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Biomedical subjects

F Piette

Publications and source records attributed to F Piette.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Neuropathology of the cerebral vessels of centenarians].

Neuropathological study of brain and brain vessels was performed in two series of 12 and 20 centenarians, focusing on the prevalence of small vessel lesions, infarction, Alzheimer's changes and mental status. These are discussed as a function of vascular risk factors. In the first series (12 cases), there was no correlation between the severity of small vessel lesions: hyalinosis (12/12), mineralisation (10/12), amyloid angiopathy (9/12), vascular risk factors (high blood pressure or diabetes), Alzheimer's lesions. However, there was a tendency for an association between amyloid angiopathy and high density of neurofibrillary tangles. In the second series (20 cases), small infarcts and lacunes were found in 9/20 cases, neurofibrillary tangles and diffuse deposits of A beta peptide were constant, senile plaques were very frequent (19/20). Five patients were demented (one vascular dementia, one Alzheimer dementia, and 3 mixed dementias). These data indicate that: 1) Lesions of the walls of small cerebral vessels do not seem linked to the vascular risk factors observed at the end of the life of centenarians. 2) Cerebral infarcts and lacunes are frequent in these patients, and are responsible, at least in part, for a high proportion of the cognitive dysfunctions. The study of larger series is needed for a better understanding of relationships between vascular and degenerative lesions in the oldest old.

Aged↗
PubMed2001

Testosterone, dehydroepiandrosterone, insulin-like growth factor 1, and insulin in sedentary and physically trained aged men.

The influence of physical activity on dehydroepiandrosterone sulfate (DHEAS), total and free testosterone (TT and FT, respectively), insulin-like growth factor I (IGF-1), follicle-stimulating hormone (FSH), luteinizing hormone (LH) and insulin concentrations in aging men was investigated. Eight trained and nine sedentary men aged 60-65 years volunteered to participate in this study. Physical activity was determined during an effort test and evaluated by the measure of the maximal aerobic power (W(aer,max)). In the trained aging men, the W(aer,max) was higher than in the sedentary group of matching age [mean (SD) 206.8 (17.1) W versus 136.6 (12.3) W; P<0.0001]. The fat percentage was higher in the sedentary (n = 9) than in the trained (n = 8) group [23.9 (3.2)% versus 14.6 (3.7)%; P<0.0001]. DHEAS and IGF-1 levels were higher in trained than in sedentary subjects, respectively 2.04 (1) micromol/l versus 1.01 (0.68) micromol/l (P=0.02) and 192.1 (40.1) ng/ml versus 132.8 (31.2) ng/ml (P= 0.003). Insulin levels were higher in sedentary subjects [11.2 (3.5) mIU/l versus 7.6 (2.2) mIU/l, P=0.03]. No statistical difference was observed between both groups for FT and total TT values, FSH values and LH values. IGF-1 was correlated with W(aer,max) (r = 0.64, P = 0.003), and DHEAS was correlated with IGF-1 (r=0.59, P=0.01). We observed a relationship between fat percentage and each of the following hormones: IGF-1 (r=-0.50, P=0.03), FT (r=-0.66, P= 0.002), TT (r=-0.54, P = 0.02) and insulin (r=0.63, P=0.004). Insulin was inversely correlated with FT (r= -0.66, P=0.002) and TT (r=-0.47, P=0.05). These results suggest that regular physical activity could maintain higher DHEAS and IGF-1 and lean body mass levels in elderly men, and participate in general well being in older age.

Aged↗
PubMed2001

Scleromyxedema (lichen myxedematosus) associated with dermatomyositis.

A 41-year-old white man is described with papules of the lower and upper back, the neck and the upper chest, a marked deposition of mucin in the upper reticular dermis, and an IgG lambda monoclonal gammopathy strongly evocative of scleromyxedema (lichen myxedematosus). Additionally, he developed intense myalgia, muscle weakness and rhabdomyolysis, which were associated with heliotrope erythema, photosensitivity and an erythematous rash of the dorsum of the hands with Gottron's papules. Muscle biopsy revealed an inflammatory myositis, and dermatomyositis was diagnosed. The association of dermatomyositis and secondary mucinosis, or muscle involvement in primary papular mucinosis are not rare. However, the association between scleromyxedema and dermatomyositis has only exceptionally been reported.

Adult↗
PubMed2001

[Complete supernumerary breast on the thigh in a male patient].

