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Biomedical subjects

B Gosselin

Publications and source records attributed to B Gosselin.

At least 145 records · Page 8Linked to original sources

[Reconstruction of the wall of the canal].

In "intact" canal wall tympanoplasty, recurrent disease and retraction pockets must be avoided by repair of attic or lateral defects. Between 1983 and 1986, the authors used septal cartilage homograft in 38 cases and mastoid bone autograft in 47 cases. The uniqueness of the last technique is the preservation of fibroperiosteum with the cortical bone shaving, allowing a good adaptability in the defect. Histologic studies, clinical follow up and operative evaluation in case of second look intervention allows discussion on advantages and disadvantages of the two materials. The tolerance is good. The two procedures are variable and reliable in 80% of cases.

Cartilage↗

[Morphologic diagnosis of pulmonary hemorrhage].

The gross and histologic morphologic features of early and advanced pulmonary hemorrhages are easy to recognize. Although there is no close correlation between the hemorrhagic appearance of the bronchoalveolar lavage fluid, the histologic features of hemorrhage, and the score of hemosiderin in alveolar macrophages, studies of bronchoalveolar lavage fluid samples are valuable for diagnosing and monitoring pulmonary hemorrhages.

Biopsy↗

Acute monoblastic leukemia with osteosclerosis and extensive myelofibrosis.

A 4-month-old infant was admitted with a monoblastic infiltration of the skin associated with osteosclerosis. Both lesions spontaneously disappeared within a few months, but 2 years later, a monoblastic leukemia occurred that was associated with marked skin erythema and myelofibrosis. Skin and bone marrow specimens showed a monoblastic infiltration with numerous intermingled mast cells of normal appearance. Whether myelofibrosis was a feature of a systemic mastocytosis or of the leukemic process is discussed in this case.

Humans↗

[Invasive thymoma with pulmonary metastasis. Complete remission 5 years after surgery and chemotherapy using the CHOP-BLEO protocol].

We report a case of invasive lympho-epithelial thymoma with pulmonary metastases, treated by complete macroscopic excision of primary tumour and then by chemotherapy using CHOP-BLEO. The epithelial nature of the tumour was confirmed by immunohistochemical studies. Chemotherapy enabled a complete and prolonged remission (greater than 63 months). Therapeutic trials of CHOP-BLEO merit further assessment and the results should be compared to the baseline treatment using platinum and prednisolone.

Adolescent↗

[Lympho-epithelial thymoma. Anatomo-clinical and therapeutic study of 113 cases].

One hundred and thirteen cases of lympho-epithelial thymomas were studied retrospectively: 56 were of epithelial type, 20 of lymphocytic type, 30 were mixed and 7 were not defined. Eighty-eight were operated on (20 stages I, 47 stages II, 13 stages III and 8 stages IV). There were 69 primary resections (57 complete and 12 incomplete), followed by radiotherapy in 54 cases and 19 secondary resections after radiotherapy (10 complete and 19 incomplete). Twenty-five patients did not have an operation and were treated with radio- and chemotherapy. After primary resection the actuarial survival at 5 years was 64.07% and at 10 years 50.86%. After a secondary resection it was 43.74% at 5 years. After radiotherapy it was 18.67% at 5 years. In operated cases the prognostic importance of staging was confirmed. The cytological structure was not. In myasthenic cases the secondary respiratory complications worsened the prognosis. Post-operative radiotherapy seems to be justified in all cases, but its effect is not statistically significant when resection was complete. Those operated after radiotherapy only showed a benefit if the resection was complete. The outcome of metastatic disease in TLE has been under-estimated and seems to depend on local control of the tumour. The use of chemotherapy remains to be defined.

Adolescent↗

[Lipoblastic liposarcoma of the lung. Ultrastructural study of a case].

A case of fatal lipoblastic pulmonary liposarcoma in a 20 year-old female is reported. A thoracotomy was performed but failed to yield the pathological diagnosis. This diagnosis was obtained by ultrastructural study of a cerebral metastasis. To our knowledge, only seven cases of pulmonary liposarcoma have been previously described in the literature and the lipoblastic aspect was never mentioned.

Adult↗

Subclinical lung inflammation in primary Sjögren's syndrome. Relationship between bronchoalveolar lavage cellular analysis findings and characteristics of the disease.

