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Biomedical subjects

P Letellier

Publications and source records attributed to P Letellier.

5 recordsLinked to original sources

[Orthotopic liver transplantation for metastases of bronchial carcinoid tumor].

We report the case of a 42 year old man in whom orthotopic liver transplantation was performed successfully for unresectable hepatic metastases of a bronchial carcinoid tumor. Prior to transplantation, somatostatin therapy, pulmonary lobectomy, and systemic chemotherapy (streptozotocin and fluorouracil) were performed. After 9 months there were no signs of clinical or biological recurrence. Orthotopic liver transplantation might be indicated for unresectable and limited liver metastases of neuroendocrine tumor.

Adult

[Prospective etiologic study of 128 patients with ambulatory dep vein thrombosis].

Etiology of deep vein thrombosis in ambulant patients (DVTA = TVPA in text) varies: cancer, blood disease, infectious focus, dysimmunity syndrome, dysglobulinemia, extrinsic compression, metabolic disorder, anomaly of hemostasis. A prospective study was carried out between June 1988 and September 1989 by angiologists in 5 regions of France to evaluate the diagnostic rentability of an epidemiologic survey and to determine possible distinctive characters of DVTA. The survey was comprised of a questionnaire, a full clinical examination and screening tests: chest x-ray, abdominopelvic ultrasound imaging, a-uro/gynecologic examination, full blood count, serum iron, ferritin, uric acid, triglycerides, cholesterol, protein electrophoresis, antinuclear antibodies, circulating anticoagulant, hemostasis factors and liver function tests. The study included 128 patients, mean age 60 +/- 16 years with a DVTA developing without a previous immobilization. The usual predominance in the left leg was not observed. The etiology was identified in 33 cases, including 20 (15.6%) as a result of the screening tests: anomalies of hemostasis (8), blood diseases (3), dysimmunity syndromes (4), extrinsic compression (3), cancer metastasis (1) and hypertriglyceridemia in a diabetic (1). The screening procedure was of no greater value in the absence of a triggering or predisposing factor, on the contrary. An anomaly of hemostasis was detected more frequently in the presence of local or regional triggering factors in the men (4 out of 4) and in the women on the pill (4 out of 4). The number of cancers discovered following screening (2%) was smaller than that expected according to the literature (10%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

[Severe hypercalcemia during hyperthyroidism].

A particularly high hypercalcemia (141 mg/ml) was observed in a man with Graves' disease. An intense muscle asthenia, with lack of dynamism and vomiting which may cause dehydration, are the most suggestive signs of hypercalcemia. Bone biopsy and above all parathormone estimations permit one to eliminate associated hyperparathyroidism. The efficacy of mithramycin used alone, without any other hypocalcemic drug, was remarkable. The direct responsibility of thyrotoxicosis as a cause of the calcium disorder seems undoubted but the precise mechanism of the hypercalcemia remains unexplained.

Adult

[Association of Behçet's disease and pelvispondylitis in a subject without HLA W 27 antigen].

The authors report a new case of Behcet's disease in association with ankylosing spondylitis. A study of the HLA system in this patient, showed the presence of an HLA 5 (Behcet's disease) and the absence of HLA W 27 (ankylosing spondylitis). The authors recall the frequency of HLA W 27 during ankylosing spondylitis, whether primary or associated with psoriasis, or enteric disease. Desensitisation to autologous saliva proved a failure. A trial of D-Penicillamine produced no beneficial effect on the course of the mucosal ulcers and the inflammatory joints.

Adult

[Lupus syndrome during treatment with isoniazid].

In a young girl, aged 17 years, there occurred, 9 months after starting treatment with isoniazid and rifampicin, clinical signs of rheumatoid arthritis with facial erythema of vespertilio type. The presence of L.E. cells and antinuclear antibodies with a high titer, the rapid disappearance of all the clinical signs on stopping isoniazid, and the transient exacerbation of the syndrome on giving a single dose of isoniazid, gave the diagnosis of systemic lupus erythematosus induced by isoniazid. 18 months after stopping the drug, the patient is apparently cured, but there persists in the serum antinuclear antibodies in low concentration (1/200). A study of acetylation of isoniazid in this patient and her 3 sisters, showed that they were all of the slow acetylating phenotype. The late prognosis of this disease and the physiopathological value of the slow acetyl phenotype are worth discussion.

Adolescent