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Biomedical subjects

F Carnot

Publications and source records attributed to F Carnot.

At least 109 records · Page 6Linked to original sources

Hepatitis B virus and hepatitis B-related viral infection in renal transplant recipients. A prospective study of 90 patients.

Hepatitis B virus (HBV) infection may induce severe hepatitis and affect long-term survival of kidney transplant recipients. Persistent viral infection has been shown to occur despite the absence of usual serologic markers. The liver and serum HBV deoxyribonucleic acid (DNA) status of 90 patients were studied prospectively; recently transplanted patients, both hepatitis B virus surface antigen (HBsAg)-positive and negative, with and without liver disease, were investigated with HBV serology, serum HBV DNA, and liver histology. Thirty-four patients had detectable HBsAg, and 21 had viral multiplication at the time of transplantation. Serial HBV DNA determinations performed in 57 of 90 patients disclosed (a) reactivation of HBV replication in 11 of 12 HBsAg-positive patients, (b) increase of viral replication when positive on the initial sample in 6 of 11 patients, and (c) development of HBV replication in 7 of 35 of the HBsAg-negative patients. Moreover, liver HBV DNA studies showed a statistical correlation between the presence of integrated liver HBV DNA and chronic hepatitis in HBsAg-negative patients. This study demonstrates prospectively the significant association of HBsAg-positive as well as HBsAg-negative HBV infection with chronic hepatitis and suggests that immunosuppressive therapy may enhance the viral replication in both HBsAg-positive and negative subjects.

Adult↗

[Peripheral subpleural intrapulmonary lymph nodes. Apropos of a clinical case and an anatomical case].

The authors report the case of a round, peripheral radiographic opacity ("coin lesion" of English-language authors) which after surgical excision was found to be an intrapulmonary lymph node. In an anatomical study on the lymphatic drainage of pulmonary segments in adults, a similar lesion was found among 483 injected segments. A review of the literature yielded 27 similar cases which are described in detail. These lymph nodes are probably more frequent than is generally believed, as shown by an experimental radiolymphographic study. Such clinical findings will no doubt be rendered more numerous by the improved sensitivity of new medical imaging techniques. Despite hypotheses put forward by the authors, the presence of these lymph nodes, which seem to be acquired by the adult lung, has not yet been explained.

Aged↗

Fulminant hepatitis in renal transplant recipients. The role of the delta agent.

In a series of about 300 renal transplant patients followed from 1972 to 1983, 3 cases of fulminant hepatitis were observed in HBs Ag-positive patients. In the liver biopsies of 2/3 of them, the delta antigen was detected by direct immunofluorescence with a specific anti-delta serum. This result demonstrates the responsibility of the delta agent for the development of fulminant hepatitis, and emphasizes the possibility of delta infection in HBs Ag-positive transplant patients with severe hepatitis.

Antigens, Viral↗

Monoclonal anti-HBs antibodies radioimmunoassay and serum HBV-DNA hybridization as diagnostic tools of HBV infection: relative prevalence among HBsAg-negative alcoholics, patients with chronic hepatitis or hepatocellular carcinomas and blood donors.

