Aortic valve replacement in the elderly: the real life.

Background: Aortic stenosis is of concern in the elderly. Although aortic valve replacement provides good long-term survival with functional improvement, many elderly patients are still not referred for surgery because of their age. Percutaneous aortic valve implantation offers an alternative to open-heart surgery.

Current hospital mortality of aortic valve replacement in octogenarians.

Background And Aim Of The Study: The increasing incidence of cardiovascular disease with age, coupled to a constant extension of life expectancy in industrialized countries, is leading to an ever-increasing number of elderly patients being referred for aortic valve replacement (AVR). In light of advances in surgical technology and cardiac protection, the operative mortality and risk factors have been updated in order to specify surgical indications.

Methods: Between January 2000 and December 2004, a total of 442 patients (203 males, 239 females) aged > or =80 years (mean age 82.

[Tamponade due to Porphyromonas gingivalis].

A 45 year old man, 10 weeks after angioplasty and endoprosthesis insertion for myocardial infarction, developed tamponade in an infectious context. RNA 16S investigation, using the universal amplification method with ribotyping, detected Porphyromonas gingivalis (a strict anaerobic bacillus associated with peridontitis) in the pericardial fluid. This appears to be the first description of such a clinical scenario, and suggests 5 aetio-pathological mechanisms: fissure syndrome, malignant tamponade, post-infarction pericardial syndrome, endoprosthesis infection and infectious tamponade.

Carpentier-Edwards supraannular porcine bioprosthesis in aortic position: 16-year experience.

Background: The aim of the study was to evaluate the long-term results of aortic valve replacement with the Carpentier-Edwards supraannular porcine bioprosthesis.

Methods: A total of 278 patients who underwent aortic valve replacement between January 1983 and December 1986 were reviewed. Mean age was 69.

[Long-term results of valve replacement using the Cobomedics prosthesis].

The Carbomedics valve prosthesis is a second generation mechanical prosthesis with a double hemi-disc. This study analysed long-term morbidity and mortality associated with this prosthesis. Between 1987 and 1996, 397 prostheses were implanted, 306 aortic, 42 mitral and 26 double replacements (3 combining a Carbomedics aortic prothesis with a mitral valve from another type) in 370 patients with a mean age of 62 (range 4 to 88 years).

Interferon-gamma mRNA expression upon in vitro T lymphocyte activation is decreased in rheumatoid arthritis patients.

A decreased production of interferon-gamma (IFN-gamma) and interleukin-2 (IL-2) upon in vitro stimulation by phytohemagglutinin (PHA) peripheral blood leucocyte in active rheumatoid arthritis (RA) patients has been described as an important immunological abnormality in this disease. However, the molecular level at which this defect might occur has not been fully documented. We have investigated the kinetics of IFN-gamma, interleukin-2 receptor (IL-2 R), and interleukin-1 beta (IL-1 beta) messenger RNA (mRNA) expression in RA patients (n = 9) and normal controls (n = 5) after PHA leucocyte activation.

Effect of relaxin on the phenotype of collagens synthesized by cultured rabbit chondrocytes.

The effect of porcine relaxin on rabbit articular and growth plate chondrocytes in primary culture was investigated by measurement of total collagen production and analysis of the phenotypes of newly synthesized collagen chains. A 24-h treatment of monolayer articular and multilayer growth plate chondrocytes with 2 micrograms per ml relaxin had no effect on total DNA and did not significantly modify the amount of [3H]proline-labelled collagen chains secreted by the cells. However, polyacrylamide gel electrophoresis demonstrated relevant modifications in relaxin treated chondrocytes.

[Effect of growth hormone on the differentiation of chondrocytes from prepuberal rabbits in serum-free culture and on the radioimmunologic activity of Sm-C/IGF1 measured in the culture medium].

This study concerns the immunoreactive somatomedin C secretion by prepubertal rabbit epiphyseal chondrocytes cultured in a defined serum-free medium. In such culture conditions, chondrocytes mainly synthesized Type II collagen (80% of total collagen) during 10 days. A small amount of Type I collagen was also found with a significant (p less than 0.

[The complement system in hepatopathies].

Low serum complement is often observed in cirrhosis of the liver. This is the result of two mechanisms: a failure to synthesise a certain number of components and regulatory proteins of complement, and an increased consumption due to activation of the complement system. This acquired deficit in complement contributes to the increased risk of infection in patients with cirrhosis.