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Biomedical subjects

A Delcourt

Publications and source records attributed to A Delcourt.

At least 19 recordsLinked to original sources
PubMed1998

Heart retransplantation: a 23-year single-center clinical experience.

BACKGROUND: The main causes of allograft failure after cardiac transplantation are primary graft dysfunction, intractable acute rejection, and coronary graft disease. Despite the important progress in the last several years in graft preservation, surgical techniques, immunosuppression, and treatment of coronary graft disease, retransplantation in selected cases is the only way to achieve long-term recipient survival. METHODS: We compare here in a case-control study 24 retransplantations with 47 first transplants in patients matched for date of transplantation. RESULTS: Between 1973 and 1996, 1,063 patients underwent cardiac transplantation in our institution. In this cohort, 22 patients had a total of 24 retransplantations (2 second-time retransplantations). The causes of retransplantations were primary graft failure (n=4), acute rejection (n=7), coronary graft disease (n=11), and miscellaneous (n=2). Survival at 1 and 5 years of patients with retransplantations is 45.5% and 31.2%, and survival of control patients is 59.4% and 38.8% (p=0.07). An interval between first transplantation and retransplantation shorter (n=11) or longer (n=13) than 1 year is associated with a 1-year survival of 27.3% and 61.5% and a 4-year survival of 27.3% and 46%, respectively (not significant). Intervals shorter than 1 year between first transplantation and retransplantation were exclusively secondary to primary graft failure or intractable acute rejection. CONCLUSIONS: In the face of lack of donor grafts, these and other data indicate that retransplantation should be considered cautiously, especially when the interval between the first transplantation and retransplantation is short.

Acute Disease↗
PubMed1998

Lymph node metastases: safety and effectiveness of MR imaging with ultrasmall superparamagnetic iron oxide particles--initial clinical experience.

PURPOSE: To evaluate the clinical and biologic safety of ultrasmall superparamagnetic iron oxide particles (AMI-227) as a contrast agent for magnetic resonance (MR) lymphography and to assess their efficacy for the differentiation of metastatic and benign nodes in patients with urologic and pelvic cancer. MATERIALS AND METHODS: Thirty adults suspected of having lymph node metastases underwent MR imaging before and 22-26 hours after intravenous infusion of AMI-227 (1.7 mg Fe/kg). Sixty histopathologically proved lymph nodes were analyzed on MR images, and 29 of these nodes were also analyzed quantitatively. RESULTS: AMI-227 was well tolerated with no major side effects. It allowed the detection of 10 additional nodes relative to those detected at MR imaging without AMI-227. None of the 27 metastatic nodes showed a decrease in signal intensity (SI) on AMI-227-enhanced images; nine of 27 metastatic nodes showed an increase in SI on T1-weighted images, probably resulting from altered capillary permeability in the tumor. A visually perceptible reduction in SI, indicating active AMI-227 uptake, was observed on postcontrast T2- and T2*-weighted images in 16 of 21 benign nodes. The SI ratio of benign nodes was lower than that of metastatic nodes on T2- and T2*-weighted images. The sensitivity of AMI-227-enhanced MR lymphography was 100%, and the specificity was 80%. CONCLUSION: AMI-227 is safe and may facilitate the differentiation of metastatic and benign nodes in patients with urologic and pelvic cancers.

Adult↗
PubMed1997

New polyazole derivatives from 2-(2,4-dichlorophenyl)-1,3-dioxolane. Antifungal activity. Structure-activity relationships.

Six new polyazole derivatives from 2-(2,4-dichlorophenyl)-1,3-dioxolane were studied for their antifungal activity against pathogenic fungi for humans and animals. The antimycotic effect was largely restricted to the filamentous fungi with Aspergillus fumigatus and Scedosporium apiospermum being remarkably susceptible. Three compounds were as effective as the two references, ketoconazole and oxiconazole. The structure-activity relationships revealed than an 'oxime group' combined with four chlorine atoms increased the antifungal properties of the chemical series.

Antifungal Agents↗
PubMed1997

Optimization of the detection of bacteriophages induced from Listeria sp.

It is necessary to isolate new phages in order to improve the rate of typeability of Listeria monocytogenes strains. We propose a method which increases the detection of induced phages in the presence of inhibitory substances synthesized or liberated by the cells during phage production. Of the 29 phages isolated, 11 (38%) were detected by the spot-on-the-lawn technique and 18 (62%) were revealed by the soft-agar technique. To increase the rate of phage detection, both techniques appear useful. Listeria cultures were subjected to phage typing procedures utilizing these newly isolated phages and the French International set of phages. It appears that the newly isolated phages are good tools for the differentiation of Listeria strains. Among them, one phage seems to be complementary to the French International set.

Bacteriophage Typing↗
PubMed1997

Endomyocardial fibrosis in Behçet's disease.

