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Biomedical subjects

P Paliard

Publications and source records attributed to P Paliard.

At least 19 recordsLinked to original sources
PubMed1992

Liver transplantation for erythropoietic protoporphyria. Report of a new case with subsequent medium-term follow-up.

We report a new case of successful liver transplantation in a 36-year-old patient with terminal hepatic failure due to erythropoietic protoporphyria. Data regarding protoporphyrin levels in erythrocytes and feces, before and after transplantation, seem to indicate that in this case protoporphyrin overproduction was in part due to liver synthesis. Four years after surgery, the patient is completely free of skin photosensitivity. His liver function tests are normal; there are no visible protoporphyrin deposits or ultrastructural abnormalities in his new liver. However, recurrence of the disease in the long term cannot be excluded, since erythrocyte protoporphyrin levels remained elevated after liver transplantation.

Adult↗
PubMed1991

[Hepatic resection for alveolar echinococcosis].

The authors report their experience with 20 patients who underwent liver resection for alveolar echinococcosis of the liver from June 1982 to March 1991. Resection was radical in 9 patients and non radical in 11 patients. The 9 patients treated by radical resection are alive. 8 patients are symptom-free and disease-free when one patient with a parasitic recurrence underwent another radical resection. Among the 11 patients treated by non radical resection, 4 of them died during the follow-up period, the cause of the death being related to the disease in 3 cases and non related in one case. When feasible, radical liver resection is the best form of therapy. When massive parasitic invasion precludes radical hepatectomy, non radical resection associated if necessary with percutaneous procedures should be considered before embarking on orthotopic liver transplantation.

Adult↗
PubMed1991

[Peliosis hepatis of late onset in a patient exposed to vinyl chloride and treated for hepatic angiosarcoma].

We report the case of a 45 year old man with asymptomatic hepatic angiosarcoma after professional exposure to vinyl chloride. Diagnosis was made with annual ultrasound examination during a medical surveillance program. Two years after surgical resection and adjuvant chemotherapy, hepatic recurrence was treated with radiation therapy and chemoembolization. A complete response was observed. Peliosis hepatis, confirmed by liver biopsy, occurred secondarily. Eight years after initial diagnosis, the patient was asymptomatic without recurrence of angiosarcoma. The difficulty of diagnosis of angiosarcoma at an early stage, therapy modalities, and the relation between peliosis, fibrosis, and angiosarcoma are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

Hepatocellular carcinoma: diagnosis by percutaneous fine needle biopsy.

One hundred fifty-nine cases of hepatocellular carcinomas (HCCs) were reviewed from a series of 1060 cases of percutaneous fine needle biopsies of the liver. The biopsies were performed under ultrasonic guidance using a 22-gauge needle with a beveled tip. Specimens were obtained from the lesion and from areas of normal-appearing liver for comparison. Two sets of slides were prepared for Papanicolaou and Giemsa staining. In 147 cases (92%), the diagnosis of malignancy was established. In 134 cases (84%), the specific diagnosis of HCC was made. Fifty-four percent of the HCCs were well differentiated without cytonuclear abnormalities. In these cases, the diagnosis was made by comparison of specimens from the tumor with those obtained from the normal liver. Thirty-seven percent of the HCC were moderately differentiated with cytonuclear abnormalities. Nine percent of the HCCs were poorly differentiated, and in these cases, identification of glycogen on periodate-Schiff's procedure staining permitted differentiation from a metastatic tumor. In 9 cases, the aspirate was inadequate: there was insufficient tissue in 3 cases and the lesion was missed in the 6 other cases. In 3 cases, a biopsy of normal liver was not obtained and the diagnosis of HCC could only be suspected. Significant bleeding after biopsy occurred in 4 of 1060 cases, all with HCC.

Biopsy, Needle↗
PubMed1988

[Outcome of patients after treatment of esophageal varices by endoscopic sclerotherapy].

One hundred and forty-one patients (100 males, mean age 56.8 +/- 11 years) with a previous bleeding episode from ruptured esophageal varices were followed prospectively after obliteration of varices by elective endoscopic sclerotherapy. Eighty two p. 100 had alcoholic cirrhosis, 30 p. 100 were Child Pugh class A, 60 p. 100 B, 10 p. 100 C. Median follow up period was 16 months. Endoscopic control was carried out on a three month schedule. Compliance was perfect in 81 p. 100 of cases. Recurrent varices developed in 58 patients within a mean (+/- SD) delay of 6.8 +/- 4.7 months. One to 2 sclerotherapy sessions were required to obliterate recurrent varices without serious complications. The frequency of variceal recurrence was significantly lower (p less than 0.001) in case of alcohol with arawal. Five patients (3.5 p. 100) presented a recurrence of variceal bleeding which was fatal in 3 cases. During the follow up period, there were 25 deaths (17.7 p. 100). Survival was significantly correlated to the Child Pugh class (p less than 0.02) and significantly increased in the group of patients who adhered to the protocol (p greater than 0.05). These results suggest that after obliteration of varices patients should be submitted to a trimestrial endoscopic control during the first year, the subsequent schedule being determined by the recurrence of varices during the first year. Endoscopic and clinical follow up of patients, which facilitates alcohol with arawal, could have a favorable effect on the course of hepatic disease.

