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Biomedical subjects

A Louvel

Publications and source records attributed to A Louvel.

At least 55 records · Page 3Linked to original sources

[Pancreatic fistula after left pancreatectomy. Frequency and severity].

In order to study the frequency and complications related to pancreatic fistula following distal pancreatectomy we have reviewed 19 patients operated on between January 1st 1981 and February 28 1986. There was no mortality but the incidence of pancreatic fistula was 52%. 40% of these cases developed a subphrenic abscess (21% of the total number of cases). These fistulas closed after an average post-operative period of 42 days. Reoperation for an infected collection was required in 4 cases. The incidence of pancreatic fistula was not related to the initial pancreatic pathology. Splenectomy did not influence the incidence of subphrenic abscess. Different techniques of closure of the distal pancreas after resection have not changed the incidence of this complication. The use of somatostatin appears to favourably influence the course of the fistula. These conclusions tend to confirm the results of other reported series.

Adolescent↗

[Adrenomegaly and other masses of the adrenal area. Diagnostic and therapeutic approaches].

During the 1982-1987 period 104 patients were surgically explored for a mass of the supra renal area. An adrenal tumor was found in 67%, an adrenal pseudo-tumor in 12.5%, a non adrenal pathology in 12.5%, and a tumoral involvement of the adrenal in 8%. Revealing circumstances were variable: 41% of the patients presented with endocrine symptoms (adrenal hypersecretion 83% or deficiency - 17%). In 30% abdominal pain was the chief complaint. In 24% the finding of the adrenal mass was totally fortuitous. In this latter circumstance the diagnostic difficulty is maximal and the strategy remains debated. Our approach would tend to be primarily surgical for fear of letting a malignant tumor evolve further.

Adrenal Gland Diseases↗

Discordant heart xenografts in the rat. Additional effect of plasma exchange and cyclosporine, cyclophosphamide, or splenectomy in delaying hyperacute rejection.

Natural antidonor antibodies are known to play a prominent role in hyperacute xenograft rejection. The aim of this work was to devise an experimental protocol to prolong the survival time of guinea pig heart xenografts transplanted into rats. A technique of continuous plasma exchange adapted to small animals was used to remove the natural cytotoxic antibodies from the recipient prior to the transplantation. In some experiments, cyclosporine (CsA), cyclophosphamide (CY), or splenectomy were associated with the plasma exchange. In this highly discordant xenogenic donor-recipient combination, the mean graft survival time in nontreated rats was 16 min. When an exchange of 1.5 plasma volume was performed 24 hr before the transplantation, no prolongation of the graft survival time was observed. When CsA, CY, or splenectomy were associated with the plasma exchange, the graft survival time was significantly increased by more than 2500% (up to 418 min with CsA). When used isolately, none of these 3 immunosuppressive methods was able to prolong the graft survival time. Natural cytotoxic antibodies were monitored by a complement-mediated cytotoxicity assay. After a plasma exchange, the titers decreased from 1:16-1:32 to 1:1-1:2. When no immunosuppressive method was associated with the plasma exchange, the antibodies returned to their initial level within the 24 hr that preceded the transplantation, and the graft was rejected as in nontreated animals. When an immunosuppressive method was associated with the plasma exchange, and particularly in the case of CsA, the titers remained low, and the hyperacute rejection was delayed. Therefore, it can be concluded that plasma exchanges, associated with CsA, are an efficient experimental protocol in the rat to increase the survival time of guinea pig heart xenografts. The effect of the treatment is correlated with the decrease in natural cytotoxic antidonor antibodies.

Animals↗

[Tumor and pseudotumor lesions of the adrenal area not to be misdiagnosed].

Thirteen patients with a mass in the adrenal gland area discovered at ultrasonography or computed tomography were studied. Hormone levels were normal in all but three patients with adrenal insufficiency. With the exception of three patients with metastatic tumours or adrenal lymphoma, all were operated upon on account of complications or for diagnostic purposes. The pre-operative diagnosis was confirmed by histology in 5 out of 10 cases (tuberculous abscess in 2, cysts in 2 and 1 haematoma in 1 case). In the remaining 5 cases the tentative diagnosis was erroneous: these patients had haematoma, neurofibroma, schwannoma, leiomyosarcoma and angiomyolipoma respectively. Thus, ultrasonography and computed tomography do not always differentiate between adrenal and extra-adrenal masses and between malignancy and non-malignancy; surgical excision therefore seems to be desirable in such cases.

Adrenal Gland Diseases↗

In vitro adrenal cortex lesions characterization by NMR spectroscopy.

