Biomedical subjects
Publications and source records attributed to B Kantelip.
The authors report about one case of giant-cell tumor of the cricoid bone (osteoclastoma, myeloplaxic tumor). The diagnosis is difficult as the clinical and radiological symptoms are not specific. A detailed iconography sums up the clinicopathological characteristics of this tumor. The authors emphasize the necessity to perform wide exeresis surgery through total laryngectomy.
The aim of this study was to examine the histology of a freshly removed kerato-lens lenticule (for keratoconus). The lenticule was obtained one year after refractive keratoplasty. It was removed by penetrating keratoplasty. The histological and transmission electron microscopic studies were performed.
A 61 years old man had a clear cell type carcinoma of the right kidney and a small asymptomatic homolateral adrenal pheochromocytoma. A von Hippel-Lindau disease suggested by this association was not confirmed in this case. However the measurement of plasma and urinary catecholamines, VMA and Iodine 131 MIBG (meta-iodo-benzyl-guanidine) scans are usefull in case of clinical doubt in patients with renal adenocarcinoma. This observation and others in medical literature demonstrate the interest of resection of adrenal glands during a nephrectomy for adenocarcinoma.
Ehlers-Danlos syndrome is a connective tissue disorder characterized by skin hyperelasticity and friability, hyperextensible small articulations, vascular fragility, and ocular and visceral symptoms. Ten types of Ehlers-Danlos syndrome have been described to date. Type IV is characterized by isolated arterial involvement with the risk of rupture, making diagnosis difficult. A 25-year-old man was operated on for a ruptured left and then right iliac artery and once again for a hepatic artery aneurysm within a nine month period. The diagnosis of Ehlers-Danlos syndrome was based on clinical and histopathologic findings. An asymptomatic iliac artery aneurysm was found in the patient's 23-year-old brother.
The aim of this retrospective study was to assess the prevalence of hepatitis C virus antibodies and their follow-up in a series of 64 orthotopic liver transplantation patients. Indications for transplantation were cirrhosis in 28 cases, primary biliary cirrhosis in 6 cases, liver cancer in 11 cases, fulminant hepatitis in 2 cases, and alveolar echinococcosis in 17 cases. The prevalence of serum antibodies to hepatitis C virus was assessed by an ELISA test (Ortho-Diagnostic-Systems). Sera were tested before liver transplantation and every two months after. Twenty-nine patients seronegative before transplantation remained negative. Four patients seropositive before liver transplantation remained seropositive. Twenty-eight patients seropositive before transplantation, became seronegative after, and 3 patients seronegative before transplantation became seropositive after. The prevalence of seroconversion was 9.3 percent. The prevalence of seropositive patients after transplantation was 11 percent. The high number of seropositive patients before transplantation (50 percent) could be explained by false positive results. Seropositivity before transplantation appeared to be related to hypergammaglobulinemia (p less than 0.001). This hypothesis was confirmed a posteriori by a concomitant disappearance of both seropositivity and hypergammaglobulinemia after transplantation in 62 percent of patients.
We report an abnormal pattern for enolase (EC 4.2.1.11) isoenzymes in the serum of a patient with squamous cell lung carcinoma. The alpha alpha-isoenzyme was present but the alpha gamma form was not detected, and near the point of application on the electrophoretogram was an abnormal band. We determined that the abnormal fraction corresponded to a macroenolase, composed of the alpha gamma-isoenzyme complexed with IgG. From a practical point of view, the presence of such a macroenolase, containing gamma-subunits, results in falsely increased results for neuron-specific enolase (NSE) in procedures that determine only the NSE concentration without consideration of the enolase isoenzymes.
Fibrous histiocytomas are commonly found on the skin, whereas the appear to affect the conjunctiva only very rarely.
The frequency of primary dysfunction of 432 Hancock pericardial bioprosthesis was evaluated during a mean follow-up period of 53.1 months per patient. This frequency was 3.20% valve-year in mitral valve prosthesis and 0.92% valve-year in aortic valve prosthesis. Only one case of calcification was noted. Dysfunction was usually due to tearing of one or several pericardial cusps (25 cases), occasionally to tissue retraction (4 cases). Pathological examination of the explanted valves showed fibrin formation followed by organization into fibrous tissue in the host, retracting or fragilizing the pericardial valvular tissue. A preliminary study of the same group had led to discontinuation of Hancock prosthesis. The long follow-up period makes it possible to compare the results obtained with those of pericardial prosthesis of the same generation, to stress the need for echocardiographic monitoring of the implanted valves and to hope that new techniques of pericardial valve fitting will improve the mechanical reliability of prosthesis which, from the point of view of thrombogenesis and haemodynamics, have unquestionable advantages.
