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Biomedical subjects

M J Payan

Publications and source records attributed to M J Payan.

At least 19 recordsLinked to original sources
PubMed2001

[Crohn's disease and small intestine adenocarcinoma].

INTRODUCTION: The relationship between digestive neoplasia and Crohn's disease remains debated but several cases of carcinoma have been reported in the past 10 years. EXEGESIS: We report two cases of intestinal adenocarcinoma found in young people. Patients were asymptomatic during 15 years after the diagnosis of inflammatory bowel disease and presented a sudden occlusive syndrome. Carcinoma was observed incidentally at gross examination, and histopathological study showed dysplasia adjacent to neoplasia. Despite adequate surgical resection, death occurred quickly. CONCLUSION: Crohn's carcinoma should be suspected in patients with long-standing disease, poor symptomatology, and stenosis. Intestinoscopy surveillance remains illusory because inflammatory stenosis is often present and infiltrative neoplasia is invisible. Thus, it is important to be vigilant in this clinical presentation.

Adenocarcinoma↗
PubMed2001

Intraductal papillary or mucinous tumors (IPMT) of the pancreas: report of a case series and review of the literature.

OBJECTIVE: Despite a better understanding of these conditions, intraductal papillary or mucinous tumors (IPMT) of the pancreas still present difficulty relating to the predictive factors of malignancy and the risk of relapse after surgical resection. The aim of this study was to report on our experience and to compare it to previously published cases. METHODS: We studied retrospectively 26 patients (mean age 60.3 yr) presenting with IPMT. Of the 26 patients, 19 had surgical resection and seven did not. The main clinical feature was acute pancreatitis occurring in 38% of the patients. Segmental pancreatectomy was performed in all the cases. At pathological assessment of resection margins, tumor resection was considered as complete in 17 cases. Margins exhibited benign mucinous involvement, and resection was considered to be incomplete in one multifocal case and in one case with diffuse spread of the tumor. RESULTS: A total of 11 tumors were benign and five were malignant. Carcinomas were invasive in four cases (two invading the pancreatic parenchyma, one the duodenum, and one the peripancreatic nodes) and in situ in one case. Malignancy was not diagnosed preoperatively except when invasion was evident (duodenal spread). Although main pancreatic duct type and obstructive jaundice appeared as suggestive features for the risk of malignancy, no reliable preoperative predictive factors for malignancy could be identified as regarding to clinical parameters, biological examinations, carcinoembryonic antigen or CA19-9 levels in serum or in pure pancreatic juice, imaging, and cytological methods. Within 40.8 months mean follow-up after surgery (range 2-96 months), three patients (16%), two with malignant and one with benign tumor, had tumor relapse after respectively 7, 27, and 14 months. Margins were positive without malignant features in the two malignant cases and negative in the other case. Tumor relapse was malignant with diffuse spreading in the three cases, and the patients died within 34 months after surgical resection. CONCLUSIONS: Our series and the review of the literature indicate that preoperative indicators of malignancy in IPMT are still lacking. Concerning resection margins, complete tumor resection is usually possible by segmental pancreatectomy. Malignant relapses are not exceptional. Incomplete resection and diffuse or multifocal tumor represent poor prognostic factors. Total pancreatectomy should be considered in such cases.

Adenocarcinoma, Mucinous↗
PubMed1999

[Lymphocytic colitis and Gougerot-Sjögren syndrome. Report of two cases].

INTRODUCTION: Microscopic colitis describes a subset of patients with chronic watery diarrhea of unknown origin, and normal endoscopic findings and microscopic evidence of an inflammatory infiltrate in the colonic mucosa. We report two cases associated with sicca syndrome. EXEGESIS: A 56-year-old woman and a 76-year-old man presented with a history of lymphocytic colitis associated with sicca syndrome. Drugs or infectious agents were not implicated in the cause of lymphocytic colitis, suggesting that sicca syndrome may be involved in the pathogenesis of microscopic colitis. CONCLUSION: These cases suggest that sicca syndrome should be detected in patients with lymphocytic colitis.

Aged↗
PubMed1999

Aggressive form of pleural epithelioid haemangioendothelioma: complete response after chemotherapy.

Epithelioid haemangioendotheliomas are rare tumours of endothelial origin. They can develop in any tissue but occur principally in the lung and liver. Their usual course is a slow progression, so that they can be treated by surgery. In aggressive forms, no treatment has proved efficient to date. This study, describes a case of bilateral pleural epithelioid haemangioendothelioma that extended to the peritoneum. The histological diagnosis was confirmed by both conventional examination and immunohistochemistry. After six courses of carboplatine plus etoposide, a complete response was obtained. The complete remission is still lasting at 18 months after the diagnosis and the patient is healthy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1999

Differential MUC 1 expression in normal and neoplastic human pancreatic tissue. An immunohistochemical study of 60 samples.

