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Biomedical subjects

J Chipponi

Publications and source records attributed to J Chipponi.

15 recordsLinked to original sources
PubMed1992

[Complementary tests in acute appendicitis].

The incidence of appendicectomy is high in France and this operation is performed in 15 to 45% of the cases for a histologically normal appendix. White blood cell count has a very good sensitivity but a bad specificity. The same observation goes for plain abdominal X-rays, the use of while must be limited in children and young women. Barium enema, frequently performed in anglo-saxon countries, show in 90 to 100% of the cases an abnormal image of the caecum or a lack of visualisation of the appendix. Ultrasounds visualize the appendix with a good sensitivity, provided there is no perforation. Laparoscopy is a good diagnostic tool, but must not be considered as a routine procedure. Studies of diagnosis scores show that, except for the white blood cell count, biological and radiological investigations are particularly interesting to eliminate another pathology.

Acute Disease↗
PubMed1991

1,25-Dihydroxyvitamin D3 receptors and human colon adenocarcinoma.

Epidemiological evidence suggests that dietary calcium and 1,25-dihydroxyvitamin D3 (1,25-(OH)2D3) might have a protective effect against colorectal cancers. Since the presence of receptors is required for steroid action, specific 1,25-(OH)2D3 receptors (RD3) were investigated in biopsies taken at different levels of the colon. The study involved 90 biopsies from patients operated on for colorectal adenocarcinoma. They were paired biopsies from adenocarcinoma tissue and adjacent normal mucosa. In addition, 26 normal intestinal mucosa biopsies from patients without cancer were examined. RD3 receptors were assayed in tissue extract by the dextran-coated charcoal technique and also characterized by sucrose density gradient sedimentation. Scatchard analysis showed a single class of specific high affinity-low capacity sites binding for 1,25-(OH)2D3. The incidence of RD3 was 86 per cent in normal mucosa (n = 77) and lower in carcinoma (n = 34), for which the incidence decreased significantly (P less than 0.001) from right colon (58 per cent) to left colon (37 per cent) and rectum (19 per cent). These data suggest that the normal colon is a potential target organ for 1,25-(OH)2D3 which might modulate calcium transport in the colon. Loss of receptivity to 1,25-(OH)2D3 is associated with malignant transformation.

Adenocarcinoma↗
PubMed1990

[Spontaneous hematoma of the liver in pregnancy: non-surgical treatment. Favorable outcome apropos of a case].

The authors report a case of spontaneous rupture of the liver during pregnancy which occurred in a 31-year old multiparous woman with pre-eclampsia. In the literature, this rare event is associated with both maternal and fetal high mortality rates. Histopathological studies have shown periportal parenchymal lesions, larger sinusoidal fibrin deposits and hemorrhagic infarctions. Our case was successfully managed with termination of pregnancy by cesarean section without surgical procedure toward subcapsular hematoma. Long term follow-up using liver scans is needed.

Adult↗
PubMed1989

[Retroperitoneal perforation of duodenal ulcer responsible for abscess].

The authors report a case of retroperitoneal perforation of a duodenal ulcer. This is a rare condition which is exceptionally responsible for abscess formation. If often has a poor prognosis. In the present case, the abscess was infrahepatic. The diagnosis of the origin of the abscess was established by radiological opacification via percutaneous puncture. Surgical drainage and irrigation performed via an extraperitoneal approach centered over the cavity, combined with triple-agent antibiotic therapy (penicillin, gentamicin, metronidazole) ensured collapse followed by sterilisation of the abscess cavity. The ulcer was cured by medical treatment. This case differs from the published case in terms of the diagnostic procedures classically used (upper gastrointestinal endoscopy and small bowel series), the infrahepatic site of the abscess and the extraperitoneal surgical treatment which avoided dissemination to the peritoneal cavity.

Abscess↗
PubMed1988

[Sarcomatous recurrence of leiomyoma of the inferior vena cava].

