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Biomedical subjects

F Lunel

Publications and source records attributed to F Lunel.

104 records · Page 6Linked to original sources
PubMed1990

[Epidemiologic aspects of viral hepatitis at a Parisian university hospital. Apropos of 130 cases].

One hundred and thirty adults with viral hepatitis were hospitalized in the Department of Hepatology-Gastroenterology at the Hospital Salpètrière between October 1984 and October 1986. Eighty had acute hepatitis and 50 suffered from chronic hepatitis. Among the former, 15 had hepatitis A, 40 had hepatitis B and/or delta and 25 had non A-non B hepatitis. The latter group was divided into 32 hepatitis B and/or delta and 18 non A-non B. The results of clinical, biological, serological and histological analyses were comparable to those reported in the literature for hepatitis A and B. Hepatitis non A-non B was more prevalent in males (72%). This predominance seems to be associated with the high number of heart transplant patients (12, 11 of them were men) in our study population. A liver biopsy was performed on 19 out of the 25 acute and on 32 of the chronic non A-non B hepatitis patients. Persistent chronic hepatitis was the most commonly found lesion. Transfusion was implicated in 53.8% of the patients, drug addiction in 18.6% of the cases and intramuscular injection or acupuncture in 5% of them. No risk factor was found in 23.2% of the patients. Seventy-two percent of the acute non A-non B hepatitis cases evolved towards a chronic form. We have attempted to find the factors involved in progression to chronicity. No correlation was found for age or the means of contamination. In contrast, immunodepression was significantly correlated. This study reflects the prevalence of non A-non B hepatitis infection post-transfusion in a hospitalized population including many transplant recipients.

Acute Disease↗
PubMed1989

Effector cells involved in nonspecific and antibody-dependent mechanisms directed against Plasmodium falciparum blood stages in vitro.

We have evaluated in in vitro conditions the possible cooperative effect of antimalarial antibodies with several human blood cell types. When used alone, immunoglobulin G from African adults who had reached a state of premunition against malaria was found to have no or very limited direct effect on invasion and multiplication of P. falciparum asexual blood stages. In contrast, these antibodies induced a marked specific inhibition of parasite growth in the presence of normal blood monocytes, and the inhibition did not appear to be strain dependent. No similar antibody-dependent cellular inhibitory effect was found using human blood polymorphonuclear leukocytes, lymphocytes, platelets, or adherent spleen cells. However, these cells could all exert in vitro some non-antibody-dependent inhibitory effect when present at high effector/target cell ratios.

Adult↗
PubMed1988

Clastogenic factor in ischemia-reperfusion injury during open-heart surgery: protective effect of allopurinol.

The hypothesis tested was that free radicals generated following ischemia and reperfusion in cardiac operations can produce clastogenic factor that results in chromosomal aberration. Fourteen randomized patients undergoing coronary artery bypass grafting were divided into two groups. In Group 1 (7 patients), myocardial protection was achieved using a cardioplegic solution without allopurinol. In Group 2 (7 patients), 100 mg of allopurinol (xanthine oxidase inhibitor) was added to the solution. In both groups, blood samples were taken from the coronary sinus before the aorta was clamped and 20 minutes after myocardial reperfusion was achieved. The blood samples were used to study the patients' chromosomes. The results were given as the percentage of chromosomal aberrations observed in 100 mitoses. There were no significant differences between the preischemic values in both groups and the postischemic values in Group 2. On the other hand, there was a significant difference between the postischemic values in Groups 1 and 2 (p less than 0.01). In conclusion, reperfusion following myocardial ischemia in cardiac operations can produce clastogenic aberrations. This clastogenic activity can be reduced by adding allopurinol to the cardioplegic solution.

Allopurinol↗
PubMed1988

Prevalence and causes of long-lasting hepatic dysfunction after heart transplantation: a series of 80 patients.

The long-term follow-up of 80 heart transplant patients (70 men, 10 women) from January 1982 to July 1985 who had received cyclosporine (CsA) showed a high incidence of mild to severe liver dysfunction. Fifty patients (62.5%) had long-lasting postoperative biological disturbances (alanine amino transferase greater than 2N and/or alkaline phosphatase greater than 1.5N for 3 months or more). Most patients were asymptomatic; eight were icteric, and one had arthralgia. The most common biological feature consisted of isolated elevation of ALAT (27 cases). Assessment of causes led to a definite etiology in 42 patients: 7 cardiac failure, 13 HBsAg-positive liver disease (26%) (chronic persistent hepatitis 8, chronic active hepatitis 2, subacute necrosis 2). Fourteen patients (28%) sustained non-A, non-B (NANB) hepatitis (chronic persistent hepatitis 5, chronic active hepatitis 1, cirrhosis 1), and 7 (14%) sustained a drug-related hepatitis. Liver biopsy and complete virus screening was contributive to the diagnosis in nearly all patients. Additionally, prolonged impairment of liver function tests occurred in 62% of heart transplant recipients, mostly during the first 6 postoperative months. Hepatitis B virus (HBV) and NANB hepatitis accounted for 26% and 28% of the cases of liver dysfunction, respectively; drug-induced hepatitis may have been involved in 14% of the cases. Complete hepatitis virus screening should be performed before heart transplant and in any case of abnormal liver function posttransplantation. HBV vaccination prior to heart transplant is recommended in HBsAg- and HBcAb-negative candidates for heart replacement. Long-term follow-up of these patients is mandatory to assess the severity of these liver dysfunctions.

