[Continuous haemodialysis with citrate anticoagulation in patients with liver failure: three cases].

Regional citrate anticoagulation for continuous renal replacement therapy provides an efficient alternative to heparin as it reduces the likelihood of haemorrhage in critically ill patients with bleeding risk or coagulopathy and increases the haemofilter survival time. Liver failure is a classic contraindication of regional citrate anticoagulation since it carries the risk of citrate accumulation and its metabolic complications, although it could be attractive for this population of patients with high bleeding risk. We report three cases of continuous haemodialysis with regional citrate anticoagulation performed in patients with severe acute liver failure, without accumulation in two cases and with a suspected beginning of accumulation in the third case.

[Posterior reversible encephalopathy related to tacrolimus in a liver transplanted HIV patient].

Tacrolimus-related posterior reversible leukoencephalopathy (PRLE) is a rare complication which should be recognized by clinicians who regularly use immunosuppressive therapy. We report the case of an HIV-positive, hepatitis C-positive liver transplant patient who presented with this complication. Immunosuppression with tacrolimus was started after postsurgery.

[Acute renal failure after acetaminophen poisoning: report of three cases].

Purpose: Management of acetaminophen overdose focuses on the risk hepatic failure. However, acute renal failure, although less frequent, can lead to serious metabolic complications and require hemodialysis. We report three cases of acute renal failure related to acetaminophen overdose.

[Acute liver failure due to a treatment by nimesulide: another case and review].

Nimesulide is a non-steroidal anti-inflammatory drug available in several European countries. A hepatic toxicity due to nimesulide has been reported but fatal cases remain rare. We report the case of a 49-year-old woman treated by nimesulide during three days, admitted to the intensive care unit for an acute liver failure with encephalopathy.

[Use of coupled plasma filtration adsorption for septic shock treatment].

Coupled plasma filtration adsorption (CPFA) is a new technology proposed for septic shock, removing both pro- and anti-inflammatory mediators. We report the first use of CPFA in France. The patient was 80-years-old and was admitted to the intensive care unit because of septic shock from urinary source.

Squamous cell carcinoma arising in a giant epidermal cyst: a case report.

Epidermal cysts are commonly encountered in surgical practice. Malignant degeneration of epidermal sebaceous cyst is uncommon. The authors report the case of a 38-year Filipino woman presenting with a voluminous sebaceous cyst of the left buttock.

Costs induced by hip fractures: a prospective controlled study in Belgium. Belgian Hip Fracture Study Group.

The economic burden of hip fractures is thought to be important, but the excess medical costs they induce remain largely unknown. We assessed the direct medical costs induced by hip fractures during and after hospitalization. Hospital costs of 170 consecutive Belgian women with hip fracture were gathered.

Peroneus quartus muscle: a case report and review of the literature.

The peroneus quartus is a supernumerary muscle of the lateral compartment of the lower leg. There are several variations of this accessory muscle, and its terminology is very confusing. The peroneus quartus is found with a frequency varying from 10 to 21.

[Pathologic fracture of the tibia associated with Charcot-Marie-Tooth disease].

The authors report a case of pathologic fracture of the distal tibia associated with Charcot-Marie-Tooth disease. Pathologic fracture was visible four weeks after initial pain. Treatment consisted in a short leg walking cast for six weeks.

Cranio-facial and humeral melorrheostosis.

First described by LERY and JOANNY in 1992, melorrheostosis is an uncommon linear hyperostosis of unknown aetiology, which may be associated with soft tissures changes. Although all bones may be affected, cranio-facial involvement is very rare. Only six such cases have been found in the literature.

[Tennis elbow: surgical findings in 17 cases and etiopathogenetic hypothesis].

Lateral epicondylitis is the most common source of elbow pain. Surgical treatment is easy but precise etiology remains uncertain. We reviewed 17 medical files of surgically treated lateral epicondylitis.

Interface peptides as structure-based human immunodeficiency virus reverse transcriptase inhibitors.

Reverse transcriptases from both human immunodeficiency viruses type 1 and 2 are obligatory dimers. A tryptophan-rich repeat motif that is highly conserved between these proteins, as well as in the reverse transcriptase from simian immunodeficiency virus, has been postulated to be involved in hydrophobic subunit interactions. A synthetic 19-mer peptide covering part of this tryptophan repeat motif was recently shown to inhibit human immunodeficiency viruses type 1 reverse transcriptase subunit dimerization (Divita, G.

Restriction of HIV-1 replication in intestinal cells is genetically controlled by the gag-pol region of the HIV-1 genome.

