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Biomedical subjects

A Geubel

Publications and source records attributed to A Geubel.

At least 55 records · Page 3Linked to original sources
PubMed1990

Dynamic spin-echo imaging with Gd-DTPA: value in the differentiation of hepatic tumors.

Thirty patients with hemangiomas (n = 6), benign liver cell tumors (n = 7), and primary or metastatic malignant tumors of the liver (n = 17) underwent dynamic MR imaging with Gd-DTPA to determine the value of the procedure in the differentiation of hepatic tumors. The diagnoses were proved by histology or follow-up. Hemangiomas had a significantly greater mean T2 value (192.1 +/- 34.8 msec) than did both benign liver cell tumors (71.9 +/- 16.9 msec; p less than .01) and primary or metastatic malignant tumors (79.7 +/- 21.2 msec; p less than .01), but the T2 values of benign liver cell tumors and malignant tumors were not significantly different. Both hemangiomas and benign liver cell tumors had a significantly greater mean signal-intensity ratio (1.86 +/- 0.60 and 1.77 +/- 0.26, respectively) than did malignant tumors (1.04 +/- 0.34; p less than .01) in the early phase after Gd-DTPA administration, and hemangiomas had a significantly greater signal-intensity ratio (1.59 +/- 0.21) than did both benign liver cell tumors (1.21 +/- 0.08; p less than .01) and malignant tumors (1.06 +/- 0.26; p less than .01) in the delayed phase. These results suggest that dynamic MR images obtained after administration of Gd-DTPA are useful in differentiating hepatic hemangiomas, benign liver cell tumors, and malignant liver lesions.

Adenoma, Bile Duct↗
PubMed1989

Primary sclerosing cholangitis and idiopathic pulmonary fibrosis: a case report.

Primary sclerosing cholangitis (PSC) and idiopathic pulmonary fibrosis (IPF) were each separately described in association with a variety of chronic idiopathic inflammatory diseases such as retroperitoneal fibrosis, Sicca complex or Riedel's thyroiditis. We report a case which may be the first description of the association between PSC and IPF. The physiopathogenic implications of such an association are discussed.

Biopsy↗
PubMed1989

Prospective trial of recombinant leucocyte interferon in chronic hepatitis B: a 10-month follow-up study.

Twenty-one adult patients with chronic hepatitis B and active viral replication as indicated by the presence of hepatitis Be antigen (HBeAg), increased DNA polymerase (DNAp) and positive hepatitis B virus DNA (HBV-DNA) for more than 6 months, were entered into a prospective trial of recombinant human interferon therapy. Ten patients had chronic persistent or chronic lobular hepatitis, 8 chronic active hepatitis and 3 postnecrotic cirrhosis. All cases were treated with 5 x 10(6) units of recombinant interferon alfa-2B given subcutaneously every other day for 12 weeks. During treatment, 18 patients (86%) showed a significant reduction of DNAp levels, which reached normal values in 10 patients (48%). Viral replication was controlled over a 10-month follow-up period in 7 out of 21 patients (33%). Of these 7, five patients became HBeAg negative and HBeAb positive. HBsAg disappeared in one patient. The only serious adverse effect was thrombocytopenia in one patient in whom rapid recovery occurred when interferon was withdrawn. Treatment was also terminated in a second patient because of local reactions at the injection sites occurring after 10 weeks of therapy. Our data indicate that relatively small doses of recombinant alfa-2B interferon given during a 12-week period induce a significant reduction in viral replication and might approximately triple the spontaneous seroconversion rate observed in patients with chronic hepatitis B.

Adult↗
PubMed1987

[Targeting of anthracyclines and hepatomas].

DNR can be targeted to the liver by linking to galactosylated human serum albumin (AG). The linkage is stable in the blood stream and allows the release of active DNR after endocytosis of the conjugate by the target cells. Receptors for AG are present at the cell membrane of hepatocytes, primary human hepatoma cells and lung metastases. After i.v. administration of AG-DNR more than 70% of the drug is taken up by the liver and in rats 50% of DNR is eliminated in the bile after 16 h. Nude mice bearing human hepatoblastoma cells implanted s.c. were treated twice a week with a dose equivalent to 6.6 mg/kg of DNR either for the free drug or the conjugate AG-DNR. After 7 injections, tumor growth is inhibited in both case, however, the conjugate seems more active and is at least twice less toxic in terms of LD50. A phase I clinical trial of AG-DNR on 11 patients bearing hepatocarcinoma revealed that despite a transitory hyperthermia (37-38 degrees C) during the first day of the 4 day-perfusion, and modifications of hepatic enzymes in 3 cirrhotic patients, no hematologic and cardiac toxicity could be detected. A subjective response has been obtained in half of the patients with a decrease of plasmatic alpha-foetoprotein levels by more than 50% in 4 patients and one complete remission of more than 23 months with disparition of pulmonary metastases.

Adult↗
PubMed1986

The arthritis of hemochromatosis. A review of 25 cases with special reference to chondrocalcinosis, and a comparison with patients with primary hyperparathyroidism and controls.

Twenty-five cases of hemochromatosis established on histological grounds were reviewed in order to study their articular complaints. Symptoms relating to articular damage were the first signs of the disease in about one quarter of the cases. More than half of the patients (n = 14) exhibited inflammatory arthritis, usually of the hands and knees. The arthritis was chronic in all the patients. Acute arthritis of the joints of the hands and feet appeared in the course of the disease in two patients. Chondrocalcinosis was present in 20% of cases with X-rays of joints (n = 20). The classical subchondral arthropathy was observed in the metacarpophalangeal joints in 35% of the patients. In two patients chondrocalcinosis and subchondral arthropathy were both present. These data are compared with those of 66 patients suffering from primary hyperparathyroidism and of 229 controls with rheumatic complaints. The severity of the arthropathy in hemochromatosis is stressed.

