[Vesicular metastasis of malignant melanoma revealed by recurrent hepatic colic crises].
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Aged↗
Biomedical subjects
A Rampal
Publications and source records attributed to A Rampal.
[Secretory carcinoma of the breast. Report of a case in a 9-year-old boy].
The authors report a child male case of secretory carcinoma of the breast, associated with a abnormal tumoral karyotype (monosomy 22). The diagnosis was made by histopathological examination. This breast carcinoma is characterized by an abundant intra and extracellulary secretory material, which present a reactivity with antimilk proteins antibodies and includes spherical dense bodies, identified by ultrastructural study. The prognosis is not bad, whatever the age of the patient, particularly for the children and young women, displaying an locoregional aggressivity. The signification of a monosomy 22 in secretory carcinoma is unknown.
Breast Neoplasms, Male↗
[Placental infection in Rwanda: comparison an HIV infected population and a control population].
We report an histological study from term placentas of 286 HIV positive women born in Rwanda. We observed chorioamnionitis without any pathogen in 15% of the cases, cocci Gram positive infection in 12 observations and malaria infection in 75% of placentas. We noted 71 cases of active malaria infection with Plasmodium falciparum trophozoites in the erythrocytes of the intervillous spaces, and 135 cases of chronic infection with malaria pigment without any parasite. An ultrastructural study performed in 8 cases of active malaria infection showed characteristic features of trophozoites and schizontes, and malaria pigment. No viral particle were seen. We did not observe any significative difference concerning the incidence of chorioamnionitis and of malaria infection in 275 HIV negative placentas. In the literature as well as in the present study, the main lesions observed in the placentas of AIDS patients were chorioamnionitis. Opportunistic infections and neoplasias of the placenta are exceptional. Detection of HIV proteins by immunochemistry or in situ hybridization is possible, but the HIV could not be identified in the trophoblast by electron microscopy. Mechanisms of the materno-fetal transmission for HIV are currently unknown.
Acquired Immunodeficiency Syndrome↗
Chronic hepatitis C and autoimmunity: good response to immunosuppressive treatment.
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Aged↗
Significance of serum immunoglobulin M to hepatitis C virus core in patients with chronic hepatitis C.
OBJECTIVES: Anti-hepatitis C virus (HCV) IgM antibodies were found in patients with both acute and chronic hepatitis C. The aims of this study were to determine the significance, in terms of liver disease, virological parameters, and response to interferon therapy, of IgM antibody to hepatitis C virus core protein (IgM anti-HCV-core) in the serum of patients with chronic hepatitis C. METHODS: The presence of IgM anti-HCVcore was investigated in 42 patients with chronic hepatitis C. Tests for IgM anti-HCVcore was carried out before interferon therapy. The patients received 3 MU of interferon-alpha three times weekly for 6 months. A response to interferon therapy was defined as normal transaminase activity and negative viremia at the end of treatment (month 6: response), and a sustained response was defined as normal ALT values and negative viremia for 6 months after completion of therapy. RESULTS: Sixteen patients (38%) displayed IgM anti-HCVcore. The mean Knodell score of the IgM anti-HCVcore-positive patients was significantly higher than that of the IgM anti-HCVcore-negative patients (11.5 +/- 3.4 vs. 9.1 +/- 3.1, p = 0.04), and the occurrence of IgM anti-HCVcore tended to be associated with serotype 1 virus (p = 0.08). Finally, a significantly higher percentage of responders to interferon at the end of therapy were IgM anti-HCVcore negative (p = 0.04), and only one patient with a ratio of sample to cutoff over 2.0 responded to interferon. CONCLUSIONS: IgM anti-HCVcore appears to be a simple serological marker of more severe liver disease in patients with chronic hepatitis C and may have relevance to the outcome of antiviral therapy.
Antiviral Agents↗
Cervical intra-epithelial neoplasia in women infected with human immunodeficiency virus.
OBJECTIVE: To investigate the relationship between human immunodeficiency virus (HIV) and cervical intra-epithelial neoplasia (CIN). DESIGN: A prospective study to determine the prevalence of cervical intra-epithelial neoplasia in 111 HIV-positive women. METHODS: In total, 111 HIV + women were enrolled and underwent cervical biopsy and CD4 T-lymphocyte determination. Of the 111 women, 26 (23.4%) had CIN and another 26 (23.4%) had histologic evidence of cervicitis. RESULTS: No significant difference was found between transmission group, CDC stage of disease, CD4 T-lymphocyte count and pregnancy. There was a significant association with concomitant human papillomavirus (HPV) infection (P < 0.001). CONCLUSION: Public health measures are needed to provide Papanicolaou smear screening and appropriate clinical follow-up and treatment of women infected with the human immunodeficiency virus.
Adolescent↗
[Are lymphocytic and collagenous colitis two forms of a single disease? Arguments taken from a biopsy quantitative study].
