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Biomedical subjects

P Modiano

Publications and source records attributed to P Modiano.

35 records · Page 2Linked to original sources
PubMed1996

[Bleomycin in Kaposi disease in a patient with heart transplantation].

INTRODUCTION: Kaposi's disease is increasingly frequent in transplant recipients. The therapeutic approach in heart transplantation is not fully established. CASE REPORT: A 61-year-old male transplant recipient (June 1992) presented Kaposi's disease on the legs. Immunosuppressive therapy was reduced, cyclosporin by 20 p. 100, withdrawal of azathioprine and 40 p. 100 reduction in prednisone was insufficient to control the disease. Due to the extension of the lesions and the major functional handicap, bleomycin was given and led to complete regression of the lesions within 6 months. DISCUSSION: This case illustrates the difficult therapeutic situation encountered in heart transplant recipients. The situation may be life-threatening with organ rejection. The first step is to reduce immunosuppressive therapy. If this is insufficient or the Kaposi is particularly aggressive, bleomycin may be used. The efficacy of bleomycin observed in our case requires confirmation in multicenter studies.

Antibiotics, Antineoplastic↗
PubMed1995

Acyclovir-resistant chronic cutaneous herpes simplex in Wiskott-Aldrich syndrome.

A 28-year-old man with Wiskott-Aldrich syndrome presented with ulcerative-proliferative lesions on his face from which herpes simplex type 1 (HSV-1) was isolated. He was initially treated with 10 mg/kg of acyclovir (Zovirax) intravenously every 8 h, but his skin lesions worsened. Clinical resistance to acyclovir was suspected, and therapy with this drug was intensified. The dosage of acyclovir was increased to 45 mg/kg, administered by continuous infusion, and the lesions subsequently resolved. The strain of HSV recovered from the patient showed acyclovir-resistance in vitro, using the colorimetric method with neutral red. Herpes simplex virus resistance to acyclovir is rare. It is more common in immunocompromised patients if subtherapeutic doses are administered in the treatment of chronic persistent forms of infection. Whenever clinical resistance to acyclovir is suspected, the dosage should be increased to 2 mg/kg per h administered via an infusion pump. If no improvement is observed in the patient's condition with this regimen, a phosphorylated medication whose mechanism of action is not dependent on viral thymidine kinase, such as foscarnet (phosphonoformic acid), should be substituted.

Acyclovir↗
PubMed1995

[Normolipemic plane xanthoma, monoclonal gammopathy, anti-lipoprotein activity, hypocomplementemia].

INTRODUCTION: Normolipaemic plane xanthomatosis is classically associated with a monoclonal gammapathy. CASE REPORT: We observed this association in a 69-year-old woman. This case was particular since anti-lipoprotein activity due to a monoclonal IgG immunoglobulin was found in the serum with abnormal complement fractions. The paraproteinaemia remained stable after a 2-year follow-up. CONCLUSION: This association is remarkable. The anti-lipoprotein activity of the monoclonal protein should be emphasized in light of the immunological processes involved in the pathogenesis of this association.

Aged↗
PubMed1994

Recurrent hemobilia after laparoscopic cholecystectomy.

Hemobilia occurred 1 month after a laparoscopic cholecystectomy, the result of an aneurysm of the right branch of the hepatic artery. The aneurysm was treated by selective arterial embolization. Recurrent bleeding 28 days later was treated by embolization with platinum coils. The mechanism of occurrence of the aneurysm and its treatment are discussed.

Adult↗
PubMed1989

[Massive hemobilia caused by erosion of the hepatic artery by cholelithiasis with cholecysto-duodenal fistula].

The authors present a case of gastrointestinal haemorrhage due to erosion of the hepatic artery by a gallstone trapped in the neck of the gallbladder. The unusual feature of this case resides in the exteriotisation of this haemorrhage via two anatomical routes: in the form of heamobilia via the common bile duct and in the form of gastrointestinal haemorrhage via a cholecysto-duodenal fistula. Haemostasis was achieved by ligation of the hepatic artery after failure of direct repair.

Aged↗
PubMed1986

[Treatment of anterior mitral valve prolapse by partial transposition of the posterior leaflet. Apropos of 7 cases].

Seven patients aged 8 to 62 years with massive mitral regurgitation due to anterior leaflet prolapse related to rupture or elongation of the chordae tendinae underwent reconstructive mitral valvuloplasty between June 1984 and September 1985, consisting in transposition of a bandlet of the posterior leaflet and its chordae to the free edge of the anterior leaflet. Medium term results with 2 to 16 months follow-up (average 8 months) showed all patients to have returned to Class I of the NYHA Classification; 5 patients had no systolic murmur, a mild systolic murmur 1 and 2/6 was present in 2 cases. The quality of the repair was confirmed by pulsed Doppler examination in all patients and by catheterisation and angiography in 3 cases. This surgical technique offers a good solution to the problem of mitral regurgitation due to severe prolapse of the anterior leaflet caused by rupture or elongation of the chordae tendinae.

Adolescent↗
PubMedDate not supplied

[An unusual complication of bronchitis: Sweet's syndrome].

Sweet's syndrome (acute febrile neutophilic deromatosis) is a rare but not exceptional disease. Its first description was done in 1964, and its diagnosis is now well defined. A few days after a common upper respiratory infection, out patient presented erythematous plaques on the head, neck and forearms, with fever and general malaise. A skin biopsy showed a neutrophilic infiltrate. Oral steroids were prescribed, and healing occured within 48 hours. Respiratory and gastointestinal infections are frequently associated with Sweet's syndrom. Other associations have been described: neoplasias (mainly hemoproliferative diseases), inflammatory diseases, pregnancy, drugs. Cases classified as 'idiopathic' need a close follow-up: Sweet's syndrome may announce a malignant disease. There are also intermediate forms with other neutrophilic dermatoses, e.g. pyoderma gangrenosum.

Anti-Inflammatory Agents↗
PubMedDate not supplied

[Rothmund-Thomson syndrome, trisomy 8 mosaicism and RECQ4 gene mutation].

BACKGROUND: We report a case of Rothmund-Thomson syndrome associated with a trisomy 8 mosaicism, and RECQ4 gene mutation. OBSERVATION: An 18-year-old man presented with a poikiloderma affecting photoexposed areas and the buttocks. This lesions appeared during the first year of life and was secondly associated with alopecia, sparse body hair, keratosis, and warts. He also had proportional short stature, thumb and patella aplasia, particular facies, and plantar malformations. Cytogenetic studies evidenced chromosomal instability and trisomy 8 mosaicism. The DNA repair capacity was normal. A mutation in RECQ4 helicase gene was found. DISCUSSION: Rothmund-Thomson syndrome is a rare hereditary syndrome characterized by early onset of poikiloderma. Patients exhibit variable features including skeletal abnormalities, juvenile cataracts, photosensitivity, and a higher than expected incidence of cutaneous or extracutaneous malignancies. Genetic patterns found in Rothmund-Thomson syndrome are heterogeneous. Normal karyotypes have been demonstrated in many patients. Various karyotypic abnormalities or reduced DNA repair was seen in others. Recently, five patients with Rothmund-Thomson syndrome were shown to segregate for mutations in RECQ4 helicase gene. Thus, clinical and genetic features in Rothmund-Thomson syndrome are polymorphous. Therefore, it could be interesting to correlate genotype and phenotype.

Abnormalities, Multiple↗