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D Goldschmidt

Publications and source records attributed to D Goldschmidt.

At least 37 records · Page 2Linked to original sources
PubMed1997

Characterization of the nuclear deoxyribonucleic acid content and nuclear morphometry in 71 primary cutaneous melanomas.

BACKGROUND: While the determination of nuclear deoxyribonucleic acid (DNA) content (DNA ploidy level) and nuclear morphometry characterization has proved to be of prognostic value in melanocytic lesions, there are several ways of performing these determinations. OBJECTIVE: To identify which of 9 DNA ploidy- and 2 nuclear morphometry-related variables are of prognostic and/or diagnostic value in 71 primary melanomas. METHODS: Histological typing, Breslow depth determination, the evaluation of Clark's level of invasion and the 11 quantitative variables (calculated in Feulgen-stained nuclei using computer-assisted microscope analysis) determined for each melanoma were submitted to discriminant analysis. RESULTS: The discriminant analysis of image cytometric variables enabled specific cell subpopulations to be identified in histological and the Breslow-related groups, but not in the Clark-related ones. CONCLUSION: The characterization of melanoma heterogeneity by means of the identification of specific DNA ploidy level-related cell subpopulations in specific Breslow-related groups enables the problem of intra- and interobserver variability in Breslow depth determination to be reduced and therefore can help dermatologists in their daily routine.

Adult↗
PubMed1997

Contribution of quantitative lectin histochemistry to characterizing well-differentiated, dedifferentiated and poorly differentiated liposarcomas.

OBJECTIVE: To find new diagnostic markers in the group of lipomatous tumors. STUDY DESIGN: The histochemical lectin staining pattern was characterized in a series of 45 lipomatous lesions, including 10 typical lipomas, 6 atypical lipomas, 8 well-differentiated, 6 myxoid, 5 dedifferentiated and 10 pleomorphic liposarcomas. Three lectins were used-peanut (Arachis hypogaea) agglutinin, which binds to terminal Gal(beta 1,3)GalNAc residues; wheat germ (Triticum vulgare) agglutinin (s-WGA, the succinylated form of WGA), which binds to ((1-4)-D-GlcNAc)n and Neu5NAc residues; and jack bean (Concanavalia ensiformis) agglutinin which binds to alpha-D-Man and alpha-D-Glc residues. Histochemical staining was quantitatively measured by means of a cell image processor. RESULTS: In the case of certain carbohydrate residues, typical lipomas closely resemble atypical lipomas, which in turn closely resemble well-differentiated liposarcomas; typical lipomas differ significantly from well-differentiated liposarcomas. This indicates that atypical lipomas, or at least some of them, could represent a biologic link between typical lipomas and well-differentiated liposarcomas. While well-differentiated and pleomorphic liposarcomas differed significantly from each other, the poorly differentiated component of dedifferentiated liposarcomas included histochemical lectin properties, which were common to both well-differentiated and pleomorphic liposarcomas. CONCLUSION: Some atypical lipomas exhibit glycohistochemical characteristics that are common to those of well-differentiated liposarcoma. The poorly differentiated component of dedifferentiated liposarcomas remains more differentiated in terms of glycohistochemical markers than do poorly differentiated pleomorphic liposarcomas.

Adult↗
PubMed1997

[Surgical closure of leg ulcers].

Surgical closure of leg ulcers has to be preceded by treatment of their etiologies in order to avoid recurrences. Best coverage technique is achieved with the use of a meshed split thickness skin graft, harvested with a dermatoma. Skin graft take depends on the vascular quality of the recipient bed, on the technique used and also on the post-operative care.

Humans↗
PubMed1997

[Pressure sores: management and treatment].

The global management of pressure sores is best ensured with a multidisciplinary approach. We present the experience of the "Groupe de Travail Escarres" (Pressure Sore Workgroup) which gathers physicians and nurses interested with this pathology. The majority of the decubitus ulcers will heal spontaneously with a conservative treatment only. This treatment typically aims at relieving the causes that lead to pressure sores, at eliminating the necrotic tissues, at obtaining favourable local conditions to allow wound healing and at controlling the health status of the patient. Surgical treatment of pressure sores is indicated when wound healing does not occur and when the health status of the patient is sufficiently good. Defect coverage is best carried out using myocutaneous flaps since their excellent blood supply allows a good cleansing of the wound.

Health Status↗
PubMed1996

Methodological aspects of using decision trees to characterise leiomyomatous tumors.

