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Biomedical subjects

C Matuchansky

Publications and source records attributed to C Matuchansky.

At least 55 records · Page 3Linked to original sources

[Familial occurrence of cancer of the colon and the rectum: results of a 3-year case-control survey].

A case-control study of the familial prevalence (first-degree relatives) of colorectal carcinoma (CRC) was performed from October 1979 through March 1983 in: (a) 170 consecutive patients with histologically proved rectal (n = 64) or colonic (n = 106) adenocarcinoma; cases of familial polyposis coli and cancer family syndrome were systematically excluded from the study; (b) 170 control subjects, who were free of CRC or colorectal adenoma(s) and matched to patients according to sex and age; (c) 170 consecutive patients with common rectal or colonic adenoma(s), and no evidence of polyposis coli; (d) 100 patients with cancer of various organs, excluding CRC and primary tumours known to be epidemiologically related to CRC. Results of family studies were expressed as "proved" (when the pathological report was received) or "probable" CRC. Eighteen (10.6 p. 100) of the 170 patients with CRC had at least one first-degree relative with past or present proved CRC, and 14 (8.2 p. 100) with probable CRC; the corresponding figures were 3 (1.7 p. 100) proved and 3 (1.7 p. 100) probable CRC in the control group, 14 (8.2 p. 100) proved and 11 (6.5 p. 100) probable CRC in the "adenoma" group and 1 (1 p. 100) and 3 (3 p. 100) in the non-colonic carcinoma group. The relative risk of CRC in close relatives was 6.3 and 4.7 in the CRC and adenoma groups respectively. For the variables studied no significant differences were found between males and females.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Cavitation of mesenteric lymph nodes, splenic atrophy, and a flat small intestinal mucosa. Report of six cases.

This study describes, in 6 patients with a flat small intestinal mucosa and splenic atrophy, a particular lesion of the mesenteric lymph nodes termed "cavitation." In 4 women and 2 men with abdominal mass, intestinal obstruction, or suspected celiac disease-associated lymphoma, unusual pseudocystic lymph node lesions were found in the jejunal or jejunoileal mesentery. These lesions consisted histologically of a large central cavity occupied by hyaline-type material and surrounded by fibrous tissue and remnants of lymph node structures. There was no histologic evidence of malignant lymphoma or mesenteric panniculitis. Diffuse subtotal villous atrophy involving at least the jejunum was found in each case, together with unequivocal biological and morphological evidence of splenic atrophy, severe malabsorption, and a history of chronic or childhood diarrhea. HLA B8 or DR3, or both, was present in 4 of 4 cases; dermatitis herpetiformis was present in 1 case. An unequivocal mucosal response to a gluten-free diet was observed in 2 cases. Four patients died of cachexia or hyposplenism-related infections. We conclude that cavitation of mesenteric lymph nodes is an original feature which may be associated with splenic atrophy and a flat small intestinal mucosa; some of these patients may have celiac disease. Pathogenesis is unknown.

Adult

[Chronic radiation-induced esophagitis after treatment of oropharyngolaryngeal cancer: a little-known anatomo-clinical entity].

Chronic esophagitis induced by radiation therapy (CRE) for carcinoma of the oropharynx and larynx, and involving an initially normal esophagus, is poorly known, and often confused with a locally recurrent malignancy. By reporting 8 consecutive cases, the aim of this study is to contribute to proving that cervical CRE does indeed exist. Eight men, aged 58 to 76 years, developed complete aphagia (7 cases) or severe dysphagia (1 case), 2 to 56 months (median 8.5 months) after radiation therapy for carcinoma of the laryngopharyngeal area. In 5 patients, the primary tumour and/or chains of cervical lymph nodes were removed before radiation therapy; in the 8 patients, the esophagus was endoscopically free of disease. The total dose of radiation exceeded 60 grays in 6 patients. Although they were initially considered as suffering from a locally recurrent malignancy on a clinical basis, none of the 8 patients had patent signs (either endoscopic or histologic) of recurrence. In each case a severe lesion of the cervical esophagus was documented (stenosis 7 cases, giant ulceration 1 case): the diagnosis of CRE was based on endoscopic, histological, and evolutive criteria. Six patients were treated by prolonged nutritional support (via enteral route, 5 cases; parenteral route, 1 case); endoscopic dilatations were used as a single treatment or in association with nutritional support in 4 cases. Three patients died of CRE-induced regional complications; post mortem examination, performed in 2 cases, confirmed CRE without evidence of locally recurrent malignancy.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

Effects of prolonged, purine-free total parenteral and enteral nutrition on urate homeostasis in man.

The influence on human urate homeostasis of prolonged, totally purine-free nutritional support, using total parenteral (TPN) or elemental enteral (EN) nutrition, is not well known. In a prospective study, we measured weekly serum uric acid, renal urate excretion and clearance, together with parameters of hydration, in 58 normally hydrated patients receiving prolonged (15 to 170 days) purine-free TPN (30 patients) or EN (28 patients) for various gastrointestinal disorders. A marked, early and sustained decrease (p less than 0.001) in serum uric acid was observed in TPN (155 +/- 9 mumol/l at day 7 versus 318 +/- 13 mumol/l before nutrition, mean +/- SEM) as well as in EN patients (192 +/- 11 mumol/l at day 7 versus 320 +/- 16 mumol/l before nutrition), together with a significant (p less than 0.01) rise in renal urate clearance. The urate clearance/glomerular filtration rate ratio increased significantly, while there was no significant change in natremia or plasma osmolarity. Serum urate and urate clearance returned to normal within 8 days of refeeding with a normally purine-containing diet. Replacement of TPN by EN or vice versa, or substitution of glucose by fructose resulted in no change in hypouricemia. A 4-day oral supply of purines (125 mg/day) in EN patients was associated with a 53% rise (p less than 0.01) in serum urate. We conclude that prolonged, purine-free TPN and elemental EN are a new cause of marked hypouricemia which is mainly due to increased urate clearance, the mechanism of the latter is still poorly known, but is not related to extracellular volume expansion.

Adolescent

[The digestive system and pancreas in 1982].

The present review is concerned with the main pathophysiological, clinical and therapeutic progresses in the following fields: gastro-esophageal reflux, gastric antisecretory drugs, chronic inflammatory bowel diseases, cancer of colon and esophagus, pancreatic diseases (chronic pancreatitis, pancreatic carcinoma), acute bacterial diseases of the digestive tract, acquired immunodeficiency syndrome of the adult, diffuse nodular lymphoid hyperplasia of the adult small bowel.

Bacterial Infections

Jejunal IgA and C3 deposition in adult Henoch-Schönlein purpura with severe intestinal manifestations.

An adult male patient with Henoch-Schônlein purpura and severe intestinal involvement is reported. Henoch-Schönlein purpura was documented by microscopic and immunofluorescent studies of the skin and kidney. At duodenojejunoscopy there were multiple ulcerations and thickening of mucosal folds. Microscopic and immunofluorescent studies of duodenum and proximal jejunum showed submucosal vasculitis and granular deposits of immunoglobulin A and complement components (C3) in the vessel walls, similar to those observed in the skin and kidney. This patient exhibited severe and prolonged intestinal lesions of Henoch-Schölein purpura, and was resistant to a 10-day course of total parenteral nutrition. However a dramatic clinical response was observed within 24 h after the initiation of plasma exchange therapy; steroids were not used. Intestinal involvement in anaphylactoid purpura may be associated with local immunologic abnormalities similar to those observed in cutaneous vessels and glomerular mesangium.

Adult