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G Chomette

Publications and source records attributed to G Chomette.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Pulmonary hyalinizing granuloma. Apropos of 2 new cases].

Pulmonary hyalinising granuloma are nodular or localised fibrosing lesions of the pulmonary parenchyma and are single or multiple. We report two new cases of this disorder which is rare, as only 62 cases have been published in the literature. It is a pathology with few symptoms, sometimes revealed by general signs. Radiologically there are nodules which are most often round or oval, intra-parenchymal, well demarcated, single or multiple. The histological appearance is characteristic: the centre of the granuloma consists of a network of dense collagen fibres which are lamellar separated by clear spaces; the periphery is the seat of rich cellular infiltration of plasmocytes and lymphocytes in the peri-vascular region. Most often there is a spontaneous benign outcome. The frequent association of pulmonary hyalinising granuloma in fibrotic disorders and the similarity in the histological appearance leads to the hypothesis of a common pathogenesis in these disorders.

Adult↗
PubMed1991

[An unusual form of primary epithelioma of the mandible: odontogenic clear cell carcinoma. Clinical and morphologic study].

One case of aggressive intramandibular epithelial tumor is presented. This tumor demonstrated an unusual pattern with areas of follicular ameloblastoma together with undifferentiated trabeculae or lobules composed of basophilic cells and of clear glycogenic-rich cells. The odontogenic nature of this tumour and its analogies with common ameloblastoma were demonstrated by electron microscopy, immunohistoenzymology and immunohistochemistry. The signification of such a neoplasm is discussed.

Adenocarcinoma↗
PubMed1991

Acinic cell carcinomas of salivary glands histoprognosis. Value of NORs stained with AgNOR technique and examined with semi-automatic image analysis.

Twenty one patients surgically treated for acinar cell salivary gland carcinomas were studied retrospectively. Four cases were excluded from the results because of an inadequate follow-up time (less than 5 years). The rest was classified into two groups: eleven patients with a favorable outcome were still alive without any recurrence after a mean follow-up period greater than 10 years; in six other patients, recurrences and metastases occurred followed by death in four cases. Previously for such tumors a high degree of histological undifferentiation usually gave rise to a poor prognosis, although some exceptions were noted. Thus, in an attempt to find a more reliable prognosis criterion, we evaluated by semi-quantitative image analysis nucleolar organizer regions by means of AgNOR count and mean area in all these cases. Our results significantly correlated with the clinical prognosis: a high count (more than 3) and a small mean area were always found in tumors with an unfavorable outcome whereas lower counts and larger mean areas were found in tumors with a favourable clinical course. Thus, this method showed promise as establishing the prognosis of acinar cell tumours.

Adult↗
PubMed1991

[Coronary disease in patients after heart transplantation].

The thinking about coronary artery disease in heart transplant patients has changed recently. This term includes not only the traditional accelerated delayed atherosclerosis of the transplant, but also proximal inflammatory vascularitis associated with severe acute rejection and distal vascularitis, which is independent of interstitial rejection. This term is also used to describe purely atheromatous lesions of the large coronary vessels which usually occur in high risk patients. The morphology, significance and prognosis of these various vascular lesions are discussed on the basis of material obtained from biopsies, transplantectomies and autopsies in the cardiovascular surgery service of the la Pitié Hospital.

Arteritis↗
PubMed1991

[Reconstruction of the intestinal tract by intracolonic ileal sleeve. An experimental study and 1st clinical cases].

An experimental study on 15 piglets allowed defining the technical procedure and controlling the anatomical and functional results of various modes of restoration of the ileocolic tract after resection with a terminolateral tubing including and intracolic ileal sleeve. Coloileal fixation was ensured only by a few seromuscular sutures and adhesion with "Tissucol". The clinical application of this procedure was very satisfactory for 9 recent right colectomies, thus confirming the results previously observed for 33 ileal perforations in Africa. The ileocolic tubing technique is easy, reliable, morbidity-free, and causes no leakage of intestinal fluid, no intestinal ischemia and no stenosis. As it prevents coloileal reflux, this assembly may prevent ileitis after right colectomy. Its valvular effect also contributes in the mechanical regulation of transit. The assembly produces a system that can be compared to the ileocecal valve.

