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Biomedical subjects

C Marche

Publications and source records attributed to C Marche.

At least 73 records · Page 4Linked to original sources

Lymph node modification in patients with the acquired immunodeficiency syndrome (AIDS) or with AIDS related complex (ARC). A histological, immuno-histopathological and ultrastructural study of 45 cases.

The authors present the results of a histopathological study on the lymph-nodes taken from 45 subjects suffering from either an AIDS or from a chronic adenopathy corresponding to the definition of AIDS related complex (ARC). The various aspects observed were classed as type I to type IV. The lymph-node modifications observed in the 29 patients with an ARC could be divided into three principle groups: an extensive follicular hyperplasia associated with other elementary lesions or type IA (25 lymph-nodes from 23 patients); changes resembling a multicentric Castleman syndrome or type IB (1 case); angioimmunoblastic-like (AIL) lesions or type II (2 cases) and an association of lesions of type II (7 lymph-nodes from 6 patients). During AIDS, the adenopathy usually disappears, and the small lymph-nodes removed, especially on autopsy, show an extensive lymphoid depletion (type III) with systematic sclerosis (15 lymph-nodes from 14 patients). When adenopathy persists, it is due to infections complications (tuberculosis, cryptococcosis, avian mycobacteriosis and Whipple's disease like lesions). Of the 10 patients in whom a Kaposi's sarcoma was observed, only 6 showed lymph-node involvement, or type IV. The different histopathological lesions seem to appear according to an evolving succession, proven by certain association of lesions and by successive biopsies. In our series, 17% of subjects with an ARC evolved to AIDS. Lymph-node biopsy allows a possible ARC to be implicated on the association of the following simple lesions: follicular hyperplasia with partial or total destruction of the perifollicular lymphocytic cisterna, infiltration of the germinative centres by streams of small lymphocytes, evolving to an aspect of a "burst" germinative centre and various sinusal reactions with, in particular, the presence of neutrophilic polynuclear cells. The biopsy also allows the forms with bad prognosis to be recognized: those with AIL-like aspect or multicentric Castleman-like syndrome, which seems to represent a particular evolutive form. Finally, it also detects, in certain cases, the localization of a Kaposi syndrome, signalling the passage to AIDS. The immunopathological studies present a double interest. Firstly, they offer arguments in favour of the diagnosis: increase in the number of T8 lymphocytes in the germinative centres with the formation of small clusters and disruption of the network of dendritic reticular cells, and the inversion of the T4/T8 ratio in the extra-follicular cortical regions, by either a decrease in T4 lymphocytes or by an increase in T8 lymphocytes.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗

[Digestive manifestations of the acquired immunodeficiency syndrome (AIDS): study in 26 patients].

We studied the gastrointestinal manifestations in 26 cases of AIDS. The patients belonged to two different epidemiological groups: the first group included thirteen french homosexual men, the second group included 6 Haitians, 6 Africans and a Pakistanian, none of them admit homosexual activity. The clinical manifestations were: chronic watery diarrhea in 17 cases, bloody diarrhea in 2 cases; loss of weight in the 26 cases; dysphagia in five cases; jaundice in one patient (due to Kaposi sarcoma of the ampulla of Vater). The digestive lesions found, alone or associated, were necrotizing enteritis (2), ulcerative colitis (1), pseudomembranous colitis (1), Candida esophagitis (10), erythematous duodenitis (6), proctitis (4), Kaposi sarcoma (3), diffuse (2) or localized (1). Thirteen patients out of the 26 presented opportunistic digestive infections due to one or several germs. These were 10 cases of esophageal infection (due to Candida albicans) and 8 cases of enterocolonic infection due to Cytomegalovirus (3 cases), Cryptosporidium (3 cases), Mycobacterium avium intracellulare (1 case), Cryptococcus neoformans (1 case). The other digestive infections cases were due to non-opportunistic pathogens: Entamoeba histolytica (3 cases); Giardia lamblia (3 cases); Strongyloides stercoralis (2 cases); Salmonella typhi (2 cases); Shigella (1 case); Herpes simplex virus (1 case). No difference was noticed between the homosexual and the heterosexual groups with respect to the nature and the frequency of the digestive infections.

Acquired Immunodeficiency Syndrome↗

[Cervical adenopathies in relation to AIDS. Course of histological aspects. Diagnostic and prognostic value].

Histopathologic appearances of lymph nodes during acquired immune deficiency syndrome (AIDS) and related conditions are analyzed, with emphasis on the diagnostic and prognostic value of cervical gland biopsy at the lymphadenopathic stage. Details are given of the characteristics of the follicular hyperplasia of the lymph nodes (type I), which appears to be the initial lesion and is possibly regressive, and emphasis placed on the poor prognostic significance of the hyperplasia simulating a Castleman syndrome and of the forms simulating an angioimmunoblastic lymphadenopathy (type II). Findings suggest that the appearance, in a still hyperplastic lymph nodes, of foci of pseudo-angioimmunoblastic homogenization, of fibroedema with lymphoid depletion or conjunctival vascular proliferation may be the initial sign of a course towards the glandular atrophy (type III) or Kaposi's sarcoma which are the attribute of confirmed AIDS.

