Search PubMed⌕ Search

Biomedical subjects

J Laurent

Publications and source records attributed to J Laurent.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Proteinuria selectivity index: prognostic value in idiopathic nephrotic syndromes].

In INS, the histological appearance constitutes a classical prognostic element: minimal-change nephropathy (MCN) responds better to treatment than focal glomerulosclerosis (FGS) or IgM nephropathy (IgMN). However, this criterion is not consistent. We evaluated the prognostic value of the proteinuria selectivity index (SI): the ratio of IgG clearance to transferrin (Tf) clearance. Proteinuria was selective for an SI less than or equal to 0.01. In the 39 MCN, the SI ranged from 0.01 to 0.39 (median 0.10) and proteinuria was selective in 21 cases. In the 13 FGS and IgMN, the SI varied from 0.05 to 0.40 (median 0.22) and proteinuria was selective in 1 case (p less than 0.01 between these two groups). The SI ranged from 0.01 to 0.17 (median 0.07) for the 25 corticosensitive (CS) forms and from 0.08 to 0.40 (median 0.20) for the 27 corticoresistant (CR) ones (p less than 0.001). Twenty-four of the 30 MCN patients and 19 of 22 cases of selective proteinuria were CS. Multivariant analysis enabled the identification of variables predictive of the response to steroids. Age, sex and level of proteinuria had no such value. The predictive value of the SI was greater than that of the histological appearance (McFadden's R-square, 47 versus 22%, p less than 0.001). When the histological aspect was known, the SI provided additional precision, but the reverse situation was not true. The predictive curve of CS as a function of the SI was sigmoidal, therefore reflecting a homogeneous distribution, despite their different histological types.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

[Hereditary angioneurotic edema. Recent progress in diagnosis and treatment. Importance of a national registry].

The hereditary angioneurotic oedema is an exceptional disease of deadly risk from glottic oedema. The diagnosis is based on a very low serum C4, with collapsed C1 INH for a patient who has repeated attacks of Quincke's oedema or pseudo occlusive digestive crisis. These crisis are prevented by taking anabolic steroids and must be treated when they are serious by intravenous C1 INH. The recent contributions of the immunogenetic and the interest of a national registry are underlined.

Angioedema↗
PubMed1990

[Idiopathic nephrotic syndrome. Effect of oral cromoglycate].

The occurrence of idiopathic nephrotic syndrome may be due to environmental antigens, and in particular to the ingestion of certain foods, as indicated by the result of food eviction tests. This led us to prescribe oral cromoglycate (800 mg/day for 2 weeks) combined with the avoidance of specific foods. Twelve patients with corticosteroid-dependent (n = 6) or corticosteroid-resistant (n = 6) idiopathic nephrotic syndrome with proteinuria greater than 1.50 g/24 h were thus treated without modification of steroid dosage. In 3 of these patients hypersensitivity to certain foods had previously been demonstrated. In 5 of the 12 patients, proteinuria was reduced by more than 50 percent; these 5 patients had received cromoglycate for 2 weeks with a free diet. After evictions were stopped, 3 patients relapsed; in 2 cases proteinuria remained absent. In 3 of the 12 cases, we subsequently used cromoglycate and evictions in corticosteroid-dependent patients in complete remission by gradual reduction of steroid dosage in the hope of lowering the dependence threshold. In one patient, the corticosteroid therapy could be discontinued during 3 months without relapse; in the other 2 patients no effect was observed. Thus, oral cromoglycate could be used together with food eviction in certain cases of idiopathic nephrotic syndrome, this being a therapeutic approach as well as a diagnostic test.

Administration, Oral↗
PubMed1990

Long-term outcome after surgery for biliary atresia. Study of 40 patients surviving for more than 10 years.

To define long-term prognosis of children who underwent surgery for biliary atresia, a retrospective study was undertaken in 122 children who underwent one of the Kasaï procedures between 1968 and 1977. Forty of the 122 children (32.7%) were alive after 10 years. Firm hepatomegaly was present in 31 and splenomegaly in 29 children. Serum bilirubin or all liver function tests were normal in 21 and 11 children, respectively; survival rate decreased with the age at operation, but no significant difference was observed in the rate of children surviving with normal serum bilirubin whether they underwent surgery before age 2 months or between 2 and 3 months. Twenty-four had esophageal varices and 15 experienced gastrointestinal bleeding. Normal liver-function tests and absence of portal hypertension were observed in 11 of 122 children. These results indicate that Kasaï's procedures were helpful in a significant proportion of children with biliary atresia who underwent surgery during this period. However, 80% of children who initially underwent surgery with Kasaï's procedures should eventually undergo liver transplantation.

