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Biomedical subjects

M Goethals

Publications and source records attributed to M Goethals.

83 records · Page 5Linked to original sources
PubMed1984

Massive dobutamine overdose in a cardiovascular compromised patient.

A case of dobutamine overdose is presented. Due to a prescription mistake a patient with recent myocardial necrosis and acute arterial occlusion received up to 70 mcg/kg/min of dobutamine IV. This resulted in arterial hypotension, diminished vascular resistance, oliguria and signs of cutaneous and mucosal hyperemia. Interruption of the dobutamine infusion and substitution with dopamine normalised all abnormalities. The differences between the hemodynamic profiles of dobutamine and dopamine are discussed.

Anuria↗
PubMed1983

Anteroseptal myocardial infarction complicated by right ventricular myocardial infarction.

A 73 year old man presented with an acute anteroseptal myocardial infarction. He became progressively hypotensive without signs of left heart decompensation or major rhythm disturbances. Swan-Ganz catheterisation revealed a pattern of right ventricular infarction and under appropriate treatment the patient recovered remarkably well. The importance of recognition of right ventricular infarction is stressed especially in this case where an anteroseptal myocardial infarction was present without the usual left posterior infarction.

Aged↗
PubMedDate not supplied

Apoptosis induced in neuronal cells by C-terminal amyloid beta-fragments is correlated with their aggregation properties in phospholipid membranes.

A number of findings suggest that lipophilic monomeric Abeta peptides can interact with the cellular lipid membranes. These interactions can affect the membrane integrity and result in the initiation of apoptotic cell death. The secondary structure of C-terminal Abeta peptides (29-40) and the longer (29-42) variant have been investigated in solution by circular dichroism measurements. The secondary structure of lipid bound Abeta (29-40) and (29-42) peptides prepared at different lipid/peptide ratio's, was investigated by ATR-FTIR spectroscopy. Finally, the changes in secondary structure (i.e. the transition of alpha-helix to beta-sheet) of the lipid bound peptides were correlated with the induction of neurotoxic and apoptotic effects in neuronal cells. The data suggest that the C-terminal fragments of the Abeta peptide induce a significant apoptotic cell death, as demonstrated by caspase-3 measurements and DNA laddering, with consistently a stronger effect of the longer Abeta (29-42) variant. Moreover, the induction of apoptotic death induced by these peptides can be correlated with the secondary structure of the lipid bound amyloid beta peptides. Based on these observations, it is proposed that membrane bound aggregated Abeta peptides (produced locally as the result of gamma-secretase cleavage) can accumulate and aggregate in the membrane. These membrane bound beta-sheet aggregated amyloid peptides induce neuronal apoptotic cell death.

Amyloid beta-Peptides↗
PubMedDate not supplied

Contribution of the hydrophobicity gradient to the secondary structure and activity of fusogenic peptides.

Fusogenic peptides belong to a class of helical amphipathic peptides characterized by a hydrophobicity gradient along the long helical axis. According to the prevailing theory regarding the mechanism of action of fusogenic peptides, this hydrophobicity gradient causes the tilted insertion of the peptides in membranes, thus destabilizing the lipid core and, thereby, enhancing membrane fusion. To assess the role of the hydrophobicity gradient upon the fusogenic activity, two of these fusogenic peptides and several variants were synthesized. The LCAT-(57-70) peptide, which is part of the sequence of the lipolytic enzyme lecithin cholesterol acyltransferase, forms stable beta-sheets in lipids, while the apolipoprotein A-II (53-70) peptide remains predominantly helical in membranes. The variant peptides were designed through amino acid permutations, to be either parallel, perpendicular, or to retain an oblique orientation relative to the lipid-water interface. Peptide-induced vesicle fusion was monitored by lipid-mixing experiments, using fluorescent probes, the extent of peptide-lipid association, the conformation of lipid-associated peptides and their orientation in lipids, were studied by Fourier Transformed Infrared Spectroscopy. A comparison of the properties of the wild-type and variant peptides shows that the hydrophobicity gradient, which determines the orientation of helical peptides in lipids and their fusogenic activity, further influences the secondary structure and lipid binding capacity of these peptides.

