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Biomedical subjects

I Besson

Publications and source records attributed to I Besson.

34 records · Page 2Linked to original sources
PubMed1993

Treatment and long-term outcome of chronic radiation esophagitis after radiation therapy for head and neck tumors. A report of 13 cases.

The natural history of chronic radiation esophagitis occurring in previously normal esophagus is still unknown. We describe here the long-term outcome of chronic esophagitis arising after neck irradiation for oropharynx and larynx carcinomas in 13 consecutive adult patients. The first clinical signs of radiation esophagitis were dysphagia or impossibility of oral intake, which appeared within 26 months (range 2-120 months) after the end of radiation for pyriform fossae carcinoma (N = 5), tonsil carcinoma (N = 2), larynx carcinoma (N = 2), pharynx carcinoma (N = 2), base of the tongue (N = 1), and thyroid carcinomas (N = 1). During upper endoscopy, an esophageal stenosis was found in 11 cases and was associated with ulceration in three cases. An isolated esophageal ulceration was present in only two cases. Chronic radiation esophagitis diagnosis was confirmed by histology and surgery in seven cases. In the last six cases, diagnosis was supported by the absence of first cancer relapses within a median follow-up of two years (16 months to nine years) and by endoscopic findings. Seven patients received parenteral or enteral nutrition. Ten patients were treated by peroral dilatations. These treatments allowed nearly normal oral diet in 11/13 patients. Only one patient was lost of follow-up after 20 months. Four patients died from chronic radiation esophagitis. One of these patients died from massive hemorrhage after peroral dilatation. Four patients died of a second carcinoma with no first cancer recurrence. Four patients were alive after six months to nine years of follow-up. Moderate dysphagia was still present, allowing nearly normal oral feeding.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Immunophenotyping study of bone marrow fractions obtained by elutriation in allogeneic bone marrow transplantation].

PURPOSE: Bone marrow transplantation (BMT) is an effective treatment for acute and chronic leukaemias. Lymphocyte depletion of donor bone marrow for preventing GVHD has been associated with a higher incidence of relapse after allogeneic BMT. This association suggests an antileukaemic effect of donor lymphocytes. In vitro studies show that cytotoxic T lymphocytes (CD3+ CD56+) and NK cells (CD3-CD56+) have an antileukaemic effect. To know which specific subpopulation of lymphocytes are depleted by counterflow centrifugation or elutriation, we analysed B, T, NK cells and hematopoietic precursors in the marrow fractions after this procedure. PATIENTS AND METHODS: Eight patients (6 CML, 1 ALL, 1 B-CLL) received an allogeneic BMT with lymphocyte depletion of the bone marrow graft using elutriation. After a Percoll gradient, donor marrow mononuclear cells (MNC) were separated with this method in five fractions (F1 to F5). RESULTS: Lymphocyte depletion of donor marrow was in average of 1.7 log. This depletion was also selective, the last fraction containing higher number of cytotoxic T lymphocytes and NK cells than the other fractions. Recovery of CD34+ cells in the four fractions concerning to post-Percoll marrow was 84%, most of them being in the last fraction. CONCLUSIONS: The use of elutriation for lymphocyte depletion is a good method for graft manipulation with the feasibility to adjust a lymphocyte/Kg. dose. Elutriation may be effective in reducing the incidence and severity of graft versus host disease and preserving the antileukaemic effect.

Adult↗
PubMed1993

[Evaluation of a commercial kit for performing in vitro bone marrow cultures].

The efficiency of the GIBCORkit "Human Bone Marrow Stem Cell Proliferation Kit" for haemopoietic progenitors cultures, has been assessed in 24 bone marrow samples. The results, compared with those obtained in a parallel study with the routine method used in our laboratory (reference method), suggests that the kit has higher capacity for detecting haemopoietic progenitors, which is due to the increased number of BFU-E (108 +/- 78 vs 23 +/- 23, p < 0.0001). Total CFU-GM (considered here as the sum of CFU-G and CFU-M), do not differ significantly from the reference method (70 +/- 64 vs 77 +/- 64, p = 0.60) despite its increased CFU-G growth (25 +/- 26 vs 67 +/- 54, p < 0.0001). The finding of similar results in a multicentric study may contribute to demonstrate the advantages of this standardized method in the clinical practice.

