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Biomedical subjects

F Barbier

Publications and source records attributed to F Barbier.

At least 37 records · Page 2Linked to original sources

Fungal colonization of the esophagus.

A prospective study was conducted in 224 patients to determine the clinical significance of esophageal colonization with yeasts under different conditions. In accordance with the results of direct smear microscopic examination and culture of esophageal brushings, patients were divided into three groups: positive, negative, and the patients, in whom saprophytic forms were detected. A higher prevalence of positive findings was noted in patients with predisposing factors for yeast invasion than in patients free of underlying disease. Eleven percent of patients with an endoscopically normal appearing esophagus were positive. We have the impression that this situation may represent a preclinical condition of fungal esophagitis. Patients treated with H2-blocking agents showed a significantly higher incidence of positive findings, than did those without such treatment. Whether patients suffering from a refluxesophagitis resistant to long-term treatment with H2 blockers, but with a significant colonization by yeasts, could benefit by an additional treatment with antimycotics remains a controversial issue and should be studied in a controlled way.

Adult↗

Congenital hepatic fibrosis.

We report the clinical features of 7 men (mean age 22 years, range 7-53 years) with congenital hepatic fibrosis (CHF). Five patients presented with variceal bleeding and/or hepatosplenomegaly due to portal hypertension. Cholangitis was the presenting symptom in the other 2 cases. Diagnosis was established by histological examination of a surgical wedge biopsy (4 patients) or needle biopsy (3 patients). A portal-systemic shunting was performed in 6 patients, three times prophylactically. None of the 5 survivors developed chronic hepatic encephalopathy. Recurrent bouts of cholangitis with septicemia and hepatic abscesses were a major complication in 5 patients with a fatal outcome in 2 cases. Six patients had associated small and large cysts in the cortex of both kidneys, compatible with adult-type polycystic disease. One patient developed terminal renal insufficiency. In 3 patients kidney function remained normal at a mean follow-up time of 7.5 years (range 1-18 years). In 2 families (4 cases) an autosomal dominant inheritance of renal disease was suggested. This study demonstrates that CHF is a rare cause of portal hypertension in late childhood and in adults. Cholangitis is a severe and frequently fatal complication. Association with a variety of congenital renal abnormalities is very frequent. However, the association with adult-type polycystic disease as reported in 4 cases is very rare.

Adolescent↗

Endoscopic sclerotherapy: the value of balloon tamponade and the importance of disinfection.

Endoscopic sclerotherapy in active variceal bleeding stopped bleeding in 48 out of 67 patients (72%). Survival of the acute bleeding episode was related to liver function: 6% mortality in Child A patients vs. 48% mortality in Child C. Comparing two treatment modalities: 24 h Linton balloon tamponade followed by sclerotherapy vs. sclerotherapy alone, our results in comparable groups slightly, although not significantly, favor tamponade-sclerotherapy treatment: 75% survival vs. 71%. As this treatment modality is more convenient and helps to avoid dangerous aspiration pneumonia, we advocate balloon tamponade prior to sclerotherapy in acute variceal bleeding. In maintenance treatment 65 patients were treated until eradication of varices. The rebleeding risk was 0.034% per patient per month, with 64% of the rebleeding within the 2 first months before complete eradication of the varices. The long-term survival depends largely on liver function: one year survival of 88% in Child A vs. 30% in Child C. Using Aethoxysklerol 1% in intravariceal injection, no stricture occurred. Using a sterile injection needle and a glutaraldehyde-disinfected endoscope, no infectious complications directly related to the procedure occurred, and all hemocultures remained negative.

Adolescent↗

Influence of pathological state on the acoustic attenuation coefficient slope of liver.

The acoustic attenuation coefficient slope (beta) of liver was estimated in vivo from the spectral difference of returned echoes. beta of normal young subjects was lower than that of older subjects (mean: 0.340 vs 0.418 dB/cm.MHz). Limited fluid withdrawal from the body by haemodialysis did not affect beta. In alcoholic liver disease beta was related to the amount of fat and of fibrous tissue in liver biopsy specimens. High values of beta were observed as soon as the degree of steatosis exceeded 5 vol%. There was a similar increase of beta in the presence of fibrous interlobular septa. In normal liver beta was related to the amount of triglycerides in the liver specimen.

Acoustics↗

[Bilateral prosthesis of the knee in a hemophilia A patient with an inhibitor].

