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Biomedical subjects

J F Michiels

Publications and source records attributed to J F Michiels.

At least 127 records · Page 7Linked to original sources
PubMed1992

[Rabies encephalomyelitis with myocarditis and pancreatitis. Report on a case recently imported into France].

We report the case of a 29 year-old man who died from rabies in France, following a dog-bite during a trip in Mexico. Although it was clinically suspected, the diagnosis was uncertain until he died because of digestive, cardiac and psychiatric misleading symptoms associated to the neurologic disorders. Post mortem diagnosis was based upon virological study in immunofluorescence on cerebral smears, viral isolation on cell-culture, and ELISA. It was confirmed by light microscopy examination which showed numerous Negri bodies, and ultrastructural study of the rhabdovirus in the central nervous system. Extranervous lesions, especially myocarditis and pancreatitis, were observed and their meaning is discussed. The physician is exceptionally confronted to the diagnosis of human rabies in France. Nevertheless, the lack of compulsory antirabic vaccination and the increase of touring in enzootic countries increase the risk of infection. As an intra vitam diagnosis in frequently lacking, the diagnosis of rabies infection needs a complete post mortem virological study as well as an histological and ultrastructural examination of the central nervous system.

Adult↗
PubMed1992

[Histopathologic features of opportunistic infections of the small intestine in acquired immunodeficiency syndrome].

The frequency of the opportunistic infections of the duodenum in AIDS patients was determined by way of histologic study in 207 patients between January 1987 and June 1991. All cases had serial paraffin sections, run through HES, PAS, Giemsa, Brown-Brenn, and Zieh-Neelsen stains, and 20 cases had in addition cytologic and electron microscopic study. 63 patients had opportunistic infections (10 cryptosporidiosis and 2 isosporiasis; 12 mycobacterial enteritis; 15 CMV enteritis; 7 candidosis; 7 intestinal microsporidiosis confirmed by electron microscopic examination; 12 Giardiasis; 3 duodenal leishmaniasis; 1 intestinal cryptococcosis). Multiple concurrent infections were noted in 6 cases. A mild to severe villous atrophy was observed in 28 cases, associated with opportunistic infection. A patchy distribution of pathogen agent was noted in 34 cases, and 37 cases were associated with oesophagal candidosis. This study points out the value of histologic examination of intestinal biopsy for the diagnosis of systemic infections as well as of unusual parasitosis, and the necessity for multiple endoscopic biopsies because of the frequent patchy distribution of pathogens.

AIDS-Related Opportunistic Infections↗
PubMed1992

Multicentric reticulohistiocytosis. Immunohistological and ultrastructural study: a pathology of dendritic cell lineage.

A case of multicentric reticulohistiocytosis is presented with extensive immunohistochemical study of the infiltrate in both paraffin and cryostat sections. Factor XIIIa dermal dendrocyte marker was demonstrated in the cytoplasm of histiocytes, which has not been reported previously in this disease. In addition, the S100 protein stained positive. This immunophenotyping study suggests a dermal dendrocyte lineage with an unusual expression of S100 protein.

Dendritic Cells↗
PubMed1992

[Fungal myocarditis in acquired immunodeficiency syndrome].

The authors report 8 cases of fungal myocarditis discovered at autopsy of a series of 118 patients with AIDS. The cardiac disease was symptomatic and responsible for death in 2 cases. Antemortem diagnosis of fungal infection was made on examination of bronchioloalveolar lavage, the cerebrospinal fluid or gastrointestinal biopsy. The demonstration of intramyocardial pathogens was postmortem in all cases. The organism was Candida albicans in 3 cases, Cryptococcus neoformans in 3 cases, and Aspergillus fumigatus in 2 cases. The lesions were not confined to the heart; multi-visceral fungal involvement was diagnosed at autopsy in all cases. Cryptococcal and Candida myocarditis have already been described in most autopsy series in AIDS, but Aspergillus myocarditis is very rare. These fungal myocarditis are usually clinically latent or masked by neurological or respiratory symptoms.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Microcystic adenoma of the pancreas: report on four cases and review of the literature.

