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R Choux

Publications and source records attributed to R Choux.

At least 55 records · Page 3Linked to original sources
PubMed1989

An exceptional 18-year follow-up after cardiac transplantation. How can malignancies occur during immunosuppressive therapy?

The present report considers the autopsic study of an homograft recipient who had been living for 18.5 years after a cardiac transplantation. The patient was treated by immunosuppressive therapy associating azathioprine and steroids. During the exceptionally long follow-up, two skin carcinomas and a lung carcinoma occurred successively. In addition, the autopsy allowed observation of a kidney adenocarcinoma associated to a polycystic disease, and a liver regenerative nodular hyperplasia containing several areas of severe dysplasia. These findings, when compared with those usually observed in immunodeficient patients, suggested the possibility that long-term immunosuppressive therapy may give rise to malignancies other than those arising after a short therapy.

Adenocarcinoma, Papillary↗
PubMed1989

Mucinous pancreatic duct ectasia in the body of the pancreas.

The authors describe one case of mucinous pancreatic duct cancer (ductectatic cystadenocarcinoma). This disease is characterized by dilatation, with mucoid secretion, in side branches of the main pancreatic duct. Unlike in other reported cases in which mean age of the patients is over 57 years, this case involved a young woman (aged 30 years), and the lesion was located in the body of the pancreas rather than in the uncinate process. Malignant transformation was noted.

Adult↗
PubMed1989

Cytochemical demonstration of glucose-6-phosphatase in human liver.

To determine the cytochemical localization of glucose-6-phosphatase in the human hepatocyte, lead - based and cerium - based media were used. By studying the effects of systematic variation of the incubation medium components, the optimal experimental conditions were determined. The exclusive localization of the cytochemical reaction in the endoplasmic reticulum and nuclear envelope, together with the results of control experiments ensured that these findings could be correlated with the phosphohydrolase activity of the multicomponent glucose-6-phosphatase system.

Cerium↗
PubMed1989

[Experimental study of the pleural effects of the pulverization, under thoracoscopic control, of a fibrin glue (Tissucol)].

The instillation of a fibrin sealant (Tissucol) has been proposed in the treatment of recurrent spontaneous pneumothorax. The present work is devoted to an experimental study in the dog of the effects of this substance on the pleural cavity one and two weeks after instillation under thoracoscopic control. Its action is compared to that of placebo (methylene blue). The instillation of a placebo (n = 5) did not alter the ventilatory mechanics or the structure of the pleura. On the other hand Tissucol (n = 6) led to a fall in the thoraco-pulmonary compliance (-14%), corresponding to that of the vital capacity (-10%). In these animals, no pleural symphysis was noted, but the histological analysis gave evidence of changes in the layers of the parietal and visceral pleura: an inflammatory mononuclear reaction (71% of cases) and/or polymorphonuclear (54%), recent fibrosis (67%) and more rarely a mesothelial hyperplasia (21%). The maintenance of the integrity of the mesothelial cellular layer would explain the absence of pleural symphysis after instillation of Tissucol. These results as well as those recently obtained in the human situation prompt us to advise other methods of pleural symphysis which have been tried and tested, such as talcage or surgery.

Animals↗
PubMed1989

[Clinical history and anatomic findings following the longest survival after cardiac transplantation].

The authors report the case history of the first patient in the world to have survived 18 and a half years with a heart transplant. This survival was marked by several episodes of rejection during the early years and various other incidents. The pathology encountered was primarily iatrogenic: diffuse osteoporosis sometimes limited the patient's activity. Two skin cancers and a lung cancer were diagnosed and treated. The patient died from progressive respiratory failure with pulmonary hypertension and signs of right ventricular failure. Pathological examination revealed a subnormal myocardium with a certain amount of overloading of the coronary arteries, confirmed the lung cancer and pulmonary hypertension and, most importantly, revealed the presence of nodular regenerative hepatic cirrhosis responsible for ascites during the last few months of life and a renal adenocarcinoma. These last two lesions are observed in immunosuppressed patients. The authors pay tribute to this patient who led an active and devoted life in the service of others.

Carcinoma, Bronchogenic↗
PubMed1989

[Giant leiomyoma of the inferior vena cava].

The authors report an uncommon case of giant leiomyoma of the inferior vena cava with intracardiac extension and arising from the external iliac vena. This case report illustrates the diagnostical problems usually encountered with this type of tumour. Indeed, despite ultrasound and transverse CT scan, the diagnosis was only assessed by histopathological analysis following a successful surgical removal of the leiomyoma. Only 7 cases of leiomyoma of the inferior vena cava are already reported in the literature. Relationship with intravenous leiomyomatosis of the uterus is also discussed.

Aged↗
PubMed1989

[Ultrastructural study of the liver in Niemann-Pick disease type C].