Anti-HBs monoclonal antibodies radioimmunoassay (m-RIA) and HBV-DNA hybridization techniques were used to detect HBs antigen (HBsAg)--associated determinants (evidence of HBV on-going infection) and HBV-DNA sequences (evidence of viral multiplication) in the serum samples of 479 patients who were HBsAg negative by standard solid-phase radioimmunoassay. They included 128 alcoholics, 104 patients with chronic hepatitis, fifty-four with an hepatocellular carcinoma, 100 with coagulation disorders and ninety-three blood donors. The aim of this study was the comparison in these populations of the prevalence of the various HBV markers. m-RIA detected HBsAg-associated determinants in 1% of blood donors, 3% of coagulation disorders, 3.1% of the alcoholics, 21.1% of chronic hepatitis and 16.6% of hepatocellular carcinoma; hybridization identified HBV-DNA sequences in 0.9%, 2.2%, 10.9%, 9.6% and 5.5% of these cases, respectively. The combined prevalence of both markers of an on-going HBV infection (with or without viral multiplication) was 14.16%, 26.9% and 22.2% in the latter groups, respectively, as compared with only 3% in patients with coagulation disorders and 2.1% of blood donors. These results confirm the frequency of HBV or HBV-related virus infection in alcoholics, in chronic hepatitis and hepatocellular carcinomas, despite the absence of HBsAg by standard RIA (or even of any other usual marker); this gives further evidence for variations in the expression of HBV infection. A high and quite similar prevalence of usual serum markers and hybridization results was observed in the alcoholics and in the patients with chronic hepatitis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Multiple leiomyomatous pulmonary nodules in women. Apropos of 2 cases of metastasizing benign leiomyoma].

Two cases of multiple pulmonary leiomyomas in women aged 51 and 45 years respectively are reported. The lesions were discovered 21 and 11 years respectively after hysterectomy for uterine fibromyoma without abnormal histological features. The pulmonary nodules were bilateral and either stable or growing slowly. They were revealed by non-specific symptoms. At surgical biopsy the histological picture was one of benign leiomyoma without mitosis. In one of the 2 patients a pulmonary nodule was explored for oestrogen and progesterone receptors with positive results. The various theories on the origin of these multiple leiomyomas are reviewed. Initially regarded as malformative tumours, they were later interpreted as metastases of uterine leiomyomas with a potential for dissemination. The finding of hormone receptors demonstrates a relationship between these pulmonary lesions, uterine leiomyomas and other multifocal leiomyomatous diseases, including lymphangioleiomyomatosis. The slow but benign course of these tumours differentiates them from metastases of low-malignancy leiomyosarcomas.

Female↗

Fluorescence as a guide to bronchial biopsy.

The presence of fluorescence was assessed in 34 unselected patients undergoing bronchoscopy, 11 of whom suffered from bronchial carcinoma. Bronchoscopic inspection was carried out with white light and then repeated with blue light after the injection of 2 ml of 10% sodium fluoresceinate. Fluorescence was graded visually. Seventy six pairs of biopsy specimens were obtained. Of 38 specimens from non fluorescent areas, histological appearances were normal in 34. Slight inflammation was observed in three biopsy specimens, and in one there was evidence of tumour even though the specimen was obtained some distance from the primary tumour. Of 38 biopsy specimens from fluorescent areas, histological examination showed appearances of moderate inflammation in 10, severe inflammation in 10, tuberculosis in one, and carcinoma in 11. In six instances histological appearances were normal. Five normal subjects who were smokers were also examined by the same technique. Appearances of metaplasia were found more often in areas showing fluorescence than in areas not showing fluorescence. Bronchial fluorescence is considered to be related to alteration in vascularity and is not specific for carcinoma. The most fluorescent areas are generally the most pathological and visible tumour is very fluorescent, but moderate degrees of fluorescence are difficult to interpret. Biopsy of every fluorescent area seems excessive.

Adult↗

Clinical and histological resolution of systemic amyloidosis after renal cell carcinoma removal.

This report describes the case of a 62-year-old woman with systemic amyloidosis involving the kidneys and digestive tract, consecutive to a renal cell carcinoma. Within 3 years after tumor removal, both the nephrotic syndrome and protein loss enteropathy regressed. Histological examination showed the disappearance of the potassium permanganate-sensitive deposits within the digestive tract. This indicates that clinical remission of systemic amyloidosis may be associated with morphologic disappearance of amyloid deposits.

Amyloidosis↗

[Cervical tracheogenic air cyst. Apropos of 2 cases].