The aim of the present work is to present the potential uses of a classification technique labeled the "decision tree" for tumor characterisation when faced with a large number of features. The decision tree technique enables multifeature logical classification rules to be produced by determining discriminatory values for each feature selected. In this report, we propose a methodology that used decision trees to compare and evaluate the information contributed by different types of features for tumor characterisation. This methodology is able to produce a set of hypotheses related to a diagnosis and or prognosis problem. For example, hypotheses can be producted (on the basis of a set of descriptive features) to explain why tumor cases belong to a given histopathological group. To illustrate our purpose, this methodology was applied to the difficult problem of leiomyomatous tumour diagnosis. The aim was to illustrate what kind of diagnostic information can be extracted from a sample data set including 23 smooth muscle tumors (14 benign leiomyomas and 9 malignant leiomyosarcomas) described by a large set of computer-assisted, microscope-generated features. Three groups of features were used relating to: (1) ploidy level determination (10 features), (2) quantitative chromatin pattern description (15 features), and (3) immunohistochemically related antigen specificities (6 features). All these features were quantified by digital cell image analysis. The results suggest that an objective distinction between leiomyomas and leiomyosarcomas can be established by means of simple logical rules depending on only a few features among which the immunohistochemically revealed antigen expression of desmin plays a preponderant part. One of the combinations of features proposed by the methodology is interesting for pathologists, because it includes two features describing the appearance of a nucleus in terms of chromatin distribution homogeneity and density, two features widely used by pathologists in tumor-grading systems.

Adolescent↗
PubMed1996

Reduction mammaplasty combined with pectoralis major muscle flaps for median sternotomy wound closure.

Sternal wound infection can be a problem in patients who undergo coronary artery bypass graft surgery and is usually treated with local flaps. Severe macromastia can cause a large wound dehiscence by inferolateral tension on the skin sutures. Chest wall reconstruction can be achieved by combining muscle flap coverage with reduction mammaplasty. Two musculoglandulocutaneous flaps can be designed, using two superiorly based pectoralis muscle flaps vascularising the medial portion of the glandular breast tissue. The flaps are advanced medially to the sternectomy site and the breast reduction is then completed by adjusting the lateral breast pillar to the medial breast pillar. A case in which this technique was successfully used is reported.

Aged↗
PubMed1996

Glomus tumours of the hand. A retrospective study of 51 cases.

The authors report a series of 51 patients with glomus tumours in the hand. The duration of symptoms before treatment averaged 10 years. No one site or finger was more commonly involved. Objective features were limited to a blue discoloration in 29%, a pulp nodule or a nail deformity in 33%. An osseous defect was seen on plain X-ray films in 36%. Diagnosis depended on clinical suspicion in 90%. Careful dissection and complete excision of the tumour almost always offer permanent relief. A direct transungual approach was used in the subungual tumours with only one cosmetic problem. Recurrence of symptoms occurred in only two cases after a pain-free interval of 2 years.

Adult↗
PubMed1996

Image cytometry analysis of Feulgen-stained nuclei in 72 lipomatous lesions including atypical lipomas and well-differentiated liposarcomas.

Well-differentiated lipomatous tumors constitute a histopathologic category whose nomenclature has been controversial, particularly with respect to the distinction between atypical lipomas of the extremities and well-differentiated liposarcomas of the retroperitoneum. To determine whether there were differences in image analytic parameters between these neoplasms, 72 lesions including 21 typical lipomas, 7 atypical lipomas, 16 retroperitoneal and 5 nonretroperitoneal well-differentiated, 9 dedifferentiated, and 14 pleomorphic liposarcomas were submitted to the computer-assisted microscopic analysis of Feulgen-stained nuclei. This methodology enabled four groups of variables to be calculated. These included: (1) quantitative chromatin pattern description (14 variables); (2) the measurement of proliferative activity (1 variable); (3) nuclear DNA content (DNA ploidy level, 5 variables); and (4) the measurement of cell density and topographical cell nuclei organization (2 variables). The results strongly suggest that atypical lipomas, whether superficial or deep, and well-differentiated liposarcomas, whether retroperitoneal or not, belong to the same category in terms of the variables analyzed.

Adult↗
PubMed1996

The value of nuclear DNA and texture analysis by digital image processing in the diagnosis of lipomatous and leiomyomatous tumours.

The present study investigates whether the quantitative chromatin pattern description carried out by means of the digital cell image analysis of Feulgen-stained nuclei can contribute valuable diagnostic information on sarcomas. A series of 77 soft tissue tumours was consequently studied. This series included 9 benign lipomas versus 26 malignant liposarcomas and 26 benign leiomyomas versus 16 malignant leiomyosarcomas. Of the 26 liposarcomas, 14 were primary and 12 recurrent tumours. Of the 16 leiomyosarcomas, 13 were primary and three recurrent tumours. The results show that the combined use of principal-components analysis and the discriminant analyses of digital data obtained by means of the computer-assisted microscope analysis of Feulgen-stained nuclei made it possible to obtain a clear-cut distinction between the three histopathological groups relating to the lipoma/liposarcoma group of soft tumours. In contrast, while a clear-cut distinction could be made between the recurrent leiomyosarcomas and the primary leiomyosarcomas, such a distinction was not possible between the benign leiomyomas and the malignant primary leiomyosarcomas. This feature, along with previous ones obtained through DNA ploidy level determination, suggests to us that leiomyomas, or at least some of them, are in the process of malignant transformation. In other words, leiomyomas might be the pre-malignant counterpart of leiomyosarcomas, a feature that the present results do not suggest for lipomas versus liposarcomas.

