[Hypergammaglobulinemia in liver cirrhosis. Role of portacaval shunts].
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Biomedical subjects
Publications and source records attributed to A Paraf.
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We report a patient with angio-immunoblastic lymphadenopathy (A.I.L.) with pulmonary localisation. The symptomatology of the A.I.L. was dominated by a polyclonal increase in gammaglobulins and a neuropathy 35 months before the generalized lymphadenopathy. We discuss this unusually long prodromal period and the nature of the neuropathy.
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Liver specimens obtained by biopsy in 18 patients with asymptomatic HBs Ag were studied with specific immunofluorescent technic for this antigen by light and electron microscopy. Only insignificant changes were disclosed by routine microscopy examination. Under light microscopy "ground glass" hepatocytes were found in eight cases. Specific immunofluorescence was found positive in nine cases and was closely correlated with the "ground glass" hepatocytes in eight of them. In one on the three cases studied by electron microscopy, only spherical and tubular formations, 20 to 30 nm in diameter found in the cisternae of the smooth endoplasma reticulum in a few hepatocytes, seem to be HBs Ag.
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A case associating a systemic mastocytosis and an acquired myeloperoxidase deficiency is reported. The myeloperoxydase deficiency is studied by cytochemical techniques in optical and electron microscopy and confirmed by biochemical measures. An important defect in bactericidal and candidacidal activity is demonstrated in vitro in P.N.M. The authors discuss the links between the two anomalies which might bring one more argument for the common origin of both granulocytes and mastocytes.
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A series of 180, Bouin-fixed and paraffin embedded liver biopsies obtained from 147 patients was investigated for the presence of hepatitis B surface antigen (HBs) by histochemical and indirect immunofluorescence techniques. A comparison between orcein staining and Masson's trichrome preparations for ground glass hepatocytes, showed that immunofluorescence was both the more reliable and the more specific method for detection of HBsAg in liver tissue. The ability to perform this technique on paraffin sections facilitates systematic studies and allows retrospective work-up. IF-HBs positive hepatocytes were found in approximately two thirds of all HBs-positive patients in their serum, but never seen in HBs-negative patients. HBs-positive cells were observed in healthy chronic carriers and in all forms of chronic hepatitis, but never in acute HBs-positive hepatitis. In patients treated with chronic hemodialysis and in renal homograft recipients, the incidence of positive cells was higher than in the chronic hepatitis groups; this could be correlated with the duration of antigenemia at the time of biopsy.
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Purified right-side-out (RSO) and inside-out (IO) plasma membrane vesicles release 35% of the total plasma membrane proteins after EDTA treatment. After such a treatment both types of vesicles exhibited the same total activity of (Na+ + K+)-stimulated Mg2+ adenosinetriphosphatase (ATPase; ATP phosphohydrolase, EC 3.6.1.3) as in their native state. The EDTA treatment increases the enzyme sensitivity to ouabain by 350-fold in IO vesicles while being without any effect RSO vesicles. Thus, proteins released only from the IO vesicles led to a change in ouabain sensitivity of the (Na+ + K+)-stimulated Mg2+ ATPase. Moreover, only proteins released from IO vesicles, when added to treated IO vesicles with divalent cations, were able to restore the original resistance of the enzyme to ouabain; released proteins from RSO vesicles failed to make such a reconstitution. Thus, we assume that these proteins detach from the inner face of the plasma membrane upon EDTA treatment and are distinct from the enzyme. Polyacrylamide gel electrophoresis indicates that these inner face plasma membrane proteins are approximately 30,000 daltons.
134 patients with radiolucent gallstones were randomly allocated to receive either placebo or 1 of 3 different doses of chenodeoxycholic acid (CDCA); 750, 1,500, or 3,000 mg). The initial dose was lowered if not well tolerated. 107 patients were treated for more than 3 months. Among them, stones dissolved in 21 and were smaller in 25 patients. Partial or complete dissolution occurred in 4 of the 13 receiving 375 mg/day, 14 of 37 receiving 750 mg, 24 of the 38 receiving 1,500 mg and 4 of 8 receiving 3,000 mg/day. The number of responders to the therapy was significantly greater in the groups of patients receiving 1,500 mg/day or 17-24 mg/kg body weight than in any other group. However, side effects, i.e., diarrhea and transaminase increase, are also dose related. It appears from this study that the optimal dose of CDCA may be between 17 and 20 mg/kg body weight.