Adult↗
PubMed1988

[Autoimmune hemolytic anemia during treatment with cyclosporin after liver transplantation].

Hemolytic anemia was observed in a 36 year-old liver transplant patient. The immunosuppressive regimen included cyclosporine A and prednisolone. Hemolysis appeared a few days after amoxicillin treatment. The presence of anti-D allo-antibodies, auto-antibodies active against erythrocytes, and an immuno-allergic phenomenon against erythrocytic membrane coated by cyclosporine was demonstrated. Increase of daily dose of prednisolone without modification of cyclosporine doses was followed by the disappearance of allo- and auto-sensitization. The role of amoxicillin in promoting these hemolytic phenomenons may be suggested.

Adult↗
PubMed1987

Obstructive jaundice by a dissecting aneurysm of celiac axis and hepatic artery.

We report a case of dissecting aneurysm of the celiac axis and hepatic artery resulting in obstructive jaundice. The aneurysm was demonstrated both by ultrasound and by angiography, but the associated aortic dissection was apparent only on CT scan. The patient was treated with percutaneous transhepatic biliary drainage, surgical exclusion of the aneurysm by ligation, and progressive dearterialization of the hepatic artery.

Aortic Dissection↗
PubMed1987

[Treatment of hepatic polycystosis by intracystic injection of alcohol].

Two patients with symptomatic polycystic liver disease were treated with aspiration and injection of alcohol into the cyst cavities. Only the cysts larger than three to five centimeters were treated. No complications were encountered. Transient pain was observed in one case. There was no recurrence of the treated cysts on follow-up examinations at five to 74 months. These results suggest that aspiration and injection of alcohol is an effective treatment for symptomatic polycystic liver disease.

Cysts↗
PubMed1986

Ultrasonically guided fine-needle biopsy in focal intrahepatic lesions: six years' experience.

We report the results of 322 ultrasonically guided percutaneous fine-needle biopsies of focal intrahepatic lesions. The technique is original in several respects; it is an aspiration of both the lesion and normal-looking liver, and it includes both cytology and histology when the tiny cores are obtained. Cytology included Papanicolaou and Giemsa staining and other special staining when necessary. Sensitivity was 88.6% and specificity was 100% in the diagnosis of malignancy. Out of 141 metastases, 14 false negatives, 5 misclassifications, and 122 correct diagnoses were obtained. Out of 69 hepatomas the correct diagnosis of malignancy was made in 63 patients and of these the correct classification in 49. Complications occurred in six patients and marked hemorrhage in four. This technique is a simple, accurate, safe method for the diagnosis of focal intrahepatic lesions.

Biopsy, Needle↗
PubMed1985

[Acute hepatitis caused by cyclofenil (Ondogyne). Apropos of 2 cases].

We report the cases of two adults suffering from acute hepatitis due to cyclofenil (Ondogyne), a drug proposed for the treatment of dysovulation and scleroderma. Hepatitis developed 30 and 102 days after the beginning of discontinuous administration of the drug. A challenge test was positive in both cases. The course of hepatitis was reversible after withdrawal of the drug. Hepatitis induced by cyclofenil is likely to be due to an hypersensitivity mechanism.

Acute Disease↗
PubMed1979

[Hepatitis: the problem of terminology (author's transl)].

Every case of hepatitis must be defined as far as possible on the basis of four reference criteria: aetiological, clinical presentation, histological and course. Each criterion offers information concerning the classification, severity and course of the disease. The use of these criteria makes it possible to avoid all errors of interpretation and to avoid imprecise terminology, a typical example of which is "subacute hepatitis" which for some implies severe acute hepatitis running a prolonged course and for others the existence of confluent necrosis without it being possible to say whether this should be classified amongst cases of acute hepatitis or chronic hepatitis. The terms acute and chronic should retain their clinical significance, the term aggressive should retain a histological significance and, insofar as the piecemeal necrosis which characterises it is seen in both types of hepatitis, it should be dissociated, in terms of classification, from chronic hepatitis.

Acute Disease↗