Aged↗
PubMed1991

[Metastases of malignant tumor in the jaw. Analysis of 30 case reports].

30 metastases of malignant tumors in jaws were retrospectively studied. They occurred more often in women than in men (17 F/13 H). In 21 cases, the primitive cancer was known and had been treated 1 to 4 years before. In the other cases (9), the bone metastasis led to the discovery of a latent tumor. Clinical signs and symptoms included swelling, pain, loosening of teeth, labio-mental anaesthesia and rarely pathologic fracture. Radiologically, all but two patients had radiolucent lesion. These metastases almost always involved the mandible (95% of cases) and in that bone, most often molar area and angle. Histologically, the majority of lesions were adenocarcinomas from breast (33%) and alimentary canal (stomach, colon). Epidermoid bronchial carcinomas were seen in 5 cases and malignant melanomas in 2 cases. Only one sarcoma of this series was arising from a liposarcoma of the thigh. In all but one patients, evolution was quickly lethal.

Adult↗
PubMed1991

[The effect of CO2 laser radiation on the morphological changes of mucocutaneous wound healing in oral surgery. A histo-enzymologic and ultrastructural study].

The tissular effects of CO2 laser were compared with those of conventional surgery on cutaneo-mucous biopsies performed during stomatologic surgery. Two hours after the incision, a cellular necrosis was seen and vessels were obliterated by a turgescent endothelium, explaining the bloodless character of wounds with laser. After 24 hours, though vasculo-exsudative end inflammatory reaction were weak, an intense functional stimulation of fibroblasts was obvious (turgescent cells with numerous organelles). At the 4th day, this fibroblastic hyperactivity was always persistant with an abundant microfibrillar secretion. Myofibroblasts, usually present during cicatrization after scalpel, were lacking in our material; this constatation should explain the relative slowness of cicatrization after CO2 laser.

Alkaline Phosphatase↗
PubMed1991

Degenerative aortic regurgitation.

In view of the growing incidence of degenerative origin among the aetiologies of aortic regurgitation, we felt it interesting to report our experience of the surgical treatment of such patients. Out of 313 patients operated on for isolated chronic aortic regurgitation between 1974 and 1989, 102 (32.6%) had aortic regurgitation of degenerative origin and form the basis of this study. The patients were divided into group I (n = 48) without aneurysm of the ascending aorta and group II (54 patients) with anulo-aortic ectasia. The first group was further subdivided according to the diameter of the ascending aorta: in group Ia (23 patients) the aorta was normal with a root diameter of less than 40 mm, while in group Ib (25 patients) the aorta was enlarged (root diameter between 40 and 54 mm). There was no statistically significant difference between the pre-operative and operative parameters of patients in groups Ia and Ib. All underwent aortic valve replacement without associated surgery of the ascending aorta. During a mean follow-up of 58 months, five patients from group Ib had aortic dissection and in another three, an ascending aorta aneurysm developed. Reoperation was performed in six cases. No such complications occurred in group Ia. At 6 years, the proportion of patients free from complications related to the ascending aorta was 100% in group Ia vs 63 +/- 6% in group Ib (P less than 0.05). In group II, all the patients underwent aortic valve replacement. The modalities of repair of the ascending aorta differed with time.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Cardiomyocyte in valvular cardiopathies. Comparative morphometry of myofibrils and mitochondria. Functional correlations].

Twenty-four endomyocardial biopsies performed during surgical correction of valvulopathies were compared with ventricular function. Patients were divided into three groups: group I without anomalies of ventricular function, group II with a slight decrease of the ventricular ejection fraction, group III with a low ventricular ejection fraction. Morphometric analysis was carried out using electron microscopic photographs and an image analyser. The results were correlated with those of functional studies. In patients of the second group, the small number of mitochondria with respect to the increased myofibrillary area seemed to indicate mitochondrial dysfunction. In patients of the third group, alterations of myocontractility expressed a myofibrillary deficiency unable to be corrected by the multiplication and the increased exchange areas of mitochondria.

Heart Valve Diseases↗
PubMed1991

[Dystrophic aortic valve insufficiency].

