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Biomedical subjects

J C Chaput

Publications and source records attributed to J C Chaput.

197 records · Page 11Linked to original sources
PubMedDate not supplied

[Evaluation of hepatitis B vaccination in a Paris hospital personnel. 386 subjects].

Among 471 healthy Antoine Béclère hospital workers, (61 male, 410 female) 386 with no serological markers for hepatitis B virus (HBV) received three intramuscular doses of HEVAC B at intervals of 1 month. Ninety-three p. cent of vaccine recipients showed good antibody anti-HBs levels after the third injection. Fifty p. cent of subjects with no response after the third dose seroconverted after a booster dose. Vaccine responders' mean age (30 years) was lower than vaccine non responders' mean age (36 years). Anti-HBs antibody levels were significantly higher in women (P less than 0.001) and were independently correlated with age and sex. Two vaccine recipients developed anti-HBc in addition to anti-HBs, probably due to an HBV infection that occurred just before vaccination.

Adult↗
PubMedDate not supplied

[Nd:YAG laser treatment of colorectal villous tumors].

Fifty-eight patients, 23 men, 35 women (mean age 76 +/- 10 yrs), with colorectal villous adenomas underwent endoscopic neodymium Yag laser therapy. In 50 patients with interpretable results, tumor ablation was complete in 45 p. 100 of extensive adenomas involving at least two thirds of the circumference and extending longitudinally for at least 4 cm, in 92 p. 100 of intermediate adenomas between 1 and 4 cm in diameter and in 100 p. 100 of small adenomas with diameter less than or equal to 1 cm. These patients had a mean follow up of 72 weeks (range 13-182 wks). Twelve adenomatous tissue recurrences occurred in 9 patients. In 10 of these recurrences, laser ablation was effective. Age, sex, dysplasia grade, macroscopic appearance, or tumor location did not influence the results which were related to the size of the villous adenomas. Four complications occurred: a symptomatic stenosis, an asymptomatic stenosis, an ileocaecal fistula and a rectal fistula near a colorectal anastomosis.

Adenoma↗
PubMedDate not supplied

[Multidimensional analysis by Cox's model of the survival of patients with alcoholic cirrhosis].

A group of 249 patients with alcoholic cirrhosis was prospectively studied in order to assess the prognostic value of 23 clinical and biochemical factors. Methods included the Cox model completed with validation by assessing the proportionality and by comparing the estimated and observed results, a study of the influence on the results of the truncated data and the factors with non normal distribution, and an expression of the results using predictive values. Results showed that encephalopathy, age, serum albumin and total bilirubin concentrations and serum gamma glutamyl transpeptidase activity had an independent prognostic value. The Cox model was validated and results showed that taking into account the truncated data and the non normal distribution modified the results. An index using the five independent prognostic factors had a good negative predictive value, permitting to predict, in one third of the patients, survival i. e. which patient had a probability to be alive at two years greater than 90 p. 100.

Factor Analysis, Statistical↗
PubMedDate not supplied

[Metabolism and kinetics of ampicillin elimination in cirrhosis. Therapeutical consequences (author's transl)].

In cirrhotic patients, the authors studied the modification of the pharmacokinetics of ampicillin in the plasma and in the ascitic fluid, as well as its concentration in the urine. The influence of the jaundice, the ascites and diuretics were studied. In cirrhosis, dilution and elimination of the antibiotic are modified, as is shown by the increase in T 1/2 alpha and T 1/2 beta. These anomalies seem to be due essentially to modifications in the distribution volume; the degree of hepatocellular insufficiency does not appear to be of importance. The ascites acts as an independent compartment, into which the antibiotic's passage is slight. The practical consequences are the following: less frequent injections, increasing of the fractionated doses, in situ injections of ampicillin in cases of infection of the ascitic liquid.

Ampicillin↗
PubMedDate not supplied

[Glomerular nephropathies and B virus: apropos of 4 cases in adults, with an immunofluorescence study and review of the literature].

The association of glomerulonephritis and persistent HBs antigenemia is reported in 4 adults with nephrotic syndrome: 2 cases of membranous glomerulonephritis associated with chronic persistent hepatitis and 2 cases of membrano-proliferative glomerulonephritis associated with active cirrhosis. In 3 patients, all positive for HBsAg, anti-HBc and HBeAg by radioimmunoassay, indirect immunofluorescent study was performed on kidney and liver biopsies. Glomerular deposit of HBcAg was detected in two cases. HBsAg and HBcAg were not found in the liver. The pathogenesis of such glomerulonephritis remains uncertain and the role of HBs antigen-antibody circulating immune complexes is not clearly proved. Two patients were treated with vidarabine intravenously. Vidarabine produced a transitory decrease of HBsAg concentration in 2 cases and a transitory loss of DNA-polymerase activity associated with a decrease of HBeAg concentration in one case. Neither seroconversion nor improvement of the glomerular disease were ascertained.

Adult↗
PubMedDate not supplied

[Palliative treatment of cancers of the esophagus and cardia with YAG neodymium laser. (Preliminary noncontrolled trial)].

The aim of this study was to report results of endoscopic YAG laser therapy in palliative treatment of esophageal and cardial carcinoma. Twenty-eight patients were treated: 9 with adenocarcinoma and 19 with squamous cell carcinoma. Among these patients, 9 had complete aphagia; radiotherapy was contraindicated in 17; in the remaining 2 patients the aim of laser therapy was to achieve sufficient luminal enlargement to allow the endoscopic insertion of a prothesis. Dysphagia improved in 24 cases; destruction of a major portion of the intraluminal tumor was achieved in 17 patients, and incomplete destruction was possible in 9 patients. In one case, the treatment had no effect. Among 22 subjects in maintenance treatment, 13 good results were obtained. Several complications of laser therapy were observed: 2 cases of minor bleeding, 2 cases of esophagitis and 1 perforation of the upper esophagus. The patient died after surgical operation. It is concluded that endoscopic YAG laser therapy for palliative treatment of esophageal and cardial carcinoma is effective, providing rapid improvement of dysphagia. Maintenance treatment is necessary to sustain the improvement. Randomized studies are now needed to compare endoscopic laser therapy with other palliative treatment of malignant tumors of the upper gastrointestinal tract.

Adenocarcinoma↗
PubMedDate not supplied

[Influence of apolipoprotein E polymorphism in alcoholic cirrhosis].

OBJECTIVE: To assess whether the polymorphism of apolipo-protein E was associated with the development of alcoholic cirrhosis and could influence the severity of liver injury evaluated by the Child-Pugh score. METHOD: We investigated 75 alcoholic patients with a histological diagnosis of cirrhosis, with negative HBV, HCV serology and a control group of 54 subjects. Polymorphism of apolipoprotein E was performed using PCR. RESULTS: There was no difference for the allele frequency and the genotype in the cirrhotic group and the control group. Cirrhotic patients with allele epsilon 2 had higher concentration of albumin (P = 0.01) and a higher level of apolipoprotein AII (P < 0.05) than those with allele epsilon 3. They also had a higher concentration of apolipoprotein AI than cirrhotic patients with allele epsilon 3 and epsilon 4 (P = 0.01). There was a statistical difference between the three genotype groups for prothrombin time (P = 0.01). There was no statistical difference between the three genotype groups for Child-Pugh score. CONCLUSIONS: Polymorphism of apolipoprotein E was not associated with the development of alcoholic cirrhosis. However patients with allele epsilon 2 had better hepatocellular function.

Adult↗