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Biomedical subjects

J Barge

Publications and source records attributed to J Barge.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Toxic megacolon with colonic perforation complicating Campylobacter jejuni ileo-colitis].

Campylobacter jejuni is an enteropathogen with invasive ability which may be responsible for acute colitis. We report the case of a 38-year-old woman who was hospitalized for severe acute colitis. Stool specimen examination revealed Campylobacter jejuni. A laparotomy was performed due to clinical deterioration and toxic megacolon. Colic perforations were observed. The examination of the colectomy specimen revealed ulcerative pancolitis. This is the first published case of Campylobacter jejuni infection complicated by toxic megacolon and perforation.

Adult↗
PubMed1993

Hodgkin's and non-Hodgkin's hepatic lymphoma: sonographic findings.

The sonographic studies of 72 patients with pathologically proven Hodgkin's or non-Hodgkin's hepatic lymphoma were retrospectively reviewed. Sixty-eight patients (94%) had secondary hepatic lymphoma (nine of them had AIDS-related lymphoma) and four patients (6%) had primary lymphoma of the liver. Forty-six of 72 patients (64%) had diffuse hepatic involvement, and 26 of 72 patients (36%) had focal liver lesions as demonstrated by sonography. Four patterns of disease were identified: (a) hepatomegaly was depicted by sonography in 26 of the 59 patients with secondary hepatic lymphoma not related to AIDS, in two of the nine patients with AIDS-related secondary hepatic lymphoma, and in one of the four patients with primary hepatic lymphoma; (b) multiple rounded well-delineated hypoechoic liver lesions were found in 22 of the 68 patients with secondary hepatic lymphoma; (c) a large heterogeneous echoic mass, which was an evocating clue to the diagnosis of primary lymphoma of the liver, was found in the four patients with primary lymphoma of the liver; and (d) an absence of sonographic abnormalities was found in 20 of the 59 patients with secondary lymphoma not related to AIDS. Liver involvement with lymphoma should be considered in any patient who develops multiple homogeneous hypoechoic liver masses, even in the absence of known underlying lymphomatous disease.

Adult↗
PubMed1993

[Ultrasound-guided biopsy in focal lesions of the liver. Report on an automated biopsy system].

Two techniques for focal liver lesion biopsy were retrospectively evaluated to compare relative safety and efficacy. After sonographic localization of the focal liver lesion and biopsy with a hand-held 18-gauge cutting needle, a pathologically adequate specimen was obtained in 49 of 55 cases (89%) requiring 1 to 4 passes (mean, 2.1 per patient). A major complication occurred in one case and minor complication were noted in three cases. Forty one biopsies were performed by using a single use automatic core biopsy system with a 18-gauge cutting needle and real time sonographic guidance. With this automatized technique, specimens adequate for diagnosis were obtained in 40 of 41 cases (97.5%), requiring only 1 pass in all cases. Neither major nor minor complication was noted with this technique. We conclude that using sonographic guidance, the automatic core biopsy system with a 18-gauge cutting needle yields a slightly better rate of adequate specimens with a lower frequency of complications.

Adult↗
PubMed1992

[What is appendicitis? Anatomopathological notions].

Appendices removed for acute abdominal syndrome have various pathological aspects. In most cases one finds acute inflammatory lesions with a varying degree of penetration into the appendicular wall, but chronic lesions or a quasi-normality which do not explain the symptoms are sometimes observed. Peculiar findings, such as parasites, recognizable infective agents or even tumoral proliferations detected by the inflammatory syndrome can be discovered.

Acute Disease↗
PubMed1992

[Questionable appendectomies].

Each year in France, 75,000 appendectomies are carried out for normal or fibrous appendix and another 75,000 for a mere inflammation of the mucosa of submucosa. To decrease the incidence--four times higher than in other countries--it is suggested to keep under observation the patient with RIQ tenderness if they have neither rebound nor guarding, a temperature below or equal to 38 degrees C and a white blood cell count lower than 10,000/mm3. By following these guidelines, there is no risk to miss perforated or suppurated appendicitis.

Abdomen, Acute↗
PubMed1992

[Large cell lymphomas: effect of histologic groups on the prognosis. Study of 210 cases treated with the same therapeutic protocols].

As part of a study of two therapeutic protocols initiated in 1982 and 1985, respectively, for localized (n = 134) and disseminated (n = 76) large cell lymphomas, histologic type was determined for each patient by several pathologists using the Kiel classification for morphologic features and the international working formulation for protocol assignment and multifactorial statistical analysis. Therapeutic results in the two hundred and ten cases were correlated with a number of prognostic factors including age, stage, tumor size, extranodal disease, and clinical or biological markers for disease activity such as the LDH level. The previously reported influence of histologic subgroup on prognosis was not found with these highly effective protocols, whether histologic type was considered alone or in combination with other prognostic factors. The only consistent finding was that anaplastic large cell lymphomas, despite their aggressive features, were most likely to have a favorable outcome.

Adolescent↗
PubMed1991

Ascites revealing peritoneal and hepatic extramedullary hematopoiesis with peliosis in agnogenic myeloid metaplasia: case report and review of the literature.