The authors report 2 cases of gas-containing cervical cysts. Surgical excision by cervicotomy showed that both of these well-defined cysts were attached to the right border of the cervical trachea by a blind "pseudo-pedicle" and were lined with respiratory-type epithelium. These were 2 tracheogenic cysts, analogous to bronchogenic cysts theoretically linked to an abnormality in the development of the bronchial buds during embryogenesis. These two cases were exceptional not only by virtue of their cervical site, but also the fact that they contained air and occurred in already old women.

Aged↗

Liver involvement in nonamyloid light chain deposits disease.

Liver examination performed in seven patients who had renal failure related to light chain deposits demonstrated in all cases the presence of liver light chain deposits. In all of our patients clinical renal involvement antedated the liver disease. The portal areas and the Disse spaces contained a granular material which strongly reacted with antilight chain antiserum (kappa or gamma). In one patient in whom lesions were severe, the sinusoid edge was ruptured and a pelliosis -like lesion was observed. In the five patients who were hemodialyzed for more than several months at the time of discovery of liver deposits, increased amounts of collagen were present in the Disse spaces, and one patient had extensive liver fibrosis by light microscopy. Clinical liver involvement was defined by moderate hepatomegaly in five patients, with ascites in two. A slight increase in phosphatase alkaline activity was frequently observed and bromsulphalein retention was present in two. In one patient liver tests remained entirely normal despite the presence of diffuse kappa light chain deposits.

Aged↗

[Presinusoidal portal hypertension in post-hepatitis cirrhosis].

Two cases of very probable post-hepatitis cirrhosis are presented. Both were complicated by presinusoidal portal hypertension (P. H. T.), the peroperative portal pressures measured directly being much higher than the wedged hepatic venous pressures. Although post-sinusoidal P. H. T. is the usual complication of most types of cirrhosis, these two cases support recent studies reporting the possibility of pre-sinusoidal P. H. T. in post-hepatitis cirrhosis. The wedged hepatic venous pressure is not a reliable indicator of portal pressure in these cases. The presence of presinusoidal P. H. T. does not exclude the diagnosis of cirrhosis but makes that of alcoholic cirrhosis very unlikely.

Adult↗

[Colonic tumors after ureterosigmoidostomy. Value of coloscopy in their detection and treatment].

Congenital malformations and tumours of the bladder are the commonest indications of uretero-sigmoidostomy, an operation associated with the name of Coffey who perfected the technique. A part from the renal and metabolic complications of this operation, the risk of benign or malignant tumours at the anastamosis should not be overlooked. Four cases are reported which underline the incidence of juvenile polyps and mixed juvenile and adenomatous polyps which tend to degenerate. The medical literature is reviewed. Uretero-sigmoidostomy is a definite cause of tumour formation. The different pathogenic hypotheses are discussed. Colonoscopy is a method of detecting the tumour, of obtaining a histological diagnosis and treating benign polyps by diathermy under endoscopic control. This technique allows preservation of the anastomosis. The prevention of these lesions should be assured by annual endoscopy for 5 years after operation.

Adult↗

Evidence that hepatitis B virus has a role in liver-cell carcinoma in alcoholic liver disease.

We compared the presence of serologic markers of hepatitis B virus (HBV) infection with the presence of the viral DNA in the livers of patients with alcoholic liver disease with or without hepatocellular carcinoma. Among 51 patients with various kinds of alcoholic liver disease but without hepatocellular cancer, 19 had one or more serologic markers of HBV, but only three had viral surface antigen in their serum. These three patients, as well as three others who had HBV antibodies but no viral antigen in their serum and two others who had no serologic markers of any kind, had HBV DNA in their liver cells. In at least five of the eight patients with viral DNA in the liver, the DNA was integrated into the genome. Among 20 patients with alcoholic cirrhosis and hepatocellular carcinoma, nine of the 16 tested had serologic markers of HBV infection, but all 20 had HBV DNA integrated into the genome of the neoplastic liver cells. These data suggest that HBV plays a part in the pathogenesis of primary liver-cell cancer in alcoholics.

Adult↗