Multicentre prospective controlled study of Barrett's oesophagus and colorectal adenomas. Groupe d'Etude de l'Oesophage de Barrett.

Previous studies have suggested that patients with Barrett's oesophagus may be at increased risk of colorectal neoplasia, though the association is disputed. In a multicentre prospective study we compared the prevalence of colorectal adenomas in patients with Barrett's oesophagus and controls. Barrett's oesophagus patients (n = 104) had histological confirmation of columnar epithelium extending more than 3 cm above the gastro-oesophageal junction.

Calcium mitigation in bioprosthetic tissues by iron pretreatment: the challenge of iron leaching.

Preliminary studies in our laboratory have shown that iron pretreatment of glutaraldehyde-preserved tissues inhibited calcification. The present study was designed to further investigate this finding and to optimize the technique. Porcine valve tissue and bovine pericardium preserved in glutaraldehyde and pretreated by iron at different concentrations and incubation times were implanted either subcutaneously in rats or as a mitral valve substitute in sheep.

Do donor or recipient species influence calcification of bioprosthetic tissues?

To determine whether donor or recipient species influence calcification of bioprosthetic tissues, glutaraldehyde-treated valvar or pericardial specimens from different species (calf, sheep, pig) were subcutaneously implanted in different animals (rat, rabbit, cow, hen). Significant differences in the rate of calcification of the implanted specimens were found, which have important practical and theoretical implications for the development of valvular bioprostheses.

Terlipressin plus transdermal nitroglycerin vs. octreotide in the control of acute bleeding from esophageal varices: a multicenter randomized trial.

We undertook a multicenter randomized trial to compare the efficacy of terlipressin combined with transdermal nitroglycerin and that of octreotide in the emergency control of acute variceal hemorrhage in cirrhosis. Over 16 mo, 87 patients with endoscopically proved active bleeding from esophageal or cardiac varices were enrolled in five centers in France and randomly assigned to receive intravenous terlipressin (2 mg and then 1 mg/4 hr over 24 hr) and transdermal nitroglycerin (10 mg/12 hr over 24 hr) (group 1) or octreotide (continuous intravenous infusion of 25 micrograms/hr over 12 hr and then 100 micrograms at hr 12 and hr 18 subcutaneously) (group 2). Initial control of bleeding was assessed at the end of 12 hr of treatment on the basis of stability of blood pressure and hematocrit level with no further transfusion requirements.

[Phosphocalcium metabolism in patients with calcified valvular bioprosthesis].

Calcium and gla-protein content are increased in the calcifications of cardiac bioprostheses. Such calcifications are more frequent during growth, pregnancy and renal failure when bone gla-protein levels are elevated. We investigated whether bone gla-protein and other markers of calcium metabolism play a role in bioprostheses calcifications.

[Place of endorectal ultrasonography in the evaluation of staging of cancer of the rectum: before or after preoperative radiotherapy?].

Of 62 patients with rectal carcinoma, who were examined by endorectal ultrasound (EER) before operation, 15 were examined after preoperative external radiation therapy. The results were compared to histological and surgical findings according to the TNM classification. When preoperative radiation therapy was not applied, the diagnostic value of EER was excellent, as well as for the detection of perirectal fat spread as for lymph node involvement.

[Contribution of microradiography in search of calcifications of valvular bioprostheses].

Implantation of a valvular bioprosthesis is one of the best treatments for valvular disease, particularly in children. Unfortunately, their use is limited as calcifications develop over time. Prevention of these calcifications is still an unresolved problem that is under study by Professor Carpentier and coworkers.

Cardiovascular effects and modulation of noradrenergic neurotransmission following central and peripheral administration of neuropeptide Y.

Experiments have been conducted to evaluate the effect of neuropeptide Y (NPY) administered at three distinct levels of the nervous system: 1) the posterior hypothalamic nucleus, 2) the spinal cord, and 3) the vascular noradrenergic neuroeffector junction. It was observed that NPY produced varying cardiovascular effects at these three distinct sites of the nervous system. Microinjections into the posterior hypothalamic nucleus resulted in an increase in blood pressure, which was reduced by prior microinjection of a muscarinic or H1-histamine antagonist but not an H2-histamine antagonist.

