Biomedical subjects
Publications and source records attributed to P Knobel.
Eosinophilic gastroenteritis is a rare lesion that may present a diagnostic problem to the surgeon. It may be confused with a malignant tumor because it often presents with intestinal obstruction. We treated two cases at the Hôpital de zone de Morges. In one case the lesion was in the gastric antrum and in the other the ascending colon. Only 27 cases of colonic eosinophilic gastritis are described in the medical literature.
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This report describes the clinicopathologic features of a 49-year-old woman who was reoperated on for bulky abdominal metastases 20 years after hysterectomy for endometrial stromal myosis (ESM). The levels of estrogen (ER) and progesterone (PR) receptors measured in the resected tumorous tissue amounted to 48.3 and 71.4 femtomoles (fmol)/mg cytosol protein, respectively. After medroxyprogesterone acetate (Depo-Provera; Upjohn) treatment of 16 months duration, the unresected pelvic tumor mass compressing the bladder and the left ureter had decreased in volume and hydroureteronephrosis had regressed. The efficacy of the therapy was monitored by computed tomography. Two years and nine months after surgery, the evolution of the tumor seems well-controlled by continuous progestin therapy and the patient is living without symptoms.
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Thirteen cases of crural or, less often, lumbar plexus neuropathies are reported which were secondary to hematomas in patients under anticoagulant therapy. They are the most frequent peripheral neurological complications of anticoagulant therapy. The clinical symptoms, which often point directly to the diagnosis, are discussed and several additional investigations (conventional X-ray, transverse tomography, EMG, etc.) are presented. The criteria for prognosis and therapeutic problems, in particular the indication for surgical drainage of the hematoma or for neurolysis, are discussed. Finally, the pathogenic mechanisms of these neuropathies are outlined.
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A report is presented on the findings in what is to our knowledge the first described case of glomerulonephritis resulting from Haemophilus aphrophilus endocarditis. After an insidious onset, serious renal failure developed which subsided with antibiotic therapy. Cardiac damage was minimal and the patient recovered his usual state of health, an outcome which has not been so satisfactory in other reported cases of endocarditis due to Haemophilus aphrophilus. The case is discussed with reference to the clinical course of the disease and the microbiologic properties of Haemophilus aphrophilus.
A 65 year old man developed endocarditis and septicemia due to Hemophilus aphrophilus, a Gram-negative coccobacillus. Renal rather than cardiac failure was the principal feature of his illness and renal biopsy was compatible with glomerulonephritis secondary to septicemia. Rapid recovery of renal function and improvement of the glomerular lesion followed antibiotic treatment of the septicemia. This case illustrates the renal damage that can occur in association with septicemia due to rarer infectious agents. As with more common organisms, specific antimicrobial therapy leads to rapid improvement of the nephropathy.
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