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Biomedical subjects

T Poynard

Publications and source records attributed to T Poynard.

At least 199 records · Page 11Linked to original sources
PubMed1990

Serial passage of west-European sporadic non-A non-B hepatitis in rhesus monkeys by inoculation with fecal extracts.

An experimental model of sporadic non-A non-B hepatitis involving a Fab nonimmune binding activity in stools was established in the rhesus monkey. The first animal was inoculated intravenously with a stool extract from a French patient who had never left the country and in whom post-transfusion hepatitis was excluded. Four passages were performed, and the infection was transmitted by parenteral as well as the oral routes by inoculation of stools or liver extracts. Infection led in three monkeys to reversible hepatocyte injury manifested by a transitory increase in serum aminotransferases. The other three animals, in which persistently high levels of aminotransferases was observed, were sacrificed on day 60 after inoculation. The incubation period, as evidenced by elevation of aminotransferases was about 3 to 4 weeks. The infectious agent was transitorily present in the stools before aminotransferase elevation. The presence of the infectious agent in the stools was correlated with the nonimmune Fab binding activity.

Adult↗
PubMed1990

Long-term results of treatment of vascular malformations of the gastrointestinal tract by neodymium YAG laser photocoagulation.

This study reports long-term results of treatment of vascular malformations of the gastrointestinal tract by neodymium YAG (Nd-YAG) laser photocoagulation in 60 patients (13 patients with hereditary hemorrhagic telangiectasia and 47 patients with angiodysplasias) and examines prognostic parameters of bleeding recurrence in 47 patients with angiodysplasias. In patients with hereditary hemorrhagic telangiectasia, the transfusion requirements were lower only in the second and third year following therapy than in the year before therapy; however, these differences were not significant. In patients with angiodysplasias, a median number of one laser session (range 1-8) was necessary to destroy angiodysplasias. A blood loss recurred in 15 patients. The cumulative probability of remaining free of blood loss recurrence at 24 months and at 54 months was 61 +/- 9%. Three parameters had an independent prognostic value, the initial number of angiodysplasias (P less than 0.02), the presence of coagulation disorders (P less than 0.05), and age (P less than 0.05).

Aged↗
PubMed1990

Endoscopic Nd-YAG laser therapy as palliative treatment for esophageal and cardial cancer. Parameters affecting long-term outcome.

The aim of this study was to report long-term results of endoscopic Nd-YAG laser therapy in the palliative treatment of 144 esophageal and cardial carcinomas and to define parameters that could predict the long-term outcome in order to better define the indications and limitations of Nd-YAG laser therapy for esophagocardial cancer. One hundred nineteen men and 25 women were treated. The mean age was 67 +/- 12 years. Histology showed 94 patients with squamous cell carcinoma and 50 with cardial or esophageal adenocarcinoma. Improvement of dysphagia was achieved in 119 of the 144 patients (83%) after a median of 2.9 sessions. For the 105 patients initially symptomatically improved by the first laser course, the cumulative probability of remaining symptomatically improved at three and six months was respectively 38.5 +/- 5% and 22 +/- 4%. Four perforations and nine esophagotracheal fistulas occurred. In the stepwise regression analysis (Cox model), among 11 variables, three variables had an independent prognostic value at six months. The importance of improvement after the initial laser treatment (P less than 0.005) and the presence of an adenocarcinoma (P less than 0.05) were positively correlated with the symptom improvement duration. The initial tumor length (P less than 0.01) was negatively correlated with the symptomatic improvement duration. Therefore, in inoperable patients, we think that laser therapy should be proposed first for adenocarcinoma and for squamous cell carcinoma less than 6 cm in length.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1990

Expression of histocompatibility antigens and characterization of the lymphocyte infiltrate in hyperplastic polyps of the large bowel.