A case of combined adenocarcinoma and small cell carcinoma of the prostate is described in a 58-year-old-man. Prostatic acid phosphatases and neuron specific enolase were found elevated in the serum. At autopsy the lung was free of tumor. The liver was replaced by numerous metastatic nodules and a voluminous mesenteric metastasis extended into the wall of the vessels (aorta and vena cava). Microscopic examination showed a small cell carcinoma component of the oat cell type and an adenocarcinoma component constituting 10% of the total tumor volume. By immunostaining, the small cell carcinoma component is neuron specific enolase+ and prostatic specific antigen-. The adenocarcinoma component is neuron specific enolase- and prostatic specific antigen+.
We report a case of Spitz nevus of the bulbar conjunctiva in a 15-year-old boy. Clinically, the lesion was juxtalimbic, nodular, red, and 6mm in diameter. Only histologic examination provided the diagnosis. Perusal of the literature revealed seven cases of Spitz nevus of the conjunctiva, but for some of them the histology was incompletely described. We compare the clinical and histologic features in cutaneous and conjunctival nevi and stress the similarity between the two. The histologic criteria which permit differentiation of melanomas and Spitz nevi in conjunctival locations are identified.
The case of a 49-year old woman who developed fibrous histiocytoma of the conjunctiva is reported. Clinically, the lesion was tumoral, unpigmented and located in the corneo-scleral limbus. The lesion was excised, and the patient remained cured throughout the 4-year follow-up. Five other cases have been published, and in all of them cure without recurrence was obtained by excision.
Fluid collection encompassing an arterial prosthesis often leads one to suspect graft infection. Four cases of aseptic seroma occurring three to five years after insertion of knitted Dacron implants for bypass are reported. The collection was serohematic in three cases, puriform in the other. Repeated bacteriological investigations did not reveal any growth and laboratory tests did not demonstrate any signs of infection. The following pathophysiologic hypotheses have been advanced: modification of the permeability of the prosthetic wall, immunoallergic reaction to the graft, and aging hematoma. The role played by anticoagulant is debatable. Management by needle aspiration or drainage failed. Multiple recurrences led to prosthetic replacement in three cases. Treatment consists of replacing the graft by one of a different fabric. These collections must be distinguished from postoperative lymphoceles, anastomotic false aneurysms, hematomas and infections.
Increasing interest is shown in the determination of the serum neuron-specific enolase for the diagnosis and the follow-up studies of small cell lung cancers. We report results obtained by an enzymatic procedure that permits the simultaneous determination of the neuron and nonneuron-specific enolase and the calculation of the ratio of these two components. The utility of this ratio which characterizes elevations of the serum neuron-specific enolase from a poor or rich source of this component was tested in 38 patients with small cell lung carcinoma and in 57 subjects suffering from other bronchogenic cancers. The control group consisted of 37 blood donors and 56 patients with respiratory disease. For the diagnosis, the sensitivity and the specificity of the enzymatically determined neuron-specific enolase compared well with published results obtained by radioimmunoassay and enzymoimmunoassay. The use of the ratio clearly increases the specificity of the test, since only 5.3 percent of false positive results are found when bronchogenic tumors other than small cell carcinoma are studied. The sensitivity was 76 and 100 percent in diagnosis of limited and extensive forms, respectively. The use of this ratio in the follow-up of the patients and for the determinations in hemolyzed samples is set out.
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In order to evaluate the clinical and histopathologic prognosis indicators of uveal melanomas treated with enucleation, 59 patients, followed up during 1 to 18 years were included in a retrospective study. Kaplan Meier survival curves were constructed and compared using the log rank test. The overall 5 and 10 years probabilities of survival were 74.9% and 48.5% respectively. Metastases were, or might have been, responsible for death in 83.3% of the cases. The median survival was 4 years 9 months (range less than 1 to 11 years). Fifty five per cent of the metastases occurred within 4 years of the enucleation and 90% within 8 years. For the patients with spindle cell melanomas, the 5 year probability of survival was 90% against 38% for the patients with epithelioid cell tumors. The median time to tumor related death was 5 years for the first group against 3 years 8 months for the second. The analysis of our data demonstrated the tumor volume to be a statistically significant clinical prognosis indicator. The following histopathologic parameters were also statistically significant prognosis indicators: the cell type (p less than or equal to 0.001), the mitotic activity, the state of the sclera, the presence of blood lakes. Statistical adjustments and determination of the instantaneous relative risk of death showed the histopathologic factors, specially the cell type, to be the most important indicators.
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