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F Darnis

Publications and source records attributed to F Darnis.

At least 37 records · Page 2Linked to original sources

[Extensive liver cancer of undetermined origin. Diagnostic procedure].

In patients with isolated malignant tumoral hepatomegaly, the investigations performed should aim at excluding a primary carcinoma of the liver and concentrate on the search for primary tumours belonging to 2 main groups: tumours responsive to hormonal treatment or chemotherapy, and obstructive tumours amenable to local palliative measures. In all cases where simple, essentially clinical examinations fail to indicate the cause of the tumoral liver enlargement, further investigations should be based on the histopathological features of the metastases.

Hepatomegaly↗

Fasting serum bile acid level in cirrhosis. A semi-quantitative index of hepatic function.

We examined the roles of the factors which influence bile acid levels in order to define to what extent fasting serum total bile acid (FSTBA) level might reflect hepatic function and/or anatomy of the portal circulation in patients with cirrhosis. In a first group of 13 patients having mild to moderately advanced cirrhosis we determined the apparent oral clearance (CLo) of chenodeoxycholic acid (764 mumol) and their FSTBA levels. In a second group of 15 similar patients we measured FSTBA levels and by hepatic vein catheterization the intrinsic clearance (CLi) of ICG as well as total hepatic blood flow (Q). We found a significant inverse log-log relationship (r = 0.752, P less than 0.01) between the FSTBA and the CLo on the one hand and significant inverse log-log relationship (r = 0.707, P less than 0.01) between the FSTBA and CLi on the other hand. Q was not found to bear any significant relation to FSTBA (r = 0.120, P greater than 0.1). To conclude, in view of the observed relationship between CLi and CLo vs FSTBA, the latter might serve as a simple non-invasive semiquantitative index of hepatic function and/or anatomy of portal circulation in cirrhosis.

Adult↗

Intrinsic hepatic clearance and Child-Turcotte classification for assessment of liver function in cirrhosis.

Child-Turcotte classification (CTC) is an empirical but widely accepted approach for assessment of severity of cirrhosis. However, it is not known to what extent CTC reflects accurately the degree of impairment of hepatic function. In this study we compared CTC, standard liver tests and intrinsic hepatic clearance (IHC) of indocyanine green as means of assessing hepatic function in 63 cirrhotic patients. As compared to 10 control patients, IHC was significantly decreased in the cirrhotic group: (mean +/- SD) 0.270 +/- 0.141 l/min vs 1.227 +/- 0.312 l/min (P less than 0.001). Serum bilirubin (SB), prothrombin time (PT) and serum albumin were significantly correlated with the degree of IHC impairment while alkaline phosphatase, ALAT and clinical criteria of CTC were not. Multivariate analysis showed that SB and PT were the only 2 variables that significantly explained the impairment of IHC. The model which best explained IHC impairment was Z = 21.77 + 4.78 PT - 1.25 SB. The rate of IHC variance explained by this model, as determined by multiple correlation coefficient square (R2), was 42.6%. These results suggest that CTC provides only gross information about the degree of impairment of liver function in cirrhosis. To evaluate the role of liver function in the prognosis or in the response to treatments, it should therefore be preferable to employ direct measurement of liver function using a clearance technique.

Adult↗

[Hepatitis and pancreatitis due to indalpine].

The authors report two cases of hepatitis and a case of pancreatitis associated with indalpine. In one case of hepatitis, onset was acute and the clinical presentation was suggestive of cholecystitis; in the other case, hepatitis was discovered by biological tests. In the two cases, hepatitis was mainly cytolytic. Outcome was favorable upon interruption of drug administration. Onset of pancreatitis was inconspicuous, with progressively increasing pain. The pancreatic lesions were diffuse and massive. After interruption of administration, outcome was eventually favorable. Elevated amylasemia was also noted in the two cases of hepatitis. It is suggested that transaminase and amylase activities should be monitored during indalpine therapy.

Aged↗

[Hepatocellular carcinoma with cirrhosis: treatment with doxorubicin. Phase II evaluation].

