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Biomedical subjects

P Chevallier

Publications and source records attributed to P Chevallier.

At least 127 records · Page 7Linked to original sources
PubMed1981

[Prognostic value of HBe antigen and anti-HBe antibody in viral hepatitis B (author's transl)].

HBe antigen (Ag) and anti-HBe antibody (Ab) were detected in 50 patients with chronic hepatitis due to virus B. In 19 cases of non-specific hepatitis and 15 cases of chronic persistent hepatitis, there was a significant correlation (p less than 0.01) between biochemical disturbances and the presence of HBe Ag. In 13 cases of HBs Ag-positive chronic persistent hepatitis (9 with HBe Ag and 4 with anti-HBe Ab) followed up for a mean period of 15 months, the biochemical disturbances were associated with the presence of HBe Ag and they subsided when the anti-HBe Ab appeared. In 4 cases of persistent chronic hepatitis and 16 cases of chronic active hepatitis followed up biochemically and histologically for a mean period of 22 months, aggravation of hepatic lesions was observed in the 8 cases where HBe Ag persisted. Conversely, histological improvement and return to normal of biochemical values were noted in 8 of the 12 remaining cases (5 seroconversions HBe Ag/Ab, 1 seroconversion HBs Ag/Ab, 3 HBs Ag and HBc Ab, and 3 HBs Ab). The results of treatment with corticosteroids alone or combined with azathioprine appeared to correlate with changes in HBe serology rather than with the pharmacological effects of the drugs. It would therefore seem that the disappearance of HBe Ag is a prerequisite of improvement of hepatitis B and that the HBe Ag/anti-HBe Ab system is an excellent prognostic index, as it closely reflects the evolutive potential of the disease, which in turn governs all therapeutic measures.

Antibodies, Viral↗
PubMed1981

Detection by immunofluorescence of a new "core-like" Ag/Ab system in liver and serum of patients with NANB hepatitis.

Using direct immunofluorescence, a nuclear antigen was found in liver of chronic hepatitis patients with circulating NANBe Ag or anti-NANBe, and selected sera from either group were used as source of conjugates. The new Ag/Ab system was designated NANBc Ag and anti-NANBc since it behaved like the core Ag of HBV . NANBc Ag was detected in coded frozen liver biopsies from patients with chronic persistent 15/25 (60%) or active 27/50 (54%) hepatitis and cryptogenic cirrhosis 16/30 (53.3%) devoid of HBV markers. Only 2/30 alcoholic cirrhosis cases (7%) used as controls were positive (p less than or equal to 0.001). The homologous anti-NANBc antibody was always detectable by indirect immunofluorescence in the patients' serum when NANBc Ag was found in the liver. It was also found in 11/135 (8%) additional cases without any other NANB marker. A correlation was observed between coded detection of the NANBc Ag/Ab system by immunofluorescence and demonstration of NANBe Ag or anti-NANBe by immunodiffusion. In acute post-transfusion NANB hepatitis, anti-NANBc was first detectable 14 days after transfusion and persisted as long as ALT remained elevated, or longer. IgM anti-NANBc present at onset became associated with an increasing proportion of IgG after the 28th day. The prevalence of anti-NANBc in sporadic NANB hepatitis (11/50 = 22%) was significantly lower (p less than or equal to 0.001) than in cases with parenteral exposure such as post-transfusion, occupational or drug addict hepatitis (47/72 = 65%). Immunofluorescent tests for NANBc Ag and Ab are promising assays for the serological diagnosis of NANB hepatitis.

Antibodies, Viral↗
PubMed1980

Identification and detection of long incubation non-A, non-B hepatitis virus and associated antigens or antibodies.

