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Biomedical subjects

M Rachail

Publications and source records attributed to M Rachail.

At least 19 recordsLinked to original sources
PubMed1993

Interest of the detection of hepatitis C virus RNA in patients with alcoholic liver disease. Comparison with the HBV status.

HCV-RNA detection was investigated in 66 chronic alcoholic patients divided into 3 groups according to the severity of liver injury: group 1 included 22 chronic alcoholics without cirrhosis, group 2, 20 patients with alcoholic cirrhosis and group 3, 24 patients with alcoholic cirrhosis and hepatocellular carcinoma. The 'nested' polymerase chain reaction (PCR) technique amplifying the 5' non-coding region was used to detect HCV-RNA. For comparison, ELISA1, ELISA2 and RIBA2 tests (Ortho Diagnostics System) were also used to detect anti-HCV antibodies. Finally HBV markers (HBsAg, anti-HBc and anti-HBs antibodies) were detected in all patients as well as HBV-DNA by PCR. In group 1, only 1 patient (4.5%) showed an HCV-RNA-positive PCR, while 3 patients (13.6%) were found to have anti-HCV antibodies detected by RIBA2. In group 2, 3 patients (15%) showed positive PCRs, whereas 4 patients (20%) had anti-HCV antibodies. Finally, in group 3, the PCR was positive in 3 patients (12.5%), while 9 (37.5%) had anti-HCV antibodies. All patients with positive PCRs showed positive anti-HCV antibodies detected by second-generation assays. On the other hand, these patients often had past HBV infection markers but rarely had HBV-DNA detected by PCR. These results suggest that in chronic alcoholic patients, regardless of the severity of liver injury, HCV replication is rarely observed by PCR. Indeed, replication is only observed when anti-HCV antibody detection is positive in second-generation assays, particularly with strong reactivity against C33-C and C22-3 antigens. The relatively high prevalence of anti-HCV antibodies in this population compared to the usual rates could be explained by the age, geographic and perhaps even socioeconomic origin of the patients.

Adult↗
PubMed1993

c-Ha-ras polymorphism in patients with hepatocellular carcinoma. Comparison of healthy subjects and alcoholic patients with cirrhosis.

It has been observed that certain rare alleles of the c-Ha-ras gene occur more frequently in patients with certain malignant tumors than in healthy individuals, suggesting that these alleles may serve as markers for particular types of cancer. In this study, we compared the restriction fragment length polymorphism at the c-Ha-ras gene locus in 40 patients with cirrhosis and hepatocellular carcinoma with that in 39 patients with cirrhosis and in 42 normal subjects, all of Caucasian origin. Southern blotting of leukocyte DNA from the above patients, after digestion with either BamH1 or AvaII, revealed the presence of allele fragments of different sizes, corresponding to 4 common alleles and 3 rare alleles. The occurrence of the 3 rare alleles was not significantly different in the 3 populations studied. On the other hand, 2 of the common alleles, a3 (P < 0.01) and a4 (P < 0.03), were found at a significantly higher frequency in patients with cancer than in the 2 other groups. These results suggest that, in hepatocellular carcinoma, there is no increase in the frequency of occurrence of the rare alleles of the c-Ha-ras, but that the distribution of the common alleles may be modified.

Blotting, Southern↗
PubMed1990

Randomized double-blind clinical trial of aluminum phosphate versus ranitidine in the acute treatment of duodenal ulcer.

A randomized double-blind clinical trial of aluminum phosphate versus ranitidine in the treatment of noncomplicated acute duodenal ulcer has been conducted in 91 patients. After randomization the 42 patients of the aluminum phosphate group were comparable to the 49 patients of the ranitidine group. At 4 weeks, 6 patients were not endoscoped and according to the intention-to-treat method they were considered as treatment failure. The endoscopy showed a 60% healing rate in the aluminum phosphate group (25/42) versus 55% in the ranitidine group (27/49); this difference was not significant. Among the factors assessed, only one, the round shape of the ulcer, was significantly and independently associated with ulcer healing in a multidimensional analysis. In conclusion, this double-blind trial showed that aluminum phosphate is an effective, save and cheap treatment of acute duodenal ulcer.

