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K LeBlanc

Publications and source records attributed to K LeBlanc.

8 recordsLinked to original sources
PubMed2003

G-CSF given after haematopoietic stem cell transplantation using HLA-identical sibling donors is associated to a higher incidence of acute GVHD II-IV.

The effect of granulocyte colony-stimulating factor (G-CSF), given after transplantation, was studied in 155 patients transplanted with haematopoietic stem cells (HSCT) from HLA-identical sibling donors at Huddinge University Hospital between 1993 and 2001. Only patients with haematological malignancies were included. Conditioning consisted of total-body irradiation in 118 and busulphan in 37 patients. They were all given methotrexate combined with cyclosporine as graft-versus-host disease (GVHD) prophylaxis. Of the 155 patients, 66 (43%) received G-CSF after HSCT. Those given G-CSF had a significantly shorter time to neutrophil engraftment (P <0.001). G-CSF treatment had no effect on erythrocyte transfusions, platelet engraftment and infections. However, patients treated with G-CSF had a significantly higher incidence of grades II-IV acute GVHD than those not given this treatment (34 vs 9%, P <0.001). The multivariate analysis showed that the effect of G-CSF was independent of other known risk factors for grades II-IV acute GVHD. Death from GVHD occurred in four and two cases (P=0.06) in the two groups, respectively. The cumulative incidences of transplant-related mortality, survival, chronic GVHD, relapse and relapse-free survival were similar in both groups. In conclusion, G-CSF given after HLA-identical sibling HSCT was associated with a higher risk of grades II-IV acute GVHD, but not transplant-related mortality.

Acute Disease↗
PubMed2003

Minimal adhesions to ePTFE mesh after laparoscopic ventral incisional hernia repair: reoperative findings in 65 cases.

BACKGROUND AND OBJECTIVES: Laparoscopic ventral incisional hernia repair involves intraabdominal placement of a synthetic mesh, and the possibility of formation of severe visceral adhesions to the prosthesis is a principal concern. Little clinical information based on reoperative findings is available about adhesions to biomaterials placed intraabdominally. We conducted a multi-institutional study of adhesions to implanted expanded polytetrafluoroethylene (ePTFE) mesh at reoperation in patients who had previously undergone laparoscopic incisional hernia repair done with the same mesh implantation technique. METHODS: Nine surgeons retrospectively assessed the severity of adhesions to ePTFE mesh at reoperation in 65 patients. For each case, adhesions were assigned a score of 0 to 3, with 0 indicating no adhesions and 3 severe adhesions. RESULTS: The mean time from mesh implantation to reoperation was 420 days (range, 2-1 739 days). No adhesions were observed in 15 cases. Forty-four cases received an adhesion score of 1, and 6 cases a score of 2; no scores of 3 were assigned. Thus, 59 patients (91 %) had either no or filmy, avascular adhesions. No enterotomies occurred during adhesiolysis. CONCLUSIONS: In this large series of reoperations after laparoscopic incisional hernia repair, no or minimal formation of adhesions to implanted ePTFE mesh was observed in 91 % of cases, and no severe cohesive adhesions were found. Comparative analyses of newer materials based on clinical reoperative findings are warranted to assess the safety of intraabdominally placed meshes.

Adult↗
PubMed1997

No evidence for an altered mRNA expression or protein level of haematopoietic cell phosphatase in CD34+ bone marrow progenitor cells or mature peripheral blood cells in polycythaemia vera.

Polycythaemia vera (PV) is a myeloproliferative disorder characterized by haematopoietic progenitor cells being hypersensitive to cytokines such as erythropoietin, interleukin-3, stem cell factor and insulin-like growth factor 1, which results in an increased production of mature blood cells. The pathogenetic cellular mechanism(s) behind this hypersensitivity to cytokines is unknown, but the number of cytokine receptors and the interaction between ligand and receptor are normal in PV. Interest has therefore focused on post-receptor mechanism(s). Haematopoietic cell phosphatase (HCP) is an intracellular tyrosine phosphatase that has been demonstrated to regulate proliferative signals negatively induced by the cytokines mentioned above. Moreover, motheaten mice that genetically lack HCP have an increased amount of erythroid progenitors that are hypersensitive to Epo, and patients with familial polycythaemia have been shown to exhibit a mutation of the Epo receptor gene that includes the docking site for HCP. We therefore studied mRNA expression of HCP in pure populations of CD34+ cells, granulocytes, platelets and lymphocytes from patients with PV, chronic myeloid leukaemia (CML) or essential thrombocythemia (ET), as well as healthy controls. Using a polymerase chain reaction analysis employing specific primers for HCP, we failed to detect any abnormalities of HCP expression in PV in any of the cell populations that were examined. Moreover, HCP mRNA expression was similar in ET and CML compared to controls. Finally, Western blot analysis revealed a normal HCP protein content in PV granulocytes and platelets. We therefore conclude that neither an impaired expression of the HCP gene nor a defect in HCP protein synthesis is present in PV, and does not seem to play a role in the aetiology of this disorder.

Aged↗
PubMed1990

Antibiotic prophylaxis in cardiothoracic surgery: results of a second survey.

The use of prophylactic antimicrobials in cardiothoracic surgery has become an accepted medical practice. The choice of drug and the duration of therapy varies among institutions. In 1985, we conducted a telephone survey to determine the choice of prophylactic antimicrobials in cardiothoracic surgery programs across the U.S. We recently conducted this survey for a second time. In our 1988 survey, 51 hospitals responded, with 34 (67%) having a standard antimicrobial regimen. Of all hospitals surveyed, first-generation cephalosporins were the most commonly used agents. First-generation cephalosporins were employed in 33 (48.4%) hospitals, cefamandole in 13 (19.1%), cefuroxime in nine (13.2%), vancomycin in three (4.4%), and vancomycin plus gentamicin in two (2.9%). A variety of other agents were employed by one of the remaining hospitals. Fourteen (27%) hospitals had automatic stop orders for antimicrobial prophylaxis in this indication. Ten (19.6%) institutions had changed the antimicrobial agent(s) used for prophylaxis in the last year. The results of this survey indicate that most hospitals continue to use first-generation cephalosporins for antimicrobial prophylaxis in cardiothoracic surgery, but there is considerable variation among institutions.

Anti-Bacterial Agents↗
PubMed1988

Effect of antibody-mediated neutropenia on the cardiopulmonary response to endotoxemia.

An ovine anti-neutrophil antibody has been produced by immunizing rabbits with purified sheep neutrophils. Serial intraarterial infusions of anti-neutrophil antibody in awake instrumented sheep produced selective and profound neutropenia. Intravascular infusion of endotoxin (Escherichia coli, 1.5 micrograms/kg/30 min) resulted in significant and equivalent increases in pulmonary artery pressure, peripheral vascular resistance, and protein-rich pulmonary lymph flow in an endotoxin group (n = 9) and a depletion + endotoxin group (n = 4). Changes in cardiopulmonary parameters were most pronounced 2 to 8 hr after endotoxin administration in both groups. Cardiac index (CI) showed a precipitous and transient fall in both experimental groups at 0.5 to 1 hr after endotoxin infusion; however, by 8 hr CI rose significantly in the endotoxin group, while it remained unchanged in the depletion + endotoxin group. A significant rise in the peripheral neutrophil count was associated with the increase in CI in the endotoxin group. Plasma and pulmonary lymph levels of thromboxane-B2 were unchanged during the depletion period with a significant increase 1 hr after endotoxin infusion. In this study questions arise regarding the exclusive role of circulating neutrophils in the microvascular permeability changes seen in sepsis-mediated adult respiratory distress syndrome.

Animals↗