Search PubMed⌕ Search

Biomedical subjects

J C Paris

Publications and source records attributed to J C Paris.

At least 55 records · Page 3Linked to original sources
PubMed1995

[Complications and course after proctectomy for Crohn disease].

The decision to perform protectomy must be considered very seriously in the course of Crohn's disease. The objectives of this study were to evaluate the consequences of this procedure: healing, sexual disorders, quality of life and the subsequent course of the disease. From 1981 to 1993, we performed 24 proctectomies: 15 females, 9 males, mean age: 39 years (18-76), mean preoperating time: 9 +/- 4 years. Rectal and anoperineal lesions were always accompanied by pancolitis; ileal involvement was observed in 11 cases (45%) at the time of diagnosis of Crohn's disease, and in 4 cases at the time of proctectomy. Proctectomy was performed after a period of rectal exclusion in 19 patients, while the rectum was not isolated for 5 others, including 2 patients after total colectomy. The indication for surgery was based on the coexistence of a microrectum (n = 16), anal stenosis (n = 15), rectovaginal or complex fistulas (n = 15). Technical features were: close rectal dissection (n = 19), levator muscle preservation (n = 7), wall effraction (n = 8), primary closure (n = 6) or perineal wound packing (n = 8). Mean follow-up: 44 +/- 24 months, statistical analysis: Fisher's test, Wilcoxon's test and Kaplan-Meier method. No perioperative deaths were observed. An intraperitoneal collection required drainage. Mean hospital stay was 21 days. Sexual complications were: dyspareunia (n = 3), ejaculation failure (n = 1), not correlated to the type of dissection. Perineal wound healing was considered to be normal when it took less than 6 months (n = 14).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Idiopathic acute pancreatitis and sarcoidosis.

Pancreatic involvement is rare in sarcoidosis. We describe a 30-year-old man who had two episodes of acute pancreatitis within one month with no current aetiology. Diagnosis of sarcoidosis was based on the presence of bilateral mediastinal adenopathies, alveolar lymphocytosis on bronchoalveolar lavage and biopsy of an enlarged lymph node showing multiple granulomas. This case and five others previously reported in the literature suggest the diagnosis of sarcoidosis should be considered in apparently acute idiopathic pancreatitis.

Acute Disease↗
PubMed1994

[Intestinal surgery in the treatment of stenoses of the small intestine in Crohn disease].

Strictureplasty is an alternative to extensive and/or multiple small bowel resections in the surgical treatment of Crohn's disease. We here report a series of 22 patients (12 M-10 F--mean age years: 28). All patients had a non-perforative form of Crohn's disease lasting for a mean of 8 years. Nine out of 22 had had previous intestinal resection. A total of 201 stenosis was identified during peroperative examination (mean per patient: 9). Only tight stenoses (diameter < 2 cms) were treated while others were left untouched (n = 22 in 11 patients). Eighty-three stenoses were treated by short strictureplasty and 24 by long strictureplasty using steel thread. One or several resections were simultaneously performed in 15 patients. Mortality was nil. A post operative abscess without loosened suture was drained. The mean follow-up in the 22 patients was 24 months (3-7 years). Clinical and radiological symptoms of stenosis were relieved after strictureplasty. Clinical recurrence occurred in 5 patients among 12 followed-up more than 2 years. Subsequent surgery was required in 4: in one case hemorrhagic ulceration developed within a long strictureplasty and in 3 others stenosis developed in plasty areas but also in previously healthy areas. In conclusion, strictureplasty is a short and long-term efficient procedure in the treatment of Crohn's disease stenosis. It allows limiting extensive intestinal resection. A more prolonged follow-up is needed in order to evaluate the rate of long-term recurrence and complications that would limit the interest of this technique.

Adolescent↗
PubMed1993

An in-depth study of Crohn's disease in two French families.

BACKGROUND: Two French families were investigated. In the first a husband, wife, and 4 children had Crohn's disease; in the second 7 of 11 children had the disease. There was no history of Crohn's disease in antecedent generations and no linkage to HLA haplotypes. METHODS: Methods included family interviews; review of medical records, radiographs, and pathology slides; serology; selective stool culture; enzyme-linked immunosorbent assay for fecal viral detection; and immunocytochemistry. RESULTS: In both families multiple cases occurred among siblings in 7-13-month periods. There appeared to be a 4-8-year recurrence of new disease in both families. Radiographs showed a remarkable similarity in the pattern of disease, confined to distal ileum and cecum, in the members of family 1. Examination for pathology showed granulomas in all 8 patients for whom tissues were available. Acid-fast organisms or Campylobacter-like organisms were not found in tissue sections, and immunocytochemistry was negative for mycobacteria and Yersinia. Stool cultures were negative for mycobacteria, Yersinia, and Mycoplasma. Torovirus and coronavirus antigens were not found in stool. Serology was negative for antibodies to Brucella, Yersinia, influenza, and three enteropathogenic viruses of animals. CONCLUSIONS: The circumstances and data suggest that an infectious microorganism is responsible for these clusterings of Crohn's disease.

Adult↗
PubMed1993

[Hepatitis E].

Explore the source record for details and available documents.

Female↗
PubMed1993

Perioperative endoscopy of the whole small bowel in Crohn's disease.