OBJECTIVE: To report on four patients with Behçet's disease associated with endomyocardial fibrosis involving the right or the left ventricle. METHODS: Charts of more than 350 patients with Behçet's disease were reviewed. Endomyocardial fibrosis was confirmed because of cardiac failure in three patients and incidentally discovered by histological examination of an operative specimen in one patient. Echocardiography displayed bright echogen endocardium. Angiocardiography showed a reduced ventricular size. Electron beam computed tomography demonstrated a lowdense area involving the endocardium. Magnetic resonance imaging showed a mass of intermediate intensity on T1 weighted images. Diagnosis of endomyocardial fibrosis was based on histological study of a biopsy specimen in one patient and of an operative specimen in three. RESULTS: Six other similar cases of endomyocardial fibrosis complicating Behçet's disease were previously reported in the medical literature. Endomyocardial fibrosis predominantly involved the right ventricle. It can be considered a feature of Behçet's disease because: (a) no other cause was discovered; (b) arteritis, valvulopathy, and intraventricular thrombus were closely linked, and (c) all patients with endomyocardial fibrosis had vasculo-Behçet pattern. CONCLUSION: Endomyocardial fibrosis may be the sequelae of vasculitis involving endocardium or myocardium, or both and complicated with intraventricular thrombosis. Behçet's disease should be added to the list of causes of endomyocardial fibrosis.

Adult↗
PubMed1996

Popliteal aneurysm due to fibromuscular dysplasia.

We report herein the case of an asymptomatic popliteal aneurysm due to fibromuscular dysplasia in a 39-year-old woman. The aneurysm was resected and arterial continuity restored by direct end-to-end anastomosis. Pathologic findings were consistent with fibromuscular dysplasia of the media. To the best of our knowledge, this is the fourth case documented by pathologic findings in the literature.

Adult↗
PubMed1996

[Video-surgery for pericardial effusion. Technique and results].

Videosurgery is a relatively non-invasive method of draining the pericardium by the creation of a pleuropericardial window. It provides an excellent view of the thoracic cavity and allows selection of pericardial and pleural, pulmonary or mediastinal biopsy sites. The authors report their preliminary results with this technique. Between May 1994 and May 1995, 22 patients with pericardial effusions were operated by videosurgery at the Pitié Hospital. None of the patients had clinical signs of tamponade. The technique consists in introducing, through 2 or 3 thoracic incisions of 15 mm, trocarts allowing passage of an endoscopic camera and different surgical instruments. Access to the thoracic cavity enabled assessment of the pleura, evacuation of pleural effusions (n = 8) and biopsy of pleural nodules (n = 2). One pulmonary biopsy was performed. Opening the pericardium enabled evacuation of pericardial effusions averaging 622 ml. Pericardial biopsies showed appearances suggesting tuberculosis (n = 2), lupic vasculitis (n = 1) and post-radiation pericarditis (n = 1). In other cases, a histologic diagnosis of non-specific pericarditis was made. A biopsy of a pleural nodule showed undifferentiated carcinoma in one case. A pulmonary biopsy revealed the presence of relatively undifferentiated carcinoma. There were no complications related to the technique. There was one recurrence of pericardial effusion at one month in a patient with carcinoma of the lung who had previously had subxiphoid drainage. There were no cases of secondary pericardial constriction. Therefore, videosurgery is a relatively non-invasive and effective technique of pericardial drainage and biopsy. When there is no emergency, it is probably the method of choice in the treatment and diagnosis of pericardial effusions.

Adult↗
PubMed1996

[Treatment of abdominal aortic aneurysms: importance of the bifurcated prosthesis].

Despite the increasing use of tube grafts to treat aortic aneurysms, bifurcated prostheses remain the most frequent solution. Advocates of the tube graft emphasize faster positioning and lower operative morbidity and mortality rates. However, the condition of the aortic orifice (where atheromatous lesions are maximal) and the aneurysmal or occlusive iliac disease frequently associated with aortic aneurysms usually require use of a bifurcation prosthesis for complete treatment of aortoiliac lesions.

Aortic Aneurysm, Abdominal↗
PubMed1994

Microbial and mycotoxic contamination of peppers and food safety.

Twelve random samples of pepper powders were analyzed for contamination by microorganisms of public health significance (bacteria, moulds) and for aflatoxin B1 concentration. Black peppers were more heavily contaminated than white peppers but the most important bacteria causing foodborne diseases were not isolated; The mould flora was dominated by xerophilic species, particularly Aspergillus fumigatus, A. flavus, A. niger and A. ochraceus. These potentially pathogenic species can be dangerous for predisposed patients. The most striking result concerns aflatoxin B1 which was detected in every sample analyzed and could not always be correlated with the occurrence of a mycotoxinogenic strain of Aspergillus, suggesting the use of a sterilizing treatment previously. So, the detection of aflatoxin B1 must be a necessary criterion to be added to microbial criteria to appreciate the quality of peppers.

Aflatoxin B1↗
PubMed1993

[Malacoplakia. Apropos of a case of retroperitoneal site].