Collagenous colitis and lymphocytic colitis are defined by a clinicopathologic syndrome with chronic watery diarrhea, microscopic lesions of colonic biopsies, and normal barium enema and colonoscopy. A histopathological study was performed on multiple colorectal biopsies to compare 12 cases of collagenous colitis (defined by a subepithelial collagen thicker than 10 microns) and 7 cases of lymphocytic colitis (defined by a number of intraepithelial lymphocytes more than 20 per 100 epithelial cells at least in one biopsied site). The study included a semiquantitative analysis of inflammatory infiltrate in the lamina propria, crypts distortion and epithelial detachment. The number of intraepithelial lymphocytes per 100 epithelial cells was determined in surface epithelium and crypts. The subepithelial collagen thickening was studied by computerised morphometry. The intraepithelial lymphocytes, villous atrophy and thickness of the subepithelial collagen were also determined in gastric and duodenal biopsies. In collagenous colitis, the subepithelial collagenous thickness ranged from 10 to 40 microns in the colon (median 20.99 microns). In 4 cases of collagenous colitis, no thickening of the collagen plate was seen in the rectum. We found constant epithelial detachment and mucosal distortion. In lymphocytic colitis, the thickness of the subepithelial collagen ranged from 6 to 10 microns in 4 cases and was less than 6 microns in 3 cases (median 6.24 microns). The median number of intraepithelial lymphocytes in surface epithelium was 22.35 (range 18.2 to 40) in lymphocytic colitis versus 12.22 (range 4.6 to 24.4) in collagenous colitis. In conclusion, we observed an overlap of both the collagenous plate thickness and the number of intraepithelial lymphocytes in collagenous colitis and lymphocytic colitis. This result favours a unified histogenesis for these two entities.
Colitis↗
[Acute toxoplasmic pancreatitis. An unusual cause of death in AIDS].
We report a case of an acute toxoplasmic pancreatitis that led to the death of an AIDS patient. Aetiological diagnosis was performed by the post mortem histological examination. On haematein-eosin staining, toxoplasmic cysts and pseudocysts were noted in the pancreatic acini. Immunohistochemical study using anti-Toxoplasma gondii polyclonal antibodies showed free parasitic forms or tachyzoites in the necrotic areas. Toxoplasmic cysts without any inflammatory reaction were observed in the lungs. In the acquired immunodeficiency syndrome, involvement of the pancreas by toxoplasmosis is very rare and associated with a multivisceral dissemination. Even if this diagnosis is exceptional, acute toxoplasmic pancreatitis must be considered in an AIDS patient when the other causes of pancreatitis, as drugs or infectious diseases, have been eliminated.
AIDS-Related Opportunistic Infections↗
[Primary angiosarcoma of the colon. Anatomo-clinical study of a case].
We report a case of angiosarcoma of the large bowel in a 66 year old man with histochemical, immuno histochemical and ultra structural study. The patient subsequently completed non surgical staging, showing no extension of the tumor. No etiologic factor was found. Despite complete surgical exeresis, the clinical course is rapidly fatal with occurrence of numerous metastases. Primary angiosarcoma of the gastro intestinal tract are very uncommon. According to the degree of differentiation the diagnosis of large bowel's primary angiosarcoma can be difficult with others large bowel sarcoma, a benign blood vessel tumor or an undifferentiated carcinoma. The immuno histochemical and ultra structural study are useful to perform the diagnosis of angiosarcoma.
Aged↗
[Irregular hepatic steatosis. Clinical and imaging study of 6 cases].
Irregular fatty infiltration of the liver is an entity that may be confused with liver metastasis. Since ultrasonography and computed tomography of the liver are frequently performed, it seems to be a relatively commonly encountered lesion. The features of this syndrome are described herein in six patients in whom a liver biopsy confirmed diagnosis. Clinical and biological findings were non-specific. In 3 cases ultrasound examination of the liver showed increased echogenic areas. In 3 cases of large lesions, the remaining normal liver was seen as areas of decreased echogenicity and the fatty infiltration was considered falsely normal. The scanographic features of this entity were much more typical than those seen on ultrasonography. With CT, irregular fatty liver usually has a distinctive appearance characterized by a non-spherical shape, absence of mass effect and a density close to water (3 cases). When the fatty lesions are focal (3 cases) and less characteristic on CT, liver biopsy should be performed to confirm the diagnosis. Repeated CT examinations can demonstrate partial or total resolution of the lesions when conditions known to be associated with fatty liver have been treated.
Adult↗
alpha-Methyldopa and the erythrocyte membrane.
Alpha-methyldopa binds to human erythrocyte membrane proteins. A portion of this binding is readily dissociable in SDS but a significant amount is very tightly bound and does not come off even under rigorous conditions. The binding is increased under oxidizing conditions and very much inhibited in the presence of reducing agents as well as superoxide dismutase and catalase. Haemoglobin competes with membrane peptides for alpha-methyldopa binding. It is postulated that haemoglobin acts as a 'sink' for the drug in the intact cell and that the first step in the pathogenesis of Coombs positivity and haemolytic anaemia results from an alteration of a critical membrane peptide secondary to binding of the drug during normal membrane breakdown.
Binding, Competitive↗
[Liver involvement in syphilis].
The authors report two cases of syphilitic hepatitis. In the first case, acute hepatitis occurred during the secondary stage of syphilis. The diagnosis was made without waiting for the hepatitis to respond to penicillin treatment, on the basis of the following signs: icterus involving inflammatory syndrome, moderate cytolysis, clear retention, eruption of papular syphilids and a strongly positive test for syphilis. The second case involved a female patient who had been treated 15 years earlier for bone syphilis with ulcerous gummas. The signs were sclerotic, gummatous, hepatic lesions revealed by a syndrome of calcified hepatic lesions. The serologic test for syphilis was negative in this patient. Laparotomy and biopsy were necessary before a firm diagnosis could be made. The authors examine literature data concerning this pathology.
Adult↗