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Biomedical subjects

G Chomette

Publications and source records attributed to G Chomette.

At least 145 records · Page 8Linked to original sources
PubMed1986

[Angiolymphoid hyperplasia with eosinophilia (Kimura's disease). Apropos a case report with ultrastructural and histoenzymological study].

One case of angiolymphoid hyperplasia with eosinophilia is related in a 30-years old woman. This observations has all the characteristics of the disease: telangiectasic oedema, nodules and infiltrated areas located in the cervico-facial skin and also in the nasal and buccopharyngeal mucosa. Histologically, the proliferation is made of adult or young capillaries surrounded by inflammatory cells. The results of the peculiar morphological methods used here prove the endothelial nature of cells: high enzymatic activities of alkaline phosphatase and ATPases; factor VIII present on the cells; ultrastructural features characteristic of more or less differentiated vessels. Besides their nosologic interest, these methods may be useful for the diagnosis of this disease with the other vascular tumors.

Adult↗
PubMed1986

Ultrastructural study of the lacrimal gland in a case of Sjögren's syndrome.

A 78-year-old woman, affected by a Gougerot-Sjögren's syndrome, had a typical keratoconjunctivitis sicca associated with xerostomia. A biopsy of lacrimal and accessory salivary glands was studied by conventional histological methods. In addition, the lacrimal gland was studied by electron microscopy. The two varieties of gland showed lesions of the same intensity with a similar decrease of lactoferrin and lysozyme. However, the ultrastructural features noted in the lacrimal gland were suggestive of an immunological reaction different from that noted in salivary glands. The attrition of ductal epithelia by lymphocytes was obvious but was never followed by regeneration and ductal ectasia. The massive infiltration of lymphocytes in the lobules and the early sclerosis of gland tissue appeared to be the main factor. Apparently, the sclerosis was not consecutive to the activity of periductal myoepithelial cells but resulted from the activity of fibroblasts in the production of basal membranes and collagen connective tissue.

Aged↗
PubMed1986

[Renal lesions induced by cyclosporin. Apropos of 4 renal biopsies and 22 necropsies of recipients of heart transplant].

The morphological study of kidney in patients without any preexistent renal disease and treated by cyclosporine corroborated the nephrotoxicity of this immunosuppressive drug. 4 biopsies (in 2 patients with Behçet's disease, in 1 recipient of allogenic medullary graft and 1 recipient of heart transplant) were performed for acute renal failure observed in a variable time after the beginning of treatment (7th day to 14 months). In two cases, they demonstrated obvious vascular lesions (arteriolar or glomerular thrombosis, fibrinoïd necrosis) and they detected constantly changes of proximal convoluted tubules (epithelial vacuolization or necrosis, calcifications). In addition, the ultrastructural study performed in all cases showed a striking increase of lysosomes and some giant mitochondria. The 8 autopsies of recipients with heart transplants treated by cyclosporine for more than 1 month corroborated also these renal changes which were always correlated with biological perturbations of the renal function (increase of level of serum creatinine). Besides the proximal convoluted tubular lesions (vacuolization, necrosis and calcifications), an obvious increase of the interstitial tissue proportional to the long time of treatment was always detected.

Adolescent↗
PubMed1986

[Post-stress nonlithiasic acute cholecystitis. Contribution of ultrasonics to the diagnosis and treatment in 50 cases].

Fifty cases of post-stress acute acalculous cholecystitis were observed during the past 9 years, mainly after major surgery or trauma. The apparently increasing incidence over the last 4 years (42 cases) could probably be explained by a better diagnostic approach of this condition by routine use of ultrasonography. No specific etiological factor could be found; however total parenteral nutrition and/or sepsis and/or use of narcotics could possibly play a role in the appearance of this complication. Although diagnosis can occasionally be suspected in the basis of abdominal and infectious signs, diagnosis was made primarily on the following ultrasonographic signs: enlarged gallbladder with thickened wall, sludge, and occasionally a double-wall aspect and a pericholecystic collection. In this series, most of the patients were treated by cholecystectomy, but a new therapeutic approach was used in 10 cases: percutaneous transhepatic drainage under sonographic control. Outcome is still poor, with a 50 p. 100 mortality rate.