Adolescent↗
PubMedDate not supplied

Transfusion-associated or nosocomial hepatitis G virus infection in patients undergoing surgery.

BACKGROUND: Despite blood donor screening, there are still cases of transfusion-associated hepatitis. From 1988 to 1992, a prospective study was conducted on the incidence of non-A, non-B posttransfusion hepatitis (PTH). STUDY DESIGN: The present investigation was designed to determine if transfusion recipients with PTH who are negative for hepatitis C virus (HCV) were positive for hepatitis G virus (HGV). Patients admitted for surgery who had normal liver tests and no transfusions during the previous 6 months were enrolled. Alanine amino transferase levels were determined monthly for 6 months after surgery and for 1 year in the case of PTH (defined as alanine aminotranferase twice the upper limit of normal in two consecutive assays). HGV RNA and E2 antibodies were tested for in samples from transfusion recipients with or without PTH and from nontransfused patients. RESULTS: Of the 308 blood recipients who were enrolled in the study, 21 (6.8%) had PTH. HGV RNA was detected at the onset of hepatitis in 3 patients with PTH (14%), 2 of whom were also anti-HCV and HCV RNA positive. One patient developed E2 antibodies without detectable HGV RNA. Three (10.7%) of 28 recipients of an allogeneic transfusion without PTH developed HGV infection. HGV RNA was also found in two nontransfused patients, which suggests nosocomial transmission of HGV. CONCLUSION: Some cases of PTH are associated with HGV; most cases of postoperative HGV infection are not associated with liver abnormalities; and most PTH cases are not associated with known hepatotropic viruses.

Adult↗
PubMedDate not supplied

The "functional" popliteal entrapment syndrome.

A patient with bilateral entrapment syndrome is reported, he only had symptoms of intermittent claudication with running. The "neutral angiograms" were normal, but the "dynamic angiographies" taken in the sustained active plantar flexion showed a complete occlusion of both popliteal arteries. No abnormalities, no anatomical trap were discovered at the time of surgery. The entrapment syndrome was caused by the muscular hyperdevelopment in this intensively trained athlete. That leads to the concept of "functional entrapment" versus "organic, anatomical entrapment". The diagnostic value of the invasive and non invasive techniques is discussed. Surgical exploration is diagnostic: this is the only means to rule out any organic anatomical entrapment. In a "functional entrapment" surgery may or may not be therapeutic.

Adult↗
PubMedDate not supplied

Hepatitis C virus infection and cryoglobulinaemia.

Mixed cryoglobulins (CG) are serum proteins that precipitate at low temperature and are commonly classified into two types according to the presence (type II) or not (type III) of monoclonal immunoglobulins. Mixed CG are observed in a wide variety of diseases. Some mixed cryoglobulinaemia occurs without evidence of an underlying disease and is considered as essential mixed cryoglobulinaemia (EMC). Many studies have underlined the possible involvement of liver diseases in the pathogenesis of cryoglobulinaemia and particularly viral hepatitis. Recently, it has been shown that 50 to 80% of patients with EMC are in fact infected with HCV. It has also been shown that CG may be found in about 50% of patients infected with HCV. HCV-RNA genomic sequences are specifically concentrated in CG as well as IgG reactive with HCV-related proteins, and monoclonal IgM with rheumatoid factor (RF) activity. The monoclonal IgM RF detected in HCV infected patients is highly restricted to the same cross-idiotype OWAO. In addition to hepatocytes, HCV-RNA has been found in both peripheral blood and BM mononuclear cells. These cells could represent a reservoir of virus and may play a major role in viral persistence; they also could act as effectors of tissue injury in various organs. HCV shows high genomic variability. It is not clear whether these genetic variations have a significant clinical impact (i.e. severity of the disease) but there is evidence that they may influence both the efficacy of the host immune response and the interferon treatment response. The role of viral factors has been studied but a clear relationship between the presence of cryoglobulinaemia, the viral load or the HCV genotype have not been demonstrated. The frequency of clinical symptoms related to mixed cryoglobulinaemia reported in the literature is extremely variable according to the series. The striking association between HCV infection and mixed type II CG (usually considered as a benign lymphoproliferative disorder) and the occurrence of HCV infection in patients with NHL suggest that HCV could be involved in the pathogenesis of some malignant lymphoproliferative disease. The progression to malignancy probably involves the accumulation of multiple mutations facilitated by chronic antigenic stimulation. The efficacy of anti-viral treatment on both CG levels and related symptoms argue strongly that HCV is involved in the production of CG.

Antigens, Viral↗