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Biomedical subjects

J Sahel

Publications and source records attributed to J Sahel.

At least 145 records · Page 8Linked to original sources
PubMed1989

Occluded pancreatic endoprostheses--analysis of the clogging material.

One of the most common late complications of transpapillary pancreatic endoprostheses is clogging of the endoprosthesis lumen. In this study we analysed the morphology and the biochemical nature of the contents of 10 clogged pancreatic endoprostheses. At the optical level the sludge presented as an organic matrix with embedded small quantities of CaCO3 crystals (and in one case CaCO3 microcalculi). Electron microscopy showed the presence of bacterial ghosts and protein threads. The characteristic pattern of proteolysed pancreatic proteins was obtained when the organic matrix was analysed by SDS-Page. The presence of trypsinogen, amylase and one of the molecular secretory forms of Pancreatic Stone Protein (PSP) was confirmed by Western-blotting. PSP was also found in association with CaCO3 crystals by immunolocalization. These results suggest that endoprosthesis clogging is due to the precipitation of whole pancreatic juice protein, probably triggered by uncontrolled proenzyme activation.

Amylases↗
PubMed1989

Mucinous pancreatic duct ectasia in the body of the pancreas.

The authors describe one case of mucinous pancreatic duct cancer (ductectatic cystadenocarcinoma). This disease is characterized by dilatation, with mucoid secretion, in side branches of the main pancreatic duct. Unlike in other reported cases in which mean age of the patients is over 57 years, this case involved a young woman (aged 30 years), and the lesion was located in the body of the pancreas rather than in the uncinate process. Malignant transformation was noted.

Adult↗
PubMed1989

[Diagnostic and therapeutic value of the panfundoscope in diseases of the posterior eye segment].

The scope of this work is to evaluate the diagnostic and therapeutic value of using Schlegel's panfundoscope with respect to the three mirror lens on the basis of a double-blind comparative study. This method is especially rewarding for the follow-up of fundus lesions, their detection through opaque media and/or a poorly dilated pupil, as well as through an intraocular lens. Panretinal photocoagulation, prophylactic annular photocoagulation of peripheral retina and vitrectomy can be performed more easily through this lay-out.

Double-Blind Method↗
PubMed1989

Calcium carbonate saturation in human pancreatic juice: possible role of ductal H+ secretion.

Saturation with calcium carbonate was measured in human pancreatic juice anaerobically collected for diagnostic purposes in 15 patients who were ultimately found not to have pancreatic disease. Bicarbonate, PCO2, proteins, and total and ionized calcium were measured in samples collected every minute during a 20-min period after intravenous administration of secretin (1 U/kg) and, 10 min later, caerulein (75 ng/kg). All samples were supersaturated with calcium carbonate. The first sample (washing-out sample) contained the highest concentrations of ionized calcium (Ca2+) and proteins but was least supersaturated with calcium carbonate. Washing-out samples also differed significantly from samples under caerulein by having a lower pH (7.52 +/- 0.30) and higher PCO2 (103.1 +/- 32.20 mmHg) versus 8.22 +/- 0.15 and 38.4 +/- 4.5 mmHg, respectively. Values of PCO2 increased and bicarbonate concentration decreased linearly with protein concentration in washing-out samples but not under hormonal stimulation. This suggests that a concentration of pancreatic juice occurs in pancreatic ducts in association with luminal H+ secretion and CO2 formation, which results from bicarbonate neutralization. During stimulation, ionized calcium concentration increased with protein concentration without any change of PCO2, so that supersaturation was more pronounced under caerulein than under secretin stimulation. Disturbances of the ductal concentration of pancreatic juice during interdigestive periods could be important for pancreatic stone formation in humans.

Bicarbonates↗
PubMed1988

Chronic obstructive pancreatitis due to tiny (0.6 to 8 mm) benign tumors obstructing pancreatic ducts: report of three cases.

Three cases of obstructive pancreatitis are described in nonalcoholic women aged 56 to 58 years with a 2-month to 5-year history of recurrent attacks of pancreatic pain associated with intermittent raised serum pancreatic enzymes. The diagnosis was made by sonography showing an enlarged hyperechogenic tail of the pancreas, with a dilated duct, the rest of the pancreas being normal, and by ERCP showing a partial stenosis of the main pancreatic duct with regular dilatation of collateral branches distally to it. Surgical resection of the pancreatic tail cured all three patients. In the obstructed part of the pancreas, the lesions are typical of obstructive pancreatitis with perilobular and sometimes intralobular fibrosis of the same degree in the different lobules of the diseased area and not patchy as in chronic calcifying pancreatitis. The changes in collateral ducts are not marked, and there is an absence of intraductal plugs. Fat necrosis and pseudocysts may be found. Tumors responsible for the obstruction were the smallest islet cell tumors (0.6 and 8 mm) and serous cystadenoma (5 mm) responsible for symptoms ever published. Cephalad to the stricture, the pancreas was normal. When the etiology of chronic pancreatitis is atypical, especially when it occurs in nonalcoholic women aged greater than 50 years, a careful sonography (or computed tomographic scan) and ERCP must be done. Serial sections of the resected pancreas at the level of the obstruction and distal to it are often necessary to demonstrate the tumor.

