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Biomedical subjects

H Michel

Publications and source records attributed to H Michel.

At least 307 records · Page 17Linked to original sources
PubMed1985

[Urinary prostaglandins in the hepatorenal syndrome of cirrhotic patients: role of thromboxane A2 and an imbalance of precursor polyunsaturated fatty acids].

The hepatorenal syndrome is considered to be a functional renal failure due to active renal vasoconstriction. The purpose of this work was to study the urinary elimination of prostaglandins and the plasmatic polyunsaturated fatty acid precursors of prostaglandins. The urinary elimination of PGE2 was not significantly different in the groups of patients studied: controls, group I (193 +/- 42 ng/24 h), cirrhotic patients without ascites, group II (274 +/- 43 ng/24 h), cirrhotic patients with ascites, group III (269 +/- 41 ng/24 h). The urinary elimination of PGE1 and PGF2 alpha varied in the same way as PGE2. In cirrhotics with hepatorenal syndrome (group IV) the urinary elimination of vasodilating prostaglandins was greatly decreased (p less than 0.001); PGE2 (53 +/- 16 ng/24 h), PGE1 (65 +/- 11 ng/24 h). The urinary elimination of PGF2 alpha was also decreased (293 +/- 75 ng/24 h). On the other hand, the urinary elimination of thromboxane, a vasoconstrictor, increased progressively from group I (287 +/- 75 ng/24 h) to group IV (980 +/- 266 ng/24 h) (p less than 0.05). Plasmatic arachidonic acid was significantly decreased in group IV (5.0 +/- 0.6 p. 100) compared to group I (10.0 +/- 0.6 p. 100) (p less than 0.001), to group II (10.3 +/- 0.5 p. 100) (p less than 0.001), and to group III (8.5 +/- 0.7 p. 100) (p less than 0.05). In conclusion, in hepatorenal patients, urinary excretion of a vasoconstricting prostaglandin (thromboxane) is increased while urinary excretion of vasodilating prostaglandins is decreased. This decrease could be secondary to a lack of plasmatic arachidonic acid, precursor of prostaglandins.

Acute Kidney Injury↗
PubMed1984

X-ray structure analysis of a membrane protein complex. Electron density map at 3 A resolution and a model of the chromophores of the photosynthetic reaction center from Rhodopseudomonas viridis.

X-ray analysis of three-dimensional crystals of the photosynthetic reaction center from the purple bacterium Rhodopseudomonas viridis led to an electron density distribution at 3 A resolution calculated with phases from multiple isomorphous replacement. The protein subunits of the complex were identified. An atomic model of the prosthetic groups of the reaction center complex (4 bacteriochlorophyll b, 2 bacteriopheophytin b. 1 non-heme iron, 1 menaquinone, 4 heme groups) was built. The arrangement of the ring systems of the bacteriochlorophyll b and bacteriopheophytin b molecules shows a local 2-fold rotation symmetry; two bacteriochlorophyll b form a closely associated, non-covalently linked dimer ("special pair"). A different local 2-fold symmetry axis is observed for the heme groups of the cytochrome part.

Bacterial Proteins↗
PubMed1984

[Clinical use in adults of 2 new muscle relaxants: atracurium and vecuronium].

115 general and urologic surgery adult patients, ASA class I-II, were divided in four groups according to initial bolus and relaxant used: group A atracurium 0.6 mg X kg-1, group B 0.5 mg X kg-1, group C vecuronium 0.1 mg X kg-1 and group D pancuronium 0.1 mg X kg-1. When the single twitch recovered to 25% of control height (T25), subgroups were individualized depending on whether repeat doses of 1/3 of initial bolus were given or not, and whether reversal was spontaneous or obtained by a standard dose of neostigmine 2.5 mg and atropine 1.25 mg. By ulnar nerve stimulation at the wrist, the force of thumb adduction was recorded on a polygraph; single twitch (tw), train of four (tof) and ratio tof 4/1 (Rtof) were measured. Anaesthesia was induced with thiopentone and fentanyl without premedication and maintained with fentanyl and N2O in oxygen; the trachea was intubated once the block was at its maximum. The onset time of maximal block was 5 min for groups A, B and C, and 7.9 min for group D. T25 was 39.9 +/- 8.5 min for group A, 34.4 +/- 9.7 min for group B, 28.9 +/- 9.9 min for group C and 70.7 +/- 25.9 min for group D. A Rtof equal to 75% was achieved in less than 65 min with atracurium and vecuronium, but much later with pancuronium. Reversal at T25 was efficient, but not really required, for atracurium and vecuronium, but necessary and useful for pancuronium.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Pseudohyperaldosteronism induced by alcohol-free aniseed aperitif in alcoholic cirrhotic patients].