HLA-DR expression, lymphocyte subsets, and the distribution of proliferating cells were studied in hyperplastic polyps from the colorectum. The density of T-cells (CD5+) (mean of cells/mm2 of tissue +/- SEM) was higher in the lamina propria of hyperplastic polyps (64.2 +/- 4.2) than in normal colonic mucosa (36.7 +/- 2.6, P less than .001). The CD4/CD8 ratio was higher in hyperplastic polyps (6.3 +/- 0.9, P less than .0001) and in colonic adenomas (5.9 +/- 0.9, P less than .001) compared with normal mucosa (2.3 +/- 0.2). Lymphocytes of the lamina propria were never Ki-67 positive either in normal mucosa or in hyperplastic polyps or adenomas. The epithelial layer of hyperplastic polyps and of normal mucosa did not express the HLA-DR antigen, whereas pericryptal fibroblasts and most of the leukocytes of the lamina propria were strongly positive for this antigen. In the epithelial layer proliferating cells were localized exclusively in the lower part of epithelial crypts, as was the case in normal mucosa, whereas in adenomas Ki-67-positive cells were present throughout the entire height of the mucosa. Thus, in hyperplastic polyps lymphocytes are increased in the lamina propria, with a predominance of the CD4 subset in close contact with HLA-DR positive pericryptal fibroblasts.

Adenoma↗
PubMed1990

Serum apolipoprotein A-I in alcoholic patients with chronic calcifying pancreatitis.

Serum apolipoprotein A-I measurement was compared in alcoholic patients according to presence or absence of chronic pancreatitis and liver fibrosis. Among alcoholic patients without liver disease, apolipoprotein A-I was significantly lower in patients with chronic pancreatitis (157 +/- 70 mg/dl) than in patients without pancreatitis (209 +/- 74 mg/dl, p less than 0.001). In cirrhotic patients, apolipoprotein A-I was lower in patients with chronic pancreatitis (82 +/- 35 mg/dl) than in patients without pancreatitis (102 +/- 45 mg/dl), but this difference was not significant. The decrease of serum apolipoprotein A-I was independent of nutritional parameters whether or not there was cirrhosis. Immunohistochemical study of pancreatic samples with chronic pancreatitis showed that apolipoprotein A-I was located in the pancreatic fibrosis whereas lobules were unstained. This study suggests that apolipoprotein A-I is trapped by the pancreatic extracellular matrix and that this sequestration might explain, in part, the decrease of the serum apolipoprotein A-I.

Adult↗
PubMed1990

Diagnostic value of serum gamma-glutamyl-transferase activity and mean corpuscular volume in alcoholic patients with or without cirrhosis.

In an attempt to assess the diagnostic values of serum gamma-glutamyltransferase (GGT) and mean corpuscular volume (MCV) variations as markers of liver disease and of abstinence in alcoholic patients, we compared 174 patients with alcoholic cirrhosis, 175 with noncirrhotic alcoholic liver disease and 67 patients with nonalcoholic cirrhosis. GGT and MCV values were checked three times, the day of admission, 7 days later, and on the last sample available during follow-up (1 to 12 months), and were compared according to the liver disease and abstinence. A decrease of GGT activity during the 1st week of hospitalization was noted in alcoholics with (-9 IU/liter) or without (-13 IU/liter) cirrhosis and not in nonalcoholic cirrhosis (+8 IU/liter), without MCV variations. During follow-up, median GGT activity was strikingly different in abstinent patients with (27 IU/liter) or without (21 IU/liter) cirrhosis and in nonabstinent patients (99 IU/liter and 123 IU/liter, respectively) (p less than 0.001). MCV decrease was noted in alcoholics whatever their abstinence or not, contrasting with the absence of decrease in nonalcoholic patients. For the diagnosis of alcoholism in cirrhotic patients, the positive predictive value (PPV) of a GGT or a MCV decrease during the 1st week of hospitalization was 0.82 and 0.78, respectively, and the negative predictive value (NPV) was 0.33 and 0.70, respectively. For abstinence during follow-up, the PPV of a GGT activity less than 50 IU/liter was 0.92 and the NPV was 0.65.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗
PubMed1990

Randomized double-blind clinical trial of aluminum phosphate versus ranitidine in the acute treatment of duodenal ulcer.

A randomized double-blind clinical trial of aluminum phosphate versus ranitidine in the treatment of noncomplicated acute duodenal ulcer has been conducted in 91 patients. After randomization the 42 patients of the aluminum phosphate group were comparable to the 49 patients of the ranitidine group. At 4 weeks, 6 patients were not endoscoped and according to the intention-to-treat method they were considered as treatment failure. The endoscopy showed a 60% healing rate in the aluminum phosphate group (25/42) versus 55% in the ranitidine group (27/49); this difference was not significant. Among the factors assessed, only one, the round shape of the ulcer, was significantly and independently associated with ulcer healing in a multidimensional analysis. In conclusion, this double-blind trial showed that aluminum phosphate is an effective, save and cheap treatment of acute duodenal ulcer.

