Biomedical subjects
Publications and source records attributed to M Joussemet.
Myeloid metaplasia with myelofibrosis develops in about 10% of patients with polycythemia vera. We report a case of a 48-year-old female with postpolycythemic myelofibrosis successfully treated with allogeneic HLA-matched bone marrow transplantation.
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Hepatitis A antibodies (anti-HAV) were surveyed in 1000 French recruits during 1990. The prevalence of anti-HAV in this group was 21.35%. Compared to a 1985 survey a 9% fall in the anti-HAV prevalence rate was observed. Living in a coastal area, low educational level, stay overseas were the main risk factors, as already noted in 1985.
The transfusion-sheet is an important document which appears first in the French legislation on May 1985 the 17. Its aim is to keep a close watch over transfusion of red blood cells, platelet concentrates and fresh frozen plasma and also immunohematologic evolution of data for every patient. In spite of its importance for everyone in charge of transfusion practice (physicians, biologists, transfusion center,...), a lot of problems may be observed in the strict and complete updating of the document. Informatisation of all the steps of the medical and biological practice appears of crucial interest to perfect its use.
Serologic data for B and D viral hepatitis are studied on 30,000 military blood donors. Because of legal norms of blood products for transfusion 761 donations (2.53% have been destroyed). Exclusion criteria for viral B hepatitis and ALT are independent. In this study the prevalency of HBV infections is significantly lower than for other blood centers: probably in account of the young age of military blood donors.
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Exploration of haemostasis was performed on plasmas thawed in an experimental microwave oven comparatively to a 37 degrees C water bath. Factor VIII:R:Ag, procoagulant and antigenic fibrinogen, and Fg:C/Fg:Ag ratio were found to be significantly, slightly decreased with microwave thawing. Factor VIII:C and VIII:C/VIII:R:Ag ratio were found to be increased with microwaves. Antigenic fractions were decreased because of partial precipitation. In addition, Fibrinogen slightly lost its activity; on the contrary, factor VIIIC was activated by micro-waves. All this allows to select parameters for new experimental microwave ovens development.
Ten days after his return from Cameroon, a twenty-six year old Frenchman, serving on voluntary service overseas, presented with fulminant falciparum malaria: shock, altered consciousness, haemolytic anaemia, threatening disseminated coagulation (platelets less than 150 X 10(-6).l-1; prothrombin time and Stuart factor less than 50%; fibrinogen less than 1.5 g.l-1). In spite of quinine therapy, parasitaemia increased from 4 to 35% within 24 h. Using an Haemonetics V50, the exchange of one and a half red blood cell masses was carried out with 17 red blood cell packs. Calcium gluconate was used to prevent the hypocalcaemia induced by the anticoagulant solution. The patient's platelets and plasma were completely reinjected. The result was very satisfactory. This kind of exchange, well tolerated clinically and biologically, would seem better than the classical exchange transfusion. When 10% of the red blood cells are infected by Plasmodium falciparum, it is necessary to exchange from one and a half to two blood masses. Lesser exchanges are always associated with important relapses and quinine therapy must be carried on during and after the exchange. Restricting this exchange only to red blood cells enabled the patient to benefit from his own coagulation factors, antibodies and platelets, and consequently to reduce the number of blood donors involved. However, metabolites (especially bilirubin and circulating immune complexes) were not eliminated. Partial plasmapheresis may be associated with erythropheresis using human albumin as plasma substitute. This technique needs to be assessed, in order to optimize immediate efficiency and post-transfusion infectious risk.
The epidemiological study of hepatitis A antibodies prevalence in 1000 french recruits shows a 20% fall in people of 18-20 years old between 1979 and 1985, and identifies variables such as residence in coasting area, stay overseas, study level, as the most important social and geographical risk factors. These results are in agreement with the evolution observed in different other european countries.
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We report the comparison of the fonctionnal platelet criteria's evolution studied in vitro by aggregation with different agents, by osmotic stress, ATP total amount and platelet volume distribution for six days of storage in two different PVC bags. The results indicate that: platelet's evolution appears more appreciable when tested by aggregation with an important amount of collagen, by hypotonic stress and volume distribution. The difference between the two different bags is shown as early as the thirs day of storage; for quality control, we can choose some criteria despite the absence of their clear correlation with transfusion efficiency.
In vitro Kallikrein inhibits the expression of lymphocytes-E-rosetting-receptor. The preincubation of alpha-2-macroglobulin with Kallikrein prevents this effect quickly. The incubation with alpha-2-macroglobulin of Kallikrein pretreated-lymphocytes is ineffective.
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Hepatitis B type 2 infection was observed in 96 French soldiers. A recent stay overseas was reported by 65% of them and an HBsAg chronic carrier state was observed in eight individuals. Anti-pre-S1 and anti-pre-S2 antibodies were not detected after recovery, but HBV DNA was detected in 58% of sera tested.