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Biomedical subjects

D Houssin

Publications and source records attributed to D Houssin.

At least 271 records · Page 15Linked to original sources
PubMed1983

Surgical management of gallstones in cirrhotic patients.

Among the cirrhotic patients admitted to our department, 64 (17 percent) were found to have cholelithiasis. In 14 patients (22 percent), cholelithiasis caused cholecystitis, obstructive jaundice, or biliary pain. These 14 patients were operated on and underwent cholecystectomy. There was one postoperative complication (gastrointestinal bleeding from esophageal varices) and one death (due to acute respiratory failure). In 50 patients (78 percent) cholelithiasis was asymptomatic. Ten of the 50 patients died from liver failure and the stones were discovered at necropsy. Seven of the patients had radiographically demonstrated stones that were not operated on. They are alive at the present time, more than 2 years later. In the remaining 33 patients, the stones were discovered during portasystemic shunt procedures. In these patients, cholelithiasis was systematically treated by cholecystectomy (8 patients) or cholecystolithotomy (25 patients). Postoperative mortality and morbidity rates were not different in these 33 patients when compared with the rates in 170 patients who underwent portal surgery alone during the same period. Our results confirm the high incidence of cholelithiasis in cirrhotic patients. Complications of gallstones are not frequent but require an emergency operation that carries a high risk in these patients. On the other hand, elective surgical treatment of asymptomatic cholelithiasis at the time of portal diversion does not bear any peculiar risk. In such a situation, cholecystolithotomy is easier and probably safer than cholecystectomy.

Cholecystectomy↗
PubMed1983

Suppression of the shunt and esophageal transection. A new technique for the treatment of disabling postshunt encephalopathy.

A new surgical procedure was developed for the treatment of disabling postshunt encephalopathy. This procedure consists of an esophageal transection with esophagogastric devascularization, followed by suppression of the shunt. Suppression of the shunt is performed postoperatively using external maneuvers. In the four patients treated, suppression of the shunt led to disappearance of the clinical manifestations of encephalopathy in three and to a significant improvement in one. Providing that the shunt is side-to-side, this new treatment would allow a dramatic improvement in the small number of patients in whom severe encephalopathy develops after portosystemic shunting.

Brain Diseases↗
PubMed1983

Mercuric chloride nephritis depends on host rather than kidney strain.

Brown-Norway (BN) rats are susceptible to the induction of an autoimmune glomerulonephritis (GN) by HgCl2 while Lewis (LEW) rats are resistant. When a kidney from a LEW rat (nonsusceptible) is transplanted into a binephrectomized (LEW X BN)F1 hybrid (susceptible) then HgCl2 injections into the recipient result in GN developing in the donor kidney. When a kidney from a BN or (LEW X BN)F1 hybrid (susceptible) is transplanted into a nonsusceptible rat, injections of HgCl2 into the recipient do not result in GN in the donor kidney. These observations show that kidneys from nonsusceptible rats function as susceptible targets and that induction of the disease depends more on the host immune system than on modification of kidney determinants by HgCl2.

Animals↗
PubMed1983

Glomerular and vascular IgG deposits in HgCl2 nephritis: role of circulating antibodies and of immune complexes.

The respective roles of circulating anti-glomerular basement membrane antibodies and of circulating immune complexes in the appearance of glomerular linear and granular IgG deposition during HgCl2-induced glomerulonephritis in the Brown-Norway rat has been studied. Syngeneic kidney transplantations have been performed at various phases of the disease. Results show that circulating antibodies are responsible for linear IgG deposition which did not change to granular deposits during the course of the disease. Electron-dense subepithelial deposits occurred only when circulating immune complexes were detected. These experiments strongly suggest that, in the mercury model, circulating immune complexes are responsible for granular IgG deposits observed in arteries and in the subepithelial space of glomeruli.

Animals↗
PubMed1983

Spontaneous long-term acceptance of RT-1-incompatible liver allografts in inbred rats. Analysis of the immune status.

In several combinations of inbred rats, liver allografts are spontaneously tolerated, and after a few weeks liver tolerant rats are in a state of donor-specific transplantation tolerance. In vivo and in vitro experiments were conducted to analyze the immunological status of LEW or BN rats with spontaneously tolerated (LEW X BN) F1 liver allografts several months after transplantation. Acute rejection of secondary donor-specific heart allografts retransplanted from liver-tolerant rats to normal syngeneic hosts suggests that the state of tolerance in liver-tolerant rats is related to an active modification of the immune system of the rat and not to a reduced immunogenicity of the graft. No cytotoxic antibodies or cells were found in liver-tolerant rats. Reactivity in mixed lymphocyte culture was normal or slightly reduced. Arguments for the presence of splenic suppressor cells were found in LEW tolerant rats using a local graft-versus-host assay, but these could not be found in BN rats, or when attempting to transfer or to break the tolerance state. A nonspecific humoral blocking factor was found in vitro in liver-tolerant rats but transfer of serum from liver-tolerant rats to normal syngeneic hosts did not permit a significant prolongation of donor-specific heart allografts. These results suggest that more than one mechanism may be involved at the maintenance phase of liver allograft tolerance.

Animals↗
PubMed1983

Spontaneous long-term survival of liver allografts in inbred rats: comparison between semi-allogenic and fully allogeneic strain combinations.

Spontaneous tolerance of liver allografts can be observed in inbred rats. In order to study the influence of the density of major histocompatibility complex alloantigens on the fate of liver allografts in the rat, liver allografts were performed in a semi-allogeneic and a fully allogeneic combination. Comparisons of the fate of heart and kidney allografts were made in the same combinations. A similar proportion of spontaneously tolerated liver allografts was observed in the two combinations; after a few months these animals were in a state of donor-specific unresponsiveness. A spontaneous prolongation of kidney allografts was observed only in the semi-allogeneic combination. These animals were not in a state of donor-specific unresponsiveness. These results suggest that induction of liver allograft tolerance in the rat is not decisively influenced by the importance of the density of major histocompatibility complex antigens present on the graft and that its mechanism may be different from that which causes spontaneous prolongation of semi-allogeneic kidney allografts.

Animals↗
PubMed1983

Graft-versus-host reaction induced by spleen grafting in inbred strains of rats. Influence of portal venous drainage.

Acute graft-versus-host (GvH) reaction was induced by spleen grafting in inbred rats. A comparison of the influence of portal or caval drainage of the spleen graft on the survival time was made. This comparison revealed a prolongation of survival time in case of a portal drainage when the graft was an auxiliary half-spleen graft. This result suggests that the liver may have, in some conditions, protective capacities against an acute GvH reaction.

Animals↗
PubMed1983

[Removal of the kidney following in situ perfusion].

Kidneys of potential donors undergoing sudden cardiac arrest are generally not gathered because the warm ischemia time is too long until nephrectomy. A rapid in situ cold perfusion technique was developed to preserve kidneys in 21 brain-dead patients after cardiac arrest not responding to cardiac resuscitation. In 7 of the 21 potential donors, the in situ perfusion was unsuccessful. In 14 other subjects this technique permitted to save 15 transplantable kidneys; 1 month after grafting, the renal function was similar to that observed in kidneys gathered in living patients. The in situ perfusion technique allows to increase by nearly 10% the efficacy of kidney gathering.

Brain Death↗
PubMed1983

Microlithiasis of the gallbladder.

Patients with microlithiasis represent a small group compared with the general population of patients with gallstones. However, it is a group which deserves particular attention because of the risk of acute pancreatitis. For this reason, cholecystectomy should be advocated in patients considered to be at low anesthetic risk in which echography or roentgenography detects the presence of minute stones in the gallbladder, even in the absence of biliary disorders.

Acute Disease↗
PubMed1982

Surgically induced acute hepatic failure in the rat.

Several surgical procedures were tested in the rat in order to create a spontaneously lethal but potentially reversible acute hepatic failure. Two combined surgical procedures fulfill these conditions: '75% hepatectomy' plus portacaval shunt and '85% hepatectomy' plus 30-min clamping of the celiac and superior mesenteric arteries. These two procedures should constitute useful tools for the evaluation of new methods of hepatic support.

Animals↗
PubMed1981

[Hepatology in 1981].

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Chemical and Drug Induced Liver Injury↗