Adolescent↗
PubMed1990

Behavioral effects induced by beta CCE in free or restrained rhesus monkeys (Macaca mulatta).

Behavioral effects of the IV injection of beta carboline carboxylic acid ethyl ester (beta CCE) were studied in chair-restrained rhesus monkeys and in rhesus monkeys freely moving in their cages. Observations made during the administration of increasing doses of beta CCE (0.5, 1 and 2 mg/kg) evidence behaviors reflecting a state of anxiety. The similarity of results obtained under the two experimental conditions excludes a potential effect of restraint on the behavioral expression of effects induced by the administered molecule. Convulsions observed in three subjects out of twelve should call for great caution when using this molecule.

Animals↗
PubMed1990

Cloning of a large gene cluster involved in Erwinia amylovora CFBP1430 virulence.

Phage MudIIPR13 insertional mutagenesis of Erwinia amylovora CFBP1430 allowed us to isolate 6900 independent CmR mutants. The frequencies of different auxotrophs in this population indicated that MudIIPR13 had inserted randomly in E. amylovora. Screening of 3500 CmR mutants on (i) apple calli and (ii) pear and apple seedlings led to the isolation of 19 non-pathogenic prototrophic single mutants, four of which expressed a LacZ+ hybrid protein. Expression of the fusion proteins was temperature sensitive. The 19 mutants could be separated into two classes according to their behaviour on tobacco: 13 were unable to elicit the hypersensitive response on tobacco (Hrp-) while six still could (Dsp-). The 19 MudIIPR13 insertions all mapped in the same virulence region. The MudIIPR13 insertions of Hrp- mutants were all clustered on the left part of this region, while the MudIIPR13 insertions of Dsp- mutants were located on the right part. All of the mutants except one, which proved to have a large deletion of the entire virulence region, could be complemented functionally by cosmids from an E. amylovora CFBP1430 genomic library. No hybridization was observed between the cosmid pPV130, which complemented 12 hrp::MudIIPR13 mutations, and the hrp genes from Pseudomonas syringae pv. phaseolicola (Lindgren et al., 1986), P. syringae pv. tomato (N.J. Panopoulos, unpublished data) or P. solanacearum (Boucher et al., 1987). Further analysis of the large virulence region will allow mapping of the border of the virulence region and facilitate the study of the function and regulation of the hrp and dsp genes.

Cloning, Molecular↗
PubMed1990

[Proteinuria selectivity: description of a new index].

An improved simple method for determination of selectivity index has been described. This new index (Creteil index) has been compared to Cameron index. The correlation between both indexes has been 0.949 (R-squared). Creteil index is a less expensive method because only two determinations are requisited in serum and urine: albumin and IgG. In Cameron index, transferrin and IgG are detected and albumin has to be measured in addition in the blood to appreciate the nephrotic syndrome.

Albumins↗
PubMed1989

Comparative study of suture and laser-assisted anastomoses in rat sciatic nerves.

Conventional suture repair of peripheral nerves results in a fibrotic reaction that is detrimental to nerve regeneration. As an alternative procedure known as "laser-assisted" repair, a laser can be used, along with a reduced number of sutures, to reanastomose served peripheral nerves. To explore the long-term implications of this technique, the right sciatic nerves of Sprague-Dawley rats were surgically cut and reanastomosed either by means of four epineurial sutures or two epineurial sutures and CO2 laser welds. Tensile strength, electrophysiology, histology, and functional studies were performed up to 11 months postoperatively. Tensile strength measurements indicate no long-term disadvantage with the laser-assisted technique, although the short-term tensile strength is lower than with conventional suture repair. The conduction velocities of the repaired nerves were similar for both techniques; however, laser-assisted repaired nerves were found to have lower stimulation thresholds and reduced branching compared to the suture repaired nerves. The measured functional recovery was similar for both repair techniques.

Anastomosis, Surgical↗
PubMed1989

Dietary manipulation for idiopathic nephrotic syndrome. A new approach to therapy.

To evaluate the role of food antigens in idiopathic nephrotic syndromes, we used dietary manipulations in 26 cases in whom steroid therapy had failed. In the six reported, restricted diets according to clinical and biological data were followed by complete remissions, suggesting that food can be responsible for idiopathic nephrotic syndrome in selected cases, and leading to a new therapeutic approach. The mechanism by which such antigens can be implicated in the pathogenesis of this glomerular disease is discussed.

