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Biomedical subjects

D Samuel

Publications and source records attributed to D Samuel.

At least 109 records · Page 6Linked to original sources
PubMed1995

Long-term clinical and virological outcome after liver transplantation for cirrhosis caused by chronic delta hepatitis.

Liver transplantation for liver diseases related to hepatitis B virus (HBV) and hepatitis delta virus (HDV) remains problematic because of the risk of viral recurrence. We report here the long-term virological outcome of patients transplanted for HDV-related liver cirrhosis (HDV cirrhosis). From December 1984 to December 1990, 76 patients with HDV cirrhosis underwent liver transplantation. Before transplantation, all the patients were HBsAg-positive/anti-HDV positive, and all but one were HBV DNA-negative by dot blot hybridization. HDV RNA was detected by HDV RT-PCR and liver HDAg by fluorescent HDV Ab. After transplantation, all the patients except four received continuous long-term anti-HBs passive immunoprophylaxis. The actuarial 5-year survival was 88%. All patients who did not receive anti-HBs immunoprophylaxis remained HBsAg-positive and developed hepatitis. Among the 68 patients receiving antiHBs immunoprophylaxis with a minimum follow-up of 2 months, HBsAg reappeared in 7 (10.3%) after a mean of 17 months. These seven patients developed hepatitis, with simultaneous HBV and HDV replication; and four cleared later HBsAg. Patients without HBV reinfection were studied for HDV reinfection: liver HD Ag or serum HDV RNA were present in 88% of the patients during the first year, without developing hepatitis; however, they were no longer detectable after 2 years in 95% of the patients. In conclusion, liver transplantation for HDV cirrhosis gives good results, with a 5-year actuarial survival of 88%.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1995

Ethmoidal myofibroblastoma.

Myofibroblastoma is an uncommon mesenchymal tumour characterized by spindle cells exhibiting the ultrastructural and immunohistochemical features of myofibroblasts. We report a case of a myofibroblastoma occurring in the ethmoid sinus, which to our knowledge is the first case reported in the literature. The clinical presentation, diagnosis, histology, and management of this lesion is discussed with a review of the relevant literature.

Actins↗
PubMed1994

[Bacterio-myco-virological surveillance of patients undergoing transplantation].

Bacterial and viral infectious complications are the main complications encountered after transplantation. Prevention of these complications should be done by a pre-transplant bacterial and virologic screening in the recipient, by a pre-transplant screening in the donor, and by routine bacterial and viral cultures after transplantation. Patients at high risk of post transplant infectious complication should be closely monitored, patients with denutrition, patients with a long stay in the ICU, patients at high risk of CMV primary-infection (donor CMV positive, recipient CMV negative), and patients receiving strong immuno-suppressive treatment for acute or chronic rejection. A better prevention and management of these infectious complications will improve the result of transplantation and reduce the post-transplant infectious morbidity.

Bacterial Infections↗
PubMed1994

The course of hepatitis C virus infection after liver transplantation.

Hepatitis C virus-induced liver disease is becoming a main indication for liver transplantation. Recurrence of hepatitis after transplantation has been reported, but its long-term consequences are unknown. Seventy-nine patients positive for hepatitis C virus (group 1) and 106 subjects negative for hepatitis C virus antibody (group 2) with a mean follow-up of 4 yr were retrospectively studied by means of serology, nested polymerase chain reaction and branched-DNA technology before and after liver transplantation. The actuarial rates of hepatitis C virus-related acute hepatitis were 72% and 20% at 4 yr in groups 1 and 2, respectively. Progression to chronic active hepatitis occurred in 61% and 36% of the subjects within 3 yr of the onset of recurrent and acquired hepatitis, respectively. No case of acute graft failure and two cases of cirrhosis were related to recurrent or acquired hepatitis C virus liver disease. Hepatitis C virus RNA levels were significantly increased in cases of hepatitis after transplantation. In contrast, the pretransplant hepatitis C virus RNA level was not predictive of recurrence. Our results establish the general persistence of hepatitis C virus infection after liver transplantation, the frequency and the severe course of recurrent liver disease. However, liver transplantation in hepatitis C virus antibody-positive patients still has a good medium-term prognosis.

Adult↗
PubMed1994

An observational study of 11 French liver transplant recipients infected with human immunodeficiency virus type 1.

We report the clinical and biological course of infection with human immunodeficiency virus (HIV) type 1 in 11 liver transplant recipients who acquired this infection between 1985 and 1987. Eight patients were infected by blood or blood products from graft-related transfusions and one by the graft itself; the remaining two patients were infected after transplantation and had independent risk factors. All patients received a triple-drug immunosuppressive regimen including cyclosporine. The mean duration of follow-up after liver transplantation was 52 months (standard error, +/- 32 months). Chronic graft rejection was documented in four cases. The cumulative incidences of HIV-related complications and HIV-related deaths were 82% and 27%, respectively. Three patients died rapidly of HIV disease. The survival rate 7 years after transplantation was 36% among the 11 HIV-infected patients, whereas it was approximately 70% among HIV-negative liver transplant recipients during the same period. The course of HIV infection in the four survivors did not appear to differ from that in other patients infected by blood transfusion.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Infected endometriotic cysts secondary to oocyte aspiration for in-vitro fertilization.

Two weeks after oocyte aspiration for in-vitro fertilization, a 38-year-old woman with a history of endometriosis presented with abdominal pain and fever. On exploratory laparotomy, both ovaries were enlarged and contained seropurulent fluid. Unilateral oophorectomy and drainage of the other ovary were performed. Pathological examination revealed infected endometriotic cysts.

Adult↗
PubMed1994

Management of bilateral nonpalpable testes: laparoscopic diagnosis and orchidectomy.

Bilateral nonpalpable testes in the adult human are associated with testicular malignancy, infertility and other abnormalities. Investigation for localization of the testes is mandatory, and either orchidopexy or orchidectomy is indicated. Laparoscopy was performed in an azoospermic male with bilateral unpalpable testes. A diagnosis of intra-abdominal testes was made and bilateral orchidectomy was performed. Laparoscopy is recommended for diagnosis and precise localization, as well as for orchidectomy, thus avoiding open abdominal operation in cases of intra-abdominal testes.

Adult↗
PubMed1994

Liver transplantation for viral hepatitis: the experience of the hepatobiliary center at Hospital Paul Brousse.

The prevalence of HBV recurrence after liver transplantation is higher in patients with viral B cirrhosis than in patients with viral B-D cirrhosis or fulminant hepatitis B and is related to the presence of HBV replication prior to transplantation. Long-term passive anti-HBs immunoprophylaxis is the best current way for prevention of HBV reinfection and improved long-term survival. The rate of recurrence of HCV infection is high, reaching 85%, and the rate of HCV hepatitis in the graft is approximately 75%. In most cases, HCV hepatitis leads to chronic hepatitis. The severity of graft hepatitis is related to the level of viremia at the time of the hepatitis and to the genotype 1b. The methods of prevention of HCV infection after liver transplantation are yet to be found. The treatment of graft HCV infection with interferon should be well evaluated and given cautiously. Other antiviral treatments without an immunostimulating effect are needed. Finally, patients transplanted for hepatitis B without HBV replication, receiving posttransplant long-term anti-HBs immunoprophylaxis, and those transplanted for HCV cirrhosis have a 5-year survival similar to other groups of transplanted patients. Patients belonging to these groups can be considered as candidates for transplantation. Patients with active HBV replication should be included in specific trials for prevention of HBV reinfection.

Actuarial Analysis↗
PubMed1994

Pretransplantation interferon treatment and recurrence of hepatitis B virus infection after liver transplantation for hepatitis B-related end-stage liver disease.

Orthotopic liver transplantation in patients with hepatitis B-related cirrhosis is commonly complicated by reinfection with the hepatitis B virus, with rapidly progressive liver disease and poor survival rate. We assessed the efficacy of prior therapy with recombinant interferon-alpha on the prevention of posttransplantation hepatitis B virus reinfection. Twenty-two patients with hepatitis B-related cirrhosis waiting for liver transplantation received 3 MU (decreased to 1.5 MU in cases of intolerance) of recombinant interferon-alpha until transplantation. The rates of posttransplantation hepatitis B virus reinfection and survival in this group were compared with those in a group of 26 patients previously given transplants for the same disease but not given interferon therapy. The same protocol of HBs antibody passive immunoprophylaxis was applied after transplantation in both groups. Recombinant interferon-alpha was administered for 14 +/- 7 wk. The treatment had an antiviral effect, with disappearance of serum hepatitis B virus DNA in seven of the eight patients initially positive for hepatitis B virus DNA and disappearance of HBeAg in two of the three patients initially positive for HBeAg. Serum hepatitis B virus DNA remained detectable with polymerase chain reaction at transplantation in 56% of the interferon-treated patients. After transplantation, hepatitis B virus reinfection was more frequent in polymerase chain reaction-positive than in polymerase chain reaction-negative patients (78% vs. 17%, p < 0.05). One patient's condition deteriorated during interferon treatment; this patient was not given a transplant. Two patients (in whom hepatitis B virus DNA disappeared from serum) improved so markedly during treatment that they were not given transplants.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