[Crohn's disease associated with anylosis. Report of a case].
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Biomedical subjects
Publications and source records attributed to F Mignon.
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Three cases of polyarteritis nodosa (P.A.N.) studied by abdominal arteriography with a follow-up examination between the 6th and 9th month are reported. In the first case, the initial arteriogram showed only the appearances of endarteritis. The second arteriogram, 9 months later, following a worsening of general condition, revealed diffuse aneurysms in the abdomen. In the second patient, who had multiple aneurysms at the time of the initial examination, arteriography agter 6 months following a new episode of the disease with an acute abdominal syndrome and collapse revealed, alongside the multiplication of the aneurysms with rupture of one of them, the disappearance of some ectasias with the obliteration of certain arteries. In the third patient, the follow-up arteriogram after treatment showed disappearance of the renal arteriograms which the first study had revealed 7 months before. These three cases give an idea of the different radiological appearances of P.A.N. The appearance of endarteritis with no specific characteristics indicates and inflammatory localisation of the disease. This is an initial stage leading to ectasia. Aneurysms may progress to rupture or may multiply. Endarteritis and ectasia may also progress towards scarring and disappear. A method of early diagnosis, arteriography makes it possible to institute treatment before the lesions reach a stage at which they must inevitably develop either into aneurysms or lead to obstruction with distal ischaemia.
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A report of the treatment by repeated dialysis of irreversible renal failure complicating 4 cases of multiple myeloma. The latter condition continued to progress, with death occurring after three, six, eight and twenty seven months. The last case was the only one with an indiscutable haematological and clinical remission. The effectiveness of chemotherapy is the reason for the use of the artifical kidney. Treatment may be hoped to be active if the renal failure is acute, a presenting feature of the myeloma. Such a hope is practically vain if the renal failure develops progressively, in a patient already on treatment. The indication for haemodialysis is thus more than open to discussion.
Renal biopsy and clinical data from 60 patients with extracapillary proliferation (crescent formation) in greater than or equal to 50% of glomeruli were correlated. Nephropathy was related to infection (15 cases) malignancy (4 cases) and trichlorethylene exposure (2 cases). Isolated proteinuria was found 0.5-20 years before biopsy in 16 patients. Outcome was significantly related to percentage of crescentic involvement. Oligoanuria and impaired function at presentation were bad prognostic signs but preceding infection was favourable. Diverse histological and immunofluorescent findings indicate that extracapillary glomerulonephritis is not a single entity. The clinical course is not always rapidly progressive.
Both gastrin and acid responses to antral stimulation by meat extracts (Oxo) were studied in 15 undialysed males with chronic renal failure (CRF). Eighteen sex and age-matched duodenal ulcers (DU) served as controls. Oxo increased acid and plasma gastrin in both groups. The rise in plasma gastrin was larger in CRF than in DU. The pattern of gastrin response in CRF suggests accumulation of gastrin in the plasma probably related to impaired renal inactivation of the hormone. Five CRF had large acid responses representing 40 to 90 percent of their maximal secretory capacity. Antral function should be measured in CRF before haemodialysis or renal transplantation.
A method is described for the study of the "in vitro" biosynthesis of mucins by human gastric biopsy samples. 14C-glucose was incorporated in the biopsies obtained from the fundus and antral regions of four normal human donors during a four hours incubation period. Labelled glycoproteins (mucins) were released in the medium and were also retained in the tissue-residue. Neutral sugars, fucose, protein and DNA determinations carried out on the tissue homogenates indicated that significant information on mucin biosynthesis can be obtained by this biopsy procedure which is particularly suitable for the exploration of gastric pathology.
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Renal biopsy and clinical data from 60 patients with crescent formation were correlated. Nephropathy was related to infection (15 cases), malignancy (four) and trichlorethylene exposure (two). Four cases had extrarenal signs. Isolated proteinuria was found 0.5-20 yr before biopsy in 16. Only 17 patients had rapidly progressive glomerulonephritis on clinical criteria. Nineteen patients (35%) are alive with functioning kidneys. Outcome was significantly related to percentage crescentic involvement (p less than 0.02) and oliguria (p less than 0.05) and renal function (p less than 0.01) at presentation. Preceding infection was a favourable sign. Extracapilly glomerulonephritis is not a single entity.
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