The aim of this study was to search for small bowel lesions by means of a perioperative endoscopy in 20 patients operated on for Crohn's disease. Seven women and 13 men (mean age 29 years) had a total retrograde exploration to the angle of Treitz during an ileocolectomy (16 of 20 patients) or a colonic or ileal resection (four of 20 patients). Endoscopic exploration was completed, through an enterotomy, from the surgical area to the angle of Treitz. Periendoscopic biopsy samples were taken on macroscopic lesions and every 20 cm systematically. In 13 of 20 cases, various lesions scattered over the whole small intestine were found. These were aphthoid ulcerations (10 patients), superficial ulcerations (seven patients), mucosal oedema (three patients), non-ulcerative stenosis (three patients), erythema (two patients), pseudopolyps (two patients), deep ulcerations (two patients), and ulcerative stenosis (one patient). In seven patients none of the lesions detected at perioperative endoscopy had been recognised by preoperative evaluation or surgical inspection of the serosal surface. A typical granuloma was found at biopsy of lesions identified by endoscopy in three cases and at biopsy of an apparently healthy area in one case. Thus 65% of patients operated on for Crohn's disease had lesions of the small intestine detected by endoscopy, which were unrecognised before surgery in more than half of the cases.

Adolescent↗
PubMed1993

[Hepatic calcifications revealing epithelioid hemangioendothelioma].

This report concerns a case of hepatic epithelioid hemangioendothelioma presenting with liver enlargement, multiple hepatic calcifications on the plain abdominal film and bilateral interstitial pneumonia. Epithelioid hemangioendothelioma is an unusual soft tissue tumor of "intermediate malignancy" characterized by a multicentric involvement of the liver and originating from endothelial cells. Histopathologic diagnosis may be difficult because of possible confusion with sclerosing epithelial tumors.

Adult↗
PubMed1993

[Late portal vein thrombosis caused by hematoma after liver transplantation].

Late portal vein thrombosis of liver grafts is uncommon and is usually revealed by variceal bleeding. We herein report a case of thrombosis discovered in an adult 10 months after liver transplantation, due to stenosis of the portal vein by extrinsic compression, probably secondary to a biopsy-induced hematoma. Development of venous collateral circulation allowed for normal function of the liver graft.

Adult↗
PubMed1992

Internal radiation therapy for hepatocellular carcinoma. Results of a French multicenter phase II trial of transarterial injection of iodine 131-labeled Lipiodol.

Preliminary Phase I trials have shown iodine 131 (131I)-Lipiodol (ethiodized oil; Laboratoires Guerbet, Aulnaysous-Bois, France) to be well tolerated and most likely effective in the treatment of hepatocellular carcinoma (HCC). In this multicenter Phase II trial, the authors tested the feasibility and reproducibility of this treatment in other medical institutions and evaluated its efficacy in 50 patients with unresectable Stage I or II HCC, by the classification of Okuda et al. The authors studied 47 men and 3 women (63.9 +/- 7.1 years old) with Stage I (n = 18) or II (n = 32) HCC, by the classification of Okuda et al., which was verified by histologic findings (n = 25), cytologic findings (n = 11), or association of a tumor with alpha-fetoprotein serum values greater than 500 micrograms/l (n = 14). This multicenter trial (1) confirmed that the 131I-Lipiodol treatment is well tolerated; (2) showed that there is a high reproducibility of results with respect to other institutions and an objective tumor response in 40% of the cases; and (3) indicated the necessity of performing a randomized controlled study.

Adult↗
PubMed1992

Variations in the glycoforms of serum alpha 1-antichymotrypsin in liver diseases and after liver transplantation.

1. Using crossed immunoaffinity electrophoresis with free concanavalin A in the first dimension, we studied the microheterogeneity of alpha 1-antichymotrypsin due to various glycoforms in sera from patients with various liver diseases and after liver transplantation. 2. Studies by isoelectric focusing and immunoblotting and by crossed immunoelectrophoresis without concanavalin A in the first dimension allowed us to show that there is no dramatic variation in electrophoretic heterogeneity of alpha 1-antichymotrypsin in the serum of patients with liver diseases or after liver transplantation when compared with that of normal subjects. Therefore the heterogeneity observed in crossed immunoaffinity electrophoresis is due to various interactions with concanavalin A. 3. The results were expressed as the ratio of concanavalin A non-reactive glycoforms plus concanavalin A weakly reactive glycoforms to concanavalin A reactive glycoforms, called R alpha 1-ACT. R alpha 1-ACT was significantly higher in patients with cirrhosis (n = 53) when compared with normal subjects (n = 30). The median R alpha 1-ACT was 1 (range 0.72-1.25) in normal subjects. It was 1.6 (range 1.18-3.02), 1.45 (range 0.65-4.12) and 2.24 (range 1.03-19) in cirrhosis of Child's grade A, B and C, respectively. There was a dramatic decrease in glycoforms with mostly biantennary glycans in some patients with Child's grade C cirrhosis. Serum levels of alpha 1-antichymotrypsin were lower than normal only in some patients with Child's grade C cirrhosis. 4. Among the patients with acute viral hepatitis studied (n = 17), five were studied longitudinally.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