Biomedical subjects
Publications and source records attributed to A Le Treut.
The authors report on 12 personal observations of lymphoportal fistulas, which represented 0.24% of their series of lymphographies. This rare complication of lymphography has no clinical or biological liver manifestations. Review of 71 cases in the literature confirmed that hepatic oil embolization only occurs when there are lymphatic masses, with or without associated thrombosis of the inferior vena cava.
Gel=like or fibrillar human bronchial mucus was reduced with mercaptoethanol under dissociating and non-dissociating conditions. Bronchial mucus was solubilized in both conditions; but reduction in phosphate buffer induced more extensive depolymerization of mucus glycoproteins than obtained under reduction in guanidine. Moreover, mucins prepared by reduction in non-dissociating conditions contained less amino acid and more carbohydrate. These data strongly suggest that reduction under non-dissociating conditions does not act only on disulfide bridges but also induces the activation of a mucolytic enzymatic system. They also would explain some of the discrepancies observed in the molecular weight determination and chemical composition of human bronchial mucus glycoproteins purified after reduction of gel-like mucus under different conditions.
Serum levels of angiotensin-converting enzyme (ACE) were measured in 111 healthy subjects and in 117 adult patients with mediastinal and pulmonary sarcoidosis. The patients were followed up for 3 years. Detailed clinical investigations and ACE level measurements were performed every three months. The activity of the disease was assessed in 94 patients without treatment and in 23 patients under corticosteroid therapy. Mean ACE levels were significantly higher (p less than 0,0001) in all patients with sarcoidosis than in controls. They were also high (greater than 35 units/ml) in 32 patients with active forms of the disease. In 19 patients with inactive forms ACE levels were either moderately raised on normal, while considerable variations were observed in those with stable, persistent sarcoidosis. Complete spontaneous or therapeutically induced remission were accompanied by a return of ACE to normal values, but this was not the case for incomplete remission. There was no correlation between ACE levels and the radiological stages of the disease. Measuring ACE levels in patients with sarcoidosis may therefore contribute to diagnosis and surveillance and help to distinguish between complete and incomplete remissions.
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Five lysosomal enzyme activities (arylsulfatase A, alpha-D-mannosidase, alpha-L-fucosidase, hexosaminidase and beta-D-galactosidase) were determined in serum and leucocytes of 30 controls and 114 patients suffering from various liver diseases, including 30 with idiopathic hemochromatosis and 34 with alcoholic cirrhosis. The results show (1) a decrease of the serum arylsulfatase A activity in idiopathic hemochromatosis, (2) an increase of this activity in cholestatic jaundice, and (3) mainly, a sharp rise of the leucocyte lysosomal enzyme activities in the liver diseases studied (chiefly idiopathic hemochromatosis and alcoholic cirrhosis). The mechanism and the meaning of these disturbances are discussed.
In a series of 25 cases of primary malignant tumours of the nasopharynx the authors the advantages of CT which provides.--positive diagnoses,--assistance in the performance of biopsy in cases with primary malignant cervical adenopathies,--the possibility of personalising radiotherapy protocols,--valuable technique for long-term supervision.
Computer tomography examinations were conducted during pre-treatment investigations in 30 patients with histologically-confirmed bladder cancer. Comparison of anatomical and radiological findings demonstrated that the C.T. scan supplied precise details on any extension of the lesion, enabling choice of therapy to be made in 90% of the cases. These results, which are confirmed by published reports, are discussed in relation to data supplied by other complementary examinations. The conclusion is that the C.T. scan should be employed systematically before starting treatment for bladder tumors.
