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Biomedical subjects

P Callard

Publications and source records attributed to P Callard.

At least 91 records · Page 5Linked to original sources

[Hepatic lipid overload in 2 cases of cholestasis associated with parenteral feeding].

The authors report 2 cases of patients with ileal stenosis who developed progressive jaundice while receiving total parenteral nutrition including lipids (Intralipid). In both cases the histologic and histochemical study of the liver demonstrated lipid overload in Kupffer cells and to a lesser extent hepatocytes. Biochemical study established that linoleic acid, a component of Intralipid, associated with a digalactosyl-diglyceride from vegetal origin were the main components of the hepatic overload. The authors hypothesize that two associated mechanisms were responsible for jaundice in their patients: Kupffer cell dysfunction due, at least in part, to lipid overload and intestinal bacterial overgrowth leading to endotoxinemia.

Adult↗

Immunolocalization of angiotensin 1 converting enzyme in the human male genital tract by the avidin-biotin-complex method.

Immunoreactivity for Angiotensin 1 Converting Enzyme was investigated in a series of 12 fixed and paraffin-embedded normal human genital tract specimens. The Avidin-Biotin-Complex immunoperoxidase method was used with overnight (12 h) incubation with a polyclonal antihuman kidney Angiotensin 1 Converting Enzyme antiserum. All tissues, including testis, different parts of epididymis, ductus deferens, prostate and seminal vesicles, demonstrated a staining pattern. Immunoreactivity was observed on the luminal surface of these epithelia especially on non-motile stereocilia. An intracellular positivity was only observed in spermatids on the acrosomal cap. Besides, an immunologic identity of Angiotensin 1 Converting Enzyme located on the different epithelia of the human male genital tract, on the endothelial cells of vessels and on the proximal tubule brush border of the kidney was observed.

Avidin↗

[Granulomatous hepatitis in cytomegalovirus infection in healthy adults].

The authors report 16 cases of cytomegalovirus (CMV) disease in previously healthy adults. Constant features included pyrexia lasting 3 to 8 weeks and mononucleosis occurring 2-3 weeks after the onset of fever. Moderate hepatomegaly without jaundice, splenomegaly and morbilliform or petechial rush were observed in 30 to 50 p. 100 of cases. None had pharyngitis. Mild increase in serum transaminase activity (2 to 5 N) was present in 13 of the 16 patients, but increased alkaline phosphatase activity was observed in only 3 of them. Liver biopsy was obtained in 10 patients. Liver lesions were characterised by the association of intra lobular granuloma, abundant mononuclear cells in the sinusoids and hepatic peri-venous inflammation but hepatocellular necrosis was not prominent. Typical intracellular inclusions were not seen, either in hepatocytes or in cells of biliary ducts. The diagnosis was ascertained by positive viremia and or viruria and presence of IgM antibodies. The outcome was favourable although clinical and biological signs lasted for about 8 weeks. The authors conclude that adults with chronic pyrexia, no pharyngitis and sub-clinical hepatitis with mild increases in transaminase activity and histologic mononucleosis hepatitis showing mononuclear infiltrates and granuloma formation are likely to have CMV disease.

Adult↗

[Severe jaundice in Legionnaires' disease: a case with early hepatic biopsy].

Although liver tests are frequently disturbed in Legionnaires' disease, jaundice occurs rarely except as a terminal event. The authors report the case of a 68 year-old man with jaundice as a presenting feature of the disease. Jaundice deepened rapidly until death a few days later. Drugs and other causes of cholestasis could be ruled out. An early liver biopsy was performed. The liver was histologically normal except for mitochondrial margination in the hepatocytes. No Legionella could be demonstrated by direct fluorescent assay. These findings suggest that: jaundice in Legionnaires' disease is not related to direct bacterial insult, cholestasis is probably consecutive to endotoxinemia, the mitochondrial margination, a rare histologic finding, could result from Legionnaires' disease. This last point needs confirmation by further studies.

Aged↗

Long-term plasma glucose normalization in experimental diabetic rats with macroencapsulated implants of benign human insulinomas.

Permselective tubular membranes (1 mm i.d.) were filled with fragments of nine freshly resected human insulinomas, closed at both ends, and implanted in the peritoneal cavity of 30 streptozocin-induced diabetic rats. In 14 animals, nonfasting plasma glucose (PG) and insulin levels were normalized by these immunoprotected transplants for up to 1 yr (PG from 520 +/- 12 to 142 +/- 3 mg/100 ml; insulin from 6 +/- 0.5 to 44 +/- 3 microU/ml). These animals showed the same weight gain after 12 mo of observation as 20 controls. The remaining 16 animals showed an incomplete or transient correction of their diabetes and survived 4-6 mo, versus less than 8 wk in untreated animals. Removal of the membrane-encapsulated insulin-secreting tissue from 8 successfully treated rats led to hyperglycemia and death within 10 days. Histology and electron microscopy of insulinoma tissue retrieved after long-term implantation showed functionally active endocrine cells and no evidence of graft rejection. In vitro perifusion gave similar results for encapsulated and nonencapsulated insulinoma tissue. The amount of insulin secreted was quite variable, and responsiveness of the insulinoma to changes in glucose concentration of the surrounding medium was observed in three out of the five tumors studied. These observations establish the effectiveness of immunoseparation by a synthetic membrane in a pancreatic xenograft model.