The human colon epithelial line HT29 represents a semipermisive cellular system for human immunodeficiency virus type 1 (HIV-1). It could be productively infected with HIV-1 NDK, a Zairian virus isolate highly cytopathic for CD4 positive lymphocytes, whereas infection with the prototype virus HIV-1 LAV was nonproductive. Recombinant viruses derived from HIV-1 LAV and HIV-1 NDK were used to determine the genetic control, step of virus/cell cycle, and molecular mechanism responsible for productive versus nonproductive infection of intestinal cells.

Lectin-mediated effects on HIV type 1 infection in vitro.

Lectins with specificity for terminal mannose residues and anti-mannan antibodies neutralize HIV-1 infection in vitro. This is assumed to be caused by binding of the agents to the viral glycoproteins. In this study we show that one such agent, the Galanthus nivalis lectin (GNA), also blocks infection at the target cell level.

Lectin effects on HIV-1 infectivity.

Lectins with specificity for terminal mannose residues and anti-mannan antibodies are assumed to neutralize HIV-1 by binding to the viral glycoproteins. In this report we demonstrate that one such agents, the lectin from Galanthus nivalis (GNA), blocks infection also at the target cell level.

Inhibition of human immunodeficiency virus type 1 reverse transcriptase dimerization using synthetic peptides derived from the connection domain.

Based on presently available information on the structure of human immunodeficiency virus type 1 (HIV-1) reverse transcriptase, peptides have been synthesized which correspond to the sequence of a particular region of the protein involved in formation of the active heterodimeric form of the enzyme. Several peptides that are 15-19 amino acids long and that are derived from the so-called connection domain of the reverse transcriptase are able to inhibit dimerization of the enzyme and thus inhibit development of its enzymatic activities. In particular, a tryptophan-rich 19-mer corresponding to residues 389-407 was relatively efficient, showing an apparent dissociation constant in the micromolar range for one or both of the subunits.

Continuous microspectrophotometric measurement of DNA polymerase activity: application to the Klenow fragment of Escherichia coli DNA polymerase I and human immunodeficiency virus type 1 reverse transcriptase.

Progress of DNA- and/or RNA-directed DNA polymerization reactions can be measured continuously using circular dichroism (CD) or ultraviolet (UV) spectroscopy. In the presence of the Klenow fragment of Escherichia coli DNA polymerase I, a CD change of -0.27 +/- 0.

[Standardized evaluation of obsessive phenomena in patients in general medicine. Prevalence and correlations].

Clinical experience in general hospital psychiatry and literature reviews supported the conjecture that psychopathological disturbances are frequent among medical patients. Wide discrepancies of prevalence data reported by different authors, however, suggested the importance of undertaking screening studies with standardized methods of assessment. Our initial studies in oncological patients confirmed the hypothesis, but also documented obsessive phenomena, assessed with Present State Examination (PSE) criteria, in more than one third of patients diagnosed of depression Consecutive studies in different medical samples have replicated those preliminary findings in the last one, close to one quarter of first day consecutive patients seen in an internal medicine out-patient clinic, and more than three quarters of the ones diagnosed of either anxiety or depression with Research Diagnostic Criteria, had obsessive symptoms as defined by the Clinical Interview Schedule (CIS).

Inhibition of mammalian spermine synthase by N-alkylated-1,3-diaminopropane derivatives in vitro and in cultured rat hepatoma cells.

A number of N-alkylated-1,3-diaminopropane derivatives [H2N-(CH2)3-NH-(CH2)nH, where n = 1-9] have been tested as potential inhibitors of partially purified rat hepatoma (HTC) cell or pure bovine spleen spermine synthase. Among the compounds described in this paper, the most potent competitive inhibitor of spermine synthase, with respect to spermidine, is N-butyl-1,3-diaminopropane with Ki values of 11.9 nM and 10.

Fluorinated analogues of spermidine as substrates of spermine synthase.

A series of mono- and geminal difluorinated analogues of spermidine (4-azaoctane-1,8-diamine) have been tested as potential substrates of partially purified rat hepatoma (HTC) cell or pure bovine spleen spermine synthase (EC 2.5.1.

Pyrimidine pathways enzymes in human tumors of brain and associated tissues: potentialities for the therapeutic use of N-(phosphonacetyl-L-aspartate and 1-beta-D-arabinofuranosylcytosine.

The activities of aspartate transcarbamylase (de novo pyrimidine biosynthesis pathway) and of deoxycytidine kinase as well as deoxycytidine deaminase (salvage pyrimidine biosynthesis pathway) were determined in extracts prepared from 40 brain tumors of different types in comparison with extracts from normal nervous tissues. Aspartate transcarbamylase, which is undetectable in normal brain tissue, is present in all tumor samples and in some cases rises to very high activities. Deoxycytidine kinase activity is present in all tissues but its level is generally higher in tumors.