Bone Marrow↗
PubMed1992

Long-term outcome of severe radiation enteritis treated by total parenteral nutrition.

The outcome of 31 patients with severe radiation enteritis treated by total parenteral nutrition (TPN) was analyzed. Before initiation of parenteral nutrition, 18 of the patients had not had abdominal surgery, while 13 had either a resection or an intestinal bypass for radiation enteritis. Median follow-up was 2 1/2 years (range: 1 month to 12 years) from the time of initiation of parenteral nutrition. Surgery was required in 15 cases because parenteral alimentation could not be continued. Only eight of these 15 were able to resume a normal oral intake. Total parenteral nutrition allowed oral feeding to be resumed in 11 (36%) after a median follow-up of 40 months (range: 6-142 months). In general, total parenteral nutrition was well tolerated and was associated with low morbidity. Eighteen patients died, 13 of complications due to radiation therapy, four of cancer recurrence, and one of an unrelated cause. Survival probability was 58% at one year and 36% at five years. When possible, prognostic factors present either before or at initiation of total parenteral nutrition were analyzed. Age, predisposing vascular factors (hypertension, diabetes mellitus, or vascular disease), and enteric fistula and/or perforation were found to have prognostic value. The probability of clinical radiation enteritis recurrence was 34% at one year and 47% at two years. A clinical recurrence of symptoms was more frequent but not significantly so after parenteral nutrition as compared to surgical therapy of radiation enteritis. Although TPN corrected denutrition and allowed deferred surgery in some patients, severe radiation enteritis remains a poorly predictable progressive disease with numerous relapses.

Enteritis↗
PubMed1991

Occurrence of hereditary leaky red cell syndrome and partial coagulation factor VII deficiency in a Spanish family.

A Spanish family was found to have the coexistence of a hereditary haemolytic syndrome associated with excessively leaky RBC membrane to sodium (Na+) and potassium (K+) cations and a partial coagulation factor VII deficiency. Haemolysis was mild in the propositus and the RBC membrane leak included a marked increase in passive permeability to Na+ and K+. This was associated with an increase in active Na+,K(+)-pump activity and in the ouabain-resistant fluxes: Na+, K(+)-cotransport and Na+, Li(+)-countertransport. Factor VII deficiency was of 50% and no clinical expression of the coagulation deficiency was observed. The family study revealed slightly abnormal RBC membrane cationic fluxes only in the father and decreased coagulation factor VII activity of 67% in the mother. Both parents were clinically and haematologically normal. It is suggested that the propositus has inherited the abnormal gene for leaky RBC syndrome from the father and the partial coagulation factor VII deficiency from the mother.

Anemia, Hemolytic, Congenital↗
PubMed1991

[Central neurologic forms of Waldenström's disease. Bing-Neel syndrome. 3 cases].

Three cases of central nervous system involvement in Waldenström's macroglobulinemia (Bing Neel's syndrome) are reported. Such cases are unusual and have a poor prognosis. One patient received chemotherapy including BCNU, cyclophosphamide, vincristine, melphalan and prednisolone, which was followed by a dramatic improvement. The pathogenesis of Bing Neel's syndrome is discussed.

Aged↗
PubMed1984

[Immunoblastic lymphadenopathy occurring during treatment with carbamazepine. 2 cases].

