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Biomedical subjects

P Jan

Publications and source records attributed to P Jan.

15 recordsLinked to original sources

AIDS wasting syndrome as an enterometabolic disorder: the gut hypothesis.

There is an interesting relationship between the HIV virus, the health of the gastrointestinal tract, and AIDS wasting syndrome, involving Tumor Necrosis Factor alpha (TNF alpha), specific and non-specific immunity in the gut, gut permeability, and oxidative stress. It is hypothesized that the progression of HIV to full-blown AIDS may be impacted by maintaining a healthy gut. A therapeutic protocol which decreases oxidative stress, inhibits TNF alpha, enhances phase I and II liver detoxification, and improves specific and non-specific immunity in the gut should be part of a therapeutic protocol for HIV-infected individuals. Through a better understanding of the pathophysiology of HIV advancing to AIDS, the practitioner can develop a treatment strategy of nutritional and lifestyle changes which could theoretically prevent an HIV infection from advancing to full-blown AIDS.

Acquired Immunodeficiency Syndrome↗

Solid malignant neoplasms after childhood irradiation: decrease of the relative risk with time after irradiation.

The pattern of the temporal distribution of solid cancer incidence after irradiation in childhood is not well known, although, its importance in radioprotection is well known. We studied a cohort of 1,055 children from 8 European cancer centres, who received radiotherapy between 1942 and 1985 for a first cancer in childhood. After a mean follow-up of 19 years, 26 children developed a solid second malignant neoplasm (SMN), as compared to 5.6 expected from general population rates. Both the excess relative risk and the excess of absolute risk of solid SMN were higher among children who were younger at time of the irradiation. After reaching a maximum 15 to 20 years after irradiation, the excess relative risk of SMN decreased with time after irradiation, when controlling for age at irradiation and sex. The analysis of the risk of thyroid, brain and breast cancer together, as a function of the dose averaged on these 3 organs lead to similar results.

Adolescent↗

[Contribution of expert systems in clinical practice: apropos of the Penelope experience, an expert system in assisted diagnosis and therapy of ovarian adenocarcinoma].

An expert system (ES) for Diagnosis and Therapy of ovarian adenocarcinoma has been developed at the Institut Gustave-Roussy. From surgical and histological results, clinical examination and additional investigative reports, the system presents a synthesis and then determines the stage of the disease. The system than proposes therapeutic indications adapted to the characteristics of the illness and of the patient, and edits a report at the end of the ES consultation. This experience allowed us to specify the field of ES applications in oncology. As tools for diagnosis and therapy, they cannot act as a substitute for the know-how of the physician, as too many medical decisions remain difficult to formalize in the ES. On the other hand the use of artificial intelligence techniques appears to be useful for establishing coherent data bases, which are necessary pre-requisites for clinical research in oncology. The integration of the system in the Hospital Information System is the guarantee of its use in current clinical practice.

Adenocarcinoma↗

Lactose and cataract in humans: a review.

In this review, the relationship between lactose and human cataract is examined from the presently available biochemical, metabolic, and epidemiological data. The exceptional cases of homozygous enzyme deficiency being excluded, fragmentary data give reason to believe that a risk of cataract secondary to lactose and galactose ingestion is present in certain subpopulations. In these population groups, the size of which is unknown, the lens could be exposed to intermittent episodes of hypergalactosemia due to the presence of a partial enzyme deficiency in the galactose metabolic pathway, and/or the persistence of a high adult jejunal lactase activity, and/or to a large and repeated consumption of either whole lactose or easily absorbed lactose (hydrolyzed forms and nonpasteurized yogurt).

Animals↗

[Diet therapy of hypercholesterolemia. From theory to practice].

Hypercholesterolemia, quite frequent in industrialized countries is a major risk factor of atherosclerosis, especially in the coronary arteries. Consensus conferences, in the United States as well as Europe, have established a practical approach to this field. The dietetic treatment, from a population standpoint, remains the corner-stone of the treatment of primary dyslipoproteinemias. The quality and quantity of lipids in the food, play a definite role. In order to lower cholesterolemia, the intake of total lipids and cholesterol must be lowered and the consumption of polyunsaturated or mono-unsaturated fatty acids must be increased. The advantage of fish (omega 3 fatty acid), soy-bean and food fibers, are discussed.

