[Inhospital prognosis of acute myocardial infarction: comparison of two periods to ten years of interval]. / Pronostic hospitalier de l'infarctus du myocarde comparaison de deux périodes a dix ans d'intervalle.

Acute myocardial infarction prognosis depends on many factors relative to the patient, to the disease and to the quality and promptness of the treatment. The interventional revascularisation is superior to pharmacological revascularisation. The aim of the study is to compare acute myocardial infarction inhospital lethality in the coronary care unit before and after use of emergency angioplasty. The retrospective study compared inhospital lethality over two four years periods separated by an interval of ten years: [1991-1994] and [2001-2004]. Lethality had increased from 7.8% to 11.3%. During the second period emergency angioplasty (under 24 hours) primary (4.8%) or rescue (2.5%), not applied in the nineties, was not related to survival and did not allow an improvement of patients' hospital prognosis. The population of the second period was characterized by: a greater average age (60.8 vs. 58.6 years), more female subjects (20.1 vs. 14.6%), less nicotinic subjects (60.2 vs. 78.5%) and less patients receiving fibrinolytic treatment (43.0 vs. 50.4%). These parameters were as many factors related to the risk of hospital death in univariate analysis. The multivariate analysis showed that after adjustment on all the other factors the lack of thrombolysis remains unquestionably related to the hospital overlethality. The time delays for admission in the intensive care unit were relatively long and comparable over the two periods (8.2 vs. 7.5 hours). Within our hospital structure early angioplasty not being able to be realized in the hour, which follows the diagnosis on a large scale, and in a continual way, it would be preferable to always consider thrombolysis first in all cases apart from contraindications without excluding the possibility of a hybrid treatment.

[Cardiac involvement in Emery-Dreifuss muscular dystrophy: a case report]. / L'atteinte cardiaque dans la dystrophie musculaire d'Emery-Dreifuss. A propos d'un cas.

Emery Dreifuss muscular dystrophy (EDMD) is an uncommon hereditary myopathy characterized by 3 symptoms: slow progressive muscular atrophy, muscular contractures and cardiac disease which affect prognosis. We report a 22 year-old patient with EDMD which shows the typical features of the associated dilated cardiomyopathy, ventricular arrhythmia, atrio-ventricular block, atrial standstill then atrial paralysis.

[Dilated cardiomyopathy and atrio-ventricular block in coeliac disease. Two case reports]. / Cardiomyopathie dilatée et bloc auriculo-ventriculaire dans la maladie coeliaque. A propos de deux observations.

We report two cases of celiac disease (CD) presented as an idiopathic dilated cardiomyopathy in association with a complete heart block in one patient, without digestive manifestation. The diagnosis of CD was obtained by both positivity of antiendomysial antibodies (AEA) and identification of the characteristic duodenal endoscopic and histological findings. Gluten-free diet improved the cardiac function in one patient but it had no effect on atrioventricular conduction in this same patient. These cases highlight the possible cardiac involvement in celiac disease and the relevance of antiendomysial and antigliadin antibodies test in case of rhythm disturbances and cardiomyopathies of unknown etiology. The effect of gluten free diet on cardiac performance was described.

Ultraviolet-visible spectroscopic study of 3,5-dithio-2,7-dimethyl-[1,2,4]-triazepine: qualitative analysis of tautomeric behaviour.

Room temperature UV-vis absorption spectra of the tautomeric system 3,5-dithio-2,7-dimethyl-[1,2,4]-triazepine in solution, in acetonitrile (CH3CN), are measured at different water volume percentages. The comparison of the obtained measures to the calculated allowed absorption transitions, using ZINDO/S package, reveals the coexistence of all the tautomeric forms in aprotic polar solution with a high dominance of the dithione form. The solute-water hydrogen bond, which seems to be of 1:n-type, favours the dithiol and monothiol conformers to the detriment of the dithione one. Further experimental investigations lead to the result that standing at ambient Laboratory conditions in the dark favours the dithione tautomeric isomer, while standing at indirect sunlight shifts the tautomeric equilibrium away from this species.

[Prognosis of intraventricular septal rupture in myocardial infarct: apropos of 13 cases]. / Pronostic des ruptures septales interventriculaires dans l'infarctus du myocarde: a propos de 13 cas.

The authors report the experience about 13 cases of postinfarction ventricular septal rupture. Patients (9 men and 4 women) aged 60 to 76 years average 68 years. The site of necrosis was the anterior wall in 8 cases and the posterior wall in 5 cases. The diagnosis of septal rupture was confirmed by echocardiography and/or angiography. 6 patients died after averages: 7 days. Surgical intervention was performed in 7 cases after a mean of 51 days following the date of the myocardial infarction after an intensive care. We emphasize to demonstrate the helpful of intensive care and the role of early surgery for a good prognosis.

[Emphysematous cystitis: apropos of 2 cases]. / Cystite emphysémateuse: à propos de 2 cas.

Emphysematous cystitis is a rare infectious disease of the lower urinary tract. Its reputedly serious prognosis is related to treatment failures revealing ignorance concerning its pathophysiological mechanisms. Two cases of this disease were seen in our department, both in diabetic men over the age of 70 years with a history of prostatism. They presented to the emergency department with complete urinary retention and alteration of the general state and fever. Urine culture isolated Klebsiella pneumoniae in both cases. Treatment consisted of bladder drainage associated with adapted antibiotic therapy and control of diabetes. A suprapubic prostatectomy was subsequently performed in one case and transurethral prostatic resection was performed in the other case. The prognosis of this disease depends on early diagnosis and rapid introduction of effective treatment.

Effect of different G protein-coupled receptor kinases on phosphorylation and desensitization of the alpha1B-adrenergic receptor.

The alpha1B-adrenergic receptor (alpha1BAR), its truncated mutant T368, different G protein-coupled receptor kinases (GRK) and arrestin proteins were transiently expressed in COS-7 or HEK293 cells alone and/or in various combinations. Coexpression of beta-adrenergic receptor kinase (betaARK) 1 (GRK2) or 2 (GRK3) could increase epinephrine-induced phosphorylation of the wild type alpha1BAR above basal as compared to that of the receptor expressed alone. On the other hand, overexpression of the dominant negative betaARK (K220R) mutant impaired agonist-induced phosphorylation of the receptor. Overexpression of GRK6 could also increase epinephrine-induced phosphorylation of the receptor, whereas GRK5 enhanced basal but not agonist-induced phosphorylation of the alpha1BAR. Increasing coexpression of betaARK1 or betaARK2 resulted in the progressive attenuation of the alpha1BAR-mediated response on polyphosphoinositide (PI) hydrolysis. However, coexpression of betaARK1 or 2 at low levels did not significantly impair the PI response mediated by the truncated alpha1BAR mutant T368, lacking the C terminus, which is involved in agonist-induced desensitization and phosphorylation of the receptor. Similar attenuation of the receptor-mediated PI response was also observed for the wild type alpha1BAR, but not for its truncated mutant, when the receptor was coexpressed with beta-arrestin 1 or beta-arrestin 2. Despite their pronounced effect on phosphorylation of the alpha1BAR, overexpression of GRK5 or GRK6 did not affect the receptor-mediated response. In conclusion, our results provide the first evidence that betaARK1 and 2 as well as arrestin proteins might be involved in agonist-induced regulation of the alpha1BAR. They also identify the alpha1BAR as a potential phosphorylation substrate of GRK5 and GRK6. However, the physiological implications of GRK5- and GRK6-mediated phosphorylation of the alpha1BAR remain to be elucidated.