To directly evaluate whether a subclinical alveolar inflammation is associated with primary Sjögren's syndrome (SS), we evaluated the distribution of cells obtained by bronchoalveolar lavage (BAL) from the lower respiratory tract in 29 patients who had primary SS, but who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. There was no difference in total cell counts of specimens from patients versus those of controls. An abnormal differential cell count was noted in 16 patients (55%). Two patterns of alveolitis were observed: a pure lymphocyte alveolitis (greater than 18% lymphocytes, present in 11 patients) and a neutrophil alveolitis (greater than 4% neutrophils, present in 5 patients). There was associated lymphocytosis in 4 of the patients with neutrophil alveolitis. All patients had normal results on pulmonary function tests. Patients with abnormal BAL findings showed clinical and biologic indexes of more severe disease than did those with normal BAL results, as demonstrated by greater extraglandular extension of the disease, higher mean values of serum gamma globulins and serum beta2-microglobulin, and higher prevalence of rheumatoid factor and of antinuclear antibody. Thus, our data demonstrate that BAL permitted the detection of subclinical inflammatory alveolitis in 55% of our patients with primary SS. A long-term followup is required to determine whether these patients will develop obvious pulmonary involvement.

Adult↗

[Splenic complications of chronic pancreatitis. Clinical and experimental study].

Splenic complications of chronic pancreatitis appear to be less exceptional than is usually accepted, particularly since preoperative diagnosis has been facilitated by ultrasound and abdominal scan imaging. Complications noted in 37 cases were: infarcts (2 cases), hematoma or false blood cysts (26 cases) and rupture (9 cases). The splenic infarcts were revealed by digestive hemorrhage, the false blood cysts of spleen by a painful mass in left hypochondrium associated with pleural effusion and rupture of spleen by an acute hemoperitoneum. Treatment included splenectomy in 19 cases, splenectomy caudal pancreatectomy in 17 cases and drainage of a splenic hematoma in one patient. Operative mortality was 16.2% and the long-term prognosis was poor and related to underlying condition. Data from an experimental study suggest that the effect of an episode of acute pancreatitis on the splenic pedicle is the most important physiopathologic factor. A hemorrhagic infarct or infarction of splenic parenchyma are common starting points for all clinicopathologic forms described.

Animals↗

[Pure bronchial adenoma. Anatomico-clinical and ultrastructural study of a case].

We report a case of monomorphic bronchial cystadenoma (or mucous gland adenoma). This exceptional tumor (only 34 cases reported up to now) is benign, but a lobectomy is often necessary because of severe inflammatory lesions of the surrounding lung. Ultrastructurally it was different from the other tumors of bronchial glands, since it contained mucous cells, myoepithelial cells, and oncocytic cells, and the basement membrane was thickened.

Adenoma↗

[Value of x-ray computed tomography in assessing the extent of invasive lympho-epithelial thymoma in the adult. Therapeutic implications].

This study concerns 12 patients who were in hospital for the work-up and treatment of an invasive lympho-epithelial thymoma. The extent of the disease was studied by systemic computed tomographic (CT) scanning of the thorax and abdomen. Three patients out of nine examined presented initially with asymptomatic renal metastasis. Three patients were treated straight away by poly-chemotherapy; the nine others benefitted either from radiotherapy alone (four cases) or from radiotherapy associated with surgery (4 cases) or an isolated surgical exploration (1 case). CT examination was carried out in 11 patients 3 months after the beginning of treatment and 7 times clinically latent metastasis were rediscovered (renal, adrenal, hepatic, thyroid, cerebral and osseous). These 11 patients benefitted secondarily from polychemotherapy. The results confirm the gravity of the condition: only three patients are living and in complete remission with a follow up of 24 to 48 months. The frequency of latent metastasis, detected by CT scanning, during the course of a malignant thymoma justifies the systematic performance of this examination in the work up of the disease extent and therapeutic surveillance in these patients, and leads one to reconsider the place of chemotherapy in the therapeutic strategy of these tumours.

Adrenal Cortex Neoplasms↗

[Subacute pneumopathy caused by hydrochlorothiazide. Cytologic study of the broncho-alveolar lavage].

