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Biomedical subjects

F Berger

Publications and source records attributed to F Berger.

At least 343 records · Page 19Linked to original sources

Intensive and sequential combination chemotherapy for aggressive malignant lymphomas (protocol LNH-80).

Ninety-seven patients with aggressive malignant lymphoma (ML) were treated with an intensive and sequential chemotherapy (protocol LNH-80). There were 42 patients with intermediate grade ML, 53 patients with high-grade ML, and two patients with true histiocytic ML. Most of the patients were in advanced stage: 21 stage III and 61 stage IV. The LNH-80 protocol schedule comprised three phases: (1) induction with three courses of an intensified CHOP-Bleo (cyclophosphamide, doxorubicin, vindesine, methylprednisolone, and bleomycin); (2) consolidation with cytarabine, followed by high-dose methotrexate and folinic acid rescue, then asparaginase; and (3) final intensification with two courses of CVAP-Bleo (cyclophosphamide, teniposide, cytarabine, methylprednisolone, and bleomycin). CNS prophylaxis included one injection of methotrexate during each induction course and the drugs of the consolidation phase. In cases of initial CNS localization, cranial radiotherapy was added. Eighty-four patients (87%) went into complete remission (CR), 18 (21%) of whom relapsed, usually during the phase of treatment or within 6 months of completing chemotherapy. Sixty-three patients are alive with an overall median follow-up of 24 months. The median survival time and the median disease-free survival have not been reached, and the survival curve seems to have plateaued at above 60%. There was no statistical difference between intermediate-grade ML (CR 90%, relapse 18%) and high-grade ML (CR 84%, relapse 24%). The toxicity of this treatment is mainly encountered during the induction phase: almost all patients had short-term neutropenia, less than 0.500 g/L in 57, with a documented infection in 25. Overall treatment-related mortality was 6%, with four patients dying during the induction phase.

Adolescent↗

[A triple association: rectocolonic adenomatosis, gastroduodenal polyposis and secreting adrenocortical adenoma].

A case of adenomatosis coli, gastroduodenal polyps, and functional adrenocortical adenoma in a 28 year-old woman is reported. The association of cystic fundic gland polyposis and duodenal adenomatosis was demonstrated endoscopically. The particular point of interest in this case report is the functional nature of the adrenocortical adenoma. Endocrine tumors associated with adenomatosis coli are generally discovered at autopsy. No similar case has been previously published.

Adenoma↗

[Histological transformation of low malignancy lymphoproliferative syndromes. Clinical and developmental study of 32 cases].

Fourteen out of 283 patients with chronic lymphoid leukaemia, 2 out of 47 with Waldenström's disease and 16 out of 136 with low malignancy lymphoma (follicular with predominant small cleaved cells, mixed follicular with small and large cells, or diffuse lymphocytic) underwent histological transformation of their disease into a highly malignant lymphoma (immunoblastic in 14 of the 32 cases). There are no clinical or biological signs that predict these changes which seem to occur haphazardly in time. Seven patients died within one month of the diagnosis. The classical treatments failed. Complete remission was obtained in 5 cases with the intensive and sequential chemotherapy used for initially aggressive lymphomas.

Antineoplastic Combined Chemotherapy Protocols↗

Localisation of C-terminal gastrin immunoreactivity in gastrinoma cells. An immunoelectron microscopy study on conventionally processed tissue.

Localisation of C-terminal gastrin immunoreactivity has been studied, using the immunogold staining procedure, on ultrathin sections of 6 human gastrinomas conventionally processed for electron microscopy. The specific labelling, whose density depended on the mean diameter of the gold marker, was restricted to endocrine secretory granules. However, in poorly differentiated cells from malignant tumours, a number of granules remained unreactive. The labelling pattern depended also on the functional state of each cell. The immunoreactive granules showed various morphological features. A moderate number of gold particles was demonstrated over the floccular content of the infrequent diagnostic G-type granules. Non-diagnostic round granules of varying size and electron density were prevalent in most cells; their usually strong immunostaining allowed immediate recognition of cell specificity. Dense granules which were large in size and angular in shape and present in one case, were also intensely labelled. In the same tumour, unequal labelling occurred over polymorphous, often elongated granules, of varying size. Granules of different types, including intermediate forms, could be found in the same cell, indicating a spectrum of granule maturation towards well-defined types of the fetal or adult normal tissues. The present methodology would help to identify gastrin-producing cells in prospective or retrospective electron microscopy studies of multi-hormonal endocrine tumours.

Adult↗

Light and electron microscope localization of G-17- and G-34-like immunoreactivities of human gastrinomas.