BACKGROUND: Supernumerary nipples are not rare but the developement of a complete supernumerary breast is exceptional. CASE REPORT: A 59-year-old man presented a progressively increasing ancient right- groin-masse. The histopathologic examination of the lesion confirmed the diagnostic of polymastia. DISCUSSION: The interest of this observation results from the very unusual occurence of polymastia (less than 1 p. 100 of supernumerary nipples), especially for a caucasian man. The prevalence appears to be higher in women and oriental people. Diagnostic of supernumerary nipple is difficult because of its atypical appearance and ectopic location. However, this diagnostic is important because ectopic breast tissue is subject to the same pathologic changes that occur in normally positioned breasts and it can be a marker for associated diseases such as urologic malformations or urogenital malignancies.

Biopsy↗
PubMed2001

[Granuloma annulare following BCG vaccination].

BACKGROUND: Granuloma annulare following BCG vaccination or tuberculin skin tests is rarely reported in the literature. We describe three cases occurring in patients under the age of 6 years. CASE REPORTS: In the first two cases, granuloma annulare was initially localized at the vaccinal site, then generalized. In the third case, diagnosis was deep granuloma annulare localized far from the initial vaccination site, with recurrence following tuberculin test. In the three cases, diagnosis was made on the basis of clinical and histological elements. DISCUSSION: The relationship between granuloma annulare and BCG may seem evident when the eruption occurs at the vaccinal site, but remains difficult to prove. Diagnosis essentially relies on the absence of other classical etiologies and a compatible delay. When a vaccination such as BCG appears to be the cause of granuloma annulare, a possible cause would be injection trauma or a cell-mediated-delayed-hypersensitivity reaction to a specific antigen contained in the vaccine, leading to development of skin disorders such as granuloma annulare in predisposed subjects. Reports of granuloma annulare following BCG are uncommon but the incidence may be underestimated. In practice, diagnosis of granuloma annulare following BCG or tuberculin skin test cannot be established until BCG dissemination infection is ruled out, a necessary clinical and paraclinical step required in all cases of eruptions following this vaccination. Granuloma annulare is a benign complication requiring no treatment and does not constitute a contraindication for other usual vaccinations.

Adjuvants, Immunologic↗
PubMed2000

Wells' syndrome associated with recurrent giardiasis.

Wells' syndrome (WS) is a rare, recurrent, inflammatory dermatosis of uncertain pathogenesis, although a hypersensitivity response to different stimuli has been postulated. Several cases in association with parasitic infections have been described. We present a patient with WS associated with recurrent giardiasis. The course of the dermatosis was strictly related to the course of the parasitic infection. Both diseases disappeared with antiparasitic treatment. To our knowledge, this association is here reported for the first time.

Cellulitis↗
PubMed2000

[A case study of Woringer-Kolopp disease. Immunohistochemical study].

Woringer-Kolopp disease is a localized epidermotropic T cell lymphoma with good prognosis. We describe a 79-year-old man with an erythematous scaly plaque of the foot. Clinical diagnosis of psoriasis, parapsoriasis and fungal infection were proposed. Histopathological and immunohistochemical findings were characteristic of Woringer-Kolopp disease. We observed an immunohistochemical positivity of tumour cells for the anti-CD103 antibody (alphaEB7 integrin) according to the epidermotropism of this localized cutaneous T cell lymphoma.

Aged↗
PubMed2000

[Rhabdomyosarcoma at site of pacemaker implantation].

BACKGROUND: Malignant proliferation at the site of implantation of a pacemaker generator is uncommon. We report the case of a patient who developed rhabdomyosarcoma. CASE REPORT: A 85-year-old man presented with a voluminous and rapidly evolving tumor localised beneath the right clavicle. This inflammatory and necrotic lesion developed on the area where a titanium pacemaker had been implanted five years earlier. Rhabdomyosarcoma was diagnosis on the basis of immunohistochemistry findings. In spite of a wide surgical excision of this primitive tumour, visceral dissemination appeared, rapidly leading to the patient's death. DISCUSSION: This observation rises the question of the role of the pacemaker implantation in tumor development. The excellent in vivo tolerance and the widespread utilization of titanium as biomaterial is an argument against its carcinogenic action. Inversely, a metal-related chronic inflammatory reaction could favor the neoplastic process in predisposed subjects as has been observed with prosthetic materials used in orthopaedics.