Four cases of microcystic adenoma of the pancreas, including ultrasonographic (US) and computed tomographic (CT) data, are described. These tumors generally present as large, well-delimited pancreatic masses whose multicystic nature is readily evidenced on postcontrast CT scans. While the presence of cysts less than 2 cm in diameter and a central, star-like calcification are very specific, the frequency of atypical forms generally justifies exploratory surgery.

Aged↗
PubMed1991

[Intestinal microsporidiosis. 3 cases in HIV seropositive patients].

Three cases of intestinal microsporidiosis are reported, in acquired immunodeficiency syndrome patients, with a chronic diarrhea. The first case is associated with an intestinal cryptococcosis and with a cytomegalovirus infection and the second case was diagnosed on ileal biopsy specimen. Since the first description of Enterocytozoon bieneusi in 1985. 49 cases of intestinal microsporidiosis are reported in the literature, all in AIDS patients and the frequency of this infection is probably underrated. Prospective studies find it in 6 to 30% of cases. This parasite must be suspected in HIV seropositive patients with clinically chronic unexplained diarrhea or with intestinal atrophy.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Primary angiosarcoma of the colon. Anatomo-clinical study of a case].

We report a case of angiosarcoma of the large bowel in a 66 year old man with histochemical, immuno histochemical and ultra structural study. The patient subsequently completed non surgical staging, showing no extension of the tumor. No etiologic factor was found. Despite complete surgical exeresis, the clinical course is rapidly fatal with occurrence of numerous metastases. Primary angiosarcoma of the gastro intestinal tract are very uncommon. According to the degree of differentiation the diagnosis of large bowel's primary angiosarcoma can be difficult with others large bowel sarcoma, a benign blood vessel tumor or an undifferentiated carcinoma. The immuno histochemical and ultra structural study are useful to perform the diagnosis of angiosarcoma.

Aged↗
PubMed1991

[Production of a monoclonal anti-Cryptosporidium sp. antibody for paraffin-embedded sections].

Since the development of acquired immunodeficiency syndrome, human Cryptosporidiosis has received increased attention. A provisional histological diagnosis can be made on gastrointestinal tract biopsy specimens by light microscopy by showing small round organisms of 2-5 microns attached to the epithelial cell apex. The definitive diagnosis of certitude can only be made by electron microscopy with the identification of various developmental stages of the parasites. We have produced a monoclonal antibody specific to Cryptosporidium sp. usable in paraffin-embedded tissue sections. Such a monoclonal antibody would be an important tool for histological diagnosis of human Cryptosporidiosis.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Non-Hodgkin's lymphoma in HIV infection. A multicenter retrospective study of 21 cases].

The incidence of non-Hodgkin's malignant lymphoma is known to be increased in patients who are seropositive for the human immunodeficiency virus (HIV). We report here a multicentre retrospective study of 21 HIV-positive patients with non-Hodgkin's lymphoma seen between 1985 and 1987. All phenotype B lymphomas of intermediate or high malignancy grade according to the Working Formulation are difficult to classify histologically. Because of this problem, reexamination of the specimens by several pathologists and perhaps also the use of other morphological prognostic criteria, such as mitotic index, seem to be desirable. In more than one-third of our patients the presence of a lymphoma led to the finding of HIV seropositivity in subjects who were all issued from populations at risk. Median age was 39 years. Spread evaluation showed stage III or IV in most cases with, in 4 out of 5 patients, extranodal sites, notably the neuromeningeal system, liver, gastrointestinal tract and bone marrow. The median overall survival was 5 months, but in April 1989 2 patients had survived for more than 30 months. Obtaining complete remission (11/21 cases) was imperative for a 10 months' survival. Eight of the 11 patients in whom complete remission was obtained had received the heavy induction chemotherapy required by the degree of malignancy, but no death due to drug toxicity was recorded. 17 patients died, with active lymphoma (12 cases) and/or infection (8 cases) being documented at the time of death. The finding of more than 500/sq. mm CD4 lymphocytes in peripheral blood in 10 cases while the lymphoma was developing, and the heterogeneity of the Epstein-Barr virus (EBV) profile in serum raise the question of the role played by T-cell immunodeficiency and by EBV infection in the physiopathogenesis of these lymphomas.

Adult↗