Gastrin- 17 (G-17) and gastrin-34-like immunoreactivities of human gastrinoma cells were investigated at light and electron microscope level using N-terminally directed antisera. The procedure includes (a) the 24 hr/immunoperoxidase staining of Bouin-fixed paraffin embedded tissues, (b) the immunoelectron microscopic labelling of aldehyde-fixed Epon-embedded tissues according to the immunogold technique. On light microscopy, a variable number of tumor cells stained for G-34. In contrast, G-17 immunoreactivity was very low or undetectable in the tumor material, although it was easily detected in endocrine cells of similarly processed human pyloric mucosa. On electron microscopy, most of the tumor cell granules belonging to the round compact or dense-cored type exhibited a variable labelling for G-34, whereas the vacuolar/floccular type remained unlabelled. In contrast, the labelling for G-17 occurred over most of the tumor cell granules, whether compact or floccular. Dense granules of varying size and shape, previously shown to store C-terminal gastrin immunoreactivity, were only faintly labelled by the two antisera. When compared to the labelling pattern of human pyloric G-cells, the predominance of round dense granules with G-34 and G-17 immunoreactivity in gastrinoma cells suggests an incomplete or defective post-translational processing of the precursor peptide.

Colloids↗

[Immunodetection of gastrin-like peptides in routine electron microscopy by the "immunogold" method].

The present immunoelectron microscopic study was carried out in order to evaluate the influence of several technical parameters of the immunogold staining procedure on the labelling intensity of gastrin-storing cells in normal and pathological states. Ultra-thin sections of double-fixed Epon embedded human pyloric mucosa were immunolabelled using a C-terminal directed antigastrin serum, followed by colloidal gold linked immunoglobulins. When the labelling density occurring over the endocrine secretory granules was quantitatively evaluated, the following conclusions could be drawn: the density increased dramatically when particles of decreasing diameter (40 nm, 20 nm, 10 nm) were comparatively used, the dilution of the primary antiserum had to be adjusted in order to obtain an intense specific labelling together with a negligible background (non specific) labelling. However, a long incubation time of the primary antiserum, as well as the use of etching procedures, resulted in an increase of the labelling density when a highly diluted antiserum was applied. Subsequent attempts to immunolabel ultrathin sections of gastrin-secreting malignant tumours showed that the goal could be achieved on tissues routinely processed for electron microscopy, provide the previous parameters were carefully selected according to the control G cell model.

Cytoplasmic Granules↗

[Actinomycoses. Anatomopathological study. Apropos of 10 cases].

From 1975 to 1983, ten cases of actinomycosis have been reported. The anatomical localizations were cervicofacial (3 cases), thoracic (2 cases), abdominal (4 cases) and aneurysmal (1 case). The interest and limits of sampling and histological staining methods are discussed. In 8 cases out of 10, the surgical biopsy established the diagnosis of actinomycosis. The "actinomycosis granule" is revealed by the standard staining and characterized with the Gram stain. This latter allowed us to confirm the diagnosis of actinomycosis in 6 cases and to rectify it in 3 other cases that were botryomycosis. Culture of tissue gave the diagnosis in one case of actinomycosis non identified by histology.

Actinomycosis↗

Multihormonal carcinoid tumor of the pancreas. Secreting growth hormone-releasing factor as a cause of acromegaly.

This report describes the histologic, immunocytochemical, and ultrastructural study of a multihormonal carcinoid tumor of the pancreas, secreting a growth hormone releasing factor (GRF) which provoked acromegaly. The patient presented a nonfamilial multiple endocrine neoplasia, type 1. The absence of radiologic signs of a pituitary adenoma in conjunction with elevated plasma levels of pancreatic polypeptide, glucagon, somatostatin, as well as growth hormone (GH), led to the discovery of the tumor. Its surgical excision produced a rapid disappearance of most of the clinical and biologic disorders. No immunoreactive GH was found in the tumor using radioimmunoassay and immunocytochemistry. In contrast, three peptides with GH-releasing activity were extracted and characterized. Immunocytochemistry showed that the GRF-reactive cells, together with rare somatostatin-storing cells, made up areas which demonstrated a medullary pattern of growth with extracellular amyloid deposits. Under electron microscopic examination, actively secreting cells were observed which carried endocrine granules of 100 to 150 nm in diameter. The other regions of the tumor presented a different type of growth and were composed of pancreatic polypeptide-, glucagon-, or somatostatin-reacting cells. Cells immunostained with antisera raised against beta-endorphin were also noted. These data suggest that GRF may be a new biologic marker for pancreatic endocrine tumors.

Acromegaly↗

Bronchial carcinoid with fibrillary inclusions related to cytokeratins: an immunohistochemical and ultrastructural study with subsequent investigation of 12 foregut APUDomas.