Acute Disease↗
PubMed1986

[Toxoplasmosis and lupus. A review of the literature apropos of 4 cases].

The authors report 4 cases of toxoplasmosis in patients with acute disseminated lupus erythematosus (ADLE). In one case, a pregnant patient with serology indicative of chronic infection, infected the neonate who died of subacute toxoplasmosis. Although ADLE is a classical cause of immunodepression, toxoplasmosis is a rare complication; only 5 cases were found in a review of the literature. Toxoplasmosis infection may resemble an exacerbation of lupus; an accurate diagnosis is essential as the treatment of the two conditions is radically different. The problems of diagnosis of toxoplasmosis in immunodepressed patients are reviewed and the therapeutic approach, especially in pregnant patients, is discussed. In ADLE, the authors recommend checking toxoplasmosis serology before starting and during treatment with corticosteroids. Special attention should be paid to pregnant women with apparently chronic serological changes as neonatal infection may occur.

Adolescent↗
PubMed1986

[Basal cell adenoma of the parotid. Apropos of a case with an ultrastructural study].

A case of Basal cell adenoma occurring in a 42 year-old woman is reported. Histological examination showed trabeculae of basaloid cells with thick Basal Membrane at the periphery. By Electron Microscopy most of the cells displayed numerous desmosomes and intracytoplasmic tonofilaments indicating epidermoid differentiation. In addition some glandular cells were observed. No myoepithelial cell were present. Electron Microscopy may be useful to differentiate basal cell adenoma from Adenoid cystic carcinoma which is made up of a majority of poorly differentiated cells.

Adenoma↗
PubMed1986

[Congenital hyperparathyroidism. 3 cases].

Hypotonia, neonatal respiratory distress with a chest wall deformity should arouse clinical suspicion to the diagnosis of primary hyperthyroidism. The most common signs at this age are hypercalcaemia, increased alkaline phosphatase, low TRPP and radiological changes especially in the hip. Radio-immunological assay of PTH and plasma concentrations of Vitamin D metabolites are important diagnostic aids but the interpretation of these results should take the clinical and familial context into consideration. Rapid bone structural changes, the resistance of the hypercalcaemia to usual therapeutic measures and the progression to rickets justify urgent surgical treatment. Nearly all cases are due to clear cell hyperplasia.

Alkaline Phosphatase↗
PubMed1986

[Enteropathy caused by clofazimine].

A case of Clofazimine enteropathy is reported, diagnosed on the demonstration of red brown birefringent crystals in the small bowel mucosa and submucosa as well as in the mesenteric lymph nodes whereas the clinical and radiological signs appear to be non specific. After the withdrawal of the drug, a clear improvement of the symptoms was achieved only under a gluten free diet. The possibility of such accidents, sometimes lethal, suggests the restriction of clofazimine to leprosy.

Clofazimine↗
PubMed1985

Human cardiac transplants. Diagnosis of rejection by endomyocardial biopsy. Causes of death (about 30 autopsies).

1,000 endomyocardial biopsies performed in 110 patients treated by cardiac graft were reviewed. These biopsies permitted early detection of acute rejection after cyclosporin treatment and a good appreciation of its intensity. By this method, almost all rejection episodes were resolved after adequate treatment. Chronic rejection was diagnosed by arteriography used in vivo or in cardiac transplants removed by surgery or necropsy. Rejection provoked an obliterative fibrous endarteritis often complicated by atherosclerosis and its ischaemic consequences. 34 autopsies were performed in patients dead at a variable time after cardiac or cardio-pulmonary transplantation. In early death (14 cases), graft failure and systemic disorders were observed. Acute and chronic rejection was noted less frequently (9 cases). Systemic infections (10 cases) occurred either early (post-surgical complications) or late (bacterial, fungal and parasitic lesions). In one case, death was due to a contemporaneous bladder carcinoma. The complications of cyclosporin treatment are briefly discussed.

Acute Disease↗
PubMed1985

Histoenzymological features of epithelial cells in lesions of oral mucosa in cysts and ameloblastomas of jaws.

A histoenzymological study was carried out on 41 tissue specimens removed at biopsy and for surgical operations of the following lesions: benign hyperkeratosis, lichen planus, severe epithelial dysplasia, carcinoma in situ, epidermoid carcinoma, radicular cyst, odontogