PubMed Health⌕ Search

Biomedical subjects

F Carnot

Publications and source records attributed to F Carnot.

At least 73 records · Page 4Linked to original sources
PubMed1994

[A rare tumor of the thoracic wall: synovial sarcoma].

The synovial sarcoma is a tumour of the soft tissues. Its thoracic localisation is unusual. The authors report a case of a recurrent tumour of the scapula, whose excision required major plastic surgery to the dorsal chest wall. The diagnosis was revealed by the biphasic histological nature which was confirmed on immunological studies. Such tumours give rise to discussions on their histogenesis; their subsequent progress is slow and recurrences are common. Healing depends on the radical nature of their excision.

Adult↗
PubMed1993

Microsporidia infection in patients with the human immunodeficiency virus and unexplained cholangitis.

BACKGROUND: Cholangitis in patients with the acquired immunodeficiency syndrome (AIDS) is usually associated with opportunistic infections by cryptosporidium species or cytomegalovirus, but in about a third of cases no opportunistic agent is identified. We suspected some of these cases of biliary disease might be explained by infection with the microsporidia species Enterocytozoon bieneusi, an obligate intracellular protozoan that causes chronic diarrhea in patients infected with the human immunodeficiency virus (HIV). METHODS: We studied eight HIV-infected homosexual men (in either group IV of the classification of the Centers for Disease Control and Prevention or group II, with a CD4 cell count of < or = 10 per cubic millimeter) who were referred because of cholangitis for which no causative agent had been found by standard tests. All the patients underwent abdominal ultrasonography and endoscopic ultrasonography or endoscopic retrograde cholangiopancreatography with collection of bile from the common bile duct. One patient had transhepatic biliary catheterization, and two others had cholecystectomy. Bile samples, duodenal- and liver-biopsy specimens, and gallbladder tissue were studied by light and electron microscopy. RESULTS: All eight patients with unexplained AIDS-related cholangitis had biliary microsporidosis. Intraepithelial E. bieneusi spores (1 to 2 microns) and supranuclear plasmodia (3 to 8 microns) were identified in the six duodenal-biopsy specimens. May-Grünwald-Giemsa staining of bile samples revealed free forms of microsporidia in all eight patients, and the presence of E. bieneusi was confirmed by electron microscopy. E. bieneusi was also identified in ductal biliary cells on a liver biopsy, in one common-bile-duct smear, and in gallbladder epithelium (in two patients). Four patients were found to have associated but previously undetected biliary or duodenal cryptosporidiosis, whereas another had biliary infection associated with cytomegalovirus. CONCLUSIONS: Infection of the biliary tract with E. bieneusi is associated with and may be a cause of AIDS-related cholangitis.

AIDS-Related Opportunistic Infections↗
PubMed1993

AIDS-related cholangitis: diagnostic features and course in 15 patients.

About 60 cases of cholangitis in patients with the acquired immune deficiency syndrome (AIDS) have been described. We report our experience concerning 15 patients infected with the human immunodeficiency virus (HIV) and who had cholangitis as defined by radiological findings. Cholangitis was the revealing event of AIDS or HIV infection in 4 patients (27%). Twelve (80%) of the patients were homosexual men. The main diagnostic features were abdominal pain (73%), cholestasis without jaundice (100%), intestinal cryptosporidiosis (80%) and abnormal findings on abdominal ultrasonography (87%). Endoscopic retrograde cholangiopancreatography appears to be essential for diagnostic and therapeutic purposes, particularly for patients with papillary stenosis who represented 64% of our population. Biological and morphological pancreatic abnormalities were associated in 2 of the 8 patients who underwent retrograde opacification of the Wirsung duct. The microbiological yield was highest in patients who underwent multiple biopsies (duodenal and papillary) and bile sampling. The organisms found included Cryptosporidium (57%) of cases), CMV (28%) and Microsporidia (7%). Twelve-month survival after the diagnosis of cholangitis was only 14% and all deaths were related to AIDS progression. Endoscopic sphincterotomy relieved abdominal pain in 86% of the patients who underwent the procedure. Evaluation of medical treatment, particularly ursodeoxycholic acid, is necessary.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Implantation metastasis following percutaneous endoscopic gastrostomy.

Since it was first described, the original percutaneous endoscopic gastrostomy (PEG) technique has proved to be a valuable adjunct in patients with head and neck tumours. This procedure is being increasingly utilized in the face of swallowing impairment related to head and neck carcinoma. Although generally well tolerated, it may be associated with complications. In this report, we document tumour implantation at the percutaneous endoscopic gastric site and review the report cases. It appears that implantation metastasis does alter prognosis.

Aged↗
PubMed1993

Hepatitis C virus RNA in anti-HCV positive hemodialyzed patients: significance and therapeutic implications.

About 25% of French hemodialysis patients have antibodies against the hepatitis C virus (HCV), which may reflect either past or active HCV infection. It is important to evaluate the significance of these antibodies, as most hemodialysis patients are candidates for kidney transplantation and have normal transaminase activities despite biopsy-proven chronic hepatitis. We prospectively assayed HCV viremia with the nested polymerase chain reaction in 61 patients on maintenance hemodialysis who had anti-HCV antibodies detectable in second generation tests (ELISA2 or RIBA2). HCV RNA was repeatedly detected in the serum of 52 (85.2%) patients. Liver biopsy, which was performed in 17 cases, revealed chronic hepatitis in 16 cases (including 2 of cirrhosis) and steatosis in one. Hypertransaminasemia was observed in only 31.3% and 30.8% of patients with chronic hepatitis and HCV viremia, respectively. Anti-HCV antibodies are frequently associated with HCV viremia, resulting usually in chronic hepatitis, although hypertransaminasemia is uncommon. HCV viremia reflects both post-transfusional and community-acquired HCV infection. These findings suggest a need for liver biopsy and antiviral treatment before kidney transplantation. The isolation of anti-HCV positive subjects in the dialysis setting should be evaluated to reduce patient-to-patient transmission of HCV.

Base Sequence↗
PubMed1993

[Efficacy of immunotherapy with vaccination against hepatitis B virus on virus B multiplication].

In a prospective, non-randomized, pilot study, we evaluated the efficacy of hepatitis B virus (HBV) vaccination in inhibiting HBV replication of chronic hepatitis B. Fourteen consecutive chronic HBs antigen carriers received standard vaccination with three injections of the GenHevac B vaccine, one month apart. All the patients had active HBV replication with chronic hepatitis but not cirrhosis. They were compared to a historical group of 34 patients who fulfilled the same inclusion criteria. Over the 6-month follow-up period after the first injection, serum HBV DNA became undetectable in 3 patients (21.4%). Four additional patients (28.6%) showed a significant decrease in HBV replication. In 4 cases, the disappearance of or decrease in HBV DNA was preceded by an increase in transaminase activities, which was also observed in one patient who did not modify his viral replication. Vaccination was otherwise uneventful. By contrast, during a mean follow-up of 40 months, only 3 (9%) of the 34 unvaccinated patients who served as controls lost serum HBV DNA, giving a 6-month HBV DNA disappearance rate of 1%. In sum, vaccination appeared able to reduce or stop HBV replication in half of the chronic HBsAg carriers with chronic hepatitis. This additional therapeutic tool may enhance the rate of response to interferon-alpha therapy, which is dependent on the level of HBV replication. Thus, immunotherapy should be considered of potential importance for the treatment of HBV infection.

Adult↗
PubMed1993

[Extrapulmonary intrathoracic pneumocystosis. Apropos of 4 cases in HIV positive patients].

The authors report 4 cases of intrathoracic extrapulmonary pneumocystosis; 3 of them involved the pleura and 1 the mediastinal lymph nodes. As in other rare but apparently increasingly frequent cases, everything seemed to incriminate the use of prophylactic Pentamidine aerosols, but only a prospective study of systemic versus aerosol prophylaxis can confirm this suspicion.

AIDS-Related Opportunistic Infections↗
PubMed1992

Interactions between human immunodeficiency virus-1, hepatitis delta virus and hepatitis B virus infections in 260 chronic carriers of hepatitis B virus.

To evaluate the factors determining the severity of chronic hepatitis B virus infection and the interactions of human immunodeficiency virus and hepatitis delta virus infections, we retrospectively analyzed 260 patients, 146 of whom were followed for a mean of 31.4 +/- 1.8 mo. Human immunodeficiency virus, hepatitis B virus, and hepatitis delta virus status and aminotransferase activities, histological activity index, alcohol consumption and the prevalence of cirrhosis were investigated. The patients included 54 homosexuals, 19 parenteral drug abusers and 187 subjects with other or unidentified risk factors for exposure to hepatitis B virus. Thirty-five patients (13%) were positive for antibody to human immunodeficiency virus; 27 were homosexual and 8 were drug abusers. The mean aminotransferase activities, histological activity index and the prevalence of cirrhosis were similar in the human immunodeficiency virus-positive and human immunodeficiency virus-negative subgroups. Actuarial survival was significantly lower in the human immunodeficiency virus-negative subgroups. Actuarial survival was significantly lower in the human immunodeficiency virus-positive group than in the human immunodeficiency virus-negative subjects (p = 0.004); the cause of death was clearly related to liver failure in four of the five human immunodeficiency virus-positive patients and two of the six human immunodeficiency virus-negative subjects who died. To evaluate the factors determining the severity of liver disease, we compared homogeneous subgroups of subjects. Among the homosexual patients, the prevalence of HBeAg and hepatitis B virus DNA, aminotransferase activities and the histological activity index did not differ according to human immunodeficiency virus antibody status.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1992

Enterocytozoon bieneusi infection in acquired immunodeficiency syndrome-related sclerosing cholangitis.

Acalculous cholecystitis and sclerosing cholangitis due to Cryptosporidium sp, and cytomegalovirus have been described in patients with the acquired immunodeficiency syndrome (AIDS). However, in about 40% of cases of AIDS-related biliary disease, no opportunistic pathogen is identified. The current case report describes the first case, to the best of the authors' knowledge, of AIDS-related sclerosing cholangitis associated with microsporidiosis. Enterocytozoon bieneusi was detected in the duodenum and bile by means of light microscopy and confirmed by electron microscopy. Microsporidian infection should be suspected in patients with AIDS-related sclerosing cholangitis as well as in cases of diarrhea in which none of the usual pathogens are found.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Hepatitis C virus in kidney recipients. Epidemiology and impact on renal transplantation.

In an attempt to evaluate the prevalence, kinetics and impact of HCV infection in renal transplantation, we analyzed 140 kidney recipients according to the histopathological status of the liver. Thirty-three HBsAg-negative patients had chronic active hepatitis, 73 HBsAg-negative patients had a normal liver, 21 HBsAg-negative kidney recipients had minimal pathological changes and 13 patients had HBsAg-positive cirrhosis. Serum antibodies to HCV were detected using the ELISA from Ortho Diagnostic and confirmatory tests using the Ortho recombinant-based immunoblot assays. The overall prevalence of antiHCV antibodies was 23.6%. AntiHCV were more frequently present in HBsAg-negative patients with chronic active hepatitis (60.6%) than in HBsAg-negative patients with normal livers (8.2%) (p less than 0.0001) or minimal liver changes (33.3%) (NS) or in HBsAg-positive patients with cirrhosis (0%) (p less than 0.001). The recombinant-based immunoblot assays confirmed antiHCV-positive ELISA results in 86.7% of patients. Among the 27 antiHCV-positive kidney recipients who had serial serological follow-up, 10 (37.0%) were already positive at transplantation and remained antiHCV-positive during follow-up. Eleven patients (40.8%) acquired antiHCV an average of 95 months after renal transplantation, while antiHCV disappeared an average of 111 months after transplantation in six (22.2%), who had antiHCV prior to transplantation. The kinetics of antiHCV antibodies did not differ according to liver histology. Patient and graft survival were not different in antiHCV-positive and antiHCV-negative kidney recipients irrespective of liver histology, and there was no difference in survival between antiHCV-positive and antiHCV-negative patients with chronic hepatitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Rejection in lung transplantation--an immunohistochemical study of transbronchial biopsies.

The number, distribution, and phenotype of mononuclear cells infiltrating the allograft lung transplant were determined immunohistochemically with monoclonal antibodies directed against cellular antigens (CD3, CD4, CD8, CD22, CD25, CD16, CD56, CD68, HLA-DR) on frozen sections of transbronchial biopsies. Seventy-two transbronchial biopsies from 21 patients undergoing lung or heart-lung transplantation were evaluated histologically and immunohistologically in a prospective study. Four major results were obtained in the graft lung parenchyma: (1) whatever the histological grading of rejection, T lymphocytes expressing CD3 were present and in a significantly higher number than in control subjects (P < 0.0005); (2) there was a positive correlation between histological rejection and the number of CD3+, CD8+, CD25+, CD16+ cells (P < 0.01); (3) the CD4/CD8 ratio was inverted (0.52 +/- 0.04), with no correlation with the histological rejection; and (4) the number and location of CD3+, CD25+ cells did not correlate with CMV identification in bronchoalveolar lavage. Immunohistochemical criteria could be used for diagnosis of rejection in the management of heart-lung transplantation.

Adolescent↗
PubMed1992

Absence of hepatitis delta virus infection in chronic hemodialysis and kidney transplant patients in france.

Hemodialyzed patients and kidney recipients are frequently multiply-transfused and infected by hepatitis B virus (HBV). Hepatitis delta virus (HDV) has a symbiotic association with HBV. The prevalence of HDV infection has, surprisingly, not been assessed in patients in hemodialysis or renal transplantation setting. We retrospectively studied the prevalence of serum delta antigen and antidelta antibodies by a microenzyme-linked immunosorbent assay in 77 of the 80 HBsAg-positive patients who underwent a kidney transplantation over a 10-year period. Of these patients, 73% had active HBV replication as assessed by the presence of serum HBV DNA and 65% had a biopsy-proved chronic active hepatitis, including cirrhosis. None of our patients had any marker of HDV infection at the end of the hemodialysis period or at the end of follow-up in transplantation. These results establish that HDV superinfection has indeed been extremely rare during end-stage renal failure and kidney transplantation in France, in contrast to HBV reactivation or hepatitis C virus infection.

DNA, Viral↗
PubMed1992

[Stage T1 malignant tumors of the arythenoid. Analysis of a series of 26 cases].

26 malignant tumours of the arytenoid classified as T1 according to the UICC 1987, were treated in the ENT and Cervico-Facial Surgery wards to Hospital Laennec between 1961 and 1990. The natural history of these lesions, locoregional efficiency of the different treatments used, the part played by chemotherapy, survival, causes of death and therapeutic modalities used as a last measure, have been analysed. The frequency of tumours with neuroendocrine has been emphasized. Such a diagnosis should be questioned when the initial biopsy does not diagnose a well differentiated epidermoid carcinoma. The use of argyrophil colouring in order to find neurosecretive granules helps in carrying out the diagnosis. The treatment of tumours, classed T1 N0 M0, of the arytenoid, is based on partial, laryngeal surgery associated with a preventive, jugulo-carotidian-ipsilateral ganglionary intervention.

Actuarial Analysis↗