A bronchial P cell carcinoid, which was negative for all hormones immunocyto chemically tested, showed a globular intracytoplasmic inclusion in almost every cell. The inclusions were not clearly distinguishable using the haematoxylin- eosin- safran procedure; they were best demonstrated with the Masson trichrome stain and the Grimelius technique and were easily detected in 1 micron thick Epon sections as target-like structures. On electron microscopy, they were found to be composed of filamentous aggregates entrapping a few endosecretory granules, which showed degenerative changes. The filaments, 8-10 nm in diameter, lacked any periodicity; they were randomly dispersed in the central area and arranged in broken concentric swirls at the periphery of the inclusions. The globules lacked the tinctorial properties of amyloid, but showed a strong immunostaining for keratin-like proteins. A systematic investigation of 12 APUDomas of bronchial or duodenopancreatic origin, using both light and electron microscopy, identified a few filamentous bodies in one case, a somatostatin cell tumour of ampulla of Vater. In both cases, the structures appeared similar to those previously reported in growth hormone cell pituitary adenomas as well as in a few bronchial or gut carcinoids. Whatever their nature, morphological data suggest that they are related to abnormalities in the secretory function, involving the Golgi apparatus, the endosecretory granules and the microtubular microfilamentous system.

Adult↗

The effect of abstinence on left ventricular performance in asymptomatic chronic alcoholics.

Twelve asymptomatic men who were chronic alcoholics (42.3 +/- 10.7 years, mean age +/- 1 SD) underwent supine bicycle exercise and gated cardiac blood pool imaging 4-7 days after alcohol withdrawal and then again 32-65 days after abstinence (42.2 +/- 15.0 days). Workloads and exercise stages were identical during both exercise studies. Rest and exercise heart rates, blood pressures, cardiac outputs, double products, and systemic vascular resistances were similar in both studies. Ejection fraction (EF) was higher after abstinence at peak exercise (0.68 +/- 0.07 vs. 0.61 +/- 0.08 P less than 0.05); end-systolic volume (ESV) was smaller at rest and at peak exercise after abstinence (P less than 0.05). During the first exercise study, 6 of 12 (50%) subjects did not increase their EF by 0.05 units and 4 of 12 (33%) had no EF increase after abstinence. Even the original "normal" responders had greater rest and exercise EFs after abstinence. In the first exercise study end diastolic volume (EDV) rose during exercise (P less than 0.05) while ESV did not change. After abstinence, EDV did not change during exercise, while ESV declined (P less than 0.05). These results show that latent cardiac dysfunction exists in asymptomatic chronic alcoholics, which is partially although not completely resolved by abstinence of brief periods.

Adult↗

Alcoholism rehabilitation: a supportive approach.

The author presents several possible components of an alcoholism treatment program in which recovery is defined as total abstinence with improved life functioning. The components include individual psychotherapy, group psychotherapy, Alcoholics Anonymous, family therapy, behavior modification, and medications. Several combinations of these components are possible, but they all stress a supportive, here-and-now approach wherein the patient explores the deleterious effects alcohol has had on his or her life, and learns to readjust to life without alcohol.

Alcoholics Anonymous↗

[Acromegaly, clinical expression of the production of growth hormone releasing factor in pancreatic tumors].

In exceptional cases, acromegaly develops as the clinical expression of an ectopic secretion of Growth Hormone (GH) or Growth Hormone-Releasing Factor (GRF), tumorous in origin. In the present report, we describe an instance of acromegaly caused by the secretion of GRF from a voluminous pancreatic tumor. The resection of this tumor resulted in a temporary disappearance of the biological and clinical symptoms of acromegaly, which then reappeared in conjunction with a rise in plasma GRF. From this pancreatic tumor, substances displaying a potent GRF activity were isolated and characterized. Amino acid analyses revealed that they were related to 3 peptides containing respectively 44, 40 and 37 aminoacids. The largest (hp GRF (1-44)-NH2) referred as hp GRF or somatocrinin is considered to be the primary molecule. The pancreatic tumor was multisecreting as proved by high plasma levels of somatostatin, pancreatic polypeptide and glucagon, normalized after the tumor removal, taken together with the immunocytochemical demonstration of the presence of these peptides in the tissue and with the isolation of somatostatin. In contrast hypercalcemia associated with an elevated plasma level of IR-PTH was unmodified by tumor removal. Diagnosis of acromegaly as ectopic endocrine syndrome will probably be facilitated by plasma GRF radioimmunoassay, as a result of production of anti synthetic GRF antibodies.

Acromegaly↗