Malacoplakia is a granulomatous inflammatory disease caused by a disorder of macrophage bactericidal function. The disease, histologically characterized by the presence of Michaelis-Gutmann bodies, has a preference for the urogenital tract and less frequently affects the gastrointestinal tract and the retroperitoneal region. We report the unusual case of a male patient who presented with retroperitoneal pseudotumoral malacoplakia associated with vesical malacoplakia. The main pathophysiological, diagnostic and therapeutic aspects of this rare disease are described.

Adult↗
PubMed1993

Adult T-cell leukemia/lymphoma revealed by a surgically cured cardiac valve lymphomatous involvement in an Iranian woman: clinical, immunopathological and viromolecular studies.

A 60-year-old woman from the town of Mashhad in northeastern Iran developed cardiac failure due to aortic and mitral regurgitations which needed cardiac valve replacement. Histopathological study of the valves revealed a T-cell non-Hodgkin's lymphoma. Blood examination showed leukemic features with 32% of abnormal white blood cells. Human T-cell leukemia/lymphoma virus type I (HTLV-I) antibodies were present in the serum and the specific env HTLV-I sequences were detected in the DNA extracted from the valves and peripheral blood mononuclear cells (PBMC) using polymerase chain reaction technique. Clonal integration of two HTLV-I copies was found in both the valves and PBMC DNA, thus the diagnosis of adult T-cell leukemia/lymphoma (ATL) was established. In contrast to the acute life-threatening cardiac localization, our case met the diagnostic criteria of chronic ATL, this was confirmed by favorable evolution without chemotherapy during the 24 months after diagnosis. According to our knowledge, this is the first report of an isolated lymphomatous cardiac valve involvement, without other cardiac abnormalities. It seems important to underline that the patient originated from Iran where endemicity of HTLV-I has only recently been discovered.

Aortic Valve↗
PubMed1992

[Peripheral calcific embolism after percutaneous mitral valvuloplasty].

The authors report a case of calcific embolization after percutaneous mitral valvuloplasty. The nature of the embolism was confirmed by anatomopathological examination after popliteal embolectomy. This complication would appear to be extremely rare but represents an additional risk in patients with calcific mitral stenosis.

Adult↗
PubMed1992

[Heart-lung transplantation. A necropsy study of thirty-seven patients].

Between 1987 and 1992, thirty-seven heart-lung transplant recipients had a postmortem examination at the Pitié-Salpêtrière Teaching Hospital in Paris, France. Except for three patients who survived 2 months, 4 months and 16 months after transplantation, respectively, most patients died in the early postoperative period (mean survival time = 34.6 days). Autopsy disclosed minor acute heart rejection in four patients and minor acute lung rejection in three patients. Five patients had obliterating bronchiolitis that was the cause of death in two cases. Main causes of death included perioperative pleural bleeding, respiratory infection with or without septicemia, diffuse alveolar lesions (adult respiratory distress syndrome and/or pulmonary edema undergoing organization) and multiple organ failure. Hemodynamic and respiratory complications responsible for multiple organ failure in the perioperative period, as well as pre-existing morbid conditions such as cirrhosis of the liver induced by heart failure, may have a major bearing on the outcome of heart-lung transplantations.

Adolescent↗
PubMed1992

[Bronchoesophageal cyst in adults. Apropos of a case].

The authors report the case of a 61-year old woman who was operated upon for a paraoesophageal cyst of the bronchogenic type. Having reviewed the French literature on the latest cases, they underline the scarcity of these congenital formations which present as mediastinal cystic tumours with benign expression and course. Computed tomography suggests the diagnosis and reveals the intraparietal site of the cyst. A return to the histogenesis of these cysts makes it possible to understand the nosological distinction with the true bronchogenic cysts and to evaluate the recent classifications.

Bronchogenic Cyst↗
PubMed1991

A pathologic analysis of the outcome following heart-lung transplantation: an autopsy study of 22 recipients.

Between 1987 and 1989, twenty-two patients who received combined heart-lung transplantation were autopsied at La Pitie Salpetriere Hospital in Paris. With the exception of two recipients who survived for 2 months and 4 months, respectively, the majority of the patients died in the early postoperative period (the mean survival was 20.1 days). At autopsy, five patients showed acute cardiac rejection of a minor grade. Perivascular and peribronchiolar mononuclear cell infiltrates suggesting acute pulmonary rejection were seen in three patients. Obliterating bronchiolitis, which might be indicative of chronic rejection, was observed in four patients who had longer survival rates, and one of these four had died of obliterating bronchiolitis. Rather than allograft rejection, the major causes of death were (1) perioperative hemorrhage, (2) infections (mainly respiratory infections and occasionally mediastinitis), (3) diffuse alveolar damage (the so-called adult respiratory distress syndrome and/or pulmonary organizing edema), and (4) multiple organ failure. The present study suggested some of the reasons why the survival rate following heart-lung transplantation is much poorer than after isolated heart transplantation. Hemodynamic or respiratory problems causing perioperative multiple organ failure as well as pre-existing complications of the recipients, such as "cardiac cirrhosis," may play an important role in the prognosis of heart-lung transplantation.

Adolescent↗