Neoplastic transformation of epithelial cell sis commonly associated with altered synthesis of mucin glycoproteins. Few studies have been performed on the correlation between MUC 1 expression and pancreatic carcinoma using immunohistochemical methods. We compared the patterns of MUC 1 expression in normal pancreatic tissue, in pancreatic carcinoma, and in chronic pancreatitis. Immunohistochemical studies were performed using 3 monoclonal anti-MUC 1 antibodies (12C10, 1G5, and H23) on surgical specimens and on fine-needle aspiration biopsy specimens. In the neoplastic cells from adenocarcinomas, high levels of cytoplasmic MUC 1 expression were observed, with some membrane staining. No such cytoplasmic expression was observed in normal tissue, tissue from chronic pancreatitis, or benign neoplastic tissue. These data show conspicuous quantitative and qualitative differences between the patterns of MUC 1 expression observed in nonmalignant vs malignant pancreatic tissue and may be useful in the histologic diagnosis of adenocarcinoma in biopsy samples.

Antibodies, Monoclonal↗
PubMed1997

Increased levels of soluble adhesion molecules in the serum of patients with hepatitis C. Correlation with cytokine concentrations and liver inflammation and fibrosis.

Lymphocyte adhesion to endothelium, extravasation, and adhesion to hepatocytes are mediated by adhesion molecules and constitute important steps in the liver inflammation due to chronic hepatitis C (HCV-CH). We measured soluble intercellular adhesion molecule (sICAM-1, sCD54), vascular cell adhesion molecule (sVCAM-1, sCD106), E-selectin (sCD62E), as well as interleukin (IL)-1 beta, IL-8, and tumor necrosis factor-alpha (TNF-alpha) concentrations in the serum of 22 patients with HCV-CH in comparison to 20 seronegative healthy volunteers. sICAM-1, sVCAM-1, sCD62E, TNF-alpha, and IL-8 but not IL-1 beta concentrations were significantly elevated in patients. sICAM-1 and sCD62E correlated with TNF-alpha and aspartate amino transferases levels. sICAM-1 correlated with liver lobular inflammation whereas sVCAM-1, sCD62E, and IL-8 correlated with liver fibrosis. Measurement of soluble adhesion molecules may be an easy way to follow liver inflammation and fibrosis during HCV-CH.

Adult↗
PubMed1996

[Entero-mesenteric infarction: diagnostic and predictive criteria of severity. Therapeutic implications. Multifactor prospective study of a series of 61 cases].

The study includes a group of 61 patients (31 males, 30 females), mean age 72 +/- 13 years with entero-mesenteric ischemia. The authors studied prospectively clinical, biological and radiological parameters in order to reinforce the diagnostic of the disease. Correlations between these parameters and peroperative findings and anatomopathology after resection were able to point out factors of severity. These factors should have a therapeutic incidence in order to improve the outcome usely bad.

Adult↗
PubMed1996

[Pancreatic and duodenal somatostatinoma. Two clinico-pathologic entities].

Somatostatinomas are endocrine tumors with predominant secretion of somatostatin. The majority occur in the pancreas and the duodenum. However, distinctive clinico-pathologic features are reported for both of them. The features of pancreatic somatostatinomas are a larger size, a more frequent clinical expression, a female predominance and a poorer prognosis. Duodenal somatostatinomas are characterized by psammoma bodies at histologic examination. We report here two cases of pancreatic and ampullary somatostatinomas, focusing on the main diagnostic problems and on the characteristics of each tumoral localization.

Aged↗
PubMed1995

Pulmonary fibrosis correlates with outcome in adult respiratory distress syndrome. A study in mechanically ventilated patients.

STUDY OBJECTIVE: The present study was carried out to evaluate the prognostic value of pulmonary fibrosis diagnosed on the basis of pulmonary samples obtained by fiberscopic transbronchial lung biopsy (TBLB) in patients treated for severe established adult respiratory distress syndrome (ARDS). DESIGN: Prospective cohort study. SETTING: Intensive Care Unit of a University Hospital. PATIENTS: Consecutive patients with a diagnosis of established ARDS. INTERVENTIONS: Samples of pulmonary tissue (3 to 6 in each patient) were obtained by fiberoptic TBLB. Severity of pulmonary fibrosis was assessed based on pathologic changes. Hematoxylin and eosin and Masson's trichrome stains were performed on each tissue sample. MAIN RESULTS: Twenty-two lung specimens were obtained from 25 consecutive patients with ARDS of various origin (postsurgical complications, 7 patients; multiple trauma, 8 patients; medical problems, 7 patients). Transbronchial lung biopsy was complicated by small or moderate hemorrhage in three patients. No case of pneumothorax was identified. Pathologic findings showed that 14 patients (64%) had pulmonary fibrosis, either mild (9 patients) or moderate to severe fibrosis (5 patients). In the patients with pulmonary fibrosis, mortality rate was 57% (8 out of 14 patients), which was significantly different (p < 0.02) from the 0% mortality rate observed in patients without pulmonary fibrosis. Severity of pulmonary fibrosis (mild vs moderate and severe) did not influence outcome. With the exception of pathologic findings, characteristics of patients with and without pulmonary fibrosis (PaO2, PaCO2, the ratio of PaO2 to fraction of inspired oxygen, and positive end-expiratory pressure) were not different. CONCLUSION: In the study patients, pulmonary fibrosis diagnosed on the basis of TBLB was closely related to fatality in established ARDS.

Adult↗