The results of 5 computer tomography examinations of the retroperitoneal region are discussed. Previous examinations in these patients had suggested, but could not confirm, the presence of a lesion in a particular organ. Normal retroperitoneal structures were found by computer tomography in 7 of the 51 cases. An extrarenal lesion was discovered in 9 of the patients and a benign renal anomaly in 15 cases. Cancer of the kidney was observed in 21 cases. No practical difficulty was encountered in making a differential diagnosis between a cyst, especially one on the left upper pole, and cancer of the kidney (35/35). The extent of spread of the cancers was easily demonstrated except when liver adhesions were present, but these were of little significance. Results of computer tomography examination of benign parenchymatous tumors are not available at the present time to enable semiological definition to be made.
Computed tomography was used to examine the adrenal glands of 100 normal subjects. This investigation, which is simple to conduct, and causes only slight disturbance to the subject, was able to identify the right adrenal in 92% of cases and the left gland in 95% of subjects. The morphological aspect of the normal gland is that of an inverted "Y" but the absence of one or both limbs of the "Y" can give an appearance of a comet or a triangle respectively. The contour is always concave or rectilinear, and any tumor which extends beyond the gland should, theoretically, be detectable. Computed tomography is therefore the method of choice for examining normal or pathological adrenal glands, and its reliability and precision appear to be superior to that of ultrasonography.
The results of computed tomography examination of adrenal tumors in 19 adults patients are reported. Diagnosis of an adenoma during Cushing's syndrome is possible, as well as detection of spread of an adrenal cortex tumor. Avascular pheochromocytoma and Conn's adenomas less than 1 cm in diameter, occurring during the course of hypertensive disease, can also be demonstrated. In cases of adrenal metastases, the main value of the CT scan is to enable precise stereotaxic biopsies to be conducted, and to allow modification of therapy as a function of results.
The method of chemical assay of angiotensin I-converting enzyme described is a modification of the previously published spectrophotometric assay based on quantitation of hippuric acid released from hippuryl-L-histidyl-L-leucine. The new procedure involves extraction of hippuric acid with ethylacetate, evaporation to dryness of the extract, solubilization of the residue with 1 mol/l NaCl and purification with petroleum ether before measurements of the absorbance at 228 nm of the aqueous phase. Under these conditions, hippuric acid insoluble in petroleum ether remains in the aqueous phase, whereas other A228-absorbing materials, readily soluble in the ether and able to interfere with the assay, are eliminated.
The authors studied the phenotypic distribution of alpha-L-fucosidase in a random sample of the population of the area of Rennes (France). The frequencies of Fu1 (0.64) and Fu2 (0.36) genes are significantly different from the frequencies observed in New York whites and blacks.
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Angio-immunoblastic lymphadenopathy (AIL) produces a characteristic lymphoproliferative syndrome, with characteristic lymphographic appearances. The authors studied the lymphographic manifestations of 18 cases of AIL. In 15 out of 18 cases, enlargement is observed in all the lymph nodes with a lacy or reticular storage pattern and sharp, well delimited margins. This lymphographic appearance reflects the histologic changes; only the peripheral sinuses, which are not involved, can be observed on lymphography.
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From 20 observations, the authors worked out the frequency and the radiological picture of chest localizations of angio-immunoblastic lymphadenitis (A.I.L.). There are 2 kinds of pulmonary involvement: --a specific one by interstitial immunoblastic infiltration (20 to 45% of cases) and showing on X ray a reticulomicronodular interstitial syndrome; --a secondary infection (33% of cases) often the cause of death. Pleural involvement is unfrequent (11% to 25% of cases) and its onset late. Mediastinal lymph-node involvement is found in 37 to 50% of cases. It is usually discovered straight away.
Blood donors from the Centre Régional de Transfusion Sanguine de Rennes were investigated for the phenotypic distribution of seven enzymatic systems : adenylate kinase, adenosine deaminase, esterase D, 6-phosphogluconate dehydrogenase, glutamate-pyruvate transaminase, phosphoglucomutase, and glyoxalase I. Two unusual phenotypes were observed: phenotype 6-1 for adenosine deaminase and phenotype 3-1 for transaminase GPT. For five of these enzymes, the statistical analysis points out significant differences in one or several of the European populations described in the literature.