Biomedical subjects
Publications and source records attributed to F Piette.
A case of basal cell epithelioma overlying a long-standing histiocytofibroma is presented. The association of these two tumors is a rare finding. The role of dermal factors in the pathogenesis of epidermal tumors is briefly discussed, just as the controversy about the reactive or neoplastic nature of the epidermal change.
Previous studies having shown differences in the clinical presentation of hyperthyroidism in the young and in the over sixty-years old patients, we studied the presentation of hyperthyroidism of late onset without previous thyroid disorder to determine if it continued to change with age after 55 years. Two hundred and ninety cases of hyperthyroidism presenting after the age of 55 years without a previous history of goitre, collected in the Department of Nuclear Medicine of the Pitié Hospital between January 1976 and May 1980, were analysed retrospectively. There was no significant correlation between age and heart rate or total circulating thyroxine (T4) and triiodothyronine (T3) concentration. A positive correlation with weight loss and a negative correlation with I 131 fixation were observed. It was higher in cases of atrial fibrillation and hyperthyroidism with normal thyroid scintigraphy. Graves' disease with goitre was associated with the most overt signs of thyrotoxicosis and the highest hormonal concentrations, contrarily to toxic adenoma. The T3 but not T4 concentration correlated positively with heart rate. T3 and T4 were positively correlated with weight loss, and this correlation remained significant at constant T4 and T3 concentrations.
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The various laser-systems can be classified according to: 1) the wavelength or range of wavelengths of the beam and 2) the method of delivery of the laser output: continuous or pulsed. -- Principal continuous-wave lasers are: -- the argon-ion laser, which produces multiple transitions ranging from 448 to 544 nm, -- the neodymium yttrium aluminium garnet (Y. A. G.) operating in the near infrared at a wavelength of 1,060 nm, -- and the carbon-dioxide laser with its output occurring in the far infrared, at 10,600 nm. Continuous-wave lasers induce essentially thermal effects which are used to coagulate or volatilize various superficial skin lesions. But when high power density is required, the relative benefit of lasers as compared with other conventional thermal devices (such as high-frequency electrocoagulator) is not obvious. On the other hand, the argon laser is capable of selectivity damaging pigmented cutaneous lesions with satisfactory healing of the laser wound and sparing of the overlying skin. This selective absorption is useful in the treatment of some vascular lesions such as port-wine stain or melanotic lesions or tattoos, and gives a good results. The specific color absorption is not so pronounced with the Nd-YAG laser and is absent with the carbon dioxide laser, chiefly used as an "optical scalpel". Photochemical effects produced by other continuous-wave lasers such as U.V. lasers, seem to be of interest in photobiology research and in destruction of tumors after the addition of a colorant. -- Pulsed laser systems produce not only thermal but also "non-linear" reactions, which are not well-known. The classical ruby laser is still appropriate in the treatment of some skin lesions.
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In patients with malignant melanoma, histiocytofibromas often appeared to be present. The frequency of this association has been determined in 60 female and 40 male patients, and compared with age- and sex-matched controls. Histiocytofibromas are significantly more common in females with malignant melanoma than in controls. This relationship is not found in males. Therefore, it would seem important to make a careful examination of nevocytic nevi in women having this benign tumour because of the high risk of developing a malignant melanoma.
An infant with disseminated cutaneous osteomatosis as described by Worret and Burgdorf is described. The diagnosis was confirmed by histology which distinguished the bone formation from sub-cutaneous calcification. The prognosis of disseminated cutaneous osteomatosis is guarded because there may be extensive skin involvement and because of the absence of effective treatment.
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Some clinical features of syphilis suggest that immune complexes may be a pathogenetic factor in the syphilitic lesions. Recently, circulating immune complexes have been reported in six patients with secondary syphilis by Søling et al. In our study, the presence of circulating immune complexes was investigated in 42 patients with syphilis (primary, secondary, serological) by the method of C1q binding test. Elevated C1q binding activity was demonstrated in two-thirds of the patients with primo-secondary syphilis, with a significant difference between this group and the controls. Only two of the 21 patients with serological syphilis showed elevated C1q binding activity. Circulating immune complexes, often at moderates rates, appear very early and decrease rapidly during treatment. It was not possible to demonstrate a decline in serum complement in association with elevated C1q binding activity. During five Jarisch-Herxheimer reactions, no increase in circulating immune complexes has been noticed compared to pre-treatment values: this suggests that circulating immune complexes have no essential importance in this reaction. The characterization of the components of these circulating immune complexes by the previously described "radioimmunoprecipitation PEG assay" (RIPEGA) will enable us to state their specificity and to conceive their potential responsibility in some lesions of secondary syphilis, such as nephrotic syndrome.
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