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Biomedical subjects

M Boisseau

Publications and source records attributed to M Boisseau.

At least 55 records · Page 3Linked to original sources

[Importance of standardization in the biological monitoring of anti-vitamin K therapy].

The aim of this work was to study certain causes of variation in the results of laboratory monitoring of treatment with vitamin K antagonists. Four centers participated in the study. In the initial phase, each center performed fifteen measurements of prothrombin time (PT) and activated partial thromboplastin time (APTT) on the same standard lyophilized plasma using its own usual reagents and its own methodology (protocol I). In the second phase of this study, each laboratory performed PT and APTT measurements on 30 frozen plasma specimens from patients receiving long term treatment with vitamin K antagonists using protocol I and protocol II (common reagents but own methodology). In the third phase, plasma from 19 patients receiving long term therapy with vitamin K antagonists were tested with common reagents and a standardized methodology (protocol III). the intralaboratory reproductability was very good; however, the use of common reagents and the standardization of methods greatly improved the intercenter reproductability. The use of common reagents allowed a stricter and a less contradictory interpretation of the tests.

Anticoagulants↗

Acute erythroblastic leukemia presenting as acute undifferentiated leukemia: a report of two cases with ultrastructural features.

This report describes two elderly patients with acute leukemia in which blast cells were undifferentiated with conventional light microscopy (L.M.) and cytochemistry. Blast cells were identified as belonging to the erythroblastic line by their ultrastructural features: glycogen deposits, lipidic vacuoles, cytoplasmic ferritin molecules and rhopheocytotic invagination. Moreover, blast cells were surrounding a central macrophage. Thus, these two patients had acute erythroblastic leukemia which differs from erythroleukemia (M6 of FAB classification) in which blast cells present myeloblastic characteristics.

Acute Disease↗

Megakaryoblastic transformation of primary thrombocythemia.

The progression of primary thrombocythemia (PT) into acute leukemia was diagnosed in a 64-year-old man who was previously treated by hydroxyurea without alkylating agents or radioactive phosphorus. Such an event has only been reported in very rare cases. The blast cells had a lymphocytic morphology but were identified as promegakaryoblasts by the ultrastructural demonstration of platelet peroxidase. These data suggest that a megakaryoblastic transformation could occur in PT as had previously been reported in chronic granulocytic leukemia.

Aged↗

[Kasabach-Merritt syndrome in infants. 2 cases].

Two infants presenting with Kasabach-Merritt syndrome point out several points: the hemangioma may look innocuous with small proportions. The coagulopathy may be represented by a simple thrombopenia or an intravascular coagulation (PDF, ethanol test) of bad prognosis. A review of 150 observations of Kasabach-Merritt syndrome suggests a simple therapeutic approach: corticotherapy (2 to 4 mg/kg) for 2 to 4 weeks or, if failure, antiaggregant drugs. Radiotherapy is proposed in cases of emergency. Heparin and antifibrinolytic treatments are restricted to cases with severe coagulopathy.

Female↗

[Comparison of platelets frozen with different cryoprotective agents].

A comparative study was performed on platelets frozen with dimethyl-sulfoxide (D.M.S.O.), glycérol and dimethyl-acetamide (D.M.A.C.). The results of tests realized in vitro (platelet yields after thawing platelet aggregation, hypotonic stress, release of enzymes and ultrastructure), and in vivo (life span and recoveries after transfusion) have clearly shown that D.M.S.O. is the best cryoprotective agent. The results obtained with glycerol were less interesting and more clinical data are needed in order to study the hemostatic effectiveness of platelets preserved with this agent. Dimethyl-acetamide gave the worse results and in our opinion, must not be used for the cryopreservation of platelets.

Acetamides↗

Ultrastructural cytochemical prospective study of adult acute lymphoblastic leukemia: detection of peroxidase activity in patients failing to respond to treatment.

