Biomedical subjects
D Blanc
Publications and source records attributed to D Blanc.
[Calcifying panniculitis].
We report a case of calcifying panniculitis which occurred in a 67-year old woman suffering from chronic renal failure and primarily involved anticoagulant injection sites. Calcifying panniculitis is a rare condition belonging to the spectrum of calciphylaxis first described by Selye in 1962. This disease seems to imply necessarily a specific morbid background including renal failure together with calcium-phosphate metabolism impairment. Following the action of a so-called "challenger" (in the present case calcium heparinate [Calciparine], a subcutaneously administered anticoagulant drug), the lesions start as painful subcutaneous nodules soon turning into plaques of necrosis. The area involved mainly includes the abdomen and thighs, due to the preferential distribution of fat and the classical use of such regions for subcutaneous injections. In our patients, histological examination disclosed an initial involvement of subcutaneous fat vessels mimicking mediacalcosis, soon followed by calcium-phosphate deposits within interadipocyte spaces. An electron microscopy study confirmed the presence of calcium crystals within the cytoplasms of some connective tissue cells and the extracellular matrix. From a review of the literature, it seems reasonable to normalize the calcium-phosphate product by reducing hyperparathyroidism as a first therapeutic step. Then, wide surgical excision of the necrotic areas should be performed to rule out any possibility of self worsening of the lesions and provide the best chance of healing without superinfection. The use of diphosphonates on pathophysiological grounds is discussed.
[Abrikossof's tumor of the esophagus. An original case. Review of the literature].
Granular-cell tumors (GCT), also called Abrikossof's tumors, are generally benign, ubiquitous tumors. An original case of granular-cell tumor of the esophagus is reported. The symptoms included dysphagia and pyrosis. Fiberendoscopy showed a peptic esophageal stenosis with ulcerations confirmed by biopsy. CT showed a round thickening of the esophageal wall, localized in height. This lesion had previously been the object of several dilatation attempts. Esophagectomy with esogastric anastomosis in the thorax was performed. The histological study allowed diagnosing a granular-cell tumor, though one of a very peculiar type: misleading symptoms, tumor infiltrating the whole height of the esophagus and a circular area. Ninety cases of granular-cell tumors are reported in the literature; they are associated with a cancer of the air passages or of the digestive tract in 11% of cases. The cancer often appears secondarily, which requires lengthy surveillance. We do not know if this association is directly related or accidental. We have found no identical case of such a lesion, involving both the whole circumference and the whole height of the esophagus, in the literature.
Systemic lupus erythematosus-like syndrome induced by alpha-interferon therapy.
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[Colonic perforation during colonoscopy. 100 cases].
The analysis of 100 cases of colon perforation during colposcopic examinations highly demonstrates such a statement. The perforation risk during colposcopies is generally of the order of 0.2% for a diagnosis coloscopy. According to the statistic data used, it can reach 0.5 to 3% in therapy coloscopy. This is a risk inherent to the technique used. It is thus required to analyse the causes and take the appropriate measures to reduce it to a minimum. Mortality due to such a complication remains high (14%), i.e about 0.015 to 0.1% (#2/10000) of all colposcopies. In 11% of the patients, serious sequelae are to be observed. This demonstrates the significance of the medico-legal problem set by these perforations during colposcopies. The whole personnel responsibility can be involved: colposcopist, surgeon, anesthetist and hospital unit.
[Edema of the eyelid disclosing Basedow's disease].
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Entamoeba histolytica zymodemes: exhibition of gamma and delta bands only of glucose phosphate isomerase and phosphoglucomutase may be influenced by starch content in the medium.
Entamoeba histolytica isolated from human can be associated with either symptomatic disease or with asymptomatic carriers. Pathogenic and nonpathogenic strains can be distinguished on the basis of differences in the electrophoretic patterns of four isoenzymes (zymodeme). With glucose phosphate isomerase and phosphoglucomutase, we observed variation of the expression of their gamma bands as a function of starch volume in culture. We cultured E. histolytica strains from different zymodemes in Robinson medium using both a low (2-4 mg/bottle) and a high (12-15 mg/bottle) content of rice starch as supplement. These cultures were monitored by electrophoresis of glucose phosphate isomerase and phosphoglucomutase. Strains having gamma or delta bands exhibited those bands when a high content of starch was used in culture, but did not do so with a low content. Contrarily, strains that never exhibited those bands did not express them when the amount of starch in the culture was increased. However, alpha and beta bands of the same isoenzymes were always present and never showed any variation. The results suggest that expression of gamma and delta bands of glucose phosphate isomerase and phosphoglucomutase are subject to culture conditions and that genes coding for those isoenzymes may be different from those coding for the alpha and beta bands.
Specific cell surface requirements for the infection of CD4-positive cells by human immunodeficiency virus types 1 and 2 and by Simian immunodeficiency virus.