Aluminum↗
PubMed1990

[Transplacental administration of diethylstilbestrol in the rat. II. Effect on the hormonal receptors of the endometrium].

Transplacental exposure to diethylstilboestrol (DES) strongly decreases the fertility of the offsprings. Progesterone receptors concentrations are significantly decreased for treated group (0.40 and 0.44 pmol/mg cytosol proteins) versus control group (0.74 pmol/mg cytosol proteins) Estradiol receptor concentrations are significantly higher for long time treated groups (0.26 pmol/mg cytosol proteins) versus control or short time treated groups (0.15 and 0.13 pmol/mg cytosol proteins).

Animals↗
PubMed1990

[Influence of the sclerosing of esophageal varices on portal pressure and azygos venous blood flow].

Endoscopic sclerotherapy is widely employed for esophageal variceal hemorrhage. However it has side effects and can aggravate portal hypertension by suppression of portosystemic shunt. The purpose of the present investigation was to study the effect of variceal thrombosis on hepatic venous pressure gradient and azygos blood flow. Eight alcoholic cirrhotic patients with a first variceal hemorrhage were included. According to Child Pugh's classification, 4 patients were group A, 2 group B and 2 group C. At each session 40 to 60 ml of 1 p. 100 polidocanol were injected into the varices. A hemodynamic study was performed in each patient before and about one week after variceal obliteration (mean 3.3 procedures). Mean value of hepatic venous pressure gradient was 16.6 +/- 5.5 mm Hg and 17.0 +/- 3.8, respectively, before sclerotherapy and after eradication of varices; azygos blood flow 663 +/- 506 ml/mn before and 682 +/- 522 after; cardiac, output was 6.5 +/- 0.7 ml/min before and 6.5 +/- 0.8 after. None of these differences were significant. These results suggest that endoscopic sclerotherapy using polidocanol does not change hepatic venous pressure gradient and azygos blood flow, and does not lower blood flow through the gastroesophageal collaterals draining into the azygos vein. This is consistent with the hypothesis that thrombosis remains localized.

Adult↗
PubMed1990

[Transplacental administration of diethylstilbestrol in the rat. I. Apropos of the fertility of its offspring].

To determine the effects of transplacental exposure to diethylstilboestrol (DES) on the fertility of the offsprings, timed pregnant Sprague Dawley OFA rats were treated with DES (10, 20, 50 and 100 micrograms/kg/d, subcutaneous) on days 10 to 18 of gestation (long time) or days 13 to 18 of gestation (short time). Only the lowest dosed groups (10 micrograms/kg/d, short and long times, and 20 micrograms/kg/d, short time) gave birth to living offsprings. The fertility of the male and female offsprings was determined postnatally by a breeding technique and appeared to be strongly decreased among females of all groups (70 to 100% of sterility) and moderately among males (11 to 18% of pathological fecundity). Fertility of offspring of these rats with pathological fecundity appeared to be normal.

Animals↗
PubMed1988

[Comparative efficacy of endoscopic sclerosis of esophageal varices by intravariceal injection of polidocanol and perivariceal injection of quinine-urea].

Concerned by mortality due to recurrent bleeding and associated risk factors in cirrhotic patients, we attempted to compare the efficiency of perivascular sclerotherapy using quinine urea with that of intravascular polidocanol and to determine the predictive factors of clinical outcome. Of 74 patients admitted for bleeding esophageal varices, 31 were treated with perivascular sclerotherapy (group I), and 43 with intravascular sclerotherapy (group II). Three months later, only 63 p. 100 of patients in group I had not rebled, compared to 90 p. 100 of patients in group II (p less than 0.001). After 6 months, no significative difference was found between the two groups. The one year survival rate was 44 p. 100 in group I and 79 p. 100 in group II (p less than 0.002). Encephalopathy and ascites were found to be predictive factors of mortality, whereas neither clinical or biologic factors were found to be predictive for recurrent bleeding. These results suggest that in esophageal sclerotherapy, the intravascular route with polidocanol provides earlier results and a better one year survival rate, compared with the perivascular route. However, survival rates depend on encephalopathy and ascites criteria.

Drug Combinations↗
PubMed1988

[Transplacental administration of diethylstilbestrol (DES) in the rat: effects on fertility and on hormonal receptors in the endometrium].

To determine the effects of transplacental exposure to diethylstilboestrol (DES) on the fertility and endometrial hormonal receptors of the offsprings, timed pregnant OFA rats were treated with DES (10, 20, 50 and 100 micrograms/kg/day, subcutaneous) on days 10 to 18 of gestation (long time) or days 13 to 18 of gestation (short time). Only the lowest dosed groups (10 micrograms/kg/day, short and long times, and 20 micrograms/kg/day, short time) gave birth to living offsprings. The fertility of the male and female offsprings was determined postnatally by a breeding technique and appeared to be strongly decreased among females of all groups (70 to 100% of sterility) and slowly decreased among males (12 to 26% of pathological fecundity). Progesterone receptor concentrations were significantly decreased for treated group (0.40 and 0.44 pmol/mg cytosol proteins) versus control group (0.74 pmol/mg cytosol proteins). Estradiol receptor concentrations were significantly higher for long time treated groups (0.26 pmol/mg cytosol proteins) versus control or short time treated groups (0.15 and 0.13 pmol/mg cytosol proteins).

Animals↗
PubMed1988

[Extrahepatic digestive surgery in the cirrhotic patient].

Extra-hepatic abdominal surgery is associated with a high degree of risk in cirrhosis patients. Thus mortality is between 8 and 67% and morbidity between 28 and 47%. The chief complications are hepatic insufficiency, sepsis and visceral failure (cardiac, renal and pulmonary). The risk differs according to the organ operated upon, it is less after ordinary cholecystectomy than following gastrectomy or partial colectomy. Herniorrhaphy was a good immediate prognosis. Prognostic factors are above all the presence of ascites, emergency surgery, clotting factors and hypoalbuminemia; mortality is of the order of 10% for child class A but 75% for class C. Improved results thus would require better patient selection and intensive preparation during the peri-operative period with in particular, prophylactic antibiotics in the case of contaminated surgery.

Anti-Bacterial Agents↗
PubMed1988

[Extrahepatic digestive surgery in cirrhotic patients: mortality, morbidity and preoperative prognostic factors].

The purpose of this work was to study postoperative mortality and morbidity with respect to preoperative prognostic factors in 67 patients with alcoholic or posthepatitis cirrhosis. Surgical procedures involved the biliary tract (n = 20), stomach (n = 16), colon or rectum (n = 12), and hernia (n = 7). Thirteen preoperative clinical and biological variables were subjected to mono- and multivariate statistical analysis. The mortality rate was 23 p. 100. There was no statistical difference between the three main surgical procedures. No patients died after herniorrhaphy. The rate of morbidity was 37 p. 100. The most common complications were sepsis, organ failure, and ascites. Three preoperative variables were found to be different between survivors and non survivors: ascites, prothrombin time and the Child-Pugh score. Multidimensional analysis demonstrated that the only variable to have an independent unfavorable prognostic value was albuminemia. These results suggest that postoperative mortality following extrahepatic abdominal surgery in cirrhotic patients is: 1) especially high after digestive procedures, 2) increased by ascites, low prothrombin time and high Child-Pugh score. Only hypoalbuminemia had a significant independent explanatory value regarding prognosis.

Adult↗