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Biomedical subjects

C Chapelon

Publications and source records attributed to C Chapelon.

At least 55 records · Page 3Linked to original sources
PubMed1987

[Lupus vasculitis].

Anatomical studies have demonstrated the high incidence of vasculitis in SLE, the appearances of which are variable and non-specific, ranging from necrotizing angiitis which is undistinguishable from periarteritis nodosa, to scarring lesions. Micro-angiitis is easily demonstrated in skin lesions and is also encountered to varying degrees in CNS, renal, cardiac, pulmonary and gastrointestinal localisations. Disease of large vessels is more rare and sometimes causes gangrene of the limbs. In SLE, vasculitis should be distinguished from thrombosis related to lupus anticoagulant and from atherosclerosis favoured by chronic steroid therapy but perhaps initiated by vascular deposits of immune complexes during the acute inflammatory stage. The treatment of lupic angiitis is mainly based on steroid therapy. The results are variable, probably due to the fibrous nature of some of the vascular lesions.

Humans↗
PubMed1987

[Panic attacks: a diagnosis to know in internal medicine. Analysis apropos of 11 patients and an attempt at a physiopathological explanation].

The authors report a series of 11 patients who consulted or were admitted to a hospital medical unit for organic symptomatology, especially hypertensive, diagnosed as panic attacks based on the criteria of the DSM III. Cardiovascular symptoms were dominant in 10 out of the 11 patients. In 7 cases, the symptoms were very suggestive of pheochromocytoma. Treatment based on tricyclic antidepressive drugs associated with behavioural therapy in 5 cases, led to the total regression of acute panic attacks in 9 out of 11 patients with a follow-up period ranging from 1 to 2 years. However, it did not prevent 2 of the patients from developing a chronic anxiety state. After reviewing the principal clinical features of panic attacks, the authors discuss their underlying physiopathological mechanisms. The results of catecholamine metabolic studies in 2 out of 3 patients suggest the possible role of an inhibitor of catecho-o-methyl-transferase, but this requires confirmation by further studies. Panic attacks are very prevalent in the general population (2 to 5 p. 100). The diagnosis must be born in mind to avoid long and costly investigations, and for specific treatment to be instituted. The main risk is the development of chronic severe morbidity with serious socio-familial consequences.

Adult↗
PubMed1986

Sarcoidosis.

Explore the source record for details and available documents.

Adult↗
PubMed1986

[Traumatic aorto-right ventricular fistula. Apropos of a case].

The authors report the case of a 19 year old young man with an aorto-right ventricular fistula caused by a stab wound. The diagnosis was not made initially during surgery to control haemorrhage (left hemothorax due to a damaged internal mammary artery). However, three weeks later, a continuous murmur was detected and the diagnosis established by echocardiography and cardiac catheterisation. The lesions were repaired by open heart surgery under cardiopulmonary bypass. The authors describe the main features of this condition based on their own experience and a review of the literature.

Adult↗
PubMed1986

[Potential course of lesions of the ascending aorta in dystrophic aortic insufficiency].

Dystrophic aortic insufficiencies represent at present time an important etiology of operated on pure and voluminous aortic regurgitations (n = 95, i.e. 28.1% of cases followed by our working team). The valvular dysplasic lesions by which they are characterized were associated in 2 out of 3 cases with parietal lesions of the ascending aorta: annulo-ectasic disease (n = 42) or important non-aneurysmal dilatation of the ascending aorta (n = 20). However, these valvular dysplasias may also appear isolated in an aorta morphologically normal at peroperative examination (n = 33). Among the 42 patients suffering from, annulo-ectasic disease (group 1) the type of surgical correction varied with the period of operation. Valvular replacement isolated (n = 3, group 1 a) or associated with aortic supracoronary surgery (n = 17, group 1b) were the procedures before 1978. Since then, 22 patients (group 1c) had a total replacement of the ascending aorta were subjected to valvular interventions (19 replacements, 1 valvuloplasty). When performed, parietal biopsy of the aorta showed in 11 out of 15 cases signs of cystic medio-necrosis. After a delay of 53 +/- 40 months, 11 out of 20 patients of group 1a and 1b died, 5 of them from the evolution of lesions at the ascending aorta (3 ruptures and 2 dissections); one patient was reoperated 12 years after the placing of a supracoronary tube, because of the development of a voluminous aneurysm of the sinuses of Valvalva which initially were only simply dilated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Sarcoidosis in internal medicine. A cooperative study of 554 cases].

The authors report the results of a retrospective cooperative study of 554 cases of sarcoidosis admitted to departments of internal medicine. The condition is more common in women (57 p. 100) than men (43 p. 100), but the onset is earlier in men. The clinical presentation is very variable and includes a wide variety of extra-thoracic localisations. "Guided" biopsy of early accessible lesions (skin, subcutaneous lymph nodes) is positive in 92 p. 100 of cases: the sensitivity of "blind" biopsy is less impressive, ranging from 49 to 69 p. 100 according to the tissue biopsied (bronchial mucosa, accessory salivary glands, liver). Alveolar lavage is positive in 65 p. 100, and angiotensin converting enzyme is positive in 58 p. 100 of untreated cases. There is a clear correlation between the results of these investigations and the radiological stage of the mediastino -pulmonary disease. Steroid therapy was instituted in 68 p. 100 of cases. The outcome with or without therapy was favourable in 82 p. 100 of cases, confirming the usually benign course of sarcoidosis when the heart is not involved.

