sensitive to nitroglycerine, and in the absence of recent myocardial infarction signs. The immediate course seemed relatively favorable; during the initial hospitalisation there were only nine myocardial infarctions and three deaths. The alarming factors of initial prognosis are essentially the persistence or recurrence under medical treatment of angina pain hardly relieved by nitroglycerine. The course over three years was bad; 23.6% of deaths, especially of cardiac origin (14/17) were noted; more than 80% or the surviving patients kept enduring more or less severe pains; persistence of electric signs on the ECG during the initial course was the only significant pronostic factor that was regularly noted. As regards the 16 patients treated by surgery, operative death rate remained high (3/16), but remote functional results were good (8/12 asymptomatic). Only randomized studies on homogenous groups, carried out during an enough long course, will enable us to specify therapeutic indications better.

Adult↗
PubMed1975

[Recording of conduction tissue potentials in intraventricular conduction disorders. (apropos of 147 patients)].

147 patients, 31 controls and 116 patients with intraventricular conduction disturbances, have been submitted to an endocardial investigation: HR lengthening in case of bundle-branch block indicates a low diffusion of the conduction disturbances and has a pejorative signification. The most important legthenings of this interval have been observed in the cases with delay in the common trunk of His bundle: -- In case of trunkular delay, 66% of the patients have a HR interval longer than 80 msec, and the average value of HR is 82 msec. -- In the absence of obvious trunkular delay, 8% of the patients only have a HR interval longer than 80 msec, with an average value of 67 msec. For these latter patients no branch potential was recorded. -- In some cases one is certain of the presence of a conduction disturbance of both branches and the HR value then never exceeded 60 msec. -- Branch potential recording makes it possible to determine the site of the conduction disturbance of the branch and show mild variations of the HR interval and of both components.

Action Potentials↗