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Biomedical subjects

E Brambilla

Publications and source records attributed to E Brambilla.

At least 217 records · Page 12Linked to original sources
PubMed1987

[Transparietal needle biopsy of pulmonary lesions with an image intensification system. Apropos of 82 biopsies].

We report the results of 82 needle biopsies of pulmonary nodules, using a fine screw needle. Owing to the very small diameter of the needle (0.8 mm), very few complications were observed (minor pneumothorax 13%, major pneumothorax 2.5%). The screw needle provided samples adequate for both cytological and histological examination. Forty-eight out of 53 cancers were diagnosed by this method (sensitivity 83%, specificity 100%).

Biopsy, Needle↗
PubMed1986

[Heterogeneity of malignant bronchial tumors. Problems of histogenesis].

The 1981 WHO classification of bronchial carcinoma, based on light microscopic analysis, proposed 4 principal classes: epidermoid carcinoma, adenocarcinoma, small cell carcinoma and large cell undifferentiated carcinoma. This apparently simple nosology underestimates the difficulties of classifying a good number of these tumors, due to a great diversity in appearance within the same histologic group. Experimental studies on the regeneration of bronchial epithelium, on lesions induced by irritants and carcinogens, suggest one undifferentiated cell line as the origin of all malignant proliferations, including neuro-endocrine tumours. To support this histogenetic hypothesis, an ultra-structural analysis of the carcinomas shows the existence and frequency of heterogenous forms, multi-differentiated, up to the level of individual cells. The same cell line may express several ways of differentiation simultaneously (bi or tri-partite differentiation). Equally immunohistochemical methods reveal antigenic differentiation (intermediary filaments, neuro-endocrine antigens) and establish a means of identifying different cellular constituents. These two methods have allowed real progress in the diagnosis of neuro-endocrine tumours, placing them firmly with bronchial tumours and seem particularly helpful in the analysis of undifferentiated small and large cell carcinomas. By another way, one finds in the majority of bronchial tumours the different antigens expressed, certainly following their histological type in variable degrees, yet with an antigenic (phenotypic) profile showing great similarity. This is a reflection of multi-differentiation in these tumours and appears as a direct consequence of their common histogenetic origin. Bronchial carcinomas are placed along a continuous spectrum of three parallel and/or simultaneous differentiations. They represent a single tumour having a tendency to express one or several ways of differentiation.

Carcinoma, Bronchogenic↗
PubMed1986

[Value of computed tomography in the diagnosis of the intrathoracic extension of bronchial cancer].

In 76 patients the diagnosis of the mediastinal extension of a bronchial cancer, assessed by computed tomography (CT), was compared to histological specimens obtained by mediastinoscopy and surgery (58/76). The extension to mediastinal nodes was present in 26 subjects (34.2%) and yet was not recognised 15 times on CT. There were 15 false negatives (FN) and 3 false positives (FP). Sensitivity 43%, specificity 94%, predictive value for positives (VPP) 70%, predictive value for negatives (VPN) 75%. Extension was present in 18 patients. These were recognised 14 times by CT. There were no false positives. (Sensitivity 70%, specificity 100%, VPP 100%, VPN 94%). We conclude That CT is useful for diagnosing direct mediastinal extension and allows the juxta-hilar extension of the cancer to be assessed. CT has no place in the diagnosis of mediastinal gland involvement. Mediastinoscopy (5.2% FN; no FP) is better than TDM for the diagnosis of extension to the mediastinal nodes both for peripheral and central cancers.

Carcinoma, Bronchogenic↗
PubMed1984

[Extrinsic allergic alveolitis in children. Apropos of 4 cases].

Four cases of extrinsic allergic alveolitis are reported. About them, we discuss: The difficulties of diagnosis that we can only affirm on the association of several clinical, biological, and radiological arguments. The physiopathology: association of immune complex hypersensitivity type III and immediate hypersensitivity type I. It's important to always search for a probable starting infectious factor (mycoplasma). The therapy: antigenic exclusion is the only way to avoid a lung fibrosis.

Adolescent↗
PubMed1983

[Rheumatoid arthritis, obliterating bronchiolitis and D-penicillamine. Apropos of a new case with ultrastructural examination and review of the literature].

Over recent years, several cases have been reported of bronchiolitis obliterans, of very rapid onset and serious clinical course in patients with rheumatoid arthritis being treated with D-Penicillamine. After reporting a new case, the authors stress the unusual features of this bronchiolar condition which is probably of iatrogenic origin and irreversible, with death occurring within a few years. The pathogenesis is poorly understood and many questions still remain concerning the relationships between rheumatoid arthritis, the bronchiolar lesions and D-Penicillamine in this disease of pulmonary collagen. The ultrastructural examination and the morphometric examination of this new case suggest the presence of predominantly type III collagen, which is normally present in the lungs in only small quantities.

Arthritis, Rheumatoid↗
PubMed1982

Ultrastructural diagnosis of pleural tumors.

The significant association of two kind of mesothelial cells, differentiated and fibroblastoid, caracterises the ultrastructure of malignant pleural mesotheliomas. The differentiated mesothelial cancer cells (MCC's), whether they are observed in fluids or in biopsies, are not caracteristic enough to assert the diagnosis of mesothelioma. They can easily be mistaken for metastatic cells. Therefore, the diagnosis of mesothelioma relies on the identification of fibroblastoid MCC's, whether they are in association with the preceeding form in epithelial-like tumors, or the main component in sarcomatous-like tumors. Since the absence of fibroblastoid MCC's would eliminate the diagnosis of mesothelioma, patient and careful search for these cells must be done in all pleural tumors with a unique differentiation (epithelial-like or sarcomatouslike). This justifies the need for electron microscopy in the diagnosis of these pleural tumors: for this reason, pleural biopsies should routinely be embedded for possible future ultrastructural examination.

