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Biomedical subjects

J F Legier

Publications and source records attributed to J F Legier.

12 recordsLinked to original sources
PubMed1994

Perforation of a Meckel's diverticulum caused by ingestion of a coin.

A 25-year-old woman ingested a quarter. Three days later, lower abdominal pain, fever, chills, and physical findings compatible with pelvic inflammatory disease developed. Radiographic examination showed the coin in the middle pelvis. Persistent abdominal complaints, abnormal physical examination, and failure of the coin to progress through the gastrointestinal tract despite conservative management led to surgical intervention. Exploration revealed an inflammatory process in the posterior uterine culde-sac with multiple omental, small bowel, and uterine adhesions due to perforation of a Meckel's diverticulum. Excision of the Meckel's diverticulum was done, and the patient recovered satisfactorily.

Adult↗
PubMed1993

Adult respiratory distress syndrome with or without systemic disease associated with infections due to Mycoplasma fermentans.

An unusual but typical clinicopathological presentation was noted among several groups of previously healthy, human immunodeficiency virus-negative patients who had an apparent fulminant infectious disease but had no etiologic agent identified. The clinical courses were characterized by rapid progression and development of adult respiratory distress syndrome with or without systemic disease. Histopathological changes in the diseases tissues (other than lung) obtained by biopsy or at autopsy ranged from extensive necrosis with only minimal inflammatory reaction to prominent lymphohistiocytic infiltrate with focal areas of acute inflammation. This report focuses on pulmonary changes in three patients. The alveolar epithelial (type I) cells and type II pneumocytes are diffusely damaged. There is interstitial edema and thickened septa. An eosinophilic alveolar membrane may form, and the alveolar space may fill with foamy macrophages. Immunohistochemical studies identified Mycoplasma fermentans infection in the patients' lungs and liver. Mycoplasma-like particles could also be identified by electron microscopy. There is a previously unrecognized form of fulminant disease in humans that is associated with M. fermentans infections.

Adult↗
PubMed1992

Traumatic seromuscular rupture of intestine.

A vehicular accident victim sustained multiple transverse split-thickness intestinal lacerations. This rare and distinctive seatbelt injury results from the impact of intestinal loops against the abdominal restraint, whereby the rigid muscle coat ruptures, while the integrity of inner layers is preserved.

Adult↗
PubMed1991

Streptococcus salivarius meningitis and colonic carcinoma.

Streptococcus salivarius caused fulminant meningitis in an elderly patient. A gastrointestinal diagnostic workup revealed an asymptomatic colonic adenocarcinoma. This first reported instance of S salivarius sepsis associated with a colonic neoplasm is not unexpected, since the organism is bacteriologically similar to S bovis, the prime bacterial indicator of occult malignancy. Exact speciation of streptococcal strains is fraught with technical difficulties, and gastrointestinal investigation may be warranted in an expanded variety of streptococcal infections.

Adenocarcinoma↗
PubMed1990

Malignant epithelioid pleural mesothelioma versus peripheral pulmonary adenocarcinoma: a histochemical, ultrastructural, and immunohistologic study of 103 cases.

The distinction between malignant epithelioid pleural mesothelioma (MEPM) and peripheral adenocarcinoma of the lung with pleural invasion (PAL) continues to represent a diagnostic challenge in selected cases. In order to provide comparative data on histologic, histochemical, and immunohistochemical features of these neoplasms, we analyzed 51 ultrastructurally categorized MEPMs and 52 PALs with the periodic acid-Schiff-diastase (PAS-D), mucicarmine, and colloidal iron stains, and a panel of immunohistologic reagents. Antibodies to cytokeratin, vimentin, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), Leu M1, the B72.3 antigen, blood group isoantigens (BGI), placental alkaline phosphatase, amylase, S100 protein, and Clara cell antigen were used, as applied to paraffin sections with the avidin-biotin-peroxidase complex technique. Ultrastructural studies revealed long, branching microvilli in MEPM cells in all cases, with length-to-diameter ratios (LDR) of 10:1 or more. In contrast, PAL manifested short, nonbranching microvilli with LDR of 8:1 or less. Reactivity with PAS-D and mucicarmine stains was strictly confined to PAL, and hyaluronidase-sensitive colloidal iron-positivity was restricted to MEPM. However, only 63% and 41% of these respective neoplasms demonstrated such histochemical reactivity. Immunohistologic results correlated well with electron microscopic classification. All MEPMs and PALs were reactive for cytokeratin; in addition, the majority of tumors in each group expressed EMA, and a minority were reactive for vimentin. In adenocarcinomas of the lung, Leu M1 was observed in all cases, CEA was apparent in 96%, B72.3 labeled 84%, and BGI were present in 67%; all PALs expressed at least two of these determinants, but none was seen in any mesothelioma. The other markers included in this study also were observed in some PAL cases, but not in MEPM. These findings suggest that immunohistology parallels electron microscopy in efficacy in the diagnostic separation of MEPM and PAL. Using antibodies to Leu M1, CEA, and the B72.3 antigen, reactivity for at least two of these three markers appears to exclude a diagnosis of pleural mesothelioma. The other glycoproteinaceous, oncoplacentofetal, and cytoplasmic antigens we studied can be used to reinforce such a determination, since their distribution is confined to adenocarcinomas.

Adenocarcinoma↗
PubMed1988

Flow cytometric analysis of ploidy in immunohistochemically confirmed examples of malignant epithelial mesothelioma.

Flow cytometry was used to compare the DNA content of 28 fresh effusion specimens that contained abundant proliferating mesothelial cells, with the ploidy profiles for 19 formalin-fixed, paraffin-embedded examples of malignant epithelial mesothelioma. Each mesothelioma lacked staining with periodic acid-Schiff (PAS) after diastase pretreatment. Nineteen of 19 mesotheliomas were immunoreactive for cytokeratin, 13 of 19 for epithelial membrane antigen, 0 of 19 for Leu-M1, and 0 of 19 for carcinoembryonic antigen. Each benign fluid specimen was DNA diploid. Nine of the deparaffinized mesotheliomas were DNA diploid, and seven had additional G0G1 peaks signifying DNA aneuploidy. Histograms from the remaining three mesotheliomas showed G0G1 peaks with prominent shoulders, probably indicating low-degree hyperdiploidy. The results suggest that ploidy analysis by flow cytometry might be useful for the separation of mesothelioma from proliferating mesothelial cells in effusion specimens. Although only 53% of the mesotheliomas were DNA aneuploid, the finding of DNA aneuploidy in an effusion specimen that contains atypical mesothelial cells would strongly support a diagnosis of mesothelioma.

Ascitic Fluid↗