The authors report 2 cases of pseudohyperaldosteronism secondary to consumption of alcohol-free "pastis" in abstinent alcoholic cirrhotics. In both cases patients presented with ascites, edema, increased blood pressure and hypokalemic alkalosis. Except for hypokalemia, the disorders improved rapidly after withdrawal of the beverage. Glycyrrhizic acid, present in little amounts in the beverage, is presumably responsible for this syndrome. Patients with alcoholic cirrhosis would be particularly at risk. It is suggested that alcohol-free "pastis" could be responsible for ascites and edema in cirrhotic patients. This drinking habit should be looked for in abstinent cirrhotic patients with ascites, particularly in case of associated systemic hypertension.

Beverages↗
PubMed1984

[Acute renal failure and hepatitis induced by clometacin].

Various types of allergic accidents have been reported with clometacin (Duperan), a synthetic analgesic introduced in France in 1971. The most prominent is hepatitis in elderly women, with hyperglobulinemia, eosinophilia, autoantibodies and giant multinucleated hepatocytes. The case presented herein concerns a 73-year-old woman who, on two separate occasions after the ingestion of clometacin at recommended dosages, developed at the same time typical acute hepatitis and non-oliguric acute renal failure. The second episode came soon after the medication was inadvertently reintroduced. Both hepatic and renal involvements were fully reversible. A renal biopsy showed predominant lesions of acute interstitial nephritis and tubulonecrosis. Three possible mechanisms are discussed: 1) sensitivity of the kidney to drugs because of preceding angiosclerosis, 2) impaired regulation of renal blood flow because of clometacin provoked decrease of prostaglandin synthesis, and 3) as in the case of nephrotoxicity due to other medications, allergic mechanisms.

Acute Kidney Injury↗
PubMed1983

[Transparietal biliary drainage. 27 cases].

During a 2-year period, 27 patients with obstructive jaundice (due to cancer in 27) underwent transhepatic biliary drainage with an 85% success rate. Most of the failures occurred in early attempts and were due to lack of experience. In neoplastic obstructive jaundice, endoprosthesis proved superior to external drainage: jaundice regressed more frequently and more completely, the patients' comfort was improved, survival was significantly prolonged and complications were less frequent. Per-operative biliary drainage, used in a controlled trial, proved useless, as patients developed cholangitis.

Adult↗
PubMed1983

[The hepatorenal syndrome].

The hepatorenal syndrome is a renal failure in patients with decompensated cirrhosis. It is characterized by the absence of histological lesions of the kidneys and a poor prognosis. The functional renal failure is due to active cortical vasoconstriction, the mechanism of which is unknown. Blockade of prostaglandins, which are vasoactive substances necessary to maintain a normal renal blood flow, results in a transient hepatorenal syndrome in cirrhotic patients with ascites. Leukotriens, which are vasoconstrictive substances, might play a major causative role. There is, as yet, no specific treatment.

Diagnosis, Differential↗
PubMed1983

Comparison of six treatments of ascites in patients with liver cirrhosis. A clinical trial.