Although dystrophic aortic regurgitation is considered to be a rare condition, if aortic regurgitation due to cystic media-necrosis which usually presents with annulo-aortic ectasia and regurgitation due to dystrophic aortic valves are included, it becomes a relatively common cause of aortic regurgitation. In the authors' experience of 313 patients operated for pure chronic aortic regurgitation, approximately 30% had dystrophic lesions and this was the second most common cause of aortic regurgitation after acute rheumatic fever. The clinical presentation is variable: excluding annulo-aortic ectasia, the other features of dystrophic aortic regurgitation are less well known. Eighty-nine cases without aneurysm of the ascending thoracic aorta were recensed and analysed in a French Cooperative study. They were divided into two groups with respect to the diameter of the ascending aorta measured by echocardiography. The incidence of late postoperative complications of the ascending aorta was higher in patients with a dilated aorta. The diagnosis of dystrophic aortic regurgitation is easy in patients with an aneurysm of the ascending aorta: in other cases, transoesophageal echocardiography is very useful for evaluating the valvular lesions. Surgical treatment of pure dystrophic aortic regurgitation with an aneurysm of the ascending aorta is well established but the best management of aortic regurgitation associated with only mildly dilated aorta is debatable.

Aorta, Thoracic↗
PubMed1991

[Nosologic frontiers of arrhythmogenic dysplasia. Quantitative variations of normal adipose tissue of the right heart ventricle].

The increasing number of arrhythmogenic idiopathic cardiomyopathies with available histological studies by biopsy or peroperative sampling has prompted the need for data about the normal structure of the right ventricle. A retrospective study of right ventricular tissues was undertaken in 148 autopsies. The quantity of adipose tissue was scored 0 (only epicardial fat visible) to 4 (total replacement of the myocardium by adipose tissue). The topography of the adipocytes was also coded 0 to 4 according to the degree of intermyocytic penetration, irrespective of the total quantify of fat. The amount and extension of adipose tissue in the right ventricular wall was striking. Fifty called "normal" appearances with a myocytic wall of normal thickness and a separate layer of epicardial fat, were only present in 61 of the 148 cases. Adipocytes were present in variable numbers, often unexpectedly high in the majority of cases, with no relationship to the age or gender of the patient with frequent individualization of the myocardial bundles. These surprising findings in normal right ventricles should be born in mind when considering the diagnosis of arrhythmogenic right ventricular dysplasia (ARVD). The histopathological appearances of ARVD are very similar but also differ very significantly, at least in typical cases. The adipocytes are often present in large numbers but this is banal and non-specific. On the other hand, the bundles which penetrate the epicardial fat are usually fibro-muscular and not purely myocytic. In addition, arterioles suggesting segmental diversions are present within the fatty layer with non-specific inflammatory cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Adipose Tissue↗
PubMed1991

[Myocardial involvement in 2 women, carriers of Duchenne de Boulogne muscular dystrophy].

Duchenne muscular dystrophy is the commonest genetic muscular disease. The prognosis, which depends on cardiac involvement, is poor. In boys, this takes the form of a hypokinetic cardiomyopathy particularly affecting the postero-lateral wall of the left ventricle which then dilates. The recent identification of the gene which transmits the disease on the X chromosome and of the coded protein, dystrophin, has improved our understanding of the disease. We report two cases of isolated cardiac involvement in two female carriers of the disease, classically thought to be unaffected. They presented with apparently idiopathic dilated cardiomyopathies. These cases show that Duchenne muscular dystrophy is an original example of a genetically determined diffuse muscular disease with cardiac involvement.

Adult↗
PubMed1991

[Contribution to the study of NORs in acinic cell tumors of the salivary glands. Morphometric comparative analysis by optic and electronic microscopy].

Quantification of number and mean area of NORs was retrospectively studied in six acinic cell tumors with a well-known follow-up by means of electron microscopy without any silver staining. The results were compared with those obtained using silver staining and optical quantification. Mean areas were inversely correlated with the number of NORs. Positive correlations were found between these results and the clinical course: tumors with good outcome were characterized by a low NOR count (less than 2) and by large mean areas (greater than 600 microns 2); on the contrary, tumors with recurrences or metastases always had high NOR counts with small mean areas.

Carcinoma↗
PubMed1991

[Dystrophic aortic insufficiency: influence of dilatation of the ascending aorta on secondary outcome].

