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Biomedical subjects

M Cerf

Publications and source records attributed to M Cerf.

At least 37 records · Page 2Linked to original sources

[Hypergastrin and hyperprolactin syndrome caused by mucinous cystadenoma of the ovary].

We report a case of a clinically and biologically typical hypergastrinemia syndrome due to ovarian mucinous cystadenoma. When examined under histoimmunofluorescence, this "border-line" tumor was shown to contain a polymorphous endocrine cell proliferation, composed primarily of G cells and, to some degree, of D cells. Electron microscopic study further evidenced a small amount of prolactin containing cells, which coincided with elevated prolactin-levels in blood. Ovariectomy combined with vagotomy and pyloroplasty resulted in a prompt disappearance of both clinical and biological abnormalities. Ovarian mucinous cystadenomas have been known for a long time to contain endocrine cells, but only five cases, including the present one, have been described with fully developed endocrine expression. We suggest that this particular condition could be more frequent than generally admitted, and could justify systematic screening for mucinous cystadenoma in the case of peptide hormone dysfunction.

Adult

Chylous ascites and encapsulating peritonitis: unusual complications of spontaneous bacterial peritonitis.

Spontaneous bacterial peritonitis was diagnosed in a 36-yr-old woman 3 wk after she had delivered. The patient had no past history of abdominal or pelvic disease. Ampicillin therapy was started and determined complete resolution of infectious manifestations. Ten days later, chylous ascites and chyluria were evidenced. Thereafter an ascitic effusion persisted for 2 months, when an occlusive syndrome developed, requiring emergency surgery. An encapsulating peritonitis was recognized, encasing small bowel loops, stomach and partially, pelvic organs. In this case, encapsulating peritonitis was most likely a consequence of simultaneous bacterial infection and transient lymphatic blockade. Both mechanisms should be considered in the development of this rare and usually unexplained disease.

Adult

[Malignant degeneration of Ménétrier disease].

Gastric cancer was found in a patient in whom Menetrier's disease had been diagnosed 18 months before. In Menetrier's disease, incidence of cancer is as high as 14% of cases. But in only 5 cases of literature including the present one, has the time sequence been clearly documented. Metachronous tumours may be found 1 to 5 years after giant hypertrophic gastritis has been diagnozed. Such data make medical management, including anti-secretory drugs and periodic endoscopic survey, hazardous. We suggest that in documented Menetrier's disease elective total gastrectomy should still be considered as a treatment of choice.

Adenocarcinoma

[Acute attacks of hepatic porphyria. Treatment with hematin. 5 cases].

The effectiveness of 2 hematins administered by intravenous infusion was compared in acute intermittent porphyria. Judging from subjective symptoms (abdominal pain), clinical improvement was complete and constant. There was a rapid decrease in urinary excretion of porphyrins precursors, with a clearer response of delta-aminolevulinic acid than of porphobilinogen. Urine levels of uroporphyrin often returned to normal after two infusions. The drugs were very well tolerated. Provided it is administered early, before neurological complications develop, treatment with hematin completely relieves abdominal symptoms and suppresses most of the biochemical changes associated with hepatic porphyria.

Acute Disease

Bacterial adhesion in human upper gastrointestinal tract.

Small bowel biopsy specimens were taken from 21 patients undergoing gastrointestinal endoscopy to detect a possible adhesion of bacteria to the mucous layer of the upper gastrointestinal tract. In 30 control biopsy specimens taken from 10 patients free from gastrointestinal pathology, no associated bacteria were found, whereas in 23 biopsy specimens taken from eight gastrectomized patients an associated bacterial flora including E. coli or Pseudomonas was grown. Bacterial adhesion was confirmed by means of transmission electron microscopy of the eight patients yielding positive cultures. Bacterial adhesion induced local alterations of the brush border membrane. These results suggest that adherent bacteria may be present in hypochlorhydric patients. Pathophysiologic consequences require further studies.

Bacterial Adhesion

[Hepatic involvement in the acquired immunodeficiency syndrome. Study of 20 cases].

Liver biopsies were systematically performed in 20 patients with evidence of an acquired immunodeficiency syndrome (18 with opportunistic infections, 9 with Kaposi's sarcoma). Hepatitis, related to hepatitis-B virus in 3 cases and to cytomegalovirus in 3 cases, was present in 6 of them. All patients had at least one of the three following lesions: non-specific portal inflammatory infiltration (6 cases), granulomatous lesions (12 cases), vascular abnormalities (12 cases). Among hepatic granulomatous lesions: 3 were due to acid-fast bacilli and 1 to Cryptococcus. Sinusoidal abnormality included proliferation of Küpffer cells (9 cases), sinusoidal dilatation (2 cases), peliosis (4 cases) and Kaposi's sarcoma (1 case). A relationship between these abnormalities cannot be excluded.

Acquired Immunodeficiency Syndrome