Adult↗
PubMed1996

The contribution of image cytometry and artificial intelligence-related methods of numerical data analysis for adipose tumor histopathologic classification.

Thirty-five lipomatous tumors were quantitatively described using 47 variables generated by means of computer-assisted microscope analysis. Of these 47 quantitative variables, 27 were computed on Feulgen-stained specimens (25 on cytologic and 2 on histologic samples) and, of the remaining 20, 8 related to vimentin and S-100 protein immunostaining patterns and the other 12 to the glycohistochemical staining patterns of peanut agglutinin, succinylated wheat germ agglutinin, and concavalin A agglutinin. The 35 lipomatous tumors included 6 atypical lipomas and 8 well differentiated, 5 dedifferentiated, 6 myxoid, and 10 pleomorphic liposarcomas. The actual diagnostic value contributed by each of the 47 variables with respect to the 5 lipomatous tumor groups was determined by means of the decision tree technique, an artificial intelligence-related algorithm that forms part of the supervised learning algorithms. Of the 47 quantitative variables, the decision tree technique retained 8: i.e., 2 tissue architecture-, 2 DNA ploidy level-, 2 morphonuclear-, 1 lectin histochemical-, and 1 vimentin immunostain-related variables. The decision tree technique made use of these 8 variables to set up logical rules that make it possible to identify atypical lipomas from well differentiated liposarcomas, on the one hand, and dedifferentiated liposarcomas from those that are well differentiated and pleomorphic, on the other. Thus, the combination of an artificial intelligence algorithm analyzing quantitative variables generated by means of the computer-assisted microscope analysis of cytologic and histologic samples from lipomatous tumors can be considered an expert system contributing significant diagnostic information to conventional diagnosis.

Algorithms↗
PubMed1996

[Post-gastroplasty plastic surgery].

Gastric volume modification by surgery (gastroplasty, gastric banding ...) is intended to improve health in patients presenting morbid obesity. However, consecutive cutaneous sequellae are always ungrateful and often particularly disabling. The treatment of these sequellae often necessitates plastic surgery correction. We present a series of 21 patients whose cutaneous sequellae secondary to gastroplasty were operated on after a mean loss of 42% of body mass index. Sixty-three anatomical sites were treated in 27 operative sessions without any general complication. The number of operative sessions was limited using a simultaneous multiple surgical team approach, which is particularly adapted to this type of patients. The local complications (11 cases) were minor (delays of healing, hematoma, seroma, abscess). Even though the final aesthetic appearance depended greatly on the preoperative situation, all the patients were satisfied with the results obtained.

Abdomen↗
PubMed1996

Quantitative measurements of desmin and vimentin immunostains and cell density in leiomyomas and leiomyosarcomas.

The distinction between benign and malignant smooth muscle tumours relying on histological features such as the mitotic index and pleomorphism remains a generally acknowledged difficulty in modern pathology. A cell image processor was therefore used to quantitatively assess the desmin and vimentin immunostain in 39 smooth muscle tumours which included 26 benign (leiomyomas) and 13 malignant (leiomyosarcomas) cases. The 13 leiomyosarcomas were primary (non-recurrent and non-metastatic). Ploidy level and cell density were also assessed on each of these 39 tumours by means of the computer-assisted microscopic analysis of 5-microns thick Feulgen-stained histological sections. The results show that while neither the ploidy level determination nor the quantitative assessment of the vimentin immunostain made it possible to distinguish between leiomyomas and leiomyosarcomas, cell density determination and the quantitative assessment of the desmin immunostain enabled such a distinction to be made. Indeed, the leiomyomas exhibited a much higher level of desmin positivity than the leiomyosarcomas, as did diploid tumours as compared to the aneuploid (benign or malignant) ones. Furthermore, the leiomyoma group exhibited a significantly lower mean cell density value than the leiomyosarcoma group. The present study further confirms the lack of relationship between ploidy level and cytological malignancy in smooth muscle tumours.

Adolescent↗
PubMed1995

A biomechanical study of the ulnar nerve at the elbow.

The relative elongation with elbow flexion of the ulnar nerve, proximal and distal to the cubital tunnel, and of the cubital tunnel retinaculum, was measured in cadaver specimens by stereophotogrammetry. The proximal part of the ulnar nerve elongated significantly with full elbow flexion. No significant change of length was measured in the distal part of the nerve. The length of the cubital tunnel retinaculum increased by an average of 45% from full elbow extension to full flexion.

Aged↗
PubMed1995

[Sebaceous carcinoma. Apropos of an extra-ocular location].

Sebaceous carcinomas of the skin are rare tumors. They most often occur on the skin of the head and neck. Their clinical diagnosis is difficult and the evolution is unpredictable. Recurrence and metastasis are not rare. Treatment of choice is large surgical excision. Opinions are divided regarding the use of chemotherapy and radiotherapy. A case of cutaneous sebaceous carcinoma on the right side of the nose that occurred on a previously irradiated skin is described, with rapid metastasis to the right paramandibular region.

Adenocarcinoma, Sebaceous↗