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Biomedical subjects

K Paradis

Publications and source records attributed to K Paradis.

49 records · Page 3Linked to original sources
PubMed1991

Reversal of intrapulmonary shunting in cirrhosis after liver transplantation demonstrated by perfusion lung scan.

A young girl with biliary atresia leading to cirrhosis developed respiratory complications with hypoxemia. Intrapulmonary shunting was diagnosed with a 99mTc-MAA perfusion lung scan, which showed marked systemic activity. The shunting resolved after liver transplantation. The perfusion lung scan offers an efficient method to screen patients with cirrhosis in whom intrapulmonary shunts are suspected and to follow their progress.

Child↗
PubMed1990

Kupffer cell engraftment across the major histocompatibility barrier in mice: bone marrow origin, class II antigen expression, and antigen-presenting capacity.

The source of population renewal for Kupffer cells (KC), the major antigen-presenting cells of the liver, remains controversial. Using a well-described murine bone marrow transplantation (BMT) model in which the donor and recipient are disparate at the major histocompatibility complex (MHC), we have studied (a) the source of KC renewal by genotypic analysis, cell surface (class II or Ia) antigens, and immune function assays; (b) the level of KC Ia expression post-BMT in transplant recipients; and (c) the capacity of newly repopulating KC to present antigen to an Ia-restricted T cell clone of donor Ia type. Kupffer cell engraftment, as assessed by each of these three methods, was noted to be predominantly of donor marrow origin by day 21 post-BMT. Cell surface Ia expression was comparable to that of nontransplanted controls of the same strain as donor mice. Within 7 days post-BMT, KC were mature antigen-presenting cells. We conclude that KC rapidly repopulate the liver from donor bone marrow post-BMT, and these macrophages are able to interact with T lymphocytes in an immunocompetent manner.

Animals↗
PubMed1990

Liver transplantation for hereditary tyrosinemia: the Quebec experience.

Sixteen tyrosinemic patients were evaluated in our institution for a possible liver transplantation. All patients showed biochemical and/or radiological evidence of liver dysfunction. Renal involvement was found to be more abnormal than expected. Seven patients have been transplanted, with two patients receiving a combined liver-kidney transplant. Hepatocarcinoma was detected in two of eight patients in whom the whole liver was examined. Six (37.5%) of the initial 16 patients have died since evaluation, one of the six dying after combined liver-kidney transplantation. Posttransplantation survival was 86%, with normal liver function, normal growth, and no recurrence of neurological crises on a normal diet.

Adolescent↗
PubMed1989

In vitro duct-like structure formation after isolation of bile ductular cells from a murine model.

The epithelium of the biliary tree is involved in the response to numerous liver disease processes including immunologic destruction during liver transplant rejection and liver graft-versus-host disease after bone marrow transplantation. Furthermore, very little is known concerning the function of this previously inaccessible epithelium, because attempts to isolate and culture biliary cells have been unsuccessful until recently. We present a method for the isolation and culture of bile ductular cells from mice with external bile duct obstruction. Over 85% of the isolated cells stain positive for cytokeratin 19, which is characteristic of murine biliary epithelium. Incubation with recombinant murine gamma-interferon resulted in increased class II antigen expression on the isolated cell surface. When these cells were placed, on a basement membrane matrix, they formed duct-like structures composed of cells that had the morphologic characteristics of bile ductular epithelium when examined by transmission electron microscopy. The ability to isolate murine biliary epithelium that forms duct-like structures will be useful for the in vitro study of biliary epithelial characteristics and injury.

Animals↗
PubMed1989

A new antigen recognized by anti-liver-kidney-microsome antibody (LKMA).

Sera from 23 children with autoimmune chronic active hepatitis and positive for anti-liver-kidney-microsome antibody (LKMA), as defined by immunofluorescence, were analysed by Western blot (WB) and two-dimensional gel electrophoresis using rat liver microsomes as antigen, and by WB and dot-blot analysis with rat liver microsomal subfractions. Western blot analysis showed three patterns of reactivity: 13 sera recognized a 50 kD polypeptide, six sera a 66 kD polypeptide and four sera both of them. Two-dimensional gel electrophoresis, WB, and dot-blot analysis showed the 66 kD antigen to have a pI of 5.4 and to be located in the smooth domain of the endoplasmic reticulum. Western blot analysis using monospecific antisera against human IgG subclasses showed the LKMA directed against the 66 kD antigen to be mainly of the IgG1 subclass. These results indicate that LKMA associated with a subgroup of autoimmune hepatitis of children react with at least two different microsomal antigens in rat liver: (1) the 50 kD polypeptide, recently shown to be a cytochrome P-450 of the IID subfamily, and (2) a new antigen of 66 kD, the location of which suggests it may also be part of the mono-oxygenase complex.

Autoantibodies↗
PubMed1986

When is endoscopic polypectomy adequate therapy for colonic polyps containing invasive carcinoma?

