Immunosuppressive therapy for chronic active hepatitis.
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Biomedical subjects
Publications and source records attributed to Y Pirson.
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We studied 121 renal-graft recipients to delineate the effects of HBs antigenemia on patient and graft survival. Grafts had functioned for at least six months; follow-up periods averaged 37 months. Mortality was significantly higher (P less than 0.05) in the HBs Ag-positive (17 deaths among 61 patients) than in the HBs Ag-negative group (eight of 60 patients). Patient and graft survivals, from six months onwards, were significantly lower at four years in the positive (64 and 60 per cent respectively) than in the negative group (87 and 80 per cent respectively). These differences resulted solely from a fivefold increase in mortality from liver disease in the positive group and were unrelated to graft rejection. HBs antigenemia did not improve graft tolerance during the first 24 months in 129 patients in whom repeated HBs Ag determinations had been obtained before operation. We conclude that HBs antigenemia has an unfavorable effect on transplant and patient survival.
Cells producing alpha-fetoprotein in human fetal liver have been studied with specific horseradish peroxidase labeled immunoglobulins. Under light microscopy, the alpha-fetoprotein is strictly localized in the cytoplasm of certain hepatocytes, distributed randomly in the hepatic lobule. Ultrastructural examination of thesame cells shows that the alpha-fetoprotein is present within the cytoplasm. Ultrastructural differences are described in hepatocytes according to whether or not the cell is producing alpha-fetoprotein at the time of sampling. These observations lead to the hypothesis that alpha-fetoprotein may correspond to a particular functional state of the hepatocyte in human fetal liver.
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Specific fundus changes have been reported in patients with membranoproliferative glomerulonephritis type II (MPGN type II). We studied the clinical course of this retinopathy in four patients who all had a long follow-up with several fundus examinations. Sequential observation was indicative of a slow progression of the retinopathy. Most eyes maintained in the chronic stages a nearly normal visual acuity, and a full visual field despite the existence of marked drusen and atrophic changes. The prognosis however must be somewhat guarded, since choroidal neovascularization developed in three eyes and caused bilateral severe visual loss in one patient.
A kidney transplantation was performed in July 1981 on a 29 year old woman who presented the signs of tuberous sclerosis and suffered from chronic renal failure. The frequency and the genetic transmission of Bourneville's disease are explained. The signs of the disease are exposed with special emphasis on the renal lesions. Only the patients with minor neurological symptoms can survive. These patients are able to develop chronic renal failure. This occurs either when the kidneys are destructed by renal cysts or tumors, or when a bilateral nephrectomy must be performed for bleeding or tumoral compression. A kidney transplantation can give them an opportunity to live almost normally. When nephrectomy is not performed, a regularly follow-up is necessary because the unknown future of the renal lesions in place.
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