Adolescent↗
PubMed1989

Congenital arachnoid cysts in children.

Congenital arachnoid cysts (CAC) are benign developmental disorders. A number of theories have been proposed to explain the origin and progression to the symptomatic stage. Management strategies range from not treating the asymptomatic cysts to craniotomy, excision of cyst wall and establishment of a communication with the adjacent subarachnoid cistern or ventricle. Other lesions may resemble CAC, and can be differentiated from CAC only by a critical review of the biopsy specimen. We have reviewed our experience with true CAC and similar lesions. Based on our experience we recommended craniotomy, excision of cyst wall and establishment of a communication with an adjacent subarachnoid cistern or ventricle as the primary procedure.

Arachnoid↗
PubMed1989

Food allergy and idiopathic nephrotic syndrome.

Patients with the idiopathic nephrotic syndrome (INS) with steroid treatment failure, who did or did not have a history suggesting food intolerance, were systematically evaluated for food allergy. We evaluated 42 cases for sensitization to usual foods. The following results were obtained: skin tests (intradermal, Stallergenes Lab) were positive in 16 out of 42 cases; total serum IgE was elevated in 12 of 42 patients; specific IgE (RAST) was positive in eight of 42 patients; the basophil histamine release test (HRT) was positive in 20 of 42 patients. For each of these tests, the results in the INS patients with steroid treatment failure were significantly different from controls. The following exclusion or challenge tests were carried out. In seven cases, an elemental diet was used; proteinuria decreased in one case, but acceptance of the diet was poor in the other cases. In 27 cases, a limited diet with exclusion of one or several foods was used. A complete remission was induced by this diet in seven steroid-dependent INS cases, allowing steroids to be discontinued during a follow-up of one to five years. However, relapses were frequent. More recently, an oligoantigenic diet was prescribed for 10 days without modifying steroid therapy. In 13 INS patients (5 steroid-dependent, 3 steroid-resistant, and 5 multiple relapses), 24-hour urine protein was significantly reduced (P less than 0.05). Proteinuria decreased by more than half in nine patients, with complete disappearance in five cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens↗
PubMed1989

[Significance of IGA antigliadin antibodies during primary glomerulonephritis with mesangial IGA deposits].

The association of IgA anti-gliadin antibodies and IgA glomerulonephritis (IgA GN) was first reported in 1987 (Am J Nephrol, 1987, 7, 178-183) and has since been confirmed by other groups. We have developed a second generation ELISA (alkaline phosphatase, biotin-avidin) and used it to test 45 adult IgA GN, 34 idiopathic membranous nephropathy (MN), 31 idiopathic nephrotic syndrome (INS), and 11 idiopathic membranoproliferative glomerulonephritis (MPG) patients. IgA anti-gliadin antibodies were found in 24 IgA GN (53%), 1 MN (3%), 1 INS (3%), and 1 MGP (9%) patients. The presence of these antibodies in a patient with proteinuria strongly suggests IgA GN, with a sensitivity of 53%, a specificity of 96%, a positive predictive value of 88% and a negative predictive value of 77%. The presence of IgA anti-gliadin antibodies in IgA GN did not necessarily indicate coeliac disease because: a) neither IgG nor IgA anti-reticulin nor IgA anti-endomysium antibodies were found; b) intestinal absorption tests (folates, EDTA) were normal; c) biopsies of the small intestine were normal; and d) a gluten-free diet did not alter the evolution of the disease. Immunochemical analysis (footprinting after separation of the gliadins by rocket electrophoresis) showed the variability of the fractions recognized by the IgA antibodies from patients and controls, in addition to the absence of a typical profile. Gliadin does not have a lectin effect, since mannan and mannose did not inhibit the ELISA. Immunofluorescent labeling of human kidney with purified rabbit IgG anti-gliadin antibodies did not reveal a common epitope shared by gliadin and renal structures.(ABSTRACT TRUNCATED AT 250 WORDS)

Enzyme-Linked Immunosorbent Assay↗
PubMed1989

[The hyper IgE syndrome (Buckley syndrome)].

An exceptional case is reported of hyper IgE syndrome and membranoproliferative glomerulonephritis with onset in 1964. Renal disease, symptoms of hyper IgE syndrome and level of serum IgE were improved by a long-term cyclosporine treatment (3/5 mg/kg/day) with a follow-up of 4 years. The characteristics of the hyper IgE syndrome, described by Buckley in 1972 are given and the respective roles of IgE-BF, IL4 and interferon in the mechanism of increase in serum IgE is discussed.

Cyclosporins↗