Adolescent↗
PubMedDate not supplied

[Bacterial endocarditis on prosthetic valves].

Bacterial endocarditis is a rare, but often lethal, complication of cardiac valve replacement. The endocarditis is called "early" when it occurs within 2 months of the operation, and "late" when it develops after that period. Contamination of the prosthesis with bacteria may occur intra-operatively or post-operatively. The clinical diagnosis is often difficult in early endocarditis when another focus of infection is present and in late endocarditis in the absence of fever and positive blood cultures. Isolation of the pathogen from blood cultures is essential to the diagnosis and treatment. Therapeutic surgery now has wider indications than formerly. The incidence of this dangerous complication can only be reduced by well-planned and well executed prophylactic measures.

Anti-Bacterial Agents↗
PubMedDate not supplied

[The advantages of histological samples in sarcoidosis. Retrospective multicenter analysis of 618 biopsies performed on 416 patients].

The diagnosis of sarcoidosis is based on the finding of an epithelioid granuloma at histological examination. A retrospective study of 618 biopsies obtained from 416 patients with sarcoid disease showed an average sensitivity of 69 p. 100. The sensitivity of guided biopsies, especially skin and lymph node biopsies, was almost 90 p. 100, whereas that of blind biopsies tended to increase with the degree of hazard involved, ranging from 49 p. 100 in proximal bronchial biopsy to 70 p. 100 in liver needle biopsy. When treatment is not urgently required, the Kveim test is safe, cheap and fairly sensitive (65 p. 100 positive results).

Biopsy↗
PubMedDate not supplied

[Systemic vasculitis associated with non-streptococcal infection. Report of 4 cases].

The responsibility of bacterial agents in the staring of systemic vasculitis is discussed on the basis of four cases: three men and one woman presenting with severe vasculitis which revealed or complicated a focus of infection without hematogenic dissemination. Two patients had gastrointestinal lesions and one had severe renal lesions. The vasculitis affected small caliber vessels, and in two out of four cases it involved arterioles of medium caliber with histological images resembling periarteritis nodosa. Antibiotic therapy alone was immediately effective against vasculitis. However, a purely cutaneous relapse occurred in three patients whose disease had regressed under an adjuvant treatment.

Adult↗
PubMedDate not supplied

Renal enlargement as presentation of isolated renal relapse in childhood leukemia.

Extramedullary relapses in children with acute lymphoblastic leukemia occur most frequently in the central nervous system and in the testis. In this report, the authors describe a 16-year-old girl with an isolated renal relapse of acute lymphoblastic leukemia after a disease-free interval of 2 years and 8 months. This clinically inconspicuous renal relapse was suggested by a routine follow-up renal sonography. No evidence of disease was found in bone marrow or peripheral blood. Renal biopsy was required to establish the diagnosis. Treatment consisted of intensive chemotherapy and autologous bone marrow transplantation. The patient has been in second complete continuous remission for 7 years. The authors recommend the use of an intensive multidrug salvage regimen.

Adolescent↗
PubMedDate not supplied

[Heart conduction disorders in long-term treatment with chloroquine. Two new cases].

Cardiac complications are exceptional in long-term chloroquine therapy; congestive heart failure and restrictive cardiomyopathy may develop, but disorders of conduction are more frequent. The characteristics of these disorders emerge from 12 cases in the literature and from 2 personal cases. The usual disorder is fascicular block which may become a complete, syncopal, atrioventricular block, as in one of our 2 patients. The time elapsed between the beginning of treatment and the occurrence of these disorders (2 to 30 years) and the total dose of chloroquine received (100 to 2,500 g) are extremely variable. Retinopathy or neuromyopathy is present in 64 and 35 percent of the cases respectively. The diagnosis is confirmed by endomyocardial biopsy with electron microscopic study which shows vaculoar myopathy with numerous large secondary lysosomes containing a dense material of lamellar structure (myelinic figures, curvilinear bodies). Regression of heart conduction disorders after withdrawal of chloroquine seems to be inconstant and incomplete. The rare occurrence of this complication raises the question of genetic predisposition. We believe that chloroquine therapy should be contra-indicated in patients with a history of conduction disorders and that a 6-monthly electrocardiographic control of these patients would be justified.

Biopsy↗
PubMedDate not supplied

Magnetic resonance imaging of human orthotopic heart transplantation: correlation with endomyocardial biopsy.

The ability of magnetic resonance imaging (MRI) to detect allograft rejection was studied concomitantly in two centers. In 29 patients MR images performed on a 0.5 T imager were compared with pathologic findings obtained by transvenous right ventricular endomyocardial biopsies. Eight patients had grade 1 or 2 acute rejection, and their myocardium thickness was increased significantly compared with values obtained in normal volunteers, in normal heart allograft patients, and in patients during the resolving phase of an acute rejection episode, whereas no abnormal signal intensity was found in the myocardium of heart allograft patients with acute rejection. This finding is quite in opposition to what was found in experimental models. This could be the result of the immunosuppressive regimen of those patients including cyclosporine, whereas few experimental studies included cyclosporine treatment. For chronic rejection or fibrosis, MRI did not allow the diagnosis because the MRI appearance was close to normal. Finally, MRI appears as a complementary technique to B-mode ultrasound in detecting nonimmunologic complications such as pericardial effusions and endocavitary processes. These data suggest that MRI could be used in the future to monitor rejection, to guide the timing of endomyocardial biopsy, and to assess the response after immunosuppressive treatment.

Adolescent↗