Prejunctional and postjunctional effects of neuropeptide Y at the noradrenergic neuroeffector junction of the perfused mesenteric arterial bed of the rat.

The effect of neuropeptide Y (NPY) on periarterial nerve stimulation-induced release of norepinephrine (NE) and increase in perfusion pressure in the perfused mesenteric arterial bed of the rat was examined. Perfusate effluents were continuously collected and assayed for endogenous NE by high-pressure liquid chromatography (HPLC) coupled to electrochemical detection. Perfusion pressure was continuously monitored by means of a pressure transducer.

Alterations in the release of norepinephrine at the vascular neuroeffector junction in hypertension.

The field stimulation induced release of 3H-norepinephrine (NE) from the isolated portal vein and endogenous NE from the isolated caudal artery and perfused mesenteric arterial bed of spontaneously hypertensive rats (SHR) and age-matched normotensive rats (Wistar-Kyoto or Sprague-Dawley) was studied. There was a significantly greater release of NE from all three preparations obtained from 10- to 12-week-old SHR compared to normotensive animals. In addition, there was a greater release of NE from the caudal artery of 5- to 6-week-old SHR compared to controls.

Comparison of norepinephrine release in hypertensive rats: II. Caudal artery and portal vein.

It was observed that there was a significantly greater field-stimulation induced release of norepinephrine from the portal vein and caudal artery obtained from 28 week old SHR compared to WKY. The greater field-stimulation induced release of norepinephrine observed in the blood vessels of the SHR compared to WKY was not seen in DOCA-salt and one kidney-one clip hypertensive animals with similar elevations of systolic blood pressure. It was also observed that there was an attenuation of the effect of the prejunctional alpha 2-adrenoceptor antagonist, yohimbine to enhance the field-stimulation induced release of norepinephrine from blood vessels of the 28 week old SHR.

Techniques for prevention of calcification of valvular bioprostheses.

Calcification of valvular bioprostheses in children is a major problem that has stimulated extensive research in our laboratory. In previous reports, we have shown that the rate of calcification could be reduced by decreasing the phosphate content in the tissue or by blocking calcification binding sites with Mg++ and/or with a surfactant (Tween 80). Since then, we have systematically investigated incorporation of numerous other surfactants and of polyacrylamide within the tissue, and these investigations form the basis of this report.

Cytotoxicity of cardioplegic solutions: evaluation by tissue culture.

Numerous cardioplegic solutions have been proposed for myocardial protection during open heart surgery. Their effectiveness has been evaluated by hemodynamic, enzymatic and histologic studies, but the cytotoxicity of these solutions has never been assessed. Human fibroblasts and endothelial cells in tissue culture were incubated for 3 hours at 19 degrees C in 12 of the most commonly used cardioplegic solutions.

[Partial trisomy of chromosome 21 by maternal translocation t(15;21) (q26.2; q21)].

A balanced reciprocal translocation, t(15;21) (q262;q21) was observed in the mother and maternal grandfather of two patients. The propositus, who received the abnormal chromosome 15 from his mother, is trisomic for the distal part of chromosome 21, and his phenotype is that of classical trisomy 21. His sister, who is trisomic for the proximal part of 21q, is slightly retarded but developmentally normal otherwise.

[Increase of the LDH-B activity in a boy with 12p trisomy by malsegregation of a maternal translocation t(12;14) (q12;p11)].

A newborn male trisomic for 12p is compared with three other 12p trisomics already reported in the literature, as well as with three patients monosomic for 12p. A "type and countertype" opposition is observed for five characters: in the trisomy, turricephaly, shortness of the nose, protruding anthelix, wide palms, and increased LDH-B activity; in the monosomy, protruding occiput, large nose, hypoplasia of the anthelix, narrow palms, and decreased LDH-B activity.

[Mosaic 14 trisomy in a female child with multiple abnormalities].

Chromosomal preparations obtained from lymphocytes and fibroblasts revealed a minor clone, 47,XX,+14, in a female newborn with multiple malformations. Other types of rearrangement of chromosome 14 are discussed.