The authors report an electron microscopic study of the liver in a case of Niemann-Pick disease type C. The diagnosis was supported by clinical data, moderate increase of phospholipids, total cholesterol, leukocytes and liver sphingomyelin and sphingomyelinase activity. Intrasinusoidal liver foamy histiocytes were filled with lamellar and multivesicular inclusions similar to those observed in sphingomyelinase deficient patients. Hepatocytes contained a few non-specific lamellar inclusions occasionally associated with triglycerides and cholesterol crystals. These results are discussed with reference to the recent biochemical findings supporting the evidence of excessive accumulation of unesterified cholesterol in Niemann-Pick disease type C.

Humans↗
PubMed1988

Chronic obstructive pancreatitis due to tiny (0.6 to 8 mm) benign tumors obstructing pancreatic ducts: report of three cases.

Three cases of obstructive pancreatitis are described in nonalcoholic women aged 56 to 58 years with a 2-month to 5-year history of recurrent attacks of pancreatic pain associated with intermittent raised serum pancreatic enzymes. The diagnosis was made by sonography showing an enlarged hyperechogenic tail of the pancreas, with a dilated duct, the rest of the pancreas being normal, and by ERCP showing a partial stenosis of the main pancreatic duct with regular dilatation of collateral branches distally to it. Surgical resection of the pancreatic tail cured all three patients. In the obstructed part of the pancreas, the lesions are typical of obstructive pancreatitis with perilobular and sometimes intralobular fibrosis of the same degree in the different lobules of the diseased area and not patchy as in chronic calcifying pancreatitis. The changes in collateral ducts are not marked, and there is an absence of intraductal plugs. Fat necrosis and pseudocysts may be found. Tumors responsible for the obstruction were the smallest islet cell tumors (0.6 and 8 mm) and serous cystadenoma (5 mm) responsible for symptoms ever published. Cephalad to the stricture, the pancreas was normal. When the etiology of chronic pancreatitis is atypical, especially when it occurs in nonalcoholic women aged greater than 50 years, a careful sonography (or computed tomographic scan) and ERCP must be done. Serial sections of the resected pancreas at the level of the obstruction and distal to it are often necessary to demonstrate the tumor.

Adenoma, Islet Cell↗
PubMed1988

[18 and one-half years' survival after cardiac graft. Clinical course and anatomical findings].

Operated upon in November, 1968, the last survivor of heart transplant recipients in those times has died on May 11, 1987, having survived 18 years and 6 months. The active life of this patient, however, was marred by episodes of graft rejection during the first post-operative years and by various incidents. It was mainly the complications of the immunosuppressive treatment that hampered his activities (osteoporosis) and provoked his death. Post-mortem examination confirmed that the heart was in good condition, found an active bronchial epithelioma and revealed iatrogenic lesions, namely adenomas, adenocarcinoma of the kidney and "regenerative" nodular hyperplasia of the liver with portal hypertension. Such lesions are observed in patients under long-term treatment with immunosuppressants. A "sleep apnoea" syndrome might have accounted for the formation of pulmonary hypertension lesions. The authors wish to pay their respects to this man who devoted himself to the service of other men.

Endomyocardial Fibrosis↗
PubMed1988

Dissolving agents of human mixed cholesterol stones.

Methyl tert-butyl ether which is a powerful cholesterol monohydrate solvent does not completely dissolve mixed cholesterol gallstones when directly infused into the biliary tree. In this work, we compared the effect of various solvents containing different proportions of methyl tert-butyl ether and dimethylsulfoxide in anhydrous and aqueous systems on the in vitro solubilization of human cholesterol stones. The dissolution rates of cholesterol obtained in the presence of methyl tert-butyl ether was markedly decreased when 10 p. 100 water was added. In contrast, the addition of dimethylsulfoxide (30 p. 100) to methyl tert-butyl ether-water system enhanced the stone-solvent contact, improved the cholesterol dissolution rates and left less stone debris. A subsequent dissolution with an alkaline, pH = 8.8, aqueous dimethylsulfoxide-ethylenediaminetetraacetic acid solution strongly reduced the non cholesterol residues. In vivo, nearly complete dissolution of human cholesterol stones implanted in the gallbladder of rabbits was obtained within 8 hours when methyl tert-butyl ether/dimethylsulfoxide (70/30) solvent was infused at a rate of 0.6 ml/h/kg. With methyl tert-butyl ether, only 84 p. 100 of the original stone weight was dissolved. The infusion of these solvents leads to morphological changes in the gallbladder wall with some focal ulcerations. These alterations can be almost completely recovered after two weeks. No histologic evidence of hepatic, duodenal or renal damage was found. We conclude that the mixture methyl tert-butyl ether/dimethylsulfoxide (70/30) constitutes a good solvent for mixed cholesterol stones. Compared with pure methyl tert-butyl ether, the mixed system allows for a more rapid and a more complete dissolution of gallstones.

Animals↗
PubMed1987

Chronic obstructive pancreatitis, nesidioblastosis, and small endocrine pancreatic tumor.

