Search PubMed⌕ Search

Biomedical subjects

J Sahel

Publications and source records attributed to J Sahel.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Value of cyto-puncture and of ultrasonic-guided micro-biopsy in solid tumors of the pancreas].

43 patients (29 men, 14 women, average age 64.7 years) with a solid lesion of the pancreas underwent echography-guided cytopuncture (needle 22 G, 88 mm) associated in 11 cases with microbiopsy (needle 21 G, 150 mm). The lesions were localized in the pancreatic head (n = 27), body (n = 13) and tail (n = 3). The sensitivity and specificity of cytopuncture were 81% and 100% respectively. There were 27 true positives (26 pancreatic adenocarcinomas and one metastasis of a prostatic adenocarcinoma); 10 true negatives (5 cases of calcifying chronic pancreatitis, 3 benign endocrine tumors, 2 cases of acute pancreatitis); and 6 false negatives (4 adenocarcinomas and 2 intrapancreatic cholangiocarcinomas). There were no false positives. Microbiopsy diagnosed 5 adenocarcinomas out of 9 cases biopsied and 2 benign endocrine tumors not detected by cytopuncture. Its sensitivity was thus 56% for malignant lesions and 64% for all lesions biopsied. Its specificity was 100%. There was one (= 2.5%) complication (dissemination on the needle pathway). We conclude that echography-guided cytopuncture is a simple and effective method of diagnosing solid tumors of the pancreas. Biopsy, though of lower sensitivity, probably serves to increase the specificity of cytopuncture, in the case of benign lesions in particular.

Adenocarcinoma↗
PubMed1990

Primary malignant melanoma of the esophagus.

This report describes a case of primary malignant melanoma of the esophagus in a 66-year-old man treated by esophagogastrectomy. Radiographic, endoscopic, echoendoscopic and histological features are given and a short review of the literature is presented.

Aged↗
PubMed1990

Eosinophilic pancreatitis: report of a case.

A case of relapsing pancreatitis in a young man is presented. Stenosis of the main duct and cystic lesions of the tail of the pancreas were shown by ultrasonography, CT scan, and endoscopic retrograde cholangiopancreatography (ERCP). After a wrong diagnosis of cancer, the pathological examination demonstrated an eosinophilic infiltration of the pancreatic tail, spleen, lymph nodes, and spleen flexure of the colon. After treatment with oral cromoglycate, the previously increased rate of polynuclear eosinophils in blood returned to normal. Similar observations were found in the medical literature.

Adult↗
PubMed1990

Pancreas divisum is a probable cause of acute pancreatitis: a report of 137 cases.

The incidence of pancreas divisum (PD) was evaluated in a retrospective series of 1,825 successful consecutive ERCPs. One hundred thirty-seven pancreas divisums (7.5%) were found in 80 males and 57 females at a mean age of 49.2 years. The ventral ducts were visualized in 82.5% and the dorsal ducts in 74.1% of attempted cannulations of the minor papilla. Pancreas divisum was significantly more frequent in patients presenting with acute idiopathic pancreatitis (50.0%) or acute biliary pancreatitis (23.7%) than in controls or in the general population. This difference was not found in acute pancreatitis due to other etiologies. Acute pancreatitis associated with PD is generally recurrent, is not severe, but may be complicated by necrotic pseudocysts. The frequency of PD was also significantly increased in patients with gallbladder stones but not with common bile duct stones. In other pathological groups--chronic pancreatitis and pancreatic cancer--the frequency of pancreas divisum was not statistically different from that observed in controls and/or in the general population. We conclude that on a statistical basis, PD is a probable cause of acute pancreatitis, especially in its idiopathic recurrent variety, and that its frequency is increased in patients with gallbladder stones.

Acute Disease↗
PubMed1990

Spontaneous healing of sclerosing cholangitis associated with stricture of the main pancreatic duct.