Adult↗
PubMed1984

The influence of liver disease on the methylation of arsenite in humans.

The capacity for inorganic arsenic (ASi) methylation in 13 healthy volunteers and in 30 patients with different types of liver disease has been assessed by measuring the amount of unmetabolized ASi, monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) excreted in urine within 24 h after the IV injection of 7.14 micrograms/kg ASi. Liver disease does not affect the percent of the injected dose excreted within 24 h but has striking and opposite effects on the proportions of MMA and DMA. MMA excretion is highly correlated with the 14C-aminopyrine breath test (r = 0.73; P less than 0.05). The reduction in the proportion of MMA excreted in urine and the increase in that of DMA are similar with regard to sensitivity and specificity for detecting liver impairment. Unlike the 14C-aminopyrine breath test, the inorganic arsenic methylation test offers the advantage of being unaffected by treatment with microsomal enzyme inducers.

Adult↗
PubMed1983

Potentiation of carbon-tetrachloride hepato-nephrotoxicity by phenobarbital in man, a case report.

A 47 year-old male epileptic who had been treated for eight years with variable doses of phenobarbital and valproate was hospitalized in the intensive care unit with the following clinical and biological features: coma grade 2, metabolic acidosis, acute renal and hepatic failure. The recent clinical history revealed that he had been using CCl4 to clean paintings for the last three days in a confined atmosphere. Upon admission, the recent absorption of CCl4 was confirmed by the detection of the solvent in blood and adipose tissue. Cellular lipoperoxidation was suggested by the presence of an increased concentration of pentane in expired air. Evidence of microsomal enzyme induction was provided by the relative preservation of aminopyrine demethylation as indicated by the 14C-aminopyrine breath test and also by the morphological evidence of endoplasmic reticulum proliferation at liver biopsy. Supportive therapy, repeated haemodialysis and administration of antioxidant drugs resulted in a complete recovery. The unusual severity of CCl4-induced liver and renal injury observed in this case is best explained by the induction of CCl4 microsomal activation due to phenobarbital therapy.

Barbiturates↗
PubMed1982

Arterialization of the portal vein in conjunction with a therapeutic portacaval shunt. Hemodynamic investigations and results in 75 patients.

Seventy-five cirrhotic patients were submitted to peroperative hemodynamic investigations including flow and pressure studies. Sixty-two patients with hepatopedal portal flow underwent a therapeutic end-to-site portacaval shunt (PC) in conjunction with arterialization of the portal vein and 13 with a stagnant flow a PC shunt alone. Thirty-five patients were operated on in emergency and 40 electively. In 61 patients portal flow was correlated with maximum perfusion pressure (r=0.66), and in 33 patients with the reduction of corrected sinusoidal pressure induced by the occlusion of the portal vein (r=0.72). Operative mortality, which was 3.5% for 57 class A and B patients and 55.5% for 18 class C patients, differed significantly (p less than 0.05) in emergency between arterialized (14.8%) and nonarterialized patients (62.5%). At the time this study was ended on July 15, 1981, the follow-up was over two years for all the patients. The five-year actuarial survival rate of the arterialized patients was 48% for the whole group and 56% for class A and B patients; the overall incidence of chronic encephalopathy was 20%. It is concluded that arterialization is a safe surgical procedure that could be beneficial in respect with operative mortality in emergency, late survival, and tolerance to portacaval shunt. However, a prospective randomized study such as the one undertaken in December 1979 is the only method to prove clearly that arterialization is really able to minimize the risk of encephalopathy and to prolong the long-term survival after portacaval shunt.

Adult↗
PubMedDate not supplied

Bilateral transient visual obscurations with headaches during alpha-II interferon therapy: a case report.

A 40 year-old woman receiving alpha interferon therapy for chronic active hepatitis C presented transient bilateral visual obscurations with associated visual field defects and headaches, with elevated cryoglobulin levels. These manifestations mimicked the clinical picture of migraine and were associated with worsening of previous moderate Raynaud's syndrome and diffuse paraventricular lesions of the white matter seen in cerebral MRI. Bilateral posterior cerebral transient ischemic episodes rather than an anterior visual pathway lesion were thought to be responsible for the clinical symptoms though the exact role of interferon in these vasospastic-like disorders remains speculative. Their possible relationship with increased cryoglobulinemia is uncertain. We suggest that Raynaud's phenomenon may have a predisposing role for these manifestations.

Adult↗
PubMedDate not supplied

Acute renal failure requiring haemodialysis after high doses percutaneous acetic acid injection for hepatocellular carcinoma.

Recently, ultrasound-guided percutaneous acetic acid injection has been proposed in the treatment of hepatocellular carcinoma as an alternative to percutaneous ethanol injection. We report the case of severe renal failure requiring haemodialysis which occurred in a patient with 4 cm hepatocellular carcinoma treated adequately by high dose percutaneous acetic acid injection. The risk of such a serious side effect, likely related to a direct toxic effect of acetic acid, should be of concern when considering percutaneous treatment of hepatocellular carcinoma. Acute renal failure has been reported as a complication of acetic acid poisoning, but to our knowledge, we report here the first case of acute renal failure following high dose percutaneous acetic acid injection.

Acetic Acid↗