Aged↗
PubMed1999

[Hemangioma and superficial arteriovenous malformations].

Haemangiomas are different from true superficial vascular malformations. The haemangiomas, mainly affecting the newborn and small babies, will, after a phase of progression, sometimes regress completely. Therapeutic abstention is the rule except in high risk angiomas when steroid therapy may be effective. Visceral involvement poses problems. Superficial vascular malformations, on the other hand, arise at all ages and may affect any blood vessel. Each type has a specific clinical presentation, complementary investigations and appropriate treatment. Some are slowly progressive, for example capillary, venous and lymphatic malformations. Others are haemodynamically active, such as the arteriovenous malformations. Capillary malformations are flat angiomas with aesthetic consequences, apart from the Sturge-Weber-Krabbe syndrome. Cold, blue venous malformations confirmed by ultrasonography and magnetic resonance imaging, when necessary, require treatment adapted to their site and size: compression, embolisation, surgery or abstention. Lymphatic malformations may be cystic or tissular: the cystic lymphangioma, a soft swelling of often healthy skin, with compartments separated by septa on ultrasound scan, is usually treated by ethibloc embolisation. Arteriovenous malformations, warm and pulsatile, demonstrated at arteriography, may progress rapidly and treatment by surgery or embolisation, when necessary, has to be complete. Finally, there are complex vascular malformations which pose very difficult problems of management.

Age Factors↗
PubMed1999

[Giant multifocal venous malformation with monomelic predominance].

INTRODUCTION: Venous malformations are usually easy to recognise. We describe one case in which the clinical aspect was suggestive of Maffucci's syndrome. OBSERVATION: A 44-year-old male, had numerous angiomatous nodules which could be emptied by pressure since infancy. The progressive increase in volume of these lesions on the arms and forearms led to enormous deformation and major disability. The thoracic area and the right foot were also affected to a lesser degree. Two endobuccal lesions were also found on the clinical examination The cutaneous lesions were tender and occasionally hyperhidrosis was present. The presence of phleboliths on Xray and the presence of venous and capillary cavities with numerous thrombi confirmed the diagnosis of venous malformation. Following the failure of the Ethibloc(R) embolization, eight excisions were made in a two-year-period with a good functional result. Elastic strapping was then applied. DISCUSSION: The diagnosis of venous malformation was based on clinical, radiological and histological findings. The absence of chondroma excluded the diagnosis of Maffucci's syndrome. Spindle cell hemangioendothelioma, "blue rubber bleb nevus" and glomangiomatosis were confirmed by the histological findings. The absence of port-wine stain or bone hypertrophy and the presence of multiple nodules excluded Klippel-Trenaunay syndrome. The presence of multifocal involvement with oral lesions, the severity of the deformation and the relative success of the surgical procedure make this case unusual.

Adult↗
PubMed1999

[Sleep apnea syndrome and stroke in the elderly population].

The objective was to compare the prevalence of sleep apnea syndrome (SAS) in elderly individuals with a history of stroke to the one in individuals, matched by age and sex with a history of insomnia. To determine if previous subjective sleep complaints in the elderly are associated with stroke. A cross-sectional study with subsequent 3-year follow-up was designed in an acute geriatric inpatient unit. 19 subjects with documented stroke and 21 subjects with insomnia were included. All participants were assessed with a sleep questionnaire, an overnight polysomnographic examination including a recording of respiratory movements, and pulse oximetry. SAS was diagnosed in 68.4 p. 100 in the stroke group compared with 28.6 p. 100 in the insomnia group (p = 0.01). The median apnea/hypopnea index was significantly higher in the stroke group: 25 events per hour versus 2 in the insomnia group (p = 0.01). The median lowest oxygen saturation was not significantly different in the two groups (p = 0.3). Snoring and previous daytime sleepiness were both correlated with stroke (p = 0.05, p = 0.003). Among sleep complaints and cardiovascular risk factors, only a history of diabetes and previous daytime sleepiness were found to be significantly associated with stroke (p = 0.01, p = 0.002). Mortality was higher in SAS subjects (58.8 p. 100) than in non SAS subjects (33 p. 100). The difference was not statistically significant (p = 0.14), but a tendency could be noticed. SAS is a common finding in elderly individuals after a stroke. Physicians must be aware of the risks of prescribing sedatives and anxiolytics to these patients.

Acute Disease↗