Biomedical subjects
Publications and source records attributed to O Huber.
The authors report two cases of malignant thymoma, lymphoepithelial type, who metastatized quickly by hematogenous route, one of them to the small bowel. This is a rare evolution, whose incidence is discussed. Vascular invasions are described in the primitive tumor, which seem to have, when seen, a real importance to establish prognosis.
The actuarial survival of 253 primary bronchopulmonary cancer patients undergoing surgery in Geneva between 1967 and 1976 is studied. The overall post-surgical mortality was 9.88%. The overall survival after exclusion of patients without radical tumor excision was 26.6% at 5 years. The small size of the tumor, the absence of mediastinal extension and an epidermoid histology are the best survival rate factors: 43.2% of stage I patients survive at 5 years against 4.86% of stage III patients. The survival for asymptomatic tumors is 43.9% at 5 years. This suggests the importance of mass screening by radiophotography. Thus, surgery retains its central role in the treatment of this disease, whilst chemo-, radio- and immunotherapy have not yet realized their full potential.
Twenty-seven patients with SLE of juvenile onset were studies for 2 years. Episodes of active disease and quiescence were defined and were related to levels of anti-dsDNA and C3. Two methods for the detection of anti-dsDNA--the Farr assay and Cr immunofluorescence--were compared. The latter method was also used to differentiate anti-dsDNA according to its Ig class and its CF property. Positive tests for anti-dsDNA and low C3 levels were correlated with activity of the disease. Results with the Farr assay and Cr Ig test were comparable, but both low C3 and Cr CF anti-dsDNA showed a significantly stronger association (p less than 0.001) with active SLE than did DNA binding by the Farr method or Cr Ig anti-dsDNA. Furthermore, in six patients followed during active disease and remission, a negative Cr CF test was the earliest sign of ensuing clinical remission; DNA binding and C3 levels took weeks to months longer to normalize. This predictive value of CF anti-dsDNA may be useful in monitoring therapy for SLE, especially if symptoms due to prior renal damage may be confused with active disease as in lupus nephritis.
A case of double paramediastinal air cyst is described. The diagnosis is easy if the identity is known. Spontaneous regression was always the outcome in the cases published so far. No treatment is necessary. Radiologic examination should include only films of the chest and baryum swallow. The lesion must be recognised in order to avoid unnecessary diagnostic and therapeutic measures.
The genetic types of alpha1-antitrypsin (Pi types) were studied in 55 adults with classical or definite rheumatoid arthritis and 56 children with juvenile rheumatoid arthritis. A comparison was made with control groups of 211 healthy adults and 512 schoolchildren. Pi types MZ and SZ were significantly more prevalent in adults with rheumatoid arthritis than in the control adults. There was no difference between the patients with juvenile rheumatoid arthritis and the control children. Reduced concentrations of alpha1-antitrypsin, as associated with heterozygotes for the Z allele, may be a contributory factor to the development of rheumatoid arthritis or to the tissue destruction of rheumatoid arthritis.
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Explore the source record for details and available documents.
We have performed 33 pylorus-preserving duodenopancreatectomies. Twenty patients presented with severe chronic pancreatitis and 13 with periampullary adenocarcinoma. We have no postoperative mortality and a 24% rate of morbidity. Complications include anastomotic leaks (2), surgical bleeding (1), anastomotic ulceration (1), and others (4). We have complete follow-up for all cases. In the tumor group, 8 (62%) patients are alive with a mean survival time of 20 months (range: 2-46). In the pancreatitis series, all patients are alive after a mean of 34 months (range: 4-66). We have observed 5 cases (15%) of anastomotic ulcerations responsible for stenosis (2) and acute perforation with peritonitis (2) occurring after a mean interval of 18 months. Four cases have been confirmed histologically after resection. The short- and long-term beneficial effects of the pylorus-preserving operation on patient well-being and nutritional status were confirmed and compared with the results achieved after a Whipple procedure performed in a series of 18 consecutive patients.
The cellular homologues of the viral oncogene c-erbA encode for the nuclear thyroid hormone receptor c-erbA (TR). The gene for the human TR beta subtype is located on chromosome 3p24, and a loss of heterozygosity around this region has been reported in breast and small cell lung cancers, suggesting that TR beta might act as a tumor suppressor gene. In the present study, we used PCR-based restriction fragment length polymorphisms to examine the 3p24 region of 19 patients with gastrointestinal tumors for loss of heterozygosity (LOH). Interestingly, only 1 of the patients had an LOH at this locus, while 4 patients had a microdeletion of both alleles in the 3p24 region. These results suggest that, in contrast to previous reports on lung and breast cancers, a loss of heterozygosity of the TR locus at 3p24 is a rare event. A critical review of the literature, however, suggests, that some of the earlier studies have used markers whose location is only imprecisely mapped and may hence point to a tumor suppressor gene candidate other than TR beta. However, a selective microdeletion of both alleles was detected in the tumors of 4 of the 19 patients, indicating that this region on chromosome 3p may be genetically unstable in gastrointestinal tumors.
Hepatocellular carcinoma is one of the most frequent tumors worldwide, and its frequency is increasing. The management of hepatocellular carcinoma has changed in recent years, this because screening allows to discover tumors at an earlier stage, and because of effective treatments are available, such as liver transplantation, liver resection, percutaneous ablation and transarterial chemoembolization. Each one of these treatments has its own advantages and drawbacks, and range of application according to the stage of the tumor and of the underlying liver disease. This review summarizes the recent progress in the management of HCC and the practice in our unit.