A 78-year-old man was admitted for jaundice. Strictures of the main pancreatic duct and of the main bile duct in the head of the pancreas were showed by ERCP. This association initially evoked a cancer of the head of the pancreas. A prosthesis was endoscopically inserted in the main bile duct. Three months later, strictures of intrahepatic bile ducts appeared, demonstrated by ERCP. The diagnosis of sclerosing cholangitis or of liver metastases was suggested. Twenty-eight months later, cholangiography and pancreatography were normal, ruling out a malignant lesion. Presently, the patient is in good condition with no biological abnormality. This observation is interesting because it shows that some cases of sclerosing cholangitis may heal spontaneously. It shows the necessity of having histological proof of pancreatic cancer.

Aged↗
PubMed1990

Diameter of the main pancreatic duct in chronic calcifying pancreatitis. Measurement by ultrasonography versus pancreatography.

The aim of this study was to compare the diameter of the main pancreatic duct measured by ultrasonography (US) and endoscopic pancreatography (ERCP) in cases of chronic pancreatitis and to evaluate the ability of US to gauge the dilation of the main duct accurately enough to do a side-to-side wirsungo-jejunostomy. Sixty-one measurements were recorded in 50 patients (47 men and 3 women; age: 43.7 +/- 10 years). In 11 cases, two measurements were made at an interval of more than one year. US always preceded ERCP. The measurements were compared in only 43 cases (71%), because evaluation by US was inaccurate in 14 cases (23%) and by ERCP in nine cases (15%). The mean value of the diameter measured by US was 4.30 +/- 3.01 mm, and by ERCP, 5.52 +/- 3.08 mm (mean +/- SD). When the diameter assessed by US (y) was greater than or equal to 3 mm, the diameter assessed by ERCP (x) was always greater than or equal to 4 mm. The value of x could be determined from y by the equation: x = y + 1.2 mm (r = 0.91, p less than 0.05) The difference between x and y was constant and did not depend on the size of the duct. It could be owing to the hyperechogenicity of the duct walls. We conclude that US is a reliable way to assess the dilation of the main pancreatic duct and might be an acceptable method of judging whether a side-to-side wirsungo-jejunostomy can be performed.

Adult↗
PubMed1990

Villous adenoma of the main pancreatic duct: a potentially malignant tumor?

This report deals with two cases of villous adenoma of the Wirsung duct. The two patients presented with upper abdominal pain, diarrhea, and weight loss. Duodenal intubation showed a complete failure of exocrine pancreatic function. Ultrasound scan, computed tomography, and endoscopic retrograde cholangiopancreatography disclosed marked dilatation of the head portion of the main pancreatic duct. A proximal duodenopancreatectomy was performed. Pathological examination revealed a papillary polyp expanding the pancreatic head and filling the main duct lumen. Histological pattern consisted of a villous adenoma without any feature of malignant change. Previously reported cases exhibit many similarities to our two cases. The putative likelihood of malignant change and the relationship between villous tumors of the Wirsung duct and of other origin remain unclear.

Adenoma↗
PubMed1990

[Candida albicans uveopapillitis. Diagnostic and therapeutic discussion apropos of a case].

Due to the difficulties encountered in the etiologie diagnosis of papillo uveitis along with the increasing occurrence of fungal infections (in paralleled with the number of AIDS affected patients), we found of interest to report a case of exsudative macular chorioretinitis with poor evolution under steroid therapy. In this patient infection by Candida Albicans was suspected and confirmed only after isolation and culture of the fungal from a vitrectomy specimen. A therapeutic apponch using Fluconazole (Triflucan allowed a dramatic improvement of visual acuity within a few months. Thus, vitrectomy appears as a decisive step in the diagnosis of endogenous ocular candidiasis. This diagnosis is even more difficult to suspect in patient without immun deficiency more any extraocular focal infestation.

Adult↗
PubMed1990

Endosonography in the localization of parathyroid tumors: a preliminary study.

