Biomedical subjects
Publications and source records attributed to A Bergue.
Peliosis has been described rarely in patients with chronic renal failure. The case reported shows the difficulty of diagnosis in a chronic hemodialysis patient with painful hepatomegaly, chronic ascites and cachexia. The rarity of this lesion under such circumstances, if the etiologies described in the literature are taken into account, is discussed.
A 21-year-old man with coeliac disease and dermatitis herpetiformis presented successively with erosive ileitis (warranting surgical resection) and erosive jejunitis (proven by jejunoscopy). Discontinuous antibiotic therapy was associated with a gluten-free diet and evolution was favorable as judged with five years follow-up. Malabsorption with mucosal ulcerations can be due to: a) chronic ulcerative duodeno-jejuno-ileitis or Jeffries' disease; b) coeliac disease which may be classified as possible, probable, or certain according to the strictness of criteria. Our case is the fourth in which a villous response was proven after gluten-free diet. It is also particular in that the erosions were superficial; c) malignant lymphoma which can reasonably be excluded here. This observation confirms that a gluten-free diet may be effective after surgical resection of the ulcerated segment in complicated coeliac disease and shows that antibiotics may be an useful adjuvant to therapy.
This present report describes a unique case of a patient with ileal varices revealed by recurrent bleeding from vesical varicosities. Ileal varices were associated with portal hypertension secondary to portal thrombosis. An unusual ileovesical shunt was demonstrated by the venous phase of the superior mesenteric arteriogram. This shunt was favored by adhesions between an abnormal ileal loop, which was infiltrated with ova of schistosoma mekongi, and the superior vesical wall. The patient was treated successively by lysis of adhesions and ileal resection. No portacaval shunt was performed.
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The authors report one case of perforated appendix associated with an inflammatory ileo-coecal pseudotumour due to malacoplakia. Right hemicolectomy resulted in uneventful and complete recovery. This case, together with a survey of available published data, enables the authors to briefly review the pathological, pathogenic and therapeutic aspects of this rare, if not exceptional, localisation of malacoplakia.
Seventeen chronic hemodialyzed patients underwent a baryum meal, a fibroscopy with biopsic studies and an evaluation of gastric acid secretion. No duodenal ulcer was found. The gastric and duodenal folds are the most common anomaly. It has been not possible to correlate these folds to a precise histological entity. None of these patients exhibited an hypersecretory state, on the other hand 3 of them were hyposecreting. A statistical relationship between BAO on the one hand and PTH, CT and Ca on the other hand was found.
A 68 years old, non-alcoholic woman, with a history of viral hepatitis 40 years before, developed jaundice. Liver biopsy showed histological evidence of activity. HB virus markers were found to be lacking on two successive tests. Immunological investigations gave negative results, except for the presence of liver/kidney microsomal auto-antibodies. Systemic and portal blood eosinophilia suggested a drug-induced disease. The patient was being treated with sodium dioctyl-sulfosuccinate + dantrone and tienilic acid. Two months after these drugs were withdrawn her condition improved; she put on weight and serum transaminases, measured on two occasions, had returned to normal levels.
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The authors performed 12 femur progressive lengthenings on rabbits during growth period. The lengthening was effected with a small distractor after a transversal bone section. The lengthening was 7,5 mm on 4 rabbits in 5 days (group 1) 10,5 mm on 4 rabbits in 7 days (groups 2), 15 mm on 4 rabbits in 10 days (group 3. At the end of the lengthening, the authors compared the non operated limb with arteris, veins, nerves, muscles and growth cartilage of the operated side. They found no modification of the muscular structure in the 3 groups. They substantieted few arterial and veinous modifications in group 1 and 2 the arteriel modifications were minimal but veinous modifications were important in group 3. The nervous anomalies wer evident in the 3 groups; the more important the lengthening, the more severe the anomalies; ranging from nerve ondulations in group 1, to vacuolar degenerscence and fibres ruptur in group 3. The authors studied the growth cartilage modificate at the furthest extremity from the femur by counting the cells in the various layers of the cartilage. They noted a significant descrease of the cell in the proliferative zone. This descrease might be due to a cartilage suffering. The modifications in the hypertrophic zone are less important, inconstant and result in a increase of the number of the cells. The authors think that the consequences of those important modifications on the nerve and on the growth cartilage are constant enough to complete this study by other lengthenings. This study coroborates their theory that all the consequences of a lengthening performed in a child are far from being perfectly known.
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The construction of a prototype apparatus adapted to the constraints of tissue structures has permitted not only the quantification of fibrosis within the liver but also analysis of its distribution. The cumulative histograms thus achieved permit the characterization of the liver in Hodgkin's disease and its differentiation from other forms of hepatic fibrosis.
The association of a mixed anaemia (by occult haemorrhage and microangiopathic haemolysis) with a thrombocytopaenia led to a search for a digestive angioma. Arteriography, followed by exploratory laparotomy with preoperative enteroscopy and frozen section histological examination, led to the discovery of a small bowel angioma (multiple phlebectasias) which was partially resected. A review of the literature emphasised the rarity of intestinal angiomas with thrombocytopaenia (Kasabach and Merrit syndrome) and forms a basis for the discussion of haematological abnormalities (intravascular coagulation, microangiopathic anaemia) which may be induced by such vascular malformations.
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