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Biomedical subjects

L Legrand

Publications and source records attributed to L Legrand.

At least 19 recordsLinked to original sources
PubMed1989

Percutaneous transluminal angioplasty without anticoagulation.

This paper presents the results of a retrospective study of 110 percutaneous transluminal angioplasties done over a period of two years on 110 consecutive patients. Anticoagulation or antiplatelet drugs were not used during or after percutaneous transluminal angioplasty. Life-table analysis was used to calculate success rates at one and three months following the procedure. Success rates were determined using three criteria: clinical improvement, pre- and post-percutaneous transluminal angioplasty Doppler studies, and radiographic appearance. Claudication was present in 87 (79%) patients and severe ischemia in 23 (21%) patients. Sixty-eight (62%) PCTAs were done in the iliac arteries, 35 (32%) in the femoral arteries, and 7 (6%) in the popliteal artery. The majority of patients (61%) had 50%-75% arterial stenosis and only 18% had complete occlusion. Percutaneous transluminal angioplasty in the iliac arteries had the best results with cumulative success rates of 90% and 85% at one and three months, respectively. Success rates in the femoral arteries were 83% and 79% and in the popliteal artery 71% and 57% at one and three months, respectively. None of our patients required amputation. Ten patients (9.1%) suffered the following complications within 30 days of percutaneous transluminal angioplasty: death (2), thrombosis (2), perforation (3), minor hematoma (2), and false aneurysm (1). In conclusion, we have shown that percutaneous transluminal angioplasty can be performed safely and effectively without the use of anticoagulation and its associated risks.

Adult↗
PubMed1987

HLA haplotypes in non-familial rheumatoid arthritis.

The frequencies of HLA-A, B, C, DR, and BF haplotypes in 44 unrelated Caucasian patients with definite seropositive rheumatoid arthritis (RA) were compared with haplotype frequencies in controls. Overall, the patients had an increased risk for HLA-DR4, DR3, and DR2 antigens, but frequencies of certain DR4 or DR3 haplotypes were not increased, suggesting the importance of other HLA loci for the evaluation of risk. The presence of DR4 alone was not found to produce an increased risk for RA since the frequencies of certain DR4 haplotypes were similar in patients and controls. Increased frequencies of HLA-B18, DR4, HLA-B15, DR4, and HLA-A1, B8, Cw7, DR3 haplotypes were found in patients. RA susceptibility has been found to be associated with the last two haplotypes in some studies of multiple case families, suggesting that similar genetic mechanisms may underlie the disease in familial and sporadic forms.

Arthritis, Rheumatoid↗
PubMed1986

Combined influences of Gm and HLA phenotypes upon multiple sclerosis susceptibility and severity.

In some Caucasian populations, multiple sclerosis (MS) susceptibility has been independently related to given alleles of HLA or Gm systems that respectively code for major histocompatibility complex class I and II antigens or immunoglobulin G heavy chains. Whether given combinations of alleles at both series of loci simultaneously influence MS susceptibility and/or severity was investigated by comparing 147 French MS patients and 226 geographically-matched healthy controls. The G2m(-23)/HLA-B35 phenotype and G1m(-1)/HLA-B7(-)/HLA-DR2 phenotype were respectively associated with significant protection against (relative risk = 0.05) and susceptibility to (relative risk = 4.3) MS. When considering MS severity, the presence of HLA-B7 antigen correlated with a more severe disease in Gm1/Gm3 heterozygous patients, but not in Gm3/Gm3 homozygous patients. Conversely, an HLA-B12-associated milder disease was restricted to Gm3/Gm3 homozygotes. These results demonstrate the combined influence on MS of genetic loci that are unlinked but immune response-associated. Combined Gm and HLA typing is very likely able to serve as a prognostic indicator in this disease.

Disease Susceptibility↗
PubMed1985

HLA antigens and seronegative rheumatoid arthritis.

HLA antigens and clinical features in a series of 46 Caucasian patients (40 females, 6 males) and definite repeatedly seronegative rheumatoid arthritis (RA) of more than two years' duration (mean 11.6 years) were compared with those in 77 seropositive RA patients and 110 controls of the same ethnic and geographic origin. Seronegative RA appeared to be less often erosive than seropositive RA, and seronegative patients had fewer extra-articular features. The frequency of the HLA antigen DR1 was raised in seronegative patients as compared with controls (p = 0.006, relative risk = 3) and with seropositive patients (p less than 0.05). HLA-DR4 was slightly increased in seronegative patients compared with controls (p less than 0.05) but was clearly less so than in seropositive patients (p less than 0.005). Early onset of disease was very significantly associated with HLA-DR1 in seronegative patients (p = 0.007), whereas HLA-DR4 was present more frequently in seropositive patients with onset prior to age 35 (p less than 0.05). No correlation between HLA antigens and intolerance to drugs was found in seronegative patients, whereas in seropositive patients side effects to gold salts were associated with DR3. These results suggest that seropositive and seronegative RA have distinct HLA-DR associations, especially in disease of early onset, in addition to well established clinical differences.