A 61-year-old man presented with ascites in the course of agnogenic myeloid metaplasia (AMM). Ascitic fluid was exudative and contained mature and immature leukocytes, erythroid cells, and megakaryocytes as observed on a bone marrow smear. Peritoneal biopsy showed myeloid metaplasia, and liver biopsy revealed intrasinusoidal myeloid metaplasia and peliosis. Ascites cleared after abdominal radiotherapy but treatment resulted in transient aplasia. Subsequently, portal hypertension was demonstrated by hepatic transjugular catheterization. Complications of splenomegaly led to splenectomy and splenorenal shunt followed by fatal acute hepatitis and septic shock. A review of the literature and an analysis of mechanisms of ascites occurring in AMM, especially peritoneal implants of myeloid tissue and occurrence of peliosis in myeloproliferative disorders, are presented.

Adult↗
PubMed1991

Non-Hodgkin's lymphoma presenting as a primary tumor of the liver: presentation, diagnosis and outcome in eight patients.

We report the diagnostic, prognostic and therapeutic features of non-Hodgkin's lymphoma in eight patients in whom the disease was seen as a primary tumor of the liver. This series illustrates the variety of situations in which lymphoma might be diagnosed: (a) abdominal pain and hepatomegaly (three cases), (b) incidental finding at evaluation of a patient with cirrhosis (two cases), (c) secondary neoplasm after treatment for Hodgkin's disease (one case) and (d) complication of AIDS (two cases). In most cases, clinical and/or radiological features were nonspecific. However, the combination of the following features must be considered as suggestive: occurrence of an apparently primary hepatic tumor in an immunocompromised patient, absence of the usual serum tumor markers and increased serum lactic dehydrogenase activity. The final diagnosis was based on histological examination of specimens obtained by ultrasonically guided liver biopsies or at surgery. All cases belonged to unfavorable histological subtypes. Immunohistochemical findings on paraffin-embedded sections demonstrated the B-lymphocyte lineage of the seven tumors available for study. In the three patients without coexisting disease, complete remission was obtained by surgery alone or combined with chemotherapy. In the two patients with coexisting cirrhosis, outcome was rapidly unfavorable, with death occurring less than 3 mo after diagnosis. Among the three immunocompromised patients, two experienced a rapid unfavorable outcome, and the remaining one was in complete remission after surgery and chemotherapy. In conclusion, primary non-Hodgkin's lymphoma of the liver arising in patients without coexisting disease has a slow progression and might be successfully treated by surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Are industrial toxic substances a risk factor in gallbladder cancer?].

Increased prevalence of gallbladder cancer has been related to specific occupations and suggests a possible professional exposure to carcinogens. The authors report the case of a 64-year-old woman who had a squamous cell carcinoma of the gallbladder with hepatic metastases, and professional exposure to trichloroethylene in a degreasing metal laboratory. Although trichlorothylene could not be assumed to be a true carcinogen for gallbladder cancer, this case underscores that epidemiologic studies taking into account professional exposure, in addition to the usual risk factors of gallbladder cancer, are requested, in order to detect a new patient group at risk for gallbladder cancer.

Carcinoma, Squamous Cell↗
PubMed1989

[Acute diarrhea in adults in a Parisian district. Clinical, bacteriologic endoscopic and histologic aspects. Study of 52 cases].

From 1985 through 1988, 52 patients aged 16 to 85 years and referred for acute diarrhea underwent routine clinical, microbiological, endoscopic and histopathological examinations. Enteropathogens were isolated in 50 percent of patients, mostly from stool samples rather than from biopsy samples, though results were sometimes dissociated. Significantly lower digestive endoscopic abnormalities were seen in 60 percent of patients. Upper gastrointestinal endoscopy was not contributive. Rectal and colonic biopsies showed histological abnormalities in nearly all cases half of which were polymorphonuclear infiltrates and crypt abscesses. Glandular distortion was not found. An analysis of clinical, endoscopic and histological data showed that major abnormalities were mostly, but not constantly, related to infections due to enteroinvasive bacteria. As in other studies, a high rate of negative stool cultures was observed. Based on these results, we suggest to perform either further and more sophisticated microbiological investigations, or to conduct a routine search for viral infections whose incidence, among adult patients with acute diarrhea, is actually unknown.

Acute Disease↗
PubMed1989

Role of IgG and complement component C5 in the initial course of experimental cryptococcosis.

Although cellular immunity has a crucial role during cryptococcosis, several in vitro studies have pointed out the importance of IgG anti-Cryptococcus neoformans antibodies and complement components during phagocytosis of the yeast by polymorphonuclear leucocytes and monocytes. We investigated the role of complement and specific antibodies in host defences against experimental cryptococcosis, using a monoclonal IgG1 antibody (E1) specific for cryptococcal capsular polysaccharide, and mice congenitally sufficient or deficient in the fifth component of complement (C5). During in vitro experiments, E1 and the normal mouse serum from C5-sufficient and -deficient mice were unable to inhibit the growth of C.neoformans. However, E1 was an efficient opsonin for the ingestion of C. neoformans by mouse peritoneal macrophages, acting in synergy with normal mouse serum. In vivo, E1 was protective in heavily infected C5-deficient mice (DBA/2) dying from an early acute pneumonia, but not in C5-sufficient mice (BALB/c) and in DBA/2 mice infected with a smaller inoculum dying from a late progressive meningo-encephalitis. Although protection against pneumonia is attributed to a local recruitment of phagocytes in C5-sufficient mice, this was not observed in C5-deficient mice protected with E1. In this case, IgG anti-C. neoformans antibodies seem to be an alternative for an efficient opsonization of the yeasts. Altogether, these data suggest that two main mechanisms may protect infected mice from an early fatal pneumonia: the efficient opsonization of the yeast by complement and the recruitment of phagocytes in infected tissues.

Animals↗