Adenoma, Islet Cell↗
PubMed1988

[Endoscopic treatment of pseudocysts and abscess in acute pancreatitis].

We report on 4 cases of necrotic pseudocysts complicating acute pancreatitis, treated by endoscopic cystostomy (3 cystogastrostomies, 1 cystoduodenostomy). Acute pancreatitis was secondary to biliary stones in 2 cases, post-surgical in one case and post-ERCP in the last case. Endoscopic treatment was performed because of recurrence of pseudocysts after percutaneous drainage guided by ultrasonography or CT scan. In 3 cases, pseudocysts were infected (pancreatic abscesses) and in 2 patients, surgery was contraindicated (severe respiratory and multiple organ failure). The outcome was uneventful in all the 4 cases and pseudocysts disappeared in a few days or weeks in 3 patients. The fourth patient underwent a complementary surgical cystogastrostomy. Endoscopic cystostomy appears to be a safe and efficient technique when performed in pseudocysts located close to the digestive wall and responsible for bulging visible during upper GI endoscopy.

Abscess↗
PubMed1987

Biliary ascariasis combined with a villous tumor of the papilla. Diagnostic and therapeutic value of endoscopy.

A 64-year-old man admitted for cholangitis presented with an ascaris lumbricoides in the biliary duct and a villous tumor of the ampulla of Vater. ERCP revealed the parasite as a "rail-like" linear defect in the main bile duct, and permitted its extraction. The ampullary tumor was repeatedly ablated with a snare and finally surgically removed because of suspicion of malignancy. This is the first report on such an association.

Ampulla of Vater↗
PubMed1987

Endoscopic cystoduodenostomy of cysts of chronic calcifying pancreatitis: a report of 20 cases.

This paper reports on the technique and results of 20 endoscopic diversions into the duodenum of cysts complicating chronic pancreatitis in 19 patients. The procedure, performed safely on the condition of visualization of a compression of the duodenal wall by the cyst, was successful 18 times in 17 patients. Complications occurred in four patients: two with bleeding (resulting in the death of one patient), two perforations treated successfully, and one transient cholangitis. Long-term results (average = 20.7 months) in 13 patients who were followed more than 6 months were good nine times, fair three times, and bad in one case. Endoscopic cysto-digestive diversion appears as an interesting alternative to surgery in selected patients with chronic pancreatitis.

Adult↗
PubMed1987

[Fine-needle cyto-puncture. Apropos of 138 liver cytologies and 66 pancreas cytologies].

In this report, we examined the sensitivity and specificity of 138 hepatic and 66 pancreatic fine needle aspiration cytology. Aspiration cytodiagnosis was performed using a fine needle, percutaneously, with ultrasonic or tomodensitometric guidance. Sensitivity of hepatic and pancreatic aspiration cytodiagnosis was 86.73% et 83.3%; specificity was respectively 97.72% an 100%. These results are compared with literature review and confirm the interest of fine needle aspiration cytology in tumoral pathology.

Adenocarcinoma↗
PubMed1987

[Complications following endoscopic papillotomy--results of an international survey].

In a collective series of 18,422 successful EPT, early complications occurred in 7.63% of cases with a mortality rate of 0.93%. EPT for benign stenosis of the sphincter of Oddi was followed by the highest morbidity. Late complications were observed in 5.1% of 6054 patients followed during more than 6 months, most of them during the first year of follow-up. Non surgical treatment was possible in 77.5% of early complications and 74% of late complications with respective mortality rates of 12.1% and 27.4%.

Ampulla of Vater↗
PubMed1987

[Bilateral meningioma of the optic nerve. Discussion apropos of a case].

The authors report a case of a 14 years old girl with a bilateral optic neuropathy especially an optic atrophy on the left eye. They show the clinical and radiological diagnostic difficulty of these symptoms before coming to the bilateral optic nerve meningioma. The authors have compared this rare case to those described in literature and insist on the importance of the CT Scan and eventually the nerve surgical exploration.

Adolescent↗