Percentage of lipid content of 22 adrenal cortex lesions and their water proton longitudinal relaxation time were measured in vitro at 60 MHz. Although water relaxation times obtained on benign and malignant samples overlap each other, measurements of the percentage of lipids performed on the same tissues allow us to distinguish the two pathologies. The specific tool of characterization should be possible to obtain through in vivo spectroscopic imaging techniques.

Adenoma↗

[Lymphomas and AIDS].

We report 21 cases of lymphomas associated with AIDS. Sixteen cases are Non Hodgkin's lymphomas of high grade malignancy. Immunoblastic B cell lymphomas are frequent: 11 cases/16, especially with extra nodal localisations. Three cases are Burkitt's lymphoma; 2 cases are large non cleaved cell lymphoma. Five cases of Hodgkin's disease are associated with AIDS related complex syndrome (ARC) showing the interest of lymph node biopsy in such patients. We analyzed 6 cases with lymphoid bone marrow infiltration and discuss the relationship between prelymphomatous states and low grade malignant lymphomas in AIDS or ARC patients.

Acquired Immunodeficiency Syndrome↗

[Papillary adenocarcinoma of Wirsung's duct].

We describe a new case of ductal papillary adenocarcinoma of the pancreas, resected in 1976 (cephalic pancreatoduodenectomy). The patient is still alive. This particular histological type of pancreatic cancer seems to be very rare (9 cases published). The difficulty of preoperative diagnosis and the possibility of long-term postoperative survival clearly differentiate ductal papillary adenocarcinoma from other glandular adenocarcinomas of the pancreas.

Carcinoma, Intraductal, Noninfiltrating↗

[Non-Hodgkin lymphoma associated with a relapse of Hodgkin's disease].

We report the case of a patient treated for Hodgkin's disease (stage IIIEA) by combination of chemotherapy (MOPP regimen) and total nodal irradiation. Five months after the completion of radiotherapy the patient presented with a relapse of his Hodgkin's disease and simultaneous occurrence of diffuse non Hodgkin's lymphoma in a different lymph node territory. The relationship between these two malignancies is discussed and the literature is reviewed.

Combined Modality Therapy↗

Human chromosome analysis in 24 cases of primary carcinoma of the large intestine: contribution of the G-banding technique.

As in the haemopathies, the application of cytogenetics to epithelial cancers could aid in the study of their pathogenesis evaluation. In this context we performed chromosome analyses on a series of human colo-rectal cancers. The technique was consistently reliable since the modal number of chromosomes could be determined in all 24 cases. In 22, karyotypes could also be established. Each tumour was characterized by a single cell clone in 21 cases and by a mosaic of 2 populations in 3 cases. Numerical anomalies were not due to chance: they enabled near-diploid (11 cases), near-triploid (9 cases), mosaic (3 cases) and highly polyploid (1 case) cancers to be distinguished. Supernumerary chromosomes were primarily in groups C and F. The most frequent markers before denaturation techniques were No 2q +, No F and minutes. Each time double-minutes were observed (5 cases), they were in invasive cancers (B and C Dukes classification). Cells were generally diploid in non-invasive cancers with fewer quantitative and structural anomalies. Tumour cytogenetics were related to the histological type and localization in the colon, as well as to the local and metastatic spread.

Adenocarcinoma↗

[Spironolactone bodies. Light and electron microscope study apropos of 4 cases of adrenal adenomas with primary hyperaldosteronism].

So-called Spironolactone bodies are reported in four adrenal cortical adenomas that were removed from patients with primary hyperaldosteronism, treated preoperatively with spironolactone. Their morphology is described optically : these round acidophilic cytoplasmic bodies have a laminated appearance that ranges in size from 2 to 20 mu in diameter. Electron microscopy of the zona glomerulosa non adenomatous cells and of adenomatous cells of glomerular type reveals numerous membranes arranged concentrically around a central core. Connections between the endoplasmic reticulum and mitochondria in the cytoplasm of the cell and lining layers of the body are described and analysed. The authors attempt to explain the formation and the increase of the bodies. Correlations appear between the number of spironolactone bodies and duration of administration of spironolactone and total drug dosage. The results are discussed with those of the literature.

Adenoma↗

[Splenic abscess. 3 cases (author's transl)].

The authors report three cases of splenic abscess. The condition developed twice during a salmonella infection associated in one case with sickle cell disease. In two patients, the spleen was the site of a suppurated infarction. One patient died shortly after operation. Study of the 79 cases of splenic abscess treated surgically published since 1960 reveals a mortality of 16%. This rare condition is seen essentially during typhoid and septicaemias (endocarditis). Such pathology in also now seen in drug addicts. The diagnosis and, hence, the prognosis should be improved by the use of echography which seems to be the most reliable investigation before peritonitis by rupture which remains a complication associated with a heavy mortality.

Abscess↗