Amino Acid Sequence↗
PubMedDate not supplied

Screening for glaucoma in a general population with the non-mydriatic fundus camera and the frequency doubling perimeter.

PURPOSE: To evaluate the usefulness of non-mydriatic fundus camera (NMFu-camera) and frequency doubling perimeter (FDP) for detecting glaucoma in a general population. METHODS: This prospective observational multicenter study consisted in screening for glaucoma in the populations of three Belgian cities. Intraocular pressure (IOP) was measured with non-contact pneumo-tonometer (NCT) and applanation tonometry (AT) if NCT IOP was > or = 17 mmHg. Visual field was screened with FDP (C-20-5) and digitized optic disc photographs (ODPs) were taken with NMFu-camera. FDP was considered abnormal if at least one defective point was found. ODPs were graded as normal or glaucomatous by consensus of three glaucoma specialists. Optic disc and visual field results were matched per eye. Subjects with known ocular hypertension and/or treated primary open angle glaucoma were excluded from the analysis. RESULTS: A total of 1620 subjects were included in the study. Their mean age was 63.2 years. AT IOP was > 21 mmHg in 8.2%. A total of 98.1% of ODPs could be interpreted. Glaucomatous optic discs were detected in 3.5% of the subjects. In this group only 24% had an AT IOP > or = 22 mmHg. FDP was abnormal in 44.5%. The sensitivity and specificity of FDP to identify patients with an optic disc graded as glaucomatous were 58.6% and 64.3% respectively. CONCLUSIONS: The combined use of the NMFu-camera and the FDP is a feasible method for an initial glaucoma mass screening. NMFu-camera may be a useful and quick method to screen for glaucomatous damage in a community. FDP in screening strategy was revealed to be not sensitive enough when setting the cut-off value at one defective test location. IOP measurements were confirmed to be a poor tool to detect glaucomatous damage.

Adult↗
PubMedDate not supplied

Intraocular pressure in children up to five years of age.

We established a value scale (Figure) of IOP for children without glaucoma. Under the age of 4 months the IOP was measured with topical anesthesia; halothane anesthesia was used in children from 4 months to 5 years. In 30 children under the age of 4 months the IOP is 8.4 +/- 0.6 mm Hg. In 44 children from 4 months to 5 years, the IOP measured under halothane general anesthesia is 7.8 +/- 0.4 mm Hg at the age of 1 year, and it gradually increases by about 1 mm Hg per year of age to 11.7 +/- 0.6 mm Hg at the age of 5 years.

Child, Preschool↗
PubMedDate not supplied

Treatment of glaucoma in children with Sturge-Weber syndrome.

BACKGROUND: Sturge-Weber syndrome is a rare congenital neuro-oculocutaneous disorder. Ocular involvement can include glaucoma and vascular malformations of the conjunctiva, episclera, choroid, and retina. METHODS: The records of 19 Sturge-Weber syndrome patients (mean age 8.2 years) treated at our institution were reviewed to determine the incidence of ophthalmologic manifestations in Sturge-Weber syndrome. RESULTS: Glaucoma occurred in 42% of all patients and was more frequent in patients with a port-wine stain involving both upper and lower eyelids. Other ocular manifestations included conjunctival/episcleral hemangioma, choroidal hemangioma, iris heterochromia, retinal detachment, strabismus, and homonymous hemianopia. In 7 of 8 patients with glaucoma, topical pharmacotherapy (beta-blockers and carbonic anhydrase inhibitors) alone failed to normalize intraocular pressures. In those patients, cryocoagulation of the ciliary body was performed. Mean postoperative intraocular pressure after a mean follow-up of 4-5 years was <22 mm Hg in 6 patients. CONCLUSIONS: Cryocoagulation of the ciliary body combined with topical medication is an effective and safe treatment option in the management of glaucoma in children with Sturge-Weber syndrome.

Adolescent↗