Three distinct antigen/antibody systems supposedly associated with an HBV-like virus of non-A, non-B hepatitis have been identified. Because of previously demonstrated cross-reactivity with HBe/3 and HBc antigens and other analogies the following terminology is tentatively used. 1. The previously reported serum antigen has been redesignated non-A, non-B e antigen, since it is equivalent to HBe/3 Ag and cross-reacts with it. Non-A, non-BeAg or Ab were detected in 51/62 post-transfusion and 11/56 sporadic acute non-A, non-B hepatitis cases, and in 12/14 cases affecting staff members. In non-A, non-B chronic persistent or active hepatitis and cryptogenic cirrhosis, the prevalence was similarly high: 14/18, 22/48 and 12/18 respectively. Ten out of 26 implicated blood donors were found positive for non-A, non-BeAg accounting for 7 out of 8 post-transfusion cases. A high prevalence of non-A, non-BeAg was also found in haemophiliacs (11/48) and haemodialysed patients (6/42), whereas anti-non-A, non-Be was respectively detected in 4/48 and 6/42 of these cases. 2. Using immunofluorescence, a second antigen termed non-A, non-BcAg has been identified in liver biopsies from 55/84 non-A, non-B chronic hepatitis or cryptogenic cirrhosis cases. All 8 positive biopsies examined by electron microscopy revealed clusters of 22--25 nm intranuclear particles identical to those described in chimpanzees. Anti-non-A, non-Bc detectable by counter-electrophoresis and indirect immunofluorescence was found in the serum of all patients of which biopsy was positive for non-A, non-BcAg. Anti-non-A, non-Bc was also detected in 5/5 non-A, non-BeAg positive cases of post-transfusion hepatitis, 2--6 weeks after onset end remained positive for the 6 month follow-up period. 3. A third antigen, tentatively designated non-A, non-BsAg, has been found less frequently than non-A, non-BeAg in serum. However, it was detectable in 3/18 and 2/12 washed ultracentrifugation pellets of sera positive for non-A, non-BeAg or anti-non-A, non-Be, respectively.

Antibodies, Viral↗
PubMed1979

[Chronic active hepatitis with a favorable course, after fulminant hepatitis].

The case reported here is that of a girl with presumably viral non A, non B, acute hepatitis with a very unusual course. Fulminant hepatitis with submassive and bridging hepatic necrosis and a 17-day coma began during the 7th week of evolution. Prolonged chronic active hepatitis followed. Treatment was initiated 6 months after the beginning of the affection and was maintained for more than 2 years, with an apparent cure persisting after follow-up period of 6 months; fibrous scars were the only abnormalities demonstrable on histologic examination of liver biopsy. It is possible that such type of fulminant hepatitis with unusual course will become more frequent, as survival of the initial acute episode increase.

Child, Preschool↗
PubMed1977

[Comparative study of three technics of inverse passive hemagglutination in the search for a surface antigen of the hepatitis b virus (Ag HBs) (author's transl)].

The following three different versions of reverse passive hemagglutination (RPHA) were evaluated for the detection of HBs antigen: Auscell I - Abbott, WH HBs - Wellcome and the hepanosticon - Organon technique and results obtained were compared with those obtained by the radio immuno assay (Ausria II of Abbott). In 493 sera studied, up to 16,8% were found positive by RPHA as compared to 17,2% positives by RIA. The percentage of false positives by the different methods varied from 4,9 to 7,3. Confirmatory tests, either absorption or neutralization, are necessary to ascertain accuracy of positive results in each of the 3 RPHA methods. The high quality of the Auscell and WH HBs confirmative test allows their sole use although they are slightly less sensitive than the RIA. We would recommand use of the Hepanosticon test whenever positive sera can be confirmed by RIA.

Evaluation Studies as Topic↗
PubMedDate not supplied

[Colostomy vs self-expanding metallic stents: comparison of the two techniques in acute tumoral left colonic obstruction].