In a 63-year old woman, a surgically removed leiomyoma of the inferior vena cava recurred, 4 years later, as a leiomyosarcoma. These two smooth muscle tumours, one benign the other malignant, seldom involve the inferior vena cava. Both produce few clinical symptoms and therefore are belatedly diagnosed, except for suprarenal or retrohepatic lesions which rapidly exhibit signs of compression. Computerized tomography, angioscans and cavography are necessary to make a provisional diagnosis and determine the operative strategy. The differential diagnosis between leiomyoma and leiomyosarcoma rests on cellular or nuclear atypias, mitotic index and sometimes cytological and staining details showing the myofibril. These tumours develop slowly in the renal segment. Treatment is primarily surgical. The case reported here raises the problem of the leiomyoma-leiomyosarcoma sequence: are we confronted with degeneration, or is there such a thing as a smooth muscle fibre disease?

Diagnosis, Differential↗
PubMed1988

[Spontaneous hepatic hematoma during pregnancy].

Spontaneous hepatic haemorrhage is a rare complication in pregnancy. It usually occurs in multiparous women who have toxaemia of pregnancy. We give a case history of a primigravid patient who was not toxemic. The hepatic haemorrhage presented as blood in the peritoneal cavity which in turn gave rise to abdominal pain with hypovolaemic shock. The surgical treatment consisted in removing the segment of the liver that had been bleeding. The physiopathology of hepatic haemorrhage as described in the literature shows that there was evidence of consumptive coagulopathy with coalescence of periportal areas of liver necrosis. Treatment therefore is that of hepatic trauma. Maternal mortality runs at 70%.

Adult↗
PubMed1978

[Instrumental technics of exploration of the mediastinum].

Several techniques can be used for the diagnosing of diseases pertaining to the mediastinum. The diagnosis can be made in 78% of cases by mediastinoscopy. When the lesion is situated beyond the reach of mediastinoscopy, needle biopsy and pleuroscopy can be used either alone or associated to mediastinoscopy. The histological diagnosis can be made in almost all cases. But a few precautions are necessary because this technique carries a certain risk for vessels. Therefore preoperative angiography of the superior vena cava or arteriography of the branches of the aortic arch should be performed to help for the diagnosis and ensure its safety.

Biopsy, Needle↗
PubMed1978

[Role of surgery in the treatment of deep venous thrombosis of the lower limbs and prevention of pulmonary embolism].

Besides anticoagulants and thrombolytic drugs, surgery should be included among the therapeutical means to prevent deep phlebitis of the lower limbs. Early phlebography, thoroughly innocuous, is necessary to any coherent therapy. The prevention of pulmonary embolism which can be done by a ligature of the inferior vena cava or by the fitting of an umbrella-shaped filtre, is performed most of the time with a clamp of Adams and de Weese. Its reliability is satisfactory as the percentage of embolic recurrences does not exceed 5%. Early venous thrombectomy prevents in 60 to 80% of cases the post-phlebitic incidents; but its indication must be reserved to young patients.

Humans↗
PubMedDate not supplied

Specific receptors for 1,25-dihydroxyvitamin D3 (1,25-DR) and human colorectal carcinogenesis.

Because it is a common prerequisite for steroid responsiveness in target tissue, we investigated the presence of specific 1,25-DR in spontaneous human colorectal adenocarcinomas (ADC) and adjacent normal-appearing mucosa (NAM) from 23 operative specimens (12 male and 11 female patients). 1,25-DR was determined in cytosol by a DCC assay technique. 1,25-DR was present in 21 of 23 NAM and in only 4 of 23 HCRA. All positive ADC were well differentiated. Receptor content expressed in femtomoles/mg of protein (mean +/- SEM) was respectively 63.9 +/- 7.6 for right colon NAM and 51.3 +/- 12.9 for left colon or rectum NAM. When we compared all NAM specimens, receptor content was 56.7 +/- 8.0 femtomoles/mg of protein. No difference in 1,25-DR NAM level was observed between right colon and left colon or rectum. In adenocarcinoma the mean content was 66.5 +/- 14 fmoles/mg of protein. Scatchard analysis showed a single class of specific high-affinity saturable 1,25-DR with a dissociation constant (Kd) of 0.97 +/- 0.57 and 1.03 +/- 0.39 chi 10(-10) M in NAM and ADC respectively. These preliminary data represent the first demonstration of 1,25-DR throughout the entire human colon and indicate that the receptivity for this hormone is often lost during malignant transformation of the human colorectal mucosa. In addition, 1,25-DR could be a marker of differentiation in ADC. These preliminary results provide evidence supporting the addition of Vitamin D to the roster of developmental cancer chemopreventative agents.

Adenocarcinoma↗