UNLABELLED: A national multicenter study (34 centers) compared six treatments in 328 patients with cirrhotic ascites. Excluded were patients with g.i. bleeding within the last six months, chronic encephalopathy, cancer, tuberculosis or the following complications persisting after three weeks: acute encephalopythy, fever greater than 38 degrees C, infected ascites or biochemical abnormalities: blood urea greater than 8 mmol/l, natremia less than 130 mmol/l, kaliemia less than 2.5 or greater than 5.5 mmol/l, WBC greater than 12000 mm3, total bilirubin greater than 85.5 mumol/l. In each center patients were randomized into two treatment groups, each center using 2 of 6 proposed treatments: (1) Spironolactone and 500 mg Na p.d (77 patients), (2) Spironolactone + furosemide or Moduretic (amiloride + hydrochlorothiazide) and 500 mg Na p.d (80 patients), (3) Spironolactone + Furosemide or Moduretic and unrestricted sodium diet (86 patients), (4) Concentrated ascites reinfusion and 500 mg Na p.d. (36 patients), (5) Unmodified ascites reinfusion and 500 mg Na p.d. (23 patients), (6) Slow ascites drainage and 500 mg Na p.d. (31 patients). Statistical analysis methods were X2, variance analysis and Spotvoll-Stoline and Dunn-Sidak tests. Before treatment, there was no significant difference between the 6 groups. RESULTS: After one month of treatment, no difference was found in the frequency of total or partial regression of ascites, complications of cirrhosis, mortality, acceptability of treatment. Mechanical treatments induced more rapid weight loss but more frequent recurrence; comparison of groups 2 and 3 did not confirm any benefit associated with unrestricted Na diet. Duration of treatment and hospitalization were shorter in group 4 than in groups 3 and 6.

Amiloride↗
PubMed1983

[Anemia caused by acanthocytosis in the cirrhotic patient: diagnosis and prognostic significance. 3 cases].

The authors report the cases of 3 patients with severe alcoholic cirrhosis and spur cell anemia. The spur cell anemia must be suspected when there is haemolytic anemia, highly macrocytic with normal serum level of cholesterol and without fatty liver. The cytologic confirmation is difficult even with a phase contrast microscope. The evolution did not exceed 7 and 8 months in 2 cases; the third patient is still alive but quite sick after 1.5 year. These data lead us to point out the difficulty of the diagnosis by routine light microscopy and to remind the poor prognosis after the spur cell anemia is discovered, as documented in the literature.

Acanthocytes↗
PubMed1982

[Zieve's syndrome and acute alcoholic hepatitis (author's transl)].

Zieve's syndrome, characterized by jaundice, hyperlipaemia and haemolytic anaemia, usually develops in young, chronically alcoholic subjects with enlarged fatty liver. Hitherto, the course of the disease was considered favourable in most patients, with complete regression of clinical, biological and anatomical symptoms. However, the discovery of acute alcoholic hepatitis during repeat needle-biopsy of the liver confirms that in some cases steatosis may mask hyaline necrosis and neutrophil infiltration. Zieve's syndrome therefore is not benign but precedes acute alcoholic hepatitis episodes on a normal, fibrotic or cirrhotic liver.

Acute Disease↗
PubMed1982

[Treatment of cholesterol gallstones with ursodesoxycholic acid (author's transl)].

A double-blind clinical trial comparing ursodesoxycholic acid and chenodesoxycholic acid in patients with cholesterol stones in the gall-bladder showed that ursodesoxycholic acid was superior to the older drug not so much in percentage of biliary calculi dissolved but in dosage reduction (50%) and improved clinical and biological tolerance.

Chenodeoxycholic Acid↗
PubMed1982

[Hepatitis caused by Campylobacter coli (author's transl)].

Campylobacter coli is known to cause ulcerous enterocolitis, but hepatitis has not yet been reported. A 50-year-old woman without history of liver disease was admitted with diarrhoea, fever, poor general condition, subicterus and enlarged liver. Campylobacter coli was grown in haemoculture, and a specific antibiotic treatment resulted in complete cure. The results of haemoculture, the necrosis and polymorphonuclear infiltrates found in liver biopsies, the return to normal of biochemical tests and liver size under antibiotic therapy and the absence of any other cause of acute or chronic liver disease are strong arguments in favour of the hepatitis being caused by Campylobacter coli in this patient.

Campylobacter Infections↗