We report a case of diffuse interstitial pulmonary disease in a 73 year old woman treated for moderate hypertension for one year with the combination of hydrochlorothiazide (50 mg/day) and Amiloride (5 mg/day). The bronchoalveolar lavage showed a neutrophilia of 23% and a 5.5% eosinophilia. The absence of any other aetiological factor and the favourable outcome on cessation of the sole medication incriminate the latter as an aetiological agent in this interstitial pneumonitis.

Aged↗

[Opportunistic pneumopathy caused by Torulopsis glabrata].

Yeasts are taking a growing place in the development of opportunistic pneumonias in a hospital environment. We report a case of pneumonia due to Torulopsis glabrata in a patient of 58 years in complete remission from a malignant oesophageal tumour after surgery and radiotherapy, and not given immunosuppressive treatment.

Candidiasis↗

[Thoracic actinomycosis. Apropos of 5 cases].

Described for the first time by Bradshaw in 1846, actinomycosis is a rare, slowly progressing disease associated with the development of anaerobic bacteria of the Actinomyces genus. It predominates in males and is actively encouraged by poor buccal and dental hygiene and by overall decline of defence mechanisms. Thoracic lesions constitute 15 to 20% of the cases and seem to be relatively increasing. Apart from fistulization to the skin, physical examination usually does not show much; only the presence of yellow grains suggests the diagnosis. Radiography is often misleading, suggesting tuberculosis or cancer. Ultrasonography and, chiefly, computerized tomography are the best methods to evaluate the extension of the disease to the pleura, the chest wall and the mediastinum. The final diagnosis is more often supplied by pathological examination than by bacteriology, which is frequently negative. Treatment is facilitated by the fact that Actinomyces is sensitive to antibiotics, notably to penicillin which still is the first choice drug. A well-conducted treatment will give satisfactory results, but sequelae of retractile fibrosis may be disabling.

Actinomycosis↗

[Acute interstitial nephritis and uveitis in the adult: apropos of 3 cases].

Acute renal failure due to tubulo-interstitial nephritis accompanied by uveitis has been observed in 3 young women (TINU syndrome). In these 3 cases, the nephropathy was preceded (1-3 months) by asthenia, anorexia, weight loss and a major inflammatory syndrome. Nonsteroidal anti-inflammatory drugs (NSAID) administration was noted. In 2 cases, uveitis appeared after the nephropathy had subsided. Renal biopsies performed in the 3 patients revealed mainly interstitial changes with mononuclear cell infiltration; immunofluorescence studies were negative. Although the severity of renal failure varied among patients, renal function recovered completely, returning to normal within 2, 3 and 24 months respectively, on corticosteroid therapy. The TINU syndrome is a rare situation compared to drug-induced acute interstitial nephritis, including NSAID related-nephritis. However, the real incidence of this syndrome might be underestimated since the uveitis can appear a few weeks later and its origin may not be related to the renal episode.

Acute Disease↗

[Dermatopolymyositis and pulmonary fibrosis associated with Gougerot-Sjogren syndrome. Study of 3 cases].

3 new cases of dermatomyositis associated with diffuse interstitial pulmonary fibrosis and, more exceptionally, with Sjögren's syndrome are reported. The pulmonary fibrosis observed in patients with dermatomyositis differs from that found in other connective tissue diseases in that it follows a more acute course and may respond to corticosteroids. Thus, in 2 of these patients treated with corticosteroids (combined in 1 case with cyclophosphamide) the high percentage of lymphocytes and polymorphonuclears in the broncho-alveolar lavage fluid, which reflects alveolitis activity, was reduced and the pulmonary fibrosis was cured in one patient and stabilized in the other.

Cyclophosphamide↗

[Renal insufficiency caused by chronic granulomatous interstitial nephritis in Löfgren's syndrome].

The authors report the case of a woman with Löfgren's syndrome who developed renal failure associated with abnormalities of acidification and concentration of the urine. In the absence of a phosphate-calcium metabolic disturbance, these signs were attributed to a granulomatous interstitial nephropathy demonstrated on renal biopsy. These abnormalities regressed completely with steroid therapy. Secondary renal failure due to an isolated granulomatous interstitial nephropathy is exceptionally rare in sarcoidosis and has never been previously reported in Löfgren's syndrome.

Acute Kidney Injury↗