Acquired Immunodeficiency Syndrome↗

[Effect of fasting and refeeding on the adaptation of the small intestine in rats. A model for physiopathologic studies].

A chronological study was carried out on 50 male Wistar rats (350 g) to determine the effects of 3 days of fasting and 16 h to 9 days of refeeding on the morphology of jejunal and ileal mucosa (villus, crypt and enterocyte heights; number of mitosis), on some aspects of their functional adaptation (sucrase, maltase, protein) and on nitrogen and lipid absorptions. Three days of fasting resulted in weight loss (12 p. 100), in a jejunal mucosa atrophy (villus height: 376 +/- 18 vs. 492 +/- 4 microns in controls; enterocyte height: 31 +/- 2 vs. 41 +/- 0.3 micron in controls) and a decrease in disaccharidases activities (sucrase: 927 +/- 90 vs. 3,363 +/- 21 mU/10 cm length in controls). No change in ileal mucosa morphometry was noticed. Ad libitum refeeding caused a rapid and progressive weight gain, a jejunal morphometric regrowth identical to control values at 16 h (villus height: 521 +/- 20, enterocyte height 42 +/- 0.9 microns), and maximum at 40 h of refeeding (villus height: 601 +/- 5 microns). Disaccharidases adaptation was delayed, with a maximum at 64 h of refeeding (sucrase: 3,524 +/- 56 mU/10 cm length). Despite a 30 p. 100 increase of food consumption over the whole study (45 p. 100 during the first 16 h of refeeding), nitrogen and lipid absorption coefficients remained identical to those found in controls with an increased nitrogen balance of 70 p. 100 at 16 h and 54 p. 100 at 40 h refeeding, as compared to controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗

[Peri-anal ulceration. Tuberculosis should not be overlooked].

Two cases of peri-anal ulceration of tuberculous origin are reported: one revealed an active pulmonary and ileo-caecal tuberculosis, the other complicated a chronic pulmonary tuberculosis of several years' duration. Cutaneous manifestations of tuberculosis are exceptional. In patients with protracted peri-anal ulceration, a biopsy should be performed that will show a typical tuberculoid granuloma. The most frequently encountered anorectal tuberculous lesions are suppurations and fistulae. The main differential diagnosis is Crohn's disease with anorectal manifestations.

Adult↗

Influence of starvation on sucrase regulation by dietary sucrose in the rat.

We have studied the action of sucrose on jejunal sucrase activity. Rats (175 g) were first starved or fed a digestible carbohydrate-free diet for 60 h and then fed a high sucrose diet for varying times up to 84 h. 1) Rats starved for 60 h showed mucosal atrophy with a decrease in protein content/10 cm (18.00 +/- 1.4 versus 40.1 +/- 3 mg (controls p less than 0.001) and in villus height (357 +/- 18 versus 526 +/- 5 microns, p less than 0.001) which was fully repaired only after 60 h on the sucrose diet (528 +/- 11 microns). Rats on digestible carbohydrate-free diet showed no mucosal atrophy. 2) Starved rats had a delayed (60 h) sucrase activity response to sucrose (53 +/- 7 versus 122 +/- 4 microns/mg protein, p less than 0.001). Maximum activity was obtained after 12 h on sucrose diet in rats maintained on the carbohydrate-free diet: 38 +/- 1 versus 108 +/- 2.3 microns/mg protein, p less than 0.001. 3) Villus and crypt cell analysis after starvation and 12 h on a high sucrose diet localized the increase in sucrase activity to the villus-crypt junction. No change occurred in the upper villus. The increase was complete all along the villus by 36 h. In contrast, after the carbohydrate-free diet, sucrase activity increased maximally at all levels of the villus by 12 h on the high sucrose diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

[Serous otitis and necrotizing angiitis].

Three cases are reported of necrotizing angiitis of otologic origin (one polyarteritis nodosa and two wegener's disease). Data in the published literature are reviewed and necrotizing angiitis classified. Two features resulting from this review are emphasized. Firstly, form the pathogenic point of view the fact that specific lesions were detected in the ear in one of these patients means that this localization may be a possible visceral manifestation, as are rhinologic and pulmonary lesions. Otologic sites may be an isolated, or in association, further type of pathogenic mechanism. From the practical point of view, any unexpected serous otitis in adults should suggest the need for an erythrocyte sedimentation test, very high values requiring investigation of etiology. This will avoid unnecessary medical and surgical treatments and the institution of immunosuppressant therapy active against all visceral lesions and the only effective means of treating the otitis. Early treatment could avoid the catastrophic prognosis observed short-term in the 3 cases reported.

Adult↗

[Cryptosporidiosis. II. Biological diagnosis].

The biological diagnosis of human cryptosporidiosis is made primarily by identifying Cryptosporidium oocysts in stool specimens under the microscope. It is advisable to fix and stain the fecal smears by the technique according to Henriksen. It is possible to examine fresh specimens and to carry out concentration techniques but this requires excellent knowledge of the cytology of the parasite. Cryptosporidium can also be identified from intestinal biopsies.

Animals↗