Adenoma, Islet Cell↗

[Immunohistochemical localization of angiotensin converting enzyme in epithelioid sarcoidosis granulomas].

An immunohistochemical study of the localization of Angiotensin one Converting Enzyme in sarcoidosis granulomas was made in 20 cases of sarcoidosis. Immunoreactive Angiotensin one Converting Enzyme was found in 92% of these cases. At the cellular level the staining was observed on the plasma membrane. No correlation was observed between the serum Angiotensin one Converting Enzyme value and the immunostaining intensity.

Cell Membrane↗

[Multiple hypersecreting lesions of the parathyroid glands during treatment with lithium].

A 64 year old woman had been on lithium carbonate for 12 years for manico-depressive psychosis. Mild asthenia leads to the diagnosis of primary hyperparathyroidism based on the findings of hypercalcemia up to 2.85 mmol/l inappropriate levels of parathormone and a non-suppressive rise of nephrogenic cyclic AMP. These symptoms were not relieved by removal of a chief cell adenoma of the left inferior parathyroid; surgical reexploration leads to the removal of an adenoma in a high, ectopic situation. Further venous samplings were collected during cervico mediastinal phlebography because of persistent hypercalcemia: parathormone levels were high in a thymic vein and a new cervicotomy revealed a fifth gland with an adenoma in the high mediastinum. After removal of the third adenoma, the patient became hypocalcemic. Lithium was not discontinued according to the patient's wishes. Eighteen months later she was well and normocalcemic on alfacalcidol therapy. Multiple adenomas of the parathyroids are rare (1.7 p. 100 to 5 p. 100) and the recurrence of an adenoma on a supernumerary gland is exceptional. Eighteen clinical cases of primary hyperparathyroidism under lithium therapy have been reported, but mild asymptomatic hypercalcemia with inappropriate increased parathormone levels seems to be more common. Duration of treatment is very variable: 1 day to 12 years, and serum calcium levels or up to 3.9 mmol have been observed. Ten patients underwent cervicotomy with removal of an adenoma 6 of them remaining under treatment, with 2 recurrences in our case. Five of the 8 non-operated patients remained on lithium therapy and showed mild hypercalcemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗

[Malignant lymphoma initially of the buttocks: possible role of repeated intramuscular injections].

The authors report the case of a patient who received intramuscular injections of bismuth and penicilline for three consecutive years. Twenty-five years later, a lymphoma of the right buttock developed. The tumor was treated with radiotherapy and remained localized for two years. It then diffused to lungs, maxilla and skin. The occurrence of a lymphoma in muscles is thought to be exceptionnal. It has been suggested that lymphomas may develop at the site of silicone injections or of protracted infections. Fibrosarcomas have been reported after intramuscular injections of iron. The observations may suggest that the muscular lymphoma observed in our patient may have been related to the injections of bismuth performed twenty-five years earlier.

Aged↗

[Fatal herpetic hepatitis in an apparently healthy adult].

The authors report the case of a 46-year old patient who died from fulminant herpetic hepatitis. No cause of immuno-depression was documented in this patient. No skin or mucosal herpetic lesion was found except a questionable urethritis. Herpes virus was demonstrated in the hepatocytes by electron microscopy and isolated from the serum. It was identified as herpes virus hominis type II. The low titer of circulating antibodies did not permit the distinction between herpetic primo-infection and reactivation. The features of the hepatic injury are discussed and compared with previous reports. An active diagnostic approach of herpetic hepatitis is considered.

Acute Disease↗

Acute interstitial nephritis due to drug hypersensitivity. An up-to-date review with a report of 19 cases.

The clinical, biologic, and pathologic features and the course and treatment of acute interstitial nephritis (AIN) due to drug hypersensitivity are reviewed. The authors report 19 additional cases of AIN, outlining some particular and unusual features. The drugs most often responsible now are penicillins and cephalosporins, cotrimoxazole, thiazide diuretics, glafenin and its derivatives, and nonsteroid anti-inflammatory agents. Diagnosis of AIN should be considered in any case of rapidly progressive renal failure occurring during drug therapy, especially when fever, skin rash, arthralgias, macroscopic hematuria, and blood or urinary eosinophilia are present. In the absence of the preceding symptoms, systematic early renal biopsy may be helpful to detect intersitial infiltrates containing lymphocytes, plasma cells, and eosinophils and/or granulomas with epithelioid cells. Immunologic tests are inconstantly positive. Their sensitivity and specificity often are doubtful in the absence of precise knowledge of the pathogenetic factors involved. Recovery may be hastened in some cases by corticoid therapy. Recurrence of the disease will be avoided by definitive suppression of offending and related drug(s).

Acute Disease↗

Drug-induced granulomatous interstitial nephritis.

Among 22 cases of drug-induced acute interstitial nephritis (AIN), noncaseating interstitial granulomas were found in eight cases (36%). Acute renal failure (ARF), oliguric in three patients, appeared within 1-20 days after the beginning of therapy. Clinical symptoms suggesting a hypersensitivity reaction were unusual, marked blood eosinophilia was absent, and immunologic tests were inconstantly positive. The discovery of interstitial granulomas may be a clue to the diagnosis of drug-induced AIN, especially when the inflammatory infiltrates do not contain eosinophils. Since significant residual renal impairment may be observed the benefit of early steroid therapy must be debated.

Adolescent↗