Adolescent↗
PubMed1985

Delay in diagnosing gastrointestinal injury after blunt abdominal trauma in children.

Intestinal perforation after blunt abdominal trauma in children is rare and thus the diagnosis may be delayed. For this reason the authors reviewed their experience with 12 children to recommend a protocol for investigation that would reduce the delay in diagnosis. Of the 12 perforations, 2 were gastric, 2 duodenal, 7 jejunal and 1 colonic. The diagnosis of jejunal perforation, in particular, was usually delayed because free air was not seen radiologically in the first few hours after injury. This may be because of delayed rupture or spasm of the injured intestine. Serial films were valuable in aiding the diagnosis and are recommended, together with assessment of solid organ injury by radionuclide scanning. In this series peritoneal lavage was not used. No child died.

Abdominal Injuries↗
PubMed1979

Regional mapping of the HLA on the short arm of chromosome 6.

A detailed gene marker study was performed on a partial 6p trisomic child resulting from a balanced maternal translocation t (2;6) (p 2505; p2105). HLA typing and mixed lymphocyte reaction showed that the breakpoint on chromosome 6 was located within the HLA gene cluster, allowing an accurate location of the D determinants. Localization of the P blood group locus within the region 6 p 2105 to 6 p ter was excluded.

Cells, Cultured↗
PubMed1979

Role of Ia-like products of the main histocompatibility complex in conditioning skin allograft survival in man.

This report correlates the survival time of 93 intrafamilial skin allografts performed under conditions of main histocompatibility complex (HLA) haploidentity with donor-recipient compatibility for products of the HLA-A, -B, -C, and -DR, as well as C3 proactivator, Glyoxalase I, and P loci located on the human 6th chromosome. Incompatibilities for HLA-A and -B (and to a lesser extent for HLA-C) and(or) for HLA-DR products exerted a strong influence upon the fate of skin allografts. When HLA-A and -B were considered alone, the most compatible group of grafts had a mean survival time of 15.8 d, as compared with 11.3 d for the most incompatible transplants. HLA-DR compatibility alone was associated with a mean survival time of 15.3 d, whereas HLA-DR-incompatible grafts had a mean survival time of 11.5 d. Incompatibilities for C3 proactivator, Glyoxalase I, and P did not have a significant effect upon graft survival. There was no evidence of an association between donor-recipient incompatibility at HLA-A, -B, or -C or at HLA-DR; such incompatibilities occurred independently of each other, in spite of the state of linkage disequilibrium known to exist between HLA-B and -DR. Incompatibilities for HLA-A, -B, and for HLA-DR exerted a potent additive effect upon graft survival. Skin grafts bearing one, two, or three incompatibilities had a mean survival time of 16.2, 13.7, and 10.7 d, respectively (P <0.0005).The results point to the important role played by the Ia-like products of the HLA complex (HLA-DR) in conditioning skin allograft survival in man. This consideration may be of direct relevance to the potential clinical usefulness of in vitro serological techniques for the detection of donor-recipient compatibility for HLA-DR.

Female↗
PubMed1979

Seventh allele of the HLA-C series (Cve).

Serum VE reacting with 29.8% of French individuals seemed to define the seventh allele of the HLA-C series as shown by serologic and genetic investigations. The gene frequency of Cve is 0.163.

Alleles↗
PubMed1978

A haplotype study of HLA complex with special reference to the HLA-DR series and to Bf. C2 and glyoxalase I polymorphisms.

Fifty-three French families were typed for alleles at seven loci of the HLA complex (HLA-A, -B, -C, -DR, -Bf, -C2 and -GLO) and 212 haplotypes were demonstrated. Eleven recombinations were observed (two A/B, two A/C, two B/Bf, one Bf/D and four D/GLO). The linkage disequilibrium was calculated not only between two alleles (delta) but between three, four...seven alleles (D). In order to compare the intensity of D values in the various haplotypes, the influence of the differences in gene frequencies was eliminated by the introduction of the standardized Ds (Ds = D/D max). The number of haplotypes in disequilibrium is relatively limited since most of the significant Ds involved about 17 haplotypes. For some haplotypes, the disequilibrium covered the whole distance from A to GLO but the stronger disequilibrium concerns the C to Bf or C to DR segment. Three hypotheses (isolation, admixture of population and selection) concerning the formation and maintenance of the disequilibria are discussed.

Epitopes↗
PubMed1978

The role of HLA-DR antigens in transplantation--survival of skin allografts in HLA-haploidentical donor-recipient combinations.

