Biomedical subjects
Publications and source records attributed to J Bonhomme.
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In 20% of the cases, painful symptoms which cannot be dismissed in general practice are experienced by women with uterine retrodeviation. The technique described here is based on anatomical reduction of Douglas' pouch with restoration of tension in the uterosacral ligaments. It is simple and rapid as expected for a minor anatomical defect. The creation of two perpendicular peritoneo-ligamentous planes ensures its solidity. The effectiveness and safety of this technique has been confirmed by a series of more than 70 patients 50% of whom were examined at regular intervals for more than 5 years after surgery.
In 164 B cell chronic lymphocytic leukemias, surface membrane immunoglobulin (SmIg) phenotype has been determined on lymphocytes from 158 patients (mean age = 66 years, sex ratio = 1.43) to examine the prognostic significance of cell marker phenotype. Correlation of clinical stages of the disease according to Rai and Binet and SmIg phenotype emphasized the absence of the SmIgG phenotype, suggesting more mature cells, at stage C according to Binet (11 of 13 being stage A) and at stage III or IV according to Rai. The majority of SmIg phenotypes was SmIgM +/- D. Survival curves according to SmIg heavy or light chain phenotypes did not emphasize a prognostic significance of cell marker phenotype. Peripheral lymphocytosis over 50,000/microliter correlated with a worse prognosis regardless of clinical staging and SmIg phenotype.
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The incidence of chronic lymphocytic leukaemia has been studied over 4 years (1980-1983) in the region of Côte-d'Or (population 478,008). The crude annual incidence rate was 7.0/100,000 for males and 3.5/100,000 for females. The corresponding age standardized rates were 5.6 and 1.8. The sex ratio was 3.1. Compared to other population based registries, the incidence is higher in Côte-d'Or and the rates are among the highest reported in the world for males and females. Age and sex specific incidence rates were low before 50 years of age and increased in older age with a male predominance. The risk of chronic lymphocytic leukaemia was slightly higher in urban than in rural areas. All cases were classified according to Binet's classification: 74% were staged O or I. The ABC classification was applied to cases diagnosed in 1982-1983: 83% were staged A. These results suggest that cases diagnosed in a well-defined population are less severe than those reported in hospital statistics.
The aim of this study was to assess the value of endoscopic decompression of the colon in a series of 29 patients affected with Ogilvie's syndrome. During the first period (1980-1982), 14 patients were treated by colonoscopic decompression alone. During the second period (1982-1985), 15 endoscopic decompressions were systematically completed by intubation of the colon. The tube was removed after 2 to 13 days. Whatever the procedure, endoscopic decompression was successfully achieved in all cases. The death rate (8/29) and number of cecostomies (2/29) were similar in the two groups of patients. Only one death was directly related to Ogilvie's syndrome itself, whereas 7 patients died from other severe underlying diseases. However, colonic dilatation recurred in 6 patients in the first group and in one patient in the second group (p less than 0.05). No complications due to the endoscopic procedures occurred in this series. It may be concluded that endoscopic treatment of Ogilvie's syndrome is a safe and effective procedure. Our results also suggest that colonoscopic intubation should be used prophylactically in order to avoid recurrences, frequently observed after simple endoscopic decompression.
The serum uric acid level varies during pregnancy. Based on the graph of this assay over time, the authors have distinguished three different ranges with very different foeto-maternal prognoses in hypertensive pregnant women. They conducted a retrospective study of 77 cases of hypertensive pregnant women with a total of 173 assays of the serum uric acid and a prospective study of 49 cases of normal pregnancies with 65 assays of the serum uric acid. The authors define a dangerous zone in which foeto-maternal complications were observed in 94 per cent of cases; a zone with a good prognosis in which complications were observed in only 2 per cent of cases; and an intermediate "warning" zone (covering one third of the assays), in which essentially foetal complications were observed in 32 per cent of cases. An interpretation of the serum uric acid in relation to the term of the pregnancy is therefore useful to determine the foeto-maternal prognosis in the majority of cases and constitutes a valuable parameter for monitoring the pregnancy and for the adaptation of the treatment to the severity of the disease.
A 24 year old man admitted to hospital with borderline lepromatous leprosy was treated with rifampicin, dapsone, and clofazimine. After four months he developed a reversal reaction and the diagnosis was modified to borderline tuberculoid leprosy. The dose of clofazimine was raised and prednisolone added to the regimen without any symptomatic response. His condition improved dramatically after five plasma exchanges on five successive days.
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In vitro culture of hairy cells were successful in 5 patients with hairy cell leukemia: splenic cells were cultured in methyl cellulose plus PHA-leucocyte conditioned stimulation medium for 7 days. Plating efficiency was 0.5% with colony cells having morphological and cytochemical characteristics of hairy cells. A linear correlation between the number of cells plated and the number of colonies produced was found for cell concentrations varying from 5.10(4) to 5.10(5).
The case of a 72 year-old man with a sinus histiocytosis is reported. The clinical course was characterised by an hemorrhagic disorder linked to a factor VIII inhibitor. The characteristics of the antibody titer, affinity and saturability have been studied. In an attempt to stop the bleeding treatment included human and porcine factor VIII concentrates, plasmapheresis and immunosuppressive drugs. Repeated plasma exchanges did not modify the inhibitor titer for more than 24 h.
A registry of malignant haematological diseases was established on January 1st 1980 in order to assess the incidence and epidemiologic features of these diseases in the department of Côte-d'Or (population 470 000). Information was collected from various sources (public or private laboratories, public or private hospitals and death certificates). During the course of two years (1980 and 1981) 194 news cases were recorded. This registry collects acute leukaemia, lymphoid and myeloid proliferative diseases, lymphomas in leukaemic phase and myelodysplastic syndromes. The crude incidence rates were 25.0/100,000 in men and 16.1/100,000 in women. Sex ratio : 1.5. Compared to other French population based registries the incidence is higher in Côte-d'Or, showing the value of specialised registries. The rates are similar to those reported in Geneva and Connecticut.
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The authors report on two cases of acute leukemia beginning with an isolated cutaneous lesion. The first case was a form of acute monoblastic leukosis which showed a favourable development following chemotherapeutic treatment, and was still in a state of remission two years later. The second case was a variety of acute monoblastic leukosis which, at the end of eighteen months' chemotherapeutic treatment, led to an unfavourable prognosis. Most interesting by, these reports highlight the mis-leading varieties of acute leukemia with an isolated cutaneous tumour. To make both accurate diagnosis and appropriate treatment possible, it is necessary to complement clinical and histological examination with hematologic and cytologic investigation.
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