A forty-one year old severe haemophiliac A (factor VIII less than 1%) complicated by an antifactor VIII inhibitor was operated on for a bilateral arthroplasty of the knees. Substitutive treatment was started by giving anti-haemophilic A cryoprecipitate at a dose of 40 IU . kg-1. The anamnestic response occurred at day 6. Consumption of the inhibitor begun with the injection of 50,000 IU of concentrated factor VIII. This method proved to be insufficient for mastering the haemorrhagic syndrome, because the antibody titre quickly reached 10 IU Oxford. Treatment was continued with Autoplex (100 IU . kg-1), during three weeks, without any clinical or biological complications. It is suggested that Autoplex be used as the substitutive treatment in cases of major surgery in severe haemophilia complicated by a factor VIII inhibitor.

Adult↗

Coagulant, fibrinolytic, and aggregating activity in ascitic fluid.

Ascitic fluid samples from 14 subjects with liver cirrhosis and from 13 patients with malignancy were investigated. Activated FX was present in ascitic fluid in small quantities with a mean value of 8.7 10(-3) IU/ml. The mean thrombin activity was 70.8 10(-3) IU/ml and the mean plasmin activity was 449.6 10(-3) CU/ml. High levels of fibrin/fibrinogen degradation products (mean 75.4 micrograms/ml) and of antithrombin III (mean 43.4%) were found. No statistically significant differences between values in liver cirrhosis and in malignancy were found. In 15 of 17 experiments 10-fold concentrated ascitic fluid caused irreversible platelet aggregation and [14C] serotonin release of normal platelet-rich plasma similar to collagen. The aggregating effect disappeared after addition of collagenase. These results do not support the concept that the coagulopathy after peritoneovenous shunting is a result of direct and rapid intravenous infusion of procoagulant substances. They rather point to a central role of collagen present in ascitic fluid.

Ascitic Fluid↗

Quantitative gas chromatographic mass spectrometric determination of pinaverium-bromide in human serum.

A method has been developed for quantitative determination of pinaverium-bromide, a quaternary ammonium derivative with papaverine-like activity, in human serum. The method involves a chloroform extraction of serum spiked with N-(6,6-dimethyl bicyclo[3.1.1]2-heptenyl-ethoxyethyl) perhydro-1,4-oxazine as internal standard. After evaporation of the solvent, and reduction of the residue with Raney-Nickel, the internal standard and the reduced pinaverium-bromide are re-extracted from the reaction mixture with toluene and analysed isothermally on a fused silica column coated with OV-101. Although chemical ionization with methane revealed intense protonated molecular ions for both pinaverium-bromide and the internal standard, selectivity and sensitivity were significantly lower in comparison with electron impact ionization at 70 e V. Therefore, quantification was performed in the electron impact mode by single ion monitoring of the common fragment ion at m/z 100.2. A linear detector response was observed up to 160 ng ml-1. A within-run assay precision better than 2% CV (n = 5) was found, and a detection limit of 1 ng pinaverium-bromide ml-1 of serum was attained.

Autoanalysis↗

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Demography↗

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Demography↗

Effects of oxametacin on coumarin anticoagulation and on platelet function in humans.

In 12 chronically anticoagulated patients the administration of 1-p-chlorobenzoyl-5-methoxy-2-methyl-3-indoacetohydroxamic acid (oxametacin, Flogar), three times 100 mg a day, decreased the thrombotest percentage from a mean of 11.2% to a mean of 8.3% after one week and of 7.8% after two weeks of treatment. A potentiating effect of oxametacin was also found when the prothrombin time or the activated partial thromboplastin time were used as parameters. In one third of our patients an adaptation of the coumarin dose or even an interruption in the warfarin administration was necessary. Although no severe bleedings occurred, care should be taken in prescribing oxametacin to anticoagulated patients. In a second part of this study we compared the ex vivo effects of a single oral dose of 1 g of acetylsalicylic acid, 50 mg of indometacin and 100 mg of oxametacin in human volunteers. Platelet aggregation and 5HT--14C release induced by collagen. Thrombofax, ADP, adrenaline (epinephrine), bovine plasma and ristocetin were measured before, 1 and 24 h after drug administration. A clear-cut inhibitory effect as induced by acetylsalicylic acid was not found for oxametacin.

Adult↗

Alpha 1-antitrypsin in pancreatitis.

A possible relationship between alpha 1-antitrypsin deficiency and pancreatitis was studied. Pi phenotype distribution in a group of 90 patients with proven pancreatitis was compared to a control group of 549 randomly selected blood donors. No significant differences were found between the patient group and the controls, nor between acute and chronic forms of pancreatitis. It is concluded that alpha 1-antitrypsin phenotype does not play an important role in pancreatic disease.

Acute Disease↗