Twelve patients with unresectable hepatocellular carcinoma associated with cirrhosis were treated with Doxorubicin which was given intravenously (30 to 50 mg/m2) every three weeks. Six patients were given only one dose of Doxorubicin. No clinical response was observed. Five patients has serum alphafoetoprotein (AFP) determination during the treatment. AFP concentration rose in 4 patients and fell in 1 patient. Survival rate after 3 and 8 months of treatment was 58 and 33 per cent. These results suggest that Doxorubicin is not an effective treatment for hepatocellular carcinoma.

Carcinoma, Hepatocellular↗

[Superficial and extensive epidermoid cancer of the esophagus].

A case of extensive squamous cell carcinoma of the esophagus in a 56 year old man, with an history of excessive alcoholic and tobacco consumption, is reported. After subtotal esophagectomy, the course was favorable 10 months after surgery. The pathological study of the surgical specimen showed that the tumor was superficial and confined to the mucosa and submucosa. The lesion measured 65 mm in length (after fixation) and was circumferential. Foci of moderate and severe dysplasia and inflammatory erosions were also observed. The relationship between extensive squamous cell carcinoma, dysplasia, esophagitis and the concept of "carcinogenic fields" are discussed. The necessity of large radical resection of the esophagus is emphasized.

Carcinoma, Squamous Cell↗

[Cholesterol crystals, cholesterol saturation of bile and biliary lithiasis].

UNLABELLED: It has been repeatedly shown that normal human gallbladder bile is commonly supersaturated wih cholesterol. It has been therefore suggested that the crucial step of the formation of cholesterol gallstones might be the nucleation and growth of cholesterol monohydrate crystals. Consequently this work was aimed at determining: 1) if cholesterol crystal formation is really a typical feature of gallbladder bile with cholesterol gallstones; 2) the influence of the degree of cholesterol saturation of bile on the formation of cholesterol crystals. Gallbladder bile from 89 patients (23 from patients with cholesterol gallstones, 7 from patients with non-cholesterol gallstones and 59 from patients free of gallstones) and hepatic bile from 17 previously cholecystectomized patients were studied. Four of these patients had cholesterol stones of the common bile duct. RESULTS: (a) gallbladder bile: cholesterol crystals were present on immediate examination in 19 of the 23 bile samples with cholesterol stones, in 2 of the 7 bile samples with non-cholesterol stones and in 1 of the 59 bile samples without stones. Only 1 bile sample with cholesterol stone developed crystals. Cholesterol saturation of bile with or without crystals did not differ significantly; (b) hepatic bile: cholesterol crystals were detected on immediate examination in one of the 17 bile samples and subsequently appeared in one of the remaining samples. Cholesterol saturation of hepatic bile (2.10 +/- 0.43) was significantly higher (p less than 0.01) than that of gallbladder bile containing cholesterol stones (1.32 +/- 0.43).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Chronic hepatic encephalopathies. Acquired cerebral degeneration not due to Wilson's disease].

We report on 4 cases of perennial hepatic encephalopathy and review similar published cases. The neurological picture consists of a cerebellar syndrome, both static and kinetic, dysarthria, choreo-athetoid abnormal movements and mental deterioration. Symptoms are permanent and usually worsen progressively. Some patients may present with a myelopathy, either isolated or combined with an encephalopathy. Relevant anatomical alterations, either encephalic or spinal, may be observed similarly in several varieties of liver disease, but in every case the role of portocaval shunts, whether spontaneous or surgically performed, appears essential. Altered results of laboratory studies, such as EEG or ammonemia, are described. Histological changes include a peculiar sort of hyperplasia of the protoplasmic astrocytes, along with a certain amount of neuronal loss. Surmised pathological mechanisms and applied therapy are briefly reviewed. For an appraisal of therapeutic results, perennial hepatic encephalopathies should be set apart from both the acute varieties and the usual chronic variety with its succession of recurrent exacerbations and remissions.

Budd-Chiari Syndrome↗

[Relation between monoclonal gammopathy and hepatobiliary disease].

Eleven cases of monoclonal gammopathy associated with chronic hepato-biliary diseases are reported. The gammopathy was benign and the majority of hepato-biliary diseases consisted of cirrhosis complicated or not by hepatocellular carcinoma. The small number of cases reported and the absence of distinctive clinical, biochemical and evolutive features of the gammopathy and hepato-biliary disease suggest that the association was fortuitous.

Adult↗