Aluminum↗
PubMed1990

[Acute tuberculous pancreatitis in a patient with acquired immunodeficiency syndrome].

The authors report a case of tuberculous pancreatitis in a 29 year old Zairan man. Serum antibodies against HIV were positive. T-lymphocyte analysis revealed 18/mm3 OKT4 with an OKT4/OKT8 ratio of 0.43. The initial examination suggested severe acute pancreatitis. Only the postmortem histopathological analysis revealed tuberculous pancreatitis, showing several miliary lesions with caseous necrosis and acid fast bacili (Ziehl stain). Subsequently, cultures (sputum, bronchoalveolar lavage, pleural effusion, ascitis) of bacili identified Mycobacterium tuberculosis. Tuberculous pancreatitis should be considered in subjects with acute pancreatitis according to the epidemiological context, once the most frequent causes of pancreatitis have been eliminated.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[What to expect from expert systems for the diagnosis of functional bowel disorders].

The goal of this study was to evaluate the computer-aided diagnosis systems used for functional intestinal disorders published between 1970 and 1989. The methodology of all prospective studies published was evaluated using a score system of 12 items, filled in by two independent observers. A total of 10 studies were identified. None of the systems studied could truly be considered as an expert system. Most systems were not methodologically sound and the median score was 11 of a possible total of 24. The two principal characteristics of functional intestinal disorders are their high prevalence and the absence of objective diagnostic criteria. Taking these two facts into consideration when elaborating a diagnostic method, expert systems should be useful for teaching purposes and for conducting prospective epidemiologic or therapeutic studies. It seems too early, however, to consider the use of veritable expert systems as an aid to the practitioner in daily practice.

Algorithms↗
PubMed1990

[Nodular regenerative hyperplasia and pulmonary arterial hypertension].

Two cases of nodular regenerative hyperplasia of the liver coexisting with pulmonary hypertension are described. Regarding its low frequency, nodular regenerative hyperplasia has been found more often than expected in our series of coexisting porto-pulmonary hypertension (2 out of 14 cases, 14 percent). In our 2 cases, pulmonary symptoms occurred before or simultaneously with hepatic symptoms. The high prevalence of this association and the unusual onset setting of symptoms suggest that this association is unfortuitous. A common pathogenesis for pulmonary and hepatic lesions is discussed.

Adult↗
PubMed1989

Endoscopic laser therapy for duodenal villous adenoma.

A 72-year-old woman had a 20-mm supraampullary villoglandular adenoma with a focal carcinoma in situ. The neurological status of the patient did not allow any major surgical procedure. Therefore laser therapy was performed using the Nd:YAG laser. Six laser sessions were necessary to destroy the whole adenoma. After 30 months of follow-up, there was neither endoscopic nor histologic recurrence. The laser therapy should be therefore considered in treating large sessile duodenal villous adenoma occurring in inoperable patients. However, a repeated endoscopic surveillance must be performed.

Adenoma↗
PubMed1989

Apolipoprotein AI is a serum and tissue marker of liver fibrosis in alcoholic patients.

The aim of this study was to assess the specific correlation of apolipoprotein-AI to hepatic fibrosis in alcoholic patients. Four hundred eighty two patients were prospectively included with serum measurement of apolipoprotein-AI within 10 days before liver biopsy. Pathologic features were semiquantitatively assessed by two observers. In 28 patients liver biopsy was used for histomorphometric assessment of fibrosis and immunohistochemical labeling of apolipoprotein-AI. Serum apolipoprotein-AI was negatively correlated to semiquantitative score of fibrosis (r = -0.50; p less than 0.001), independently of the scores of steatosis and alcoholic hepatitis (r = -0.44; p less than 0.001) and of the value of serum albumin, bilirubin, and prothrombin time (r = -0.22; p less than 0.001) and independently of the nutritional parameters (r = -0.29; p less than 0.009). The mean value of apolipoprotein-AI decreased according to the grade of fibrosis from 220 +/- 6 mg/dl (mean +/- SEM) to 110 +/- 8 mg/dl. Serum apolipoprotein-AI was negatively correlated to the percentage of fibrosis (r = -0.70; p less than 0.001) in the biopsies morphometrically assessed. The labeling was superimposed to the extracellular matrix. In conclusion, this study shows that decrease of apolipoprotein-AI is a serum and tissue marker of liver fibrosis independently of steatosis, alcoholic hepatitis, liver function tests, and nutritional parameters.

Apolipoprotein A-I↗