72 research outputs found
Detection of major coronary artery anomalies in a pediatric and adult population: A prospective echocardiographic study
Primary prevention with a defibrillator: are therapies always really optimized before implantation?
AIMS:Left ventricle ejection fraction (LVEF) ≤ 30-35% is widely accepted as a cut-off for primary prevention with an implantable cardiac defibrillator (ICD) in patients with both ischaemic and non-ischaemic cardiomyopathy supposedly on optimal medical therapy. This study reports evolutions of LVEF and treatments of patients implanted in our institution with an ICD for primary prevention of sudden death, after 2 years of follow-up. METHODS AND RESULTS: Among 84 patients with LVEF under 35% implanted between 2005 and 2007, 28 (33%) had improved their LVEF >35% after the 2 years of follow-up. During this period, even if Beta-blockers (98%) and renin-angiotensin system (RAS) blockers (95%) were already initially prescribed, treatments were significantly optimized with improvement of maximal doses of beta-blockers and RAS blockers at 2 year follow-up compared with initial prescription (62 vs. 37% and 68 vs. 45%, respectively). In patients with improved LVEF, a trend toward a better treatment optimization and revascularization procedures (in the sub-group of ischaemic patients) were observed compared with non-improved LVEF patients. CONCLUSIONS: In our study of patients with prophylactic ICD, one-third of them have improved their LVEF after a 2 year follow-up. Despite an optimal medical therapy at the time of implantation, we were able to further improve the maximal treatment doses after implantation. This study highlights the issue of what should be considered as \u27optimal\u27 therapy and the possibility of improvement of LVEF related to a real optimized treatment before implantation
Progesterone receptors: a key for neuroprotection in experimental stroke
Progesterone receptors (PR) are expressed throughout the brain. However, their functional significance remains understudied. Here we report a novel role of PR as crucial mediators of neuroprotection using a model of transient middle cerebral artery occlusion and PR knockout mice. Six hours after ischemia, we observed a rapid increase in progesterone and 5-dihydroprogesterone, the endogenous PR ligands, a process that may be a part of the natural neuroprotective mechanisms. PR deficiency, and even haploinsufficiency, increases the susceptibility of the brain to stroke damage. Within a time window of 24 h, PR-dependent signaling of endogenous brain progesterone limits the extent of tissue damage and the impairment of motor functions. Longer-term improvement requires additional treatment with exogenous progesterone and is also PR dependent. The potent and selective PR agonist Nestorone is also effective. In contrast to progesterone, levels of the neurosteroid allopregnanolone, which modulates -aminobutyric acid type A receptors, did not increase after stroke, but its administration protected both wild-type and PR-deficient mice against ischemic damage. These results show that 1) PR are linked to signaling pathways that influence susceptibility to stroke, and 2) PR are direct key targets for both endogenous neuroprotection and for therapeutic strategies after stroke, and they suggest a novel indication for synthetic progestins already validated for contraception. Although allopregnanolone may not be an endogenous neuroprotective agent, its administration protects the brain against ischemicdamageby signaling mechanisms not involving PR. Collectively, our data clarify the relative roles of PR and allopregnanolone in neuroprotection after stroke.Fil: Liu, Ailing. Institut National de la SantĂ© et de la Recherche MĂ©dicale; Francia. UniversitĂ© Paris Sud; FranciaFil: Margaill, Isabelle. Institut National de la SantĂ© et de la Recherche MĂ©dicale; Francia. Universite de Paris V; Francia. University Paris Descartes; FranciaFil: Zhang, Shaodong. Institut National de la SantĂ© et de la Recherche MĂ©dicale; Francia. UniversitĂ© Paris Sud; FranciaFil: Labombarda, Maria Florencia. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Instituto de BiologĂa y Medicina Experimental. FundaciĂłn de Instituto de BiologĂa y Medicina Experimental. Instituto de BiologĂa y Medicina Experimental; Argentina. Universidad de Buenos Aires. Facultad de Medicina. Departamento de BioquĂmica Humana; ArgentinaFil: Coqueran, BĂ©rard. Institut National de la SantĂ© et de la Recherche MĂ©dicale; Francia. Universite de Paris V; FranciaFil: Delespierre, Brigitte. UniversitĂ© Paris Sud; Francia. Institut National de la SantĂ© et de la Recherche MĂ©dicale; FranciaFil: Liere, Philippe. UniversitĂ© Paris Sud; Francia. Institut National de la SantĂ© et de la Recherche MĂ©dicale; FranciaFil: Marchand Leroux, Catherine. Institut National de la SantĂ© et de la Recherche MĂ©dicale; Francia. Universite de Paris V; FranciaFil: O’Malley, Bert W.. Baylor College of Medicine;Fil: Lydon, John P.. Baylor College of Medicine;Fil: de Nicola, Alejandro Federico. Consejo Nacional de Investigaciones CientĂficas y TĂ©cnicas. Instituto de BiologĂa y Medicina Experimental. FundaciĂłn de Instituto de BiologĂa y Medicina Experimental. Instituto de BiologĂa y Medicina Experimental; ArgentinaFil: Sitruk Ware, Regine. The Rockefeller University; Estados UnidosFil: Mattern, Claudia. MetP Pharma AG; SuizaFil: Plotkine, Michel. Universite de Paris V; FranciaFil: Schumacher, Michael. Institut National de la SantĂ© et de la Recherche MĂ©dicale; Francia. UniversitĂ© Paris Sud; FranciaFil: Guennoun, Rachida. UniversitĂ© Paris Sud; Francia. Institut National de la SantĂ© et de la Recherche MĂ©dicale; Franci
Nuclear Progesterone Receptors Are Up-Regulated by Estrogens in Neurons and Radial Glial Progenitors in the Brain of Zebrafish
In rodents, there is increasing evidence that nuclear progesterone receptors are transiently expressed in many regions of the developing brain, notably outside the hypothalamus. This suggests that progesterone and/or its metabolites could be involved in functions not related to reproduction, particularly in neurodevelopment. In this context, the adult fish brain is of particular interest, as it exhibits constant growth and high neurogenic activity that is supported by radial glia progenitors. However, although synthesis of neuroprogestagens has been documented recently in the brain of zebrafish, information on the presence of progesterone receptors is very limited. In zebrafish, a single nuclear progesterone receptor (pgr) has been cloned and characterized. Here, we demonstrate that this pgr is widely distributed in all regions of the zebrafish brain. Interestingly, we show that Pgr is strongly expressed in radial glial cells and more weakly in neurons. Finally, we present evidence, based on quantitative PCR and immunohistochemistry, that nuclear progesterone receptor mRNA and proteins are upregulated by estrogens in the brain of adult zebrafish. These data document for the first time the finding that radial glial cells are preferential targets for peripheral progestagens and/or neuroprogestagens. Given the crucial roles of radial glial cells in adult neurogenesis, the potential effects of progestagens on their activity and the fate of daughter cells require thorough investigation
Transient transfection of human CDNF gene reduces the 6-hydroxydopamine-induced neuroinflammation in the rat substantia nigra
New mitochondrial genome organization in three interspecific somatic hybrids of Medicago sativa including the parent-specific amplification of substoichiometric mitochondrial DNA units
Cavernous transformation of the portal vein associated to multiorgan developmental abnormalities
Initial diagnosis of cavernous transformation of the portal vein
(portal cavernoma) is rarely made in adults. Its main clinical manifestation is
upper gastrointestinal hemorrhage due to variceal bleeding. More rarely,
diagnosis is made from obstructive jaundice. In children, this condition is
frequently associated to prehepatic portal hypertension and congenital
anomalies, the most frequent of which are atrial septal defects or
malformations of the biliary tract or of the inferior vena cava.
We describe here a case of a 23-year-old female presenting with massive
hematemesis due to the presence of esophageal and small intestinal varices.
She had a cavernous transformation of the portal vein with prehepatic portal
hypertension associated with heretofore unreported malformations such as
right pulmonary hypoplasia, cardiac dextroposition, and right renal ectopia.
A unifying hypothesis (e.g. an intrauterine vascular insult) to explain the
pathogenesis of these defects seems unlikely. Appropriate tests failed to
identify specific functional abnormalities in these organs. Although she bled
more than once, the combination of sclerotherapy and b-blockers has been,
thus far, able to control the major clinical consequences of this diseas
Progesterone Increases the Expression of Myelin Basic Protein and the Number of Cells Showing NG 2
Detection of major coronary artery anomalies in a pediatric and adult population: A prospective echocardiographic study
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