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Biomedical subjects

H Sevestre

Publications and source records attributed to H Sevestre.

At least 55 records · Page 3Linked to original sources
PubMed1993

Occult hepatocellular carcinoma in cirrhosis: value of ultrasound-guided biopsy of portal vein system thrombus.

We report two cases of occult hepatocellular carcinoma associated with alcoholic cirrhosis, in which the diagnosis of malignancy was respectively established by ultrasound-guided biopsy of umbilical vein and portal vein branch thrombus. When measurement of serum alpha-foetoprotein, and liver ultrasonography and/or computed tomography failed to clearly demonstrate hepatocellular carcinoma, the presence of a thrombosis of the portal vein system is highly suggestive of malignancy, which may be easily confirmed by venous biopsy.

Aged↗
PubMed1993

[Treatment of postoperative incisional hernias by a composite prosthesis (polyester-polyglactin 910). Clinical and experimental study].

Because of complications resulting from the use of intraperitoneal prosthetic materials, the authors studied a new double Layered composite mesh (formed by a Dacron mesh, and a polyglactin 910 mesh). The experimental study (40 rats) compared the composite mesh with Dacron mesh. Statistical analysis demonstrated the following conclusions. At 6 months, the poor fibroblastic activity with the composite mesh, indicated the absence of replacement of the polyglactin 910 mesh by a neo-tissue. The Dacron mesh remained in contact the abdominal viscera and contracted with them as many adhesions as when Dacron mesh was used alone. The composite mesh showed poor biological tolerance, lower than that of Dacron mesh. The clinical study concerned 24 patients, 3 recurrences were observed. In one case, we observed migration of the mesh in the small bowel. The unfavorable results of the experimentation, and the risk of visceral migration lead us to avoid the use of composite mesh in intraperitoneal sites.

Animals↗
PubMed1992

Fibrin ring granulomas in hepatitis A.

Fibrin ring granuloma is characterized by a fibrinous ring surrounding a central fat vacuole. It has been found in the liver and bone marrow of patients with Q fever, and occasionally with visceral leishmaniasis, cytomegalovirus, Epstein-Barr virus, Staphylococcus epidermidis infections, Hodgkin's lymphoma, and hypersensitivity to allopurinol. We describe a case of serologically confirmed viral hepatitis A with this lesion in the liver biopsy. A false positive anti-hepatitis A virus IgM result has been excluded. This is, to our knowledge, the second reported case of type A hepatitis with hepatic fibrin ring granulomas. It confirms that hepatitis A should be included in the differential diagnosis of this lesion.

Acute Disease↗
PubMed1991

[Hepatoid adenocarcinoma of the stomach].

One year after gastric resection for cancer, a 67 year old patient was hospitalized because of a large hepatic tumor with extremely high serum alpha-foetoprotein levels (13,245 ng/ml). Histological and immunohistochemical studies of the gastric tumor revealed hepatoid foci with alpha-foetoprotein and protease inhibitor-producing cells. Histopathological and immunohistochemical features of this and the 8 previously reported cases of hepatoid adenocarcinoma of the stomach are analyzed.

Adenocarcinoma↗
PubMed1991

[Giant vertebro-basilar aneurysm. Frontal syndrome].

A 72-year-old man presented with an apparent frontal syndrome. He also had bilateral trigeminal neuralgia, a pyramidal syndrome of all 4 limbs, balance disturbances, a horizontal nystagmus when looking to the left and a right velopalatine paralysis. CT scan with contrast showed a hyperdense rounded lesion in the left cerebello-pontine angle. Cerebral angiography showed this to be a large aneurysm of the end of the vertebral arteries. The patient died suddenly. Autopsy confirmed the site and presence of the aneurysm. Balance disturbances, the pyramidal syndrome and velopalatine paralysis could all be explained by brain stem compression and the bilateral nature of the trigeminal neuralgia by compression of the trigemino-thalamic tract. The apparent frontal syndrome, the authors suggest could have resulted from subacute raised intracranial pressure.

Aged↗
PubMed1991

[Superior vena cava syndrome and Riedel's thyroiditis. Report of a case: review of the literature].

