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B Dousset

Publications and source records attributed to B Dousset.

At least 127 records · Page 7Linked to original sources
PubMed1993

Role of the kidney in the expression of low molecular weight factors with growth factor activity.

Small molecules of peptidic nature, called low molecular weight growth factors (LMW-GF < 1000 Da) are present in normal human serum ultrafiltrate. They enhance the somatomedin activity as measured by the incorporation of 35SO4 into chick embryo cartilages. On the basis of this in vitro test, LMW-GF activities were measured in serum ultrafiltrates of hemodialyzed patients and renal transplant recipients during the post-transplantation follow-up. LMW-GF activity was always zero in patients with chronic renal failure. It was checked that these results were not due to the presence of low molecular weight somatomedin inhibitors or to the increased sulfate concentration. After successful renal transplantation, the LMW-GF activity of patients ultrafiltrates returned to normal at the same time or before the improvement of renal function. In case of post-transplant complications, a decrease in LMW-GF activity accompanied or even occurred prior to impairment of renal function. In functioning graft, LMW-GF activity reappears rapidly, whereas its normalization is delayed in case of tubular nephropathy or episode of acute rejection. It was suggested that the kidney is involved in LMW-GF molecules production or processing. It could be speculated that LMW-GF activity might be a prognostic factor in renal transplantation.

Adult↗
PubMed1993

[Endothelin and kidney].

Endothelial and epithelial cells release a potent 21-residue peptide, endothelin (ET) which is an endothelium-derived-contracting-factor (EDCF). The peptide causes contraction of vessels and induces sustained blood pressure elevation. Beside its role in the vasoconstriction ET has strong inotropic effect on the myocardium and induces smooth muscle cells contractions. Renal actions, similar to angiotensin and norepinephrine, focus on its potential importance in nephrology. Acute and chronic renal failure showed increased plasma and urinary ET levels. An understanding of the regulation of the release of ET may provide knowledge about the pathogenesis of acute renal failure, the progression of chronic renal failure and cyclosporin A induced toxicity. Further research is needed to substantiate the new and promising perspective of ET in human diseases and therapy.

Animals↗
PubMed1992

[Endothelin, a peptidic vasoconstrictor].

Endothelin is a 21 aminoacids peptide belonging to the family of endothelium-derived contracting factors. It exists as 3 isoforms which have similar actions. It is principally, but not exclusively, synthesized and secreted by the vascular endothelial cells. Hypoxia, physical stretching and various endogenous substances stimulate its secretion. Its specific receptors are widespread in tissues, and the endothelin-receptor binding process produces a rise of intracellular calcium through the formation of inositol phosphate. Endothelin is the most potent of known vasoconstrictor substances. In addition, it acts on the myocardium and has a contracturant effect on other smooth muscle fibres. It also contributes to the release of endogenous peptides, inhibits platelet aggregation and has mitogenic properties. Endothelin can be determined in biological fluids, such as plasma, urine and cerebrospinal fluid, using immunoanalysis methods. Several pathological situations are associated with an increase of plasma endothelin concentrations; these situations include arterial hypertension, myocardial infarction, cardiogenic shock and renal failure. Although not all physiopathological applications of endothelin have been elucidated, our current knowledge of this substance indicates that it will be of importance in human medicine.

Acute Kidney Injury↗
PubMed1992

Long-term immunosuppression after liver transplantation: are steroids necessary?

Steroid therapy was withdrawn in 85% of 152 orthotopic liver transplant recipients with grafts surviving for more than 3 months, and 87% of these remained steroid-free. Steroid therapy was restarted in 8% for reasons other than rejection. The most common was conversion of immunosuppression because of cyclosporine nephrotoxicity. The incidence of rejection after steroid withdrawal was low: 3.8% for chronic rejection (CR) and 4.5% for acute rejection. Only 3 grafts (1.9%) were lost because of CR. No risk factors have been identified for the development of CR after steroid withdrawal, but a protective role for azathioprine has been suggested.

Adolescent↗
PubMed1992

Liver transplantation: the challenges of the 1990s.

An enormous increase in liver transplantation has been observed over the last decade since it now represents a suitable therapeutic option for patients with end-stage liver disease. The overall one-year survival rate is about 75% for adults and 85% for children, when fulminant hepatic failure and malignancies are excluded. Such improvements in both survival and quality of life are due to many concurrent factors: better timing and selection; development of the UW solution for liver preservation; improvement in operative management including surgical technique, veno-venous bypass and cell-saver; progress in intensive care management of immunosuppressed patients. Nevertheless, the increasing demand for livers is now confronting the transplant teams with organ shortage, for which the introduction of graft reduction, hepatic biparition and living-related donation will contribute to alleviate the scarcity of donors. As a consequence of the increasing number of long-term survivors, greater efforts are now being directed towards the long-term outcome after liver transplantation: disease recurrence, the need for permanent immunosuppression and the quality of rehabilitation will become the challenges of the 1990s before reaching the next step towards multiple organ transplantation.

Humans↗
PubMed1992

Orthotopic liver transplantation for hepatic GVHD following allogeneic BMT for chronic myeloid leukaemia.

A 21-year-old man who had an HLA-identical sibling donor BMT for chronic myeloid leukaemia developed grade IV acute GVHD of the liver that was unresponsive to corticosteroids and anti-IL2 receptor monoclonal antibody. He was treated with an orthotopic liver transplant and is currently well 6 months later with normal liver function and no evidence of GVHD in the transplanted liver.

Adult↗
PubMed1992

[Significance of the level of carcinoembryonic antigen in the alveolar lavage fluid in cancerous and non-cancerous bronchopulmonary pathology].

In a prospective study the level of carcinoembryonic antigen (ACE) were simultaneously measured in plasma and bronchoalveolar lavage liquid (LBA), in fifteen patients suffering from bronchopulmonary cancer and fifteen patients suffering from non-malignant pulmonary disease. In these two groups the level of ACE in LBA liquid (cancer 8,990 +/- 4,050 ng/ml; controls 2,510 +/- 1,060 ng/ml) were clearly more elevated than the corresponding plasma levels (cancer 1,931 +/- 1,760 ng/ml; controls 8.2 +/- 2 ng/ml) and the plasma levels of ACE were more elevated in the cancer group; in the same group the ACE levels in the LBA liquid were more elevated in the tumour group (4,770 +/- 2,180 ng/ml versus 808 +/- 300 ng/ml). This study has also shown the elevated levels of ACE in the LBA liquid in patients suffering from chronic bronchial inflammation (2,510 +/- 1,060 ng/ml) and during the course of acute bacterial pneumonia. The contribution of the ACE level in LBA liquid in relation to the plasma levels in the diagnosis of bronchopulmonary cancer would thus appear to have no clinical value, but the exact relationships between the phenomenon of chronic bronchial inflammation and metaplasia of the bronchial epithelium merit further study.

Biomarkers, Tumor↗
PubMed1992

Orthotopic liver transplantation with a reduced-size graft: an ideal compromise in pediatrics?

This study retrospectively reviewed the results of 81 orthotopic liver transplantations in 72 pediatric patients with either a full-size graft (n = 41) or a reduced-size graft (n = 40) during a 4-year period. Two types of liver reduction were used to obtain a left lobe graft (n = 30) or a left lateral segment graft (n = 10). The choice of the reduction technique was based on two criteria: the donor/recipient body weight ratio and the transverse size of the recipient's abdomen. The patients who underwent transplantation with a reduced-size graft were younger and smaller than those who received a full-size graft. The mortality rate of the candidates on the pediatric transplantation waiting list was 2.7% during the same period. The 3-year survival rate after elective transplantation was 85% and 75% in the full-size graft group and the reduced-size graft group, respectively (difference not significant). The use of reduced-size grafts was associated with higher amounts of red cell and fresh-frozen plasma transfusions after graft revascularization. The incidence of postoperative bleeding and bile leakage from the transected surface was low, whereas hepatic artery and biliary complications were less frequent in the reduced-size graft group than in the full-size graft group. At the time of follow-up, liver biochemical test results and quality of life were not different between the two groups. Despite the constraining technique and the increase in intraoperative blood loss, orthotopic liver transplantation with a reduced-size graft allows us to overcome the shortage of pediatric donors and improve the overall survival rate of children with end-stage liver disease.

Activities of Daily Living↗
PubMed1991

Growth hormone response following growth hormone releasing hormone injection in thalassemia major: influence of pubertal development.

Thirty-five patients with thalassemia major, aged 7 to 21 years, were studied to define the relationship between the pubertal development and the growth-hormone (GH) secretion during sleep, after administration of GH-releasing factor (hpGRF 1-44), and betaxolol-glucagon or arginin-insulin. Pubertal development was classified as being appropriate or delayed for chronological age. GH response to pharmacological stimuli and during sleep was not linked to the pubertal development according to the chronological age. The peak of GH secretion after GHRH injection was significantly delayed in thalassemic patients with retarded puberty. The integrated secretion of GH during the 120-min test was slightly but not significantly reduced in these patients. The prepubertal pattern of GHRH response was restored in the patients receiving substitutive therapy by HCG or testosterone. The alteration of GH response to GHRH in thalassemic patients is likely to be only due to delayed puberty and decreased endogeneous GHRH secretion since it is corrected by androgen or gonadotropin replacement.

Adolescent↗
PubMed1991

[Preliminary results with "ex situ" surgery for hepatic tumors: an alternative between palliative treatment and liver transplantation?].

We report 3 cases of liver tumors which were unsuitable for conventional resection and which were removed using a technique combining hypothermic portal perfusion with an anhepatic period of more than 2 hours. The liver was mobilized after section of the infra- and supra-hepatic inferior vena cava in 2 cases. The tumor was a cholangiocarcinoma in 2 cases and colonic metastasis in 1 case. Non-tumoral liver parenchyma was normal in all cases. The inferior vena cava was involved by the tumor in 2 cases. Complete tumor resection was achieved in all cases, but required reconstruction of the hepatic veins in 1 case. Two patients in whom portal venous bypass was not used developed hemodynamic failure after liver revascularization. One of them died. In patients without underlying chronic liver disease and with unresectable tumor by conventional technique, "ex situ" resection can be a worthwhile therapeutic alternative.

Adenoma, Bile Duct↗