A preoperative transesophageal exploration of the parathyroids by endosonography was performed on 23 patients with primary hyperparathyroidism. The system used was a 7.5 MHz transducer mounted on the tip of an endoscope with an external diameter of 13 mm. The field of visualization was 360 degrees. A retrograde exploration was done moving up from the aortic arch to the upper esophageal sphincter. All patients underwent surgery afterward, and adenomas were found. In 12 cases the adenoma was visualized. All 12 adenomas were posteriorly located on the right side (four cases) and left side (eight cases) of the esophagus. Nine of these 12 tumors were on the posterior face of the thyroid lobes, with six tumors in the middle one third of the thyroid lobe and three in the lower one third of the thyroid lobe. The other three tumors were located below the lower pole of the thyroid lobes in the upper posterior mediastinum. Mean tumor weight was 1165 mg. Of the 11 tumors that could not be visualized, eight tumors were anteriorly located; three of these tumors were on the anterior and lateral surface of the lower pole of the thyroid, and five were in the thyrothymic tracts. The remaining three tumors were located on the back of the thyroid lobes; two of these tumors were at the upper esophageal sphincter, and one was on the side of the pharynx. Mean tumor size was 1334 mg. Localization of parathyroid tumors by endosonography appears possible but only if lesions are located posteriorly, close to the esophagus. Endosonography is not indicated before routine cervical exploration for primary or secondary hyperparathyroidism. As in other such studies, endosonography could be useful in cases of persistent or recurrent hyperparathyroidism.

Adenoma↗
PubMed1990

Does jaundice increase the frequency of gastroduodenal ulcerations?

We have studied the frequency of gastric and duodenal ulcerations in 200 jaundiced patients (106 males, 94 females, mean age: 69.1) compared with 100 patients without jaundice (65 males, 35 females, mean age: 47.8). The study was designed to determine the effect of sex, age, duration and etiology of jaundice on the frequency of ulcerations. Each patient underwent ERCP, with careful examination of the stomach and duodenum. Ulcerations were seen in 35 patients with jaundice (17.5%) and in 2 patients without jaundice (2%). The difference was significant for duodenal ulcerations (p less than 0.01), but not for gastric ulcerations. There was no significant difference in the influence on the frequency of ulcerations of sex and duration of the jaundice. Ulcerations were more frequent in the case of neoplastic obstruction of the main bile duct (p less than 0.001) than in other etiologies.

Aged↗
PubMed1990

[Oculomotor paralysis and Lyme disease].

Lyme disease is an infectious multi system disorder caused by the spirochète Borrelia Burgdorferi. Neurologic syndromes occurring during the second stage of the illness are common and the neurologic feature is extremely variable. We report a case of Lyme disease with diplopia. In contrast with most reported cases of ocular motor involvement in Lyme disease, no other systemic symptoms were detected. The serodiagnosis, although mildly positive, was confirmed by western blot antibodies analysis and evaluation of CSF antibodies. Symptoms readily vanished 3 days after the introduction of antibiotherapy. The efficacity of antibiotic therapy on the quality and timing of functional recovery justifies the use of this therapy.

Adult↗
PubMed1990

[Carcinoma in situ in localized Caroli's disease].

A new case of Caroli's disease associated with cholangiocarcinoma is reported. It is the first in situ carcinoma description. Intrahepatic biliary cysts are a predisposing condition, even if mechanism remains hypothetical.

Aged↗
PubMed1989

Neurotransmission in the frog retina: possible physiological and histological correlations.

In the frog retina, extracellular recordings of transient ganglion cells have shown that the inhibitory surround of the receptive field of these cells was mediated by gamma-aminobutyric acid and acetylcholine (through the nicotinic receptors). Histoautoradiographic and immunocytochemical studies for the two respectively have shown that these neurotransmitters can act through horizontal and amacrine cells. The separation of the ON and OFF channels mediated by glutamate at the bipolar cell level may also be obtained by glycine and/or acetylcholine (through muscarinic receptors). Respective histoautoradiographic and immunocytochemical studies indicate that these neurotransmitters act at the amacrine cell level. These data are consistent with the functional separation of spatial and temporal organization of retinal information, with horizontal cells especially responsible for the spatial organization of the ganglion cell responses and amacrine cells involved in both spatial and temporal organization of the responses.

Acetylcholine↗