Human CD4 was expressed on a range of mammalian cell lines. CD4+ non-primate cells, derived from rat, hamster, mink, cat, and rabbit, bind recombinant gp120 of human immunodeficiency virus type 1 (HIV-1) but are resistant to HIV-1 infection. CD4 expression on various human, rhesus, and African green monkey cell lines confers differential susceptibilities for HIV-1, HIV-2, and simian immunodeficiency (SIV) strains. For example, CD4+ TE671 rhabdomyosarcoma cells are sensitive to HIV-1 and HIV-2 but resistant to SIV, whereas CD4+ U87 glioma cells are resistant to HIV-1 infection but sensitive to HIV-2 and SIV. HIV-1 infection was not dependent on human major histocompatibility class I expression. Studies of cell fusion and of infection by vesicular stomatitis virus pseudotypes bearing HIV-1 and HIV-2 envelopes showed that the differential cell tropisms of HIV-1, HIV-2, and SIV are determined at the cell surface.
Citropten and bergapten suction blister fluid concentrations after solar product application in man.
Citropten (5,7-dimethoxycoumarin) and bergapten (5-methoxypsoralen) are present in bergamot oil which is used as a cosmetic tanning product. The aim of this study was to quantify, using HPLC, the amount of citropten and bergapten in the skin after the application of suntan products (emulsion and oil formulations). A suction blister technique, performed on the volar aspect of the forearm, permitted the collection of these two molecules. The blister fluid concentrations were 37 and 51 ng/ml (emulsion) and 26 and 23 ng/ml (oil), respectively, for citropten and bergapten. Our results show that the suction blister technique could be used for comparing transepidermal penetration of several compounds in vivo in man.
Renal manifestations of hereditary angioedema.
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[Subcorneal pustular dermatosis associated with epidermoid carcinoma of the lung].
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Unusual adverse reaction to an acaricide.
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Adult Still's disease and mesangial glomerulonephritis. Report of two cases.
Two patients with adult Still's disease and abnormal urinalysis underwent kidney biopsy 2 to 21 years after onset of the disease. Unexpectedly, mesangial glomerulonephritis was discovered. Even if a fortuitous association could not be excluded, the real prevalence of glomerular involvement in ASD should be determined by further studies in view of a potential immune complex pathogenesis of this condition.
UV-induced erythema and photocarcinogenesis.
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A signaling role for the cytoplasmic segment of the CD8 alpha chain detected under limiting stimulatory conditions.
To test for the functional importance of the cytoplasmic segment of the CD8 molecule, a mouse T-cell hybridoma expressing a T-cell receptor specific for the class I major histocompatibility complex product H-2Kb was transfected with a set of CD8 alpha-chain (Ly-2) and/or beta-chain (Ly-3) genes encoding polypeptides with carboxyl-terminal truncations or substitutions. When challenged with Kb-positive splenocytes, transfectants expressing Ly-2 homodimers that lacked cytoplasmic tails responded nearly as effectively as wild-type Ly-2 transfectants. However in marked contrast to the wild-type Ly-2 transfectants, tailless Ly-2 transfectants were greatly impaired in their ability to respond to Kb-transfected L cells. Coexpression of the Ly-3 gene did not restore this impaired response. The unique functional property of the Ly-2 alpha cytoplasmic segment was further supported by the analysis of a chimeric Ly-3 subunit in which the cytoplasmic segment was replaced by the one from the Ly-2 alpha subunit. When associated with a soluble Ly-2 subunit lacking a transmembrane segment, the chimeric Ly-3 was indeed sufficient to restore the response to Kb-transfected L cells. Since the lateral mobility of the tailless Ly-2 molecules on the cell surface was nearly identical to that of the wild-type Ly-2 molecules, their partially impaired function may indicate that they have lost their cis-acting signaling properties but retained their ability to bind class I products of the major histocompatibility complex.
Intractable epidermolysis bullosa acquisita: efficacy of cyclosporin A.
We report the case of a 66-year-old man who presented with a spontaneous blistering involving both skin and mucous membranes, diagnosed as an inflammatory form of epidermolysis bullosa acquisita. During a 5-year course, the condition failed to respond to various therapies. Finally, only ciclosporin, together with a low dose regimen of prednisone, achieved a dramatic improvement with a total clearing within 6 months, persisting 1 1/2 years after discontinuation. Such results prompt us to propose such an association as a primary therapeutic scheme in an otherwise barely tractable disease.
[Microtraumatic pathology of the lumbar isthmus: isthmic lysis or spondylolysis].
The authors report the study of a series of 23 partial isthmic lyses which occurred in a young population (15 cases) and in an adult one (8 cases) between 1983 and 1988, in the form of persistent lumbosacral pains. The initial radiological signs, the key to an early diagnosis, are defined: cortical notches more often regarding the lower cortex than the upper one, incomplete fissures reaching the two cortical poles, gradual narrowing of the isthmus. The value of standard radiography is underlined, with the oblique incidences close to the profile regularly ensuring the diagnosis, with the exception of 4 cases out of 23 for which tomography was required. As regards the evolution, the value of the diagnosis of the initial lesions is recalled, giving the hope of a restoration of the posterior inter-articular fractures by a rigid setting (4 months on average). This ability to reconstruct the lumbar isthmus is observed in the young subjects (10 out of 13 immobilizations) but also in the adult subjects (3 reconstructions for 5 immobilizations carried out). These results enable the early detection of prelytic states, in order to administer an suitable treatment resting on the rigid setting of the lumbosacral region, re-education and the control of the risk factors.