UNLABELLED: Self-expanding metallic stents is an alternative treatment to colostomy that is the treatment of choice in acute tumoral left colonic obstruction. AIM OF THE STUDY: To compare morbidity, mortality, length of hospital stay and treatment performed after desobstruction using the two methods. PATIENTS AND METHODS: Thirty-three patients admitted for acute obstruction of the left colon were retrospectively separated in two groups depending on the type of intervention performed to treat the obstruction ("colostomy" group: 17 patients and "self-expanding stent group": 16 patients). We studied complications after desobstruction, hospital courses and surgical strategy performed after the acute phase. RESULTS: Time between desobstruction and colectomy was shorter in the "self-expanding stent group" than in the "colostomy group" (18.5 days versus 73 days). Age superior than 75 years and colostomy were the two main factors predicting the risk of definitive colostomy (P < 0.05). Global mean hospital stay was longer in the colostomy group (32.7 days versus 19.3 days, P = 0.02). Two perforations and one local recurrence occurred in the "self-expanding stent group". CONCLUSIONS: Self-expanding metallic stent can decrease the permanent colostomy rate and the number of interventions. The recurrence rate seems to be theoretically increased with the stenting method. Then, colostomy must be done for patients in curative situation. The self-expanding metallic stent should be used as a palliative care.

Acute Disease↗
PubMedDate not supplied

Descending necrotizing mediastinitis: a rare pathology to keep in mind.

The spreading of a cervical infection to the mediastinum is a complication rarely observed, and its prognosis is still very severe. The infectious spreading follows known anatomical tracts, leading to the invasion of definite mediastinal spaces. The cervicothoracic scanning is the ideal procedure leading to the diagnosis, the localization of the infectious sites, and to the demonstration of an abscess and the presence of air in the mediastinum. We report a case of a patient in whom the early use of specific imaging and of proper aggressive surgical intervention did not allow the elimination of a fatal outcome.

Adult↗
PubMedDate not supplied

Percutaneous nucleotomy: preliminary communication on a decompression probe (Dekompressor) in percutaneous discectomy. Ten case reports.

For the past years, new therapeutic options have been proposed secondary to the progress in the interventional imaging. The purpose of this article is to report a preliminary study on the use of the 1.5 mm "Dekompressor probe" (Stryker, Kalamazoo, MI, USA) in the percutaneous discectomy by decompression. We have conducted, from September 2003 to March 2004, a retrospective review on 10 patients (mean age of 49.8), chosen at random, presenting a nonextruded herniated disc resisting all medical treatments. The procedure is CT guided or performed under fluorosocopy, a discography is performed by introducing the probe at the level of the protruded disc. After local anesthesia, an incision of a few millimeters is performed, allowing the introduction of a coxial trocar to the level of the disc. The decompression probe is then introduced. No technical failure occurred. The results in our series show, in eight patients, a satisfactory result with a decrease of the initial VAS of more than 70% and a complete elimination of the medical therapy. Our preliminary results are encouraging but should also be confirmed by a multicentric based on a large series, and the criteria of inclusion or exclusion must be strictly respected to obtain satisfactory clinical results.

Decompression, Surgical↗
PubMedDate not supplied

MR features of gastrointestinal stromal tumors.

We report on two patients presenting with gastrointestinal stromal tumors (GIST). The important tumor size and the marked tissular hypersignal seen on T2-weighted magnetic resonance images (MRI) should be considered as magnetic resonance (MR) features strongly indicating diagnosis of GIST.

Aged↗
PubMedDate not supplied

MRI features of a pancreatic schwannoma.

A case of a pancreatic schwannoma is presented. The patient, a previously healthy woman, is hospitalized with the diagnosis of purulent pleuritis. Ultrasonography (US) of the abdomen shows a 3-cm mass in the head of the pancreas. Magnetic resonance imaging (MRI) reveals, in T1-weighted sequences, the mass to be hypointense, and an early and persistent enhanced signal is noted following the administration of gadolinium. In T2-weighted fat saturation sequences, the lesion appears markedly hyperintense. A duodenopancreatotomy is performed, and the pathologic specimen demonstrates a schwannoma of the pancreas with Antoni A pattern.

Contrast Media↗