The authors present the case of a 42-year-old female patient, initially admitted to hospital for the etiological diagnosis--which remained negative--and the treatment of a superior vena cava syndrome. This patient was seen again two years later as the superior vena cava syndrome recurred, while a thyroid syndrome appeared at the same time. Exeresis followed by a clinicopathological study demonstrated Riedel's chronic fibrous thyroiditis. The authors study the causal relationships between both conditions and their integration into multifocal fibroses. To their knowledge, this is the first case in which the superior vena caval syndrome is the site of occurrence of fibrosis, precedes the thyroid involvement. The new radiological technique at our disposal--CT, MRI--should allow more easily searching for the various sites of the fibrosing disease (biliary ducts, pancreas, duodenum, retroperitoneum, mediastinum, orbits), and immunological studies will make it possible to better classify them and define their pathogenesis.

Adult↗
PubMed1990

Arterioportal fistulas: twelve cases.

During the last 20 years, we encountered 14 arterioportal fistulas in 12 patients. Gastrointestinal hemorrhage or mesenteric artery insufficiency were the most frequent conditions found after the diagnosis. Arterioportal arterial fistulas were congenital in two cases and acquired in 10; seven of these 10 were iatrogenic. One patient had three successive and different sites of arterioportal fistula. The fistula originated from a branch of the celiac axis in nine cases, the superior mesenteric artery in three, and the inferior mesenteric artery in two. One patient died of massive anal bleeding before any treatment was possible. Eight fistulas were treated surgically and five by arterial embolization. After treatment there was no early mortality, while hemorrhagic and ischemic complications regressed in all cases. Three hemorrhagic recurrences were observed in patients with preexisting cirrhosis (two cases) or by recurrence of a congenital arteriovenous fistula (one case). Closure of symptomatic arterioportal fistula is justified. The choice of the most appropriate method for each patient should be discussed between the surgeon and interventional radiologist on a case by case basis.

Adult↗
PubMed1990

Systemic AA amyloidosis induced by liver cell adenoma.

Systemic AA amyloidosis is a rare complication of benign tumours. This report describes a patient with hepatocellular adenoma associated with reactive AA amyloidosis. He had a nephrotic syndrome with deteriorating renal function and an increase of serum concentrations of acute phase proteins, mainly C-reactive protein. Resection of the tumour was followed by improvement in renal function and a marked decrease of the serum concentrations of acute phase proteins.

Amyloidosis↗
PubMed1990

[Carney's syndrome disclosed by hemoperitoneum].

The authors report a case of Carney's triad in a blood-group O woman who successively sustained a) at age 13, a multicentric gastric leiomyoblastoma revealed by an hemoperitoneum; b) 6 years later, a pulmonary chondroma diagnosed by chest standard roentgenogram and CT scan, associated with leiomyoblastoma recurrence and hepatic metastases; c) 10 years later, a juxta-carotid tumor of unknown (paraganglion?) origin. This patient is presently in good clinical condition, in spite of hepatic metastases known for 5 years. Based on this case and the 33 previously reported cases, the main features of this very unusual entity are analyzed.

Adolescent↗
PubMed1990

[Cavernous lymphangioma of the liver. A report of 2 cases and review of the literature].

The authors report 2 cases of hepatic lymphangioma observed in a 54-year-old woman, and in a 39-year-old man. These tumors were discovered upon ultrasound examination performed for jaundice due to viral hepatitis, and for abdominal right upper quadrant pain respectively. Computed tomography and angiography showed hypervascularized tumors. Diagnosis was established through surgical biopsy specimens. The clinical course was uneventful, during respectively the 9- and 3-year follow-up periods, respectively. From these and the 40 previously reported cases, the authors describe the different features of this unusual tumor.

Adult↗
PubMed1990

[Gynecologic and breast granulocytic sarcomas. Review of the literature. Apropos of a case in the cervix uteri].

We report a case history of a woman of 66 years of age who had a granulocytic sarcoma of the cervix which presented as metrorrhagia and which at first was thought to be an anaplastic cancer. The poor general state of the patient made it impossible to start any anti-leukaemic treatment and the patient died two months after the diagnosis was made. A review of the literature shows that 62 cases of granulocytic sarcoma have been reported of which 22 were in the breast, 19 in the ovary, 13 in the cervix or the uterus, 6 in the vagina and 2 in the vulva. The cells seem to invade the blood and the bone marrow in all occasions by the time of diagnosis or at the most a few weeks later and cases of granulocytic solitary sarcoma are very rare. It blood has not been attacked it is difficult to make a histological diagnosis unless immunological marking and Giemsa staining is carried out together with Leder's reaction. The treatment should be similar to those used for acute myeloid leukaemia.

Aged↗