The results of 79 skin grafts performed in haploidentical donor-recipient pairs are correlated with HLA-A, -B, -C, and -DR compatibility. A strong detrimental effect of DR incompatibilities has been demonstrated. This effect is independent from that exerted by products of the HLA-A, -B, and -C loci. An additive effect of HLA-A, -B, and -DR incompatibilities on allograft survival time has been observed.

Chromosome Mapping↗
PubMed1977

[The Ly-Li system, a new locus of the HLA complex].

Antibodies raised through immunization of volunteers not differing for serologically defined HLA-A, B and C antigens enabled us to define since 1975 a new antigenic system controlled by the HLA complex. These new allo-antigens, designated Ly-Li, are expressed on B lymphocytes but are absent from T lymphocytes, platelets, erythrocytes and fibroblasts. Multiple alleles belong to the Ly-Li differentiation antigen system. The gene frequencies of three alleles thus far detected are 0.1558 for Li2; 0.1867 for Li3 and 0.122 for Li4. Like in the serologically defined HLA antigen systems, "inclusions" were observed also in Ly-Li system, suggesting the existence of private and public specificities. Among 48 families, 23 were informative in showing that the Ly-Li locus segregated with the HLA complex. Data on three families with recombinant haplotypes between HLA-B and D, and between Bf and HLA-D, indicated that the Ly-Li locus was near HLA-D (possibly identical with HLA-D). Anti-Ly-Li antibodies inhibited cellular proliferation in mixed leucocyte culture (MLC) primarily when directed against the antigens of stimulator cells. There was a good correlation between Ly-Li and HLA-D alleles, particularly between Li2 and DW5 (r = 0.70). Usually, HLA-D specificities were "included" in the related Ly-Li specificities, but not vice-versa. In contrast, there was a higher correlation between Ly-Li specificities and those detected by the PLT (primed lymphocyte test). The Ly-Li system seems to be of great importance for the functional characterization of lymphocyte subpopulations, for the selection of the best donor in organ transplantation, and for the investigation of susceptibility genes in diseases associated with HLA-D.

Alleles↗
PubMed1977

Detection by three cellular immunological techniques of the antigenic determinants of the Ly-Li system, expressed on human B lymphocytes.

A clear correlation was observed between the presence of an Ia-like antigenic B-cell system Ly-Li, detected serologically, and three cellular immunological techniques: [1] mixed lymphocyte reaction (MLR) inhibition by an anti-Li antiserum; [2] level of restimulation of anti-Ly-Li in-vitro-primed lymphocytes; and [3] detection of HLA-D alleles by homozygous typing cells. These results suggested that the allelic products detected serologically may be identical to those detected by the first two techniques, namely MLR inhibition and in-vitro-primed lymphocyte typing, and, possibly, HLA-D typing using homozygous typing cells, although the correlation was repeatedly found to be less clear for the last technique.

B-Lymphocytes↗
PubMed1976

[Determination by three technics of cellular immunology of the antigenic determinants of the Ly-Li system expressed on human B lymphocytes].

A clear correlation has been observed between the presence of the antigenic B cell system Ly-Li detected serologically, and 3 cellular immunology techniques: 1. MLR inhibition by anti-Li serum; 2. level of restimulation of anti-Ly-Li in vitro primed lymphocytes; 3. detection of HLA-D alleles by homozygous typing cells. These results suggest that the allelic products detected serologically may be identical to those detected by the first two techniques, namely MLR inhibition and in vitro primed lymphocyte typing, and possibly HLA-D typing using homozygous typing cells, although the correlation was found to be repeatedly less clear for the last technique.

B-Lymphocytes↗
PubMed1975

Formal genetics of the HL-A region.

The extreme polymorphism of the HL-A system is due to the presence of two (SD1, SD2) and perhaps three linked polyallelic genes. The distinction of "bridging antibodies" (reacting with several HL-A specificities recognizing separate sites on the HL-A molecule) from the main HL-A determinant as it is demonstrated by absorption/inhibition experiments increases this complexity. The HL-A linkage group is composed of other systems: LD1, LD2, PGM3, ADA (?), P, ME1, IPO-B and possibly a "hay fever gene". No gametic or zygotic selection was found in spite of the presence of HL-A antigens on spermatozoa. Mixed lymphocyte reaction (MLR) is principally governed by LD genes. The main (LD2) gene is probably situated outside the interval SD1, SD2, near SD2. Other LD genes (LD1 inside the interval SD1-SD2 and LD3) are suspected. The presence of an immune response gene (Ir) has not yet been demonstrated although several diseases associated with specific SD2 antigens are known. These different genes (SD1, SD2, LD1, LD2, LD3 and Ir) probably form a functional unit in the allo-immunozation.

Alleles↗