Dysimmune lymphadenopathies during carbamazepine treatment. A report of two cases. We report on two cases of dysimmune lymphadenopathies with histological aspect of angio immunoblastic lymphadenopathy (AIL) developing after administration of carbamazepine. Clinical manifestations consisted of fever, erythroderma, generalized pruritus, facial edema, lymphadenopathy, liver enlargement. The two patients had anemia, hypogammaglobulinemia, impaired liver function and a negative Coomb's test. Lymphocyte stimulation test with carbamazepine in vitro was positive in both cases. Lymph node biopsy disclosed the angioimmunoblastic proliferation characteristic of AIL. After discontinuing carbamazepine, a complete remission was obtained.

Carbamazepine↗
PubMedDate not supplied

Characterization of water distribution in cell pellets using nonlabeled sodium thiosulfate as an interstitial space marker.

A procedure for determination of the intracellular water content of cells using a single, nonlabeled solute as an interstitial space marker is proposed. Sodium thiosulfate, which can be accurately assayed by a tritrimetric method, is found to be a good compound for this purpose. Cells are recovered both by filtration and centrifugation; the two techniques gave the same value for internal water, i.e., 650 mg of H2O/g of wet matter for Corynebacterium melassecola and 390 mg of H2O/g of wet matter for Penicillium roquefortii spores. The methodology of data handling, based on a regression technique, is also described. It allows one to obtain very reliable results and should be useful for any marker.

Biotechnology↗
PubMedDate not supplied

[Treatment of hepatitis C virus infection in the Poitou- Charentes region].

OBJECTIVES: The prognosis of hepatitis C virus infection could be improved by early treatment. However, this is only possible if most patients with hepatitis C consult a specialized institution. The aim of this study was to evaluate the modalities of care of hepatitis C virus infection in one French district. METHODS: Between November and December 1997, 89 biological laboratories from the "Poitou-Charentes" district were asked to provide results of hepatitis C virus serology tests performed during this period. A questionnaire concerning epidemiological and follow-up data was sent to the medical practitioner who prescribed the test, for all positive tests. RESULTS: Seventy eight out of 89 (88%) laboratoires agreed to participate in the study. During the study period, 6,168 subjects were tested and 196 (3.2%) were positive. This test was a diagnostic test in 69 cases (53%) and a confirmation test in 61 cases (47%). The epidemiological questionnaire was filled out in 130 cases. The main putative factors of viral contamination were: intravenous or nasal drug addiction in 69 cases (53%), blood transfusion in 39 cases (30%), and a nosocomial risk factor in 16 cases (12%). Treatment and care of virus infection was evaluated in 113 cases from the follow-up questionnaire: a liver biopsy was performed in 30 cases (27%) and interferon therapy was administered in 13 cases (12%). Liver biopsy was not performed in 83 cases (73%) due to normal transaminase levels or a contraindication to interferon therapy. The main causes of an absence of care or follow-up were: fear of complications of liver biopsy and/or side effects to interferon therapy (19%), chronic alcoholism (18%) and active drug addiction (8%). CONCLUSION: The main causes of failure to administer adequate care in hepatitis C patients were chronic alcoholism, drug addiction and fear of liver biopsy or side effects of interferon therapy. These data should be taken into account for future screening or information compaigns for the general population.

Adult↗
PubMedDate not supplied

[Blink reflex and jaw reflex in neurinoma of the acoustic and trigeminal nerves (author's transl)].

The blink reflex was studied in four patients with neurinoma of the acoustic nerve and in two patients with trigeminal neurinoma. It was abnormal in all cases except in one neurinoma of the acoustic nerve inside the canal. The jaw reflex, studied in four cases, showed unilateral impairment in two cases of trigeminal neurinoma and one case of acoustic neurinoma; it was normal in the case of acoustic neurinoma in the canal. The blink reflex and jaw reflex merit inclusion among the further tests conducted in cases of suspected neurinoma of the trigeminal or acoustic nerves. However, they are of less interest than oto-vestibular tets in the early diagnosis of neurinoma of the eighth nerve. These techniques deserve a place of choice in investigations of atypical facial neuralgia in general and suspected neurinoma of the trigeminal in particular.

Adult↗