Dietary Carbohydrates↗

[Classification of primary dyslipoproteinemias].

The prevention of atherosclerosis implies a better knowledge of dyslipoproteinemias. The metabolic disease must first be defined before considering its treatment and evaluate the atherogenic risk. The clinician must take advantage of two different classifications. The WHO classification (WHO: World Health Organization) permits to consider six phenotypes (I, IIa, IIb, III, IV, V), according to the serum levels of cholesterol and triglycerides. The genetic classification permits to relate one or several genetic anomaly to these phenotypes. The main clinical and biological characteristics of primary dyslipoproteinemias are summarily reported.

Humans↗

[Impotence in the diabetic].

Two-hundred-and-two impotent diabetic patients gave their consent to be investigated. Impotence is linked to diabetes mellitus in 58.9% of patients so all the other etiologies have to be systematically eliminated. Neuropathy or arteriopathy, when isolated, are found with the same frequency, but these 2 etiologies are often associated (47 patients). No statistical difference between IDDM and NIDDM was found. Mercury strain gauge plethysmography and venous occlusion coupled to ECG allows detection of arterial lesions in diabetic impotence. Patients agreed to submit to all of the various therapeutic possibilities. Combination of alpha-blockade and good glycemic control induced the best results.

Adult↗

[Esophageal localization revealing Hodgkin's disease].

The authors report the case of a 28 year old man with Stage III E Hodgkin's disease presenting with massive upper oesophageal involvement with cervical and mediastinal lymphadenopathy. The diagnosis was confirmed by lymph node and endoscopic biopsies (mixed cellularity). A complete remission was obtained by chemotherapy (ABVD) followed by extended radiotherapy. Then other cases have been previously reported. Upper oesophageal involvement with mediastinal lymphadenopathy often occurring in young patients raises the differential diagnosis of a carcinoma. The efficacy of chemotherapy of first intention is underlined.

Adult↗

[Non-gynecologic fluid images of pelvis. Ultrasonic study].

From a series of 6,573 echographic surveys of pelvis in male and female, the authors point out 789 liquid images among them 82 are non gynecologic lesions. A statistical study of the different observed etiologies is proposed and compared with those of the literature. The main cases observed are gathered under several items: abscess, hematomas, urinary, digestive and vascular images and studied semiologically. The discussion points out the low frequency in opposition to the etiological diversity of this type of image and precise the diagnostic procedures rules which include other imaging methods especially computed tomography.

Abscess↗

[Polysplenia with duplication of the inferior vena cava. Apropos of a case].

A case of polysplenia fortuitously discovered in an adult by sonography, then studied by computed tomography and inferior vena cavography, is reported. In the absence of cardiac anomalies, the different elements of the syndrome are discussed: multiple spleens, abdominal heterotaxia and vascular malformations. The duplication of the inferior vena cava is exceptional in this disease. Its original characteristic is shown by the cavography and brought to its embryologic origin.

Aged↗

[Growth of the fetal kidney. Echographic study].

An echographic study of the fetal normal kidney in 274 fetuses (548 kidneys measured) from 15 to 40 weeks of pregnancy is proposed by the authors. This work includes morphologic and biometric study with the growth curves of 4 parameters. It is shown that both kidneys are morphologically similar and their growth is continuous and there is a constant ratio between the different parameters. Ratios are established: Length/BPD = 0,45 +/- 10%, Width/BPD = 0,27 +/- 10%, Thickness/BPD = 0,26 +/- 10% which are very useful for the echographist. One hopes that with morphologic and biometric criteria of normality, the early detection of urinary tract malformations will be easier.

Female↗

[A case of pseudocyst of adrenal gland (author's transl)].

A case of pseudocyst of adrenal gland is reported. The first findings have been acute pain and falling hematocrit. Then hepatomegaly is present. All the investigations--ultrasonography, radionuclidescan, arteriography--failed to demonstrate the origin and saided liver cyst. The diagnosis is operative. The pseudocyst hemorrhagic are 32% of adrenal cysts. We think the computer tomography will be an important contribution for the diagnosis of false hepatomegaly.

Adrenal Gland Diseases↗