Ultrastructural cytochemical studies revealed peroxidase activity in five of 25 adult patients with apparent null lymphoblastic leukemia (ALL) in whom the peroxidase reaction studied with light microscopy was negative. None of these 5 patients responded to a chemotherapy regimen used for adult ALL. The importance of ultrastructural cytochemistry which allows the recognition of myeloblastic differentiation in undifferentiated blast cells is also demonstrated. The correct classification of such cases may be important for prognosis because they appear to be resistant to the chemotherapy used in treating ALL.

Adolescent↗

[Hemolysis and platelet function in patients with prosthetic heart valves. Changes during exercise and with propranolol].

10 control subjects and 27 patients with prosthetic valves (15 with Björk aortic valves, 6 with mitral prostheses, 4 with aortic and mitral valves, 1 with a Björk mitral and a Starr aortic valve, and 1 with a Beall mitral valve) underwent, at intervals of 24 hours, two maximal exercise tests, initially without (day J) and subsequently with (day J + 2) propranolol in a dose of 80 mg/24 h, haemolysis and platelet function being assessed immediately before and immediately after each test. Exercise tolerance was not altered by propranolol in this dose, provided the heart size was not more than 1500 ml. Haemolysis, as assessed by the level of lactic dehydrogenase (LDH1) was increased by exercise, especially in the aortic prosthesis cases in which the LDH1 was increased by 21.6% (p less than 0.025). The increase was less marked under propranolol treatment, when it was 12.3% (p less than 0.05). Propranolol did not correct the platelet clumping caused by the prosthetic mitral valves, but did decrease platelet stickiness on exercise in the patients with prostheses (delta = -11.7%; p less than 0.05). Propranolol can not therefore be recommended for increased haemolysis if there is no demonstrable dysfunction of the prosthetic valve. Neither would we advise its use at present with the aim of reducing thrombotic accidents.

Adult↗

[Valve protheses and anti-vitamin K. Biological study in patients given weak and strong doses of anticoagulants].

57 patients with Björk aortic valves had an in-depth study of their coagulation carried out. It seems that the well-anticoagulated group (39 patients) had more marked haemolysis, had a higher mean level of fibrinogen and PDF, but less biological signs of activation of fibrinolysis than the group who were non- or mildly-anticoagulated (18 patients). The increased platelet aggregation, which is often noted, was correlated with the signs of haemolysis, or of activation of the breakdown of fibrinogen. Apart from the problem of haemolysis, anticoagulant treatment appears biologically to be a moderating factor in the activation of the breakdown of fibrinogen and, by this means, of the utilisation of clotting factors.

Anticoagulants↗

[Influence of acute exertion and physical training on platelet function of the coronary patient].

The platelet function, fibrinogen level, and the various lipid fractions were studied in 17 coronary patients before, during and after a maximal effort, both before and after a three month period of physical training. Exercise capacity increased by 26%, stickiness went down by 27% at rest (p less than 0.025) and 42% on exercise (p less than 005), and aggregation varied (according to the method used) between 24%, 25% and 2% at rest (p less than 0.001) and 36%, 43% and 32% on exercise (p less than 0.001); the levels of fibrinogen and the lipid fraction remained unchanged. A patient whose exercise capacity was not increased by training had no alteration in platelet aggregation. According to this small series, physical training has an effect similar to that of acetyl salicyclic acid. The possible significance of these results is discussed.

Adenosine Diphosphate↗

[Ultrastructure of the blood platelets in the newborn infant and in the young mongolian child. Study of 13 cases].

Blood platelets from infant and new born mongolians were examined and compared taking into consideration existing or non existing haematologic anomalies, such as transitory leucoblastosis with or without hyperthrombocytosis and acute leucosis without thrombopenia. These abnormalities were correlated with the analysis of control samples from haematologically normal new-born and premature children as well as samples from adult mongolian, patients with other chromosomal alterations (13-15, phi) and new-born or adults with thrombocytosis. The presence of dysmorphic platelets could be observed in variable degrees and numbers in all the mongolian samples. The characters of the morphologic abnormalities, constantly observed with variations due to pathological causes, denote either metabolic or structural thrombopathy.

Acute Disease↗