We correlated the histopathology with outcome for all patients with endoscopically removed colonic polyps containing invasive adenocarcinoma seen at our institution over a 10-yr period. Invasion was defined as infiltration of malignant cells into the submucosa. Of a total of 1523 adenomatous polyps, 41 polyps (2.7%) in 39 patients contained invasive adenocarcinoma. One patient was excluded from further analysis because of a synchronous colonic carcinoma. Fourteen patients (37%) had favorable histologic features (grade I or grade II carcinoma with free margin of resection and absence of lymphatic invasion), and none developed metastatic carcinoma during the follow-up period (mean 6.5 yr, range 4-10.6 yr). Twenty-four (63%) had unfavorable histologic features (grade III tumor with tumor at or near the margin of resection or lymphatic invasion), and 10 of these (42%) had either residual local or metastatic carcinoma in subsequent operations or during the follow-up period. This difference in outcome was statistically significant (p less than 0.05) when compared with the outcome of the group with favorable histology. We conclude that endoscopic polypectomy is adequate therapy for colonic polyps containing invasive carcinoma, provided that the favorable histologic features are present.

Adenocarcinoma↗
PubMed1985

Thrombosis as a complication of inflammatory bowel disease in children: a report of four cases.

Thrombosis and thromboembolism have rarely been reported in inflammatory bowel disease (IBD) in children. Four cases of thrombosis, two with apparently serious thromboembolism, are reported in three patients with ulcerative colitis and one with Crohn's disease. Two patients were on steroid treatment at the time of the initial thromboembolic event. Thrombosis may result from a "hypercoagulable state" that occurs in IBD, brought about by a combination of altered clotting factors and the presence of a thrombogenic gastrointestinal mucosa, the risk of which is increased by steroid medications. Children and adolescents with IBD are at risk for serious thromboembolic complications.

Adolescent↗
PubMed1984

Cardiac involvement in cystic fibrosis revealed by a ventricular arrhythmia.

Cardiac involvement in cystic fibrosis (CF) is characterized by acute cardiac failure in the infant with myocardial fibrosis found on pathological examination. In the older child with chronic pulmonary disease, cor pulmonale tends to predominate the clinical picture. We report the case of an adolescent with CF presenting with ventricular arrhythmia. Cardiac scan, repeated echocardiograms and Holter monitoring were suggestive of an infiltrative process. We propose this case to be similar to those of CF in infants with cardiac involvement.

Adolescent↗
PubMed1984

Percutaneous endoscopic gastrostomy: a preferred method of feeding tube gastrostomy.

Percutaneous endoscopic gastrostomy was attempted in 16 patients using local anesthesia and intravenous meperidine and diazepam sedation. The procedure was shown to be safe, easy to perform, and avoided the need for laparotomy. We suggest percutaneous endoscopic gastrostomy be the preferred route of alimentation in those patients requiring feeding gastrostomy.

Enteral Nutrition↗
PubMed1983

Drug and treatment efficacy of chenodeoxycholic acid in 97 patients with cholelithiasis and increased surgical risk.

Patients with symptomatic cholelithiasis who represent higher than normal surgical risks may be the most suitable candidates for medical dissolution of gallstones. Chenodeoxycholic acid was given to 97 patients in a dosage of 15 mg/kg of body weight per day for a period of two years. Complete gallstone dissolution occurred in 27 of 97 patients (28%). If dropouts are excluded then the success rate is 27 of 64 patients (42%). Diarrhea was a common but manageable side effect for most. Thirty-two percent of patients developed chemical liver test abnormality; however, in only 13% was the degree of abnormality sufficient to require temporary (3%) or permanent (10%) cessation of therapy. Although better chemotherapeutic agents are needed, chenodeoxycholic acid is a reasonable choice for patients with non-calcified cholelithiasis in a functioning gallbladder if the patient is a heightened surgical risk. Because of the prolonged treatment period and the possibility of hepatotoxicity this treatment program requires a substantial commitment on the part of both the patient and the physician.

Chenodeoxycholic Acid↗
PubMedDate not supplied

Detection of anti-endoplasmic reticulum antibody-positive autoimmune hepatitis in children, using an ELISA technique.

Anti-endoplasmic reticulum antibody positive autoimmune hepatitis in children is characterized by the recognition of a single 50,000 MW protein of the endoplasmic reticulum in liver microsomal fractions by their sera. We have developed an enzyme-linked immunosorbent assay technique with rat liver microsomal preparations as the antigen to be used for detection of this disease. Titers obtained may be useful in following the course of the disease and as an aid in determining when therapy can be discontinued. The technique is rapid, sensitive, reproducible, and simple to perform and is easier to manipulate than immunofluorescence or radioimmunoassay techniques.

Animals↗
PubMedDate not supplied

[Breast feeding and hypernatremic dehydration. 3 case studies].

Despite the well-recognized advantages of breast-feeding, a rare but life-threatening complication may occur with failure to thrive resulting in severe malnourishment or hypernatremic dehydration. We report 3 more cases. Two of them with severe hypernatremic dehydration and cachexia were treated using peritoneal dialysis rather than intravenous fluids in order to rapidly correct the severe metabolic acidosis but slowly the serum osmolarity. Although insufficient breast-milk volume appears to prevail over positive sodium balance in the pathway to hypernatremic dehydration, high sodium concentrations were found in breast milk as previously reported. However, the discovery of a low lactose content inversely related to that of sodium in breast-milk, suggests more complex disturbances in lactation and may draw up new hypothesis in the pathogenesis of this challenging syndrome.

Breast Feeding↗