This cooperative study recensed 89 cases of patients operated for aortic regurgitation in whom the dystrophic process was confirmed on anatomical (thin, translucent valves without symphysis, multilation or sclerosis) and histological criteria (mucinous infiltration). They included 81 men (91%) and the average age was 52 +/- 14 years. The valvular degeneration was part of a generalised dystrophy of elastic tissue in 8 patients (6 "formes frustes" of Marfan's syndrome, 2 Lobstein's syndrome). The patients were divided into 2 groups according to the diameter of the ascending aorta measured by echocardiography and/or aortography. In Group 1 (n = 40), the aorta was not dilated (diameter less than 40 mm) whereas in Group 2 (n = 49), the diameter of the ascending aorta was dilated (40-55 mm) but not aneurysmal (loss of parallelism of the aortic walls). The two groups were comparable before surgery with respect to age, sex, functional class, degree of left ventricular dilatation, left ventricular ejection fraction and presence of associated coronary disease). There were no differences in the operative parameters but aortic parietal biopsy (n = 35) revealed clear signs of cystic medianecrosis more often in Group 2 than in Group 1 (14/25 versus 1/10, p less than 0.05). No operative procedure was performed on the ascending aorta during aortic valve replacement. One operative death occurred in each group. After an average follow-up of 4 years, there was a higher mortality in Group 2: the actuarial 7 year survival rate being 74% in Group 1 and 54% in Group 2. This was explained by a higher incidence of ascending aortic complications. Only 1 patient in Group 1 developed an aneurysm of the ascending aorta requiring reoperation compared to 14 patients in Group 2, 8 of whom were reoperated (p less than 0.01). These results suggest that non-aneurysmal dilatation of the ascending aorta in patients with dystrophic aortic regurgitation is a poor prognostic factor because of the high incidence of secondary aortic parietal complications (aneurysm, dissection).

Actuarial Analysis↗
PubMed1990

Immunohistochemical studies of S-100 protein alpha and beta subunits in adenoid cystic carcinoma of salivary glands.

Immunohistochemical studies were performed to explore the distribution of S-100 protein and its alpha, beta subunits in 76 adenoid cystic carcinomas (ACC) of the salivary glands. Histopathologically. ACC was divided into cribriform, tubular, basaloid and trabecular types which could be mixed in the same tumor. S-100 protein was usually positive in tumor cells forming cribriform structures; foci of strongly positive tumor cells were also distributed in the luminal layer of tubular structures, and in areas transitional between cribriform and tubular patterns. S-100 alpha staining was confined to some tumor cells in cribriform areas, to luminal tumor cells in tubular structures and to few tumor cells in basaloid structures. S-100 beta reaction was usually localized to luminal surfaces in a fine granular pattern in tubular and microtubular structures in a distribution somewhat similar to that in the normal salivary gland. Great heterogeneity in the immunohistochemical distribution of S-100, S-100 alpha and S-100 beta proteins was found in the various histologic types of ACC and the pattern was different from that seen in pleomorphic adenomas. It is possible that the ACC tumor cells positive for S-100 protein may be closely related to true or modified myoepithelial cells.

Carcinoma, Adenoid Cystic↗
PubMed1990

Stromal changes in early invasive breast carcinoma. An immunohistochemical, histoenzymological and ultrastructural study.

The purpose of this work was to detect in periductal connective tissue of breast carcinoma in situ changes induced by intraductal tumor cells before any dehiscence in basement membrane. Histological, electron microscopic, immunohistochemical and histoenzymological methods were used in 3 carcinomas in situ, 4 microinvasive carcinomas and 13 control invasive carcinomas. We could demonstrate a high functional activity of fibroblasts with secretion of mucopolysaccharides and type III collagen around intraductal carcinomas. These changes occurred simultaneously to those of the basement membrane which was either thinning or thickening. Any dehiscence in basement membrane secondarily induced in this periductal stroma the usual changes seen in invasive stroma, peculiarly numerous vascular pedicles, myofibroblasts, elastic material. These periductal stromal changes are interpreted according to recent concepts about the possible influence of tumor cells upon their environment: stimulation of mitotic and metabolic activity of fibroblasts: stimulation of angiogenesis by means of an angiogenic factor.

Breast Neoplasms↗