[Setting up of a pilot project in medical demography in Aquitaine].
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Adult↗
Biomedical subjects
A Moreau
Publications and source records attributed to A Moreau.
[Test of differential anti-T and anti-B lymphocyte compatibility in renal transplantation. A partial solution to the problem of hyperimmune patients].
In view of their beneficial effect on the functional survival of transplanted kidneys, pretransplantation blood transfusions of haemodialysed patients have become routine procedure. At the same time, the number of hyperimmune patients awaiting transplantation has been increasing, as these are often excluded on account of positive cross-match. Cross-matching is usually done by testing recipients' sera against total donor's lymphocytes, so that positive cross-match due to specific anti-T cell cytotoxic antibodies cannot be differentiated from that due to anti-B cell antibodies. Differential anti-T cell and anti-B cell cross-matching showed no significant difference between the survival of 34 transplants with B cell-positive cross-match and that of 126 transplants with B cell-negative cross-match (67% and 60% respectively at 12 months). It also showed that anti-B cell antibodies had no adverse effect on the survival of transplants. The presence of antibodies or auto-antibodies with optimal cytotoxicity at 4 degrees C did not appear to correlate with a significantly longer transplant survival as compared to other transplanted patients. Finally, a high degree of a anti-T cell immunization or a strongly positive B cell cross-match on transplantation day did not seem to jeopardize transplant survival in a B-cell-positive cross-match population of transplanted patients. The differential cross-matching method has made it possible to successfully transplant a substantial number of hyperimmune patients: at least 62% of patients with B cell-positive cross-match also had positive total lymphocyte cross-match which would have precluded renal transplantation.
Antilymphocyte Serum↗
[Hypoxemia and aging (author's transl)].
Hypoxemia during rest reveals the aging of the respiratory tract. The evolution curve of the PaO2 related to age is parallel to that of static elastic recoil pressure. This hypoxemia is moderate and without any serious functional consequences in a healthy subject. Abnormalities of the ventilation-perfusion ratio are the main causes. The increase of the anatomical dead space and the increase of the right-left shunt only play a moderate part. On the other hand the increase of closing volume seems the major factor. Thus the ventilation distribution becomes dependent on the amplitude of the tidal volume. The response of the aged subject to hypoxia is lessened for mechanical and neurological reasons explaining why a respiratory distress can appear rapidely and sometimes unexpectedly.
Adaptation, Physiological↗
[Gestalt therapy, extension of psychoanalysis (author's transl)].
Gestalt therapy extends considerably psychoanalysis. 1. Transfer in psychoanalysis allows to work on the disturbed relations which the patient transfers onto his analyst, relations created by the parents and repeated now. The extended transfer in a therapeutic group of life allows to work on the fact that the patient recreates here and now the difficulties he encounters in life. 2. The game of the analyst and the encounter show that beyond transfer and projection, a real encounter may take place, a precious means to create life here and now. 3. The difference between individual therapy and group-therapy is about this: the former is centered on illness, the latter on life; the former helps to understand, the latter to live; the individual talks about facts from the past and from elsewhere and the group lives "here and now", which allows to test feelings, a powerful source of life. 4. A session of group-therapy, as developed here, allows to see how one can find a response to a need or avoid to find a response to it. 5. A comparison-table between psycho-analysis and gestalt shows the difference of method, diagnosis, therapeutic process, therapeutist's attitude and of the position of the patient. 6. Psycho-analysis is perhaps a relay after religion? Several elements make us believe this: tension in contacts, ritual, authority, protection, neutrality, guilty making. 7. To contest or contest one-self has helped me to compare the contester with the psycho-analyst: both contest society, but they don't change their behavior. The gestalt-therapeutist is in a way like a hippie: though contesting society, he brings a change to his way of life, while being closer to life.
Adult↗
[Extensive bone marrow necrosis and thrombotic microangiopathic anemia revealing disseminated adenocarcinoma].
BACKGROUND: Bone marrow necrosis and thrombotic microangiopathy are uncommonly associated. We report an observation. CASE REPORT: A 52-year-old man with extensive bone marrow necrosis, associated with hemolytic microangiopathic anemia, was treated unsuccessfully with corticosteroids and plasmapheresis. Outcome was fatal. Autopsy showed disseminated bone marrow necrosis and medullary invasion by adenocarcinoma cells in this patient operated 13 years earlier for gastric cancer. DISCUSSION: Extensive bone marrow necrosis or thrombotic microangiopathy can complicate usually advanced cancer. Prognosis is poor without response to chemotherapy. Corticosteroids and plasma exchange are sometimes successful. A relative efficacy of treatment with staphylococcal protein A immunopheresis is reported by several authors in thrombotic microangiopathy.
Adenocarcinoma↗