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Biomedical subjects

V Aubert

Publications and source records attributed to V Aubert.

31 records · Page 2Linked to original sources
PubMed1994

Total laparoscopic hysterectomy: preliminary results.

Total hysterectomy carried out entirely via laparoscopy benefited 31 patients. In all cases the operation was carried out using conventional, re-usable instruments (grasping forceps, laparoscopic scissors, bipolar coagulation). The mean duration of the operation was 171 min. No serious peri- or post-operative complications were encountered and no transfusion was required. The mean drop in haemoglobin was 1.3 g/100 ml and the average length of hospital stay was 4 days. In one case (3.26%) we converted to laparotomy because a lateral myoma made it impossible to achieve haemostasis of the uterine pedicle under suitably safe conditions. These results confirm that total hysterectomy via laparoscopy is a safe, feasible and reproducible technique. Future work will establish the exact place and methods for laparoscopic surgery for hysterectomy; it can be suggested, however, that laparoscopic surgery is only indicated when vaginal hysterectomy is contra-indicated or impossible. So, laparoscopic hysterectomy constitutes an alternative to laparotomy rather than to vaginal hysterectomy. The combination of an immobile uterus and poor vaginal accessibility is the prime indication for total hysterectomy via laparoscopy.

Adult↗
PubMed1994

Bronchial provocation with cat allergen: correlation between the individual IgE-CRIE pattern and the occurrence of a late allergic reaction.

Twenty-one mild asthmatic patients allergic to cat dander underwent a bronchial provocation test (BPT) with a cat extract. An early allergic response (EAR) was observed in all 21 patients and a late allergic response (LAR) in 8/21 patients. In the EAR, the patients with subsequent LAR had a greater fall in FEV1. Their baseline FEV1, and total dose of inhaled allergen were not significantly different from patients who did not develop a LAR, but their serum specific IgE level was higher. Crossed immunoelectrophoresis (CIE) of the same cat extract showed that it contained eight different proteins. An IgE-CRIE was obtained from all 21 patients, using radiolabelled anti-IgE and autoradiography. Radiolabelled standards allowed a semiquantitative scoring of the radiostaining. The CRIE pattern of the eight patients with LAR showed a higher score of radiostaining and a greater number of proteins bound to IgE. The two major allergen cat albumin and Fel dI bound equally to IgE of patients with and without LAR whereas another protein (antigen No. 7) bound to IgE of 100% of patients with LAR but of only 38% of patients without LAR. These data suggest that the pattern of the IgE response to specific proteins of a cat extract may be related to the occurrence of LAR after BPT with this allergen.

Adolescent↗
PubMed1991

Clinical evaluation of a new in-vitro assay for specific IgE, the immuno CAP system.

The Pharmacia CAP system is a new assay for specific IgE characterized by a new solid phase (hydrophilic polymer encased in a capsule). The CAP results were compared to those of the Phadebas IgE RAST and skin-prick tests (SPT) performed in 145 subjects suffering from rhinitis and/or asthma with eight common inhalant allergens (total number of tests = 1160). Concording CAP/RAST results were found in 91% of the tests. The CAP was positive in 78% and the RAST in 65% of the positive SPT. Conversely, the CAP was negative in 90.6% and the RAST in 96.4% of the negative SPT. A pattern negative SPT, negative RAST and positive CAP' was found in 56 tests (40 subjects): in four such subjects, the CAP positivity was confirmed by a positive IgE crossed radioimmunoelectrophoresis. Three borderline positive results were found among 240 negative controls (serum from cord blood or non-atopics). These data indicate that compared with SPT the CAP system is (a) more sensitive than the Pharmacia RAST and (b) does not seem less specific.

Adolescent↗
PubMedDate not supplied

Evaluation of an intrathecal immune response in amyotrophic lateral sclerosis patients implanted with encapsulated genetically engineered xenogeneic cells.