Cytoskeleton↗
PubMed1982

Non-Hodgkin's malignant lymphomas: a cytologic classification based on statistical analysis and correlated with prognosis.

On the basis of cytologic studies of 144 patients with non-Hodgkin's malignant lymphomas (NHML), a cytologic classification was established that was composed of three groups (1, 2 and 3) containing nine classes (1A, 1B, 1C; 2A, 2B, 2C; 3A, 3B, 3C). Statistical analyses were carried out using 52 well-defined elementary cytologic characteristics. All the results given by the data-gathering procedures (hierarchical and dynamic clustering methods), by the descriptive analyses (multifactorial and canonical analysis) and by the stepwise discriminant analysis were in agreement with the proposed cytologic classification system. The most discriminating cytologic characteristics of the classes were the cell size, the nuclear-cytoplasmic ratio, the degree of cytoplasmic basophilia, the homogeneity of the cytoplasm and the number of mitoses. The use of these properties renders this classification system reproducible and applicable to clinical practice. A comparison was made between the cytologic classes and the NHML patients as grouped according to their clinical courses. Of the patients in classes 2A, 2B and and 2C, 94% showed acute leukemic characteristics. Of those contained in classes 3A, 3B and 3C, 78% showed poor prognosis or metastatic patterns. Of those contained in classes 1A, 1B and 1C, 76% showed a good prognosis pattern.

Adolescent↗
PubMed1982

The alleged antithiamine activity of o-diphenols: an artefact of oxygen in the thiochrome method?

1H-n. m. r. and t. l. c. measurements show that ortho-diphenols induced little or no chemical change in thiamine when co-dissolved in aqueous solution at pH 7.8. Thiamine determinations on the same solutions by the classical thiochrome method are critically susceptible to the amount of dissolved oxygen. An oxygen saturated equimolar solution of thiamine and pyrocatechol (0.03 mM), after 24 hours at pH 7.8 and at 37 degree, gives almost no thiochrome fluorescence response unless the solution is first degassed to remove all traces of oxygen. It is suggested that earlier literature reports of the pronounced anti thiamine effect of o-diphenols were erroneously based on this apparent disappearance of thiamine when oxygen is not excluded.

Caffeic Acids↗
PubMed1981

Evidence against the reported antithiamine effect of caffeic and chlorogenic acids.

Contrary to earlier literature reports, chlorogenic acid (I) is shown to have little or no deleterious effect on thiamine (II) when the 2 compounds are codissolved in aqueous solution. Evidence from nmr spectroscopy and from t. l. c. determination demonstrate that when II is heated at 60 degrees C and at pH 7.8 for 24h, about 10% is destroyed. This result is the same whether I is present or not. Incubating II with I or with caffeic acid (III) in a phosphate buffer at pH 7 or in thiamine assay medium at pH 6 for up to 24h at 37 degrees C did not reduce the growth activity of II or Lactobacillus viridescens. We conclude that I and III are not antithiamine agents.

Caffeic Acids↗
PubMed1980

[Pneumoconiosis due to amorphous silica smoke. Mineralogical and ultrastructural study of 6 cases (author's transl)].

Pneumoconiosis was diagnosed in 10 patients working in a silicon factory. The exposure time varied between seven and thirty-five years. All patients had only slight or no symptoms, except one presenting an important dyspnea. The radiologic study showed an interstitial syndrome. The functional lung test revealed a restrictive syndrome. Seven patients underwent fibroscopy with alveolar washing and transbronchial biopsy. A surgical biopsy was performed in two patients. The histological lesions showed an accumulation of alveolar and interstitial macrophages and the existence of fibrous interstitial micronodules. The ultrastructural study revealed an interstitial fibrosis. The macrophages contained numerous dense, homogenous small spheres of amorphous structure, composed of silicon and oxygen. These spheres represent amorphous silica smoke particles. Less than 1% of the particles are crystalline silica. Thus, the amorphous silica particles seem to be responsible for the histological and radiological lesions observed.

Humans↗
PubMed1980

[Lymphomatoid granulomatosis: anatomo-clinical and ultrastructural study of two observations (author's transl)].

Two anatomoclinical observations of lymphomatoid granulomatosis are reported. The first case concerns a patient presenting a cutaneous localisation and a severe pulmonary infection with acute febrile dyspnea and macronodular opacities seen in pulmonary radiographs. The treatment associating cortisone and chlorambucil led to a complete remission. Five years later a pulmonary recurrence was treated successfully with the same association. The second patient presents dyspnea upon progressive effort, a radiologic and functional syndrome of interstitial involvement. In the absence of precise diagnosis after pulmonary biopsy, the patient was treated with corticosteroids. Four months later, encephalitic damage led to death. In the 2 observations, the biopsies or autopsic samples from the lungs or brain showed necrotic nodular lesions. Bordering on the necrosis, the small arteries and veins are strictured or obstructured by an infiltrate of lymphocytes, plasmocytes, histiocytes, and large cells with atypical nucleus. The ultrastructural examination of the 2 pulmonary biopsies shows the reactional polymorphic nature of the lymphoid infiltrate, the generally imprecise nature of atypical large cells and the modifications of vascular elastic limitations. The blades of elastine are surrounded by microfibrillar material. These different data are compared with those in the literature.

Adult↗