A patient is described in whom a small 0.8-mm-diameter endocrine tumor was found in association with localized pancreatitis, stricture of the main pancreatic duct, and nesidioblastosis. The endocrine tumor, localized 7 mm from the main duct, obstructed a collateral pancreatic duct and four of its branches. Pancreatitis was localized into two areas. It was fairly severe in a small area of the body drained by the obstructed collateral duct and extended around it, reaching the main pancreatic duct which was partly occluded at this level by periductal fibrosis. Pancreatitis was mild in the left part of the pancreas distally from the incomplete stricture of the main duct. The head and body of the pancreas between the stricture and the duodenum were normal. Nesidioblastosis was present in the obstructed parts of the pancreas. It is suggested that the tumor could have caused pancreatitis, stenosis of the main duct, and nesidioblastosis.

Chronic Disease↗
PubMed1987

Sequential connective matrix changes in experimental acute pancreatitis. An immunohistochemical and biochemical assessment in the rat.

The effects of acute pancreatitis on the rat pancreatic connective tissue matrix were studied following intraductal pancreatic injection of trypsin solution and serial killing of the animals. Pancreatic tissue was examined using light microscopy, hydroxyproline measurement and indirect immunofluorescence, using antibodies against collagen types I, III, IV, procollagen III, fibronectin and laminin. Light microscopy revealed that acute pancreatitis was present for up to four days after injection and that perilobular and intralobular fibrosis appeared at four days and subsequently regressed. Immunofluorescence studies demonstrated an abnormal fibronectin deposit at one day in acute pancreatitis. At four days this deposit was co-located with fibrosis which was composed of collagen and procollagen type III. By eight days the immunofluorescence and light microscopic changes were minimal. Biochemical analysis confirmed a significant rise in hydroxyproline concentration at four days, which was maximal at eight days, subsequently decreasing. This peak at eight days probably reflects collagen breakdown products.

Acute Disease↗
PubMed1987

Biliary ascariasis combined with a villous tumor of the papilla. Diagnostic and therapeutic value of endoscopy.

A 64-year-old man admitted for cholangitis presented with an ascaris lumbricoides in the biliary duct and a villous tumor of the ampulla of Vater. ERCP revealed the parasite as a "rail-like" linear defect in the main bile duct, and permitted its extraction. The ampullary tumor was repeatedly ablated with a snare and finally surgically removed because of suspicion of malignancy. This is the first report on such an association.

Ampulla of Vater↗
PubMed1987

Pancreatic extracellular matrix alterations in chronic pancreatitis.

The proliferation of pancreatic extracellular matrix, which characterizes chronic pancreatitis, has been analysed using immunohistochemistry. The relationship of matrix components to intraductal precipitates and the presence of serum proteins in precipitates were also studied to investigate the suggestion that ductal permeability increases in chronic pancreatitis. Pancreatic tissue from organ donors was compared with that from patients with chronic calcifying or chronic obstructive pancreatitis. Frozen sections were labeled with monospecific antibodies to collagen types I, III, pro-III and IV, laminin, fibronectin, IgG, IgA, and IgM and then visualized by indirect immunofluorescence. In chronic pancreatitis, interstitial collagens and fibronectin appeared increased and disorganized in both fibrous tissue and areas that appeared histologically normal. Type IV collagen distribution was abnormal and in some sites was present with interstitial collagen. In addition, intraductal precipitates were shown to contain immunoglobulins, and defects were identified in the duct basal lamina associated with precipitates. These results demonstrate that in chronic pancreatitis interstitial collagens are extensively disorganized, the fibrosis possibly being relatively labile. The presence of serum proteins in intraductal precipitates confirms an increase in ductal permeability, and associated defects in the basal lamina appear to define a route via which serum proteins may enter the intraluminal compartment.

Adult↗
PubMed1987

[Fine-needle cyto-puncture. Apropos of 138 liver cytologies and 66 pancreas cytologies].

In this report, we examined the sensitivity and specificity of 138 hepatic and 66 pancreatic fine needle aspiration cytology. Aspiration cytodiagnosis was performed using a fine needle, percutaneously, with ultrasonic or tomodensitometric guidance. Sensitivity of hepatic and pancreatic aspiration cytodiagnosis was 86.73% et 83.3%; specificity was respectively 97.72% an 100%. These results are compared with literature review and confirm the interest of fine needle aspiration cytology in tumoral pathology.

Adenocarcinoma↗
PubMed1987

[Retro-pancreatic inflammatory pseudotumor].

The authors report a case of retro-pancreatic tumor in a 65 year-old man associated with impaired general condition. At gross examination by the surgeon, the pancreatic gland seemed to be enlarged. Histologic analysis found fibrous tissue and inflammation with lymphoid cells. The diagnosis of inflammatory pseudotumor was based on similar aspects found in some orbital lesions. The "tumor" disappeared under steroid therapy but recurred as soon as the treatment was stopped. Several etiologic factors related to the unusual location of the lesion were discussed.

Aged↗