A phase I/II clinical trial has been performed in 12 amyotrophic lateral sclerosis (ALS) patients to evaluate the safety and tolerability of intrathecal implants of encapsulated genetically engineered baby hamster kidney (BHK) cells releasing human ciliary neurotrophic factor (CNTF). These patients have been assessed for a possible intrathecal or systemic immune response against the implanted xenogeneic cells. Hundreds of pg CNTF/ml could be detected for several weeks in the cerebrospinal fluid (CSF) of 9 out of 12 patients, in 2 patients up to 20 weeks after capsule implantation. Slightly elevated leukocyte counts were observed in 6 patients. Clear evidence for a delayed humoral immune response was found in the CSF of only 3 patients out of 12 (patients #4, #6, and #10). Characterization of the antigen(s) recognized by the antibodies present in these CSF samples allowed to identify bovine fetuin as the main antigenic component. The defined medium used for maintaining the capsules in vitro before implantation contains bovine fetuin. Fetuin may therefore still be adsorbed to the surface of the cells and/or the polymer membrane, or be present in the medium surrounding the encapsulated cells at the time of implantation. Because of the insufficient availability of CSF samples, as well as the relatively poor sensitivity of the assays used, a weak humoral immune response against components of the implanted cells themselves cannot be excluded. However, the present study demonstrates that encapsulated xenogeneic cells implanted intrathecally can survive for up to 20 weeks in the absence of immunosuppression and that neither CNTF nor the presence of antibodies against bovine fetuin elicit any adverse side effects in the implanted patients.

Adult↗
PubMedDate not supplied

Bronchial provocation with cat allergen: long-term outcome of the late allergic reaction and the individual IgE CRIE pattern.

In bronchial provocation tests with allergen, about 50% of the patients experienced a late allergic reaction (LAR), which has been associated with a specific IgE pattern as determined by crossed radioimmunoelectrophoresis (CRIE). Long-term outcome of this LAR is still unknown. Six patients allergic to cat, with documented LAR and specific IgE CRIE patterns were rechallenged in the same conditions after a mean interval of 2.5 years. Forced expiratory volume in one second (FEV1) and resistance results of the bronchial provocation tests (BPT) were compared, as well as specific IgE level and IgE CRIE patterns. All six patients were still suffering from asthma when exposed to a cat, although they were not being treated for asthma. Three patients (50%) had lost their LAR without specific treatment. They were older, with a longer history of asthma, but presented a very similar early allergic reaction to similar allergen doses. The other 3 were more reactive to the allergen but presented similar LAR after a slightly worse early allergic reaction (EAR). Specific IgE levels had decreased and the IgE CRIE pattern showed a diminished intensity of staining in the three patients who had lost their LAR, as opposed to the other three. These data suggest that asthmatic patients can lose their LAR over time without treatment. The occurrence of a LAR seems to be associated with a specific IgE CRIE pattern and IgE level. Further analysis of the individual antigen fractions might help to understand the mechanism of allergic reactions.

Adult↗
PubMedDate not supplied

Evaluation of a new semiquantitative immunodot assay for the screening of specific IgE.

The Immunodot CMG is a new, simple assay for the semiquantitative screening of specific IgE. It does not necessitate any particular equipment. It consists of two nitrocellulose strips on which either five indoor or five outdoor allergens are bound. In the present evaluation, 82 serum samples from allergic patients were tested with the first strip and 101 with the second. The results were compared with those obtained with the CAP System (Kabi Pharmacia). A version using undiluted serum and a short incubation time (short version) appeared to be more sensitive than a long version using serum diluted 1:5. In most cases, the results agreed with those of the CAP System. Discordant results were found in 2-9% of the cases according to the allergen, and were most often negative with Immunodot CMG and positive with the CAP System, indicating a slightly lower sensitivity for the new test. When compared to the CAP System, the Immunodot CMG showed a sensitivity of 84.5% and a specificity of 94%. Readings were found to be reproducible and easy to perform with the naked eye. Our results showed that the Immunodot CMG test is comparable to the CAP System, which is slightly more sensitive but requires much more elaborate and expensive equipment.

Allergens↗
PubMedDate not supplied

Anaphylactoid purpura like vasculitis following fibrinolytic therapy: role of the immune response to streptokinase.

We report the case of a patient who presented with a clinical picture of serum sickness with some characteristics of anaphylactoid purpura (Henoch-Schönlein purpura) five days after receiving streptokinase as a treatment for myocardial infarction. The appearance of Henoch-Schönlein like vasculitis after streptokinase treatment was particularly intriguing in view of the common association of streptococcus infection with this type of vasculitis. The production of streptokinase specific IgG and IgA antibodies was studied in the patient and compared with six controls treated with identical doses of streptokinase without adverse effects. A more rapid increase of streptokinase specific IgA was detected in the patient, with a significant higher amount of streptokinase specific IgA and IgG after six days of treatment. These results suggest that different kinetics could induce a precipitation of the immune complexes responsible for vasculitis. However, we cannot exclude that the IgA found in the vessel walls was only an "innocent bystander" deposited as a secondary event.

Aged↗