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Biomedical subjects

N David

Publications and source records attributed to N David.

At least 19 recordsLinked to original sources

Distinct sequence elements control the specificity of G protein activation by muscarinic acetylcholine receptor subtypes.

Relatively little is understood concerning the mechanisms by which subtypes of receptors, G proteins and effector enzymes interact to transduce specific signals. Through expression of normal, hybrid and deletion mutant receptors in Xenopus oocytes, we determined the G protein coupling characteristics of the functionally distinct m2 and m3 muscarinic acetylcholine receptor (mAChR) subtypes and identified the critical receptor sequences responsible for G protein specificity. Activation of a pertussis toxin insensitive G protein pathway, leading to a rapid and transient release of intracellular Ca2+ characteristic of the m3 receptor, could be specified by the transfer of as few as nine amino acids from the m3 to the m2 receptor. In a reciprocal manner, transfer of no more than 21 residues from the m2 to the m3 receptor was sufficient to specify activation of a pertussis toxin sensitive G protein coupled to a slow and oscillatory Ca2+ release pathway typical of the m2 subtype. Notably, these critical residues occur within the same region of the third cytoplasmic domain of functionally distinct mAChR subtypes.

Amino Acid Sequence

Double-blind, placebo-controlled, multi-centre trial of the efficacy and tolerance of niflumic acid ('Nifluril') capsules in the treatment of tonsillitis in adults.

A double-blind, placebo-controlled study was carried out in 231 adult patients suffering from acute diffuse pharyngitis or acute tonsillitis with fever and dysphagia to assess the effectiveness of niflumic acid combined with standard antibiotic therapy in relieving pain and inflammation. Patients were allocated at random to receive either 4 capsules of 250 mg niflumic acid or placebo daily in addition to 1.5 million units phenoxymethyl penicillin for 4 to 5 days. Clinical assessments before and after 2 and 4 days of treatment showed that there was faster resolution of fever, pain, adenopathy, pharyngeal congestion and dysphagia, and improved patient comfort in the niflumic acid group. Few side-effects were recorded and there were only 4 drop-outs due to side-effects in patients receiving niflumic acid.

Adolescent

[Aneurysm of the membranous ventricular septum. Apropos of 4 cases surgically treated].

Four patients with aneurysms of the membranous ventricular septum were operated either because of complications or for associated malformations. The authors describe the anatomical, radiological and, above all, the echocardiographic and angiographic features of this malformation. Surgical management is necessary in complicated cases or when there are associated congenital malformations. The information provided by echocardiography in the diagnosis and follow-up of ventricular septal defects indicates that this malformation is not as rare as was previously thought.

Adolescent

[Echocardiographic monitoring of the left ventricle in infants and children presenting the primary form of acute cardiac failure].

A retrospective multicenter study was based on influential echocardiograms performed in 34 children, the majority (29/34) being under 2 years of age, and presenting with a primary form of acute congestive heart failure. Four died early. The average duration of serial echocardiographic monitoring was 25 months (9-72 months) in the others. During the acute stage, the left cardiac cavities were extremely dilated and the shortening fraction was reduced to 15 +/- 4%. The 4 decreased children belonged to a group of 17 children who had a shortening fraction less than 13%. From the 8th day significant improvement of the left ventricular function was observed. Recovery was faster during the first 6 months of evolution and became very low after 1 year. The age at onset, the severity of the initial left ventricular changes, and the speed of recovery during the first 15 days were not predictive of the degree of eventual recovery of left ventricular function. At the end of the study 28 of the 30 surviving children had recovered a normal shortening fraction. However 16 of 30 still showed some dilatation, albeit moderate in most cases, of this ventricle. These data show that most children presenting with a primary form of acute congestive heart failure recover satisfactory heart function and that the initial echocardiographic features are not predictive of the subsequent course.

Acute Disease

[Congenital aortic valve stenosis treated by dilatation. Apropos of a case with hemodynamic control 12 months later].

Intraluminal dilatation of congenital aortic valve stenosis was attempted in a 14-year old boy. Significant improvement was obtained, with a fall in transaortic gradient from 80 to 30 mmHg. A control haemodynamic examination performed 12 months later confirmed that the result was stable; there was no aortic leakage, and myocardial hypertrophy had begun to regress at echocardiography. This case is of interest in that dilatation is less costly than surgical commissurotomy. However, this technique cannot be widely used until satisfactory long-term results have been demonstrated in a large population of children.

Adolescent

[Scimitar syndrome in infants. Physiopathology and therapeutic implications in 12 cases].

Twelve children, aged 6 days to 6 months (mean: 42 +/- 23 days) were diagnosed as presenting with the scimitar syndrome. In this syndrome, anomalous pulmonary venous drainage, hypoplasia of the right pulmonary artery and parenchyma, variety of "sequestrum" of the right pulmonary artery and parenchyma, variety of "sequestrum" of the right pulmonary base usually fed by subdiaphragmatic branches of the aorta are associated. Respiratory disorders were constant, severe in 8 cases. X-rays showed "dextro-cardia" and "hypoplasia of the right lung". Endocardiac investigation assessed the diagnosis and showed pulmonary arterial hypertension in 11 cases, with (5) or without (6) associated heart defect. One case with good tolerance remains under simple supervision; 4 were operated on from the associated lesions only and died; 7 took benefit of a simple surgical removal of the branches feeding the sequestrum, with one death and 6 successes. The poor prognostic significance of the sequestrum is thus indirectly demonstrated and the value of its devascularization is emphasized.

Cardiac Catheterization

[Separation and assay of the MB isoenzyme of serum creatine phosphokinase. Results apropos of 152 cases].

MB iso-enzyme of creatine phosphokinase (CPK) was estimated after chromatography. The technique used, Mercer's technique, was simple and rapid. It required 1 ml of serum. The study carried out in 152 subjects showed that CPK was increased (N less than 90 mU/ml). In the group of 104 patients with myocardial infarction (average CPK levels = 829 mU/ml +/- 516), the MB iso-enzyme was found in the serum in significant levels (average level of the MB fraction = 10.9% +/- 5.4). On the other hand, in the control group of 44 patients with various diseases, (CPK = 672 mU/ml +/- 531) the MB iso-enzyme remained low (0.35% +/- 0.44). In two subjects with myocardial infarction, no MB fraction was found. On the other hand, in two patients who died, one from necrotic, prostatic adenocarcinoma, the other from necrotic epidermoid lung cancer, the MB iso-enzyme was significantly increased. The test proposed here, which is applicable in a routine laboratory, seems the most specific of all laboratory examinations available to the clinician for the diagnosis of myocardial infarction.

Chromatography