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Biomedical subjects

H Lambert

Publications and source records attributed to H Lambert.

At least 163 records · Page 9Linked to original sources

[Light and electron microscopic study of hepatic lesions in the course of hyperlactatemia in diabetic patients (author's transl)].

Histopathological study of the liver has been undertaken on twenty-one diabetics with hyperlactatemia exceeding 5 mEq/1 of whom seven were treated with phenformin, six with metformin and eight not biguanide-treated. Hyperlactatemia occurred during the course or during resolution of severe ketoacidosis or of hyperosmolar coma. Hepatic lesions were invariably present. By light microscopy, massive steatosis, steatonecrosis or necrosis of variable extent were observed. Ultrastructural study showed constant mitochondrial abnormalities. These results support the hypothesis of a major role for mitochondrial changes in hepatic cells in provoking pathological hyperlactatemia. In diabetic patients, these mitochondrial lesions could be induced either by an anoxic process resulting from a variety of metabolic insults or by some as yet undefined toxic action of biguanides or by the combination of both of these factors.

Adult↗

[Phalloidian toxins].

The phalloidian toxins are very complex. The classification proposed by Wieland distinguishes between the various amatoxins and phallotoxins. The authors study successively: Methods of isolation, the general structure and chemical composition, their localization and concentration in mushrooms. This is an analytical study of the phallotoxins and amadoxins. Various experimental intoxication protocols using total extracts of the toxins purified with different doses and different animals have revealed the main signs of experimental intoxication with phallotoxins. This is characterized especially by hepatic and renal lesions. The phallotoxins have a more specific action on the cell membrane and metabolism. The amatoxins have a more specific action on the cell nucleus and protein synthesis. The action on DNA dependent RNA polymerases is particularly characteristic.

Amanita↗

[Compared study of micro-aggregates filters (output, filtration pressure and study of the deposit with scanning electron microscopy) (author's transl)].

Special filters for the elimination of cellular aggregates were conceived especially to prevent pulmonary complications in patients shocked particularly after massive transfusions as well as to prevent cerebral complications after extra-corporeal circulation. The performances and the conditions of use of these filters (perfusion output, change of the filter) were considered. Four filters were carefully studied: the Fenwal filter, the Swank filter, the Biotest filter and the intersep Johnson and Johnson filter. The following studies were carried out for each filter: the perfusion output (of three bottles filtered one after another with or without pressure); the filtration pressure (Swank technique) of the whole blood up-and-down filter; the viscosity and various hematologic parameters (NF, hemoglobin and gobular ATP); finally, the deposit was studied morphologically with scanning electron microscopy. It appeared that a good capacity of aggregates elimination (decrease of the filtration pressure of 95%) was often linked to a feeble output and the necessity of replacing the filter. The efficacy of the Fenwal filter, the Swank filter, the Biotest filter and the intersept filter was practically the same, but the Intersept filter provided the best output with an equal filtration capacity. The other parameters remained about the same. The deposits included fibrinogen, deformed red blood corpuscules (echinocytes), leucocytes and platelets.

Blood Transfusion↗

Acute intoxication by phenformine hyperlactatemia reversible with extra-renal purification.

The authors report the observation of an acute intoxication with 25.5 g of metaformin, 2.5 g of phenobarbital and 12.5 g of belladonna extract in a 53 year-old diabetic patient having been treated with metformin for 5 years. The evolution was dominated by the association of a barbituric coma with an hyperlactatemia which reached 21 mmol/l during the 18th hour and normalized at the 36th hour thanks to an hemodialysis on polyacrilonitrile membrane, which was carried out for 24 hours. The biological evolution was determined in considering the barbitemia, lactacidemia and metforminemia rates. An hepatic biopsy made during the decrease of the hyperlactatemia enabled to consider histological lesions of steatosis and ultrastructural lesions of mitochondrial alteration, already described in the course of pathological hyperlactatemia.

Humans↗

[Acute renal failure and consumption coagulopathy in the puerperium].

Disseminated intravascular coagulation accompanied 18% of cases of acute renal failure during puerperal disorders. We studied in particular 31 cases of disseminated intravascular coagulation with renal failure due to obstetric disorders : 12 post-abortion infections, 3 retentions of a dead foetus, 5 infections, 6 cases of toxemia, 2 retroplacental hemorrhages, two hemorrhages during the third stage, one uremohemolytic syndrome. For diagnosis one relies on the clinical data (bleeding, purpura, shock, hemolysis, visceral involvement) and laboratory data, (coagulation should be supervised throughout the course). The renal lesions are either cortical necrosis, or interstitial nephritis. The analogies with experimental phenomena suggest a human equivalent of the Schwartzmann-Sanarelli syndrome.

Acute Kidney Injury↗

[Heat stroke and disseminated intravascular coagulation. Apropos of 2 cases].

Two cases of fatal heat stroke, concerning a 20 year-old soldier and a 44 year-old psychiatric patient, treated with neuroleptics, are reported. The clinical picture, starting suddenly with coma and hyperthermia, was quite identical for both. Secondarily, while hyperthermia decreases and the conscience improved partially, an hemorrhagic syndrome similar to a consumption coagulopathy, acute renal insufficiency and acute hepatic failure appear. Death occurred after aggravated neurological disorders and respiratory distress. The anatomical lesions spread on all the viscera include tubular nephritis, and hepatic centro-lobular necrosis and an interstitial and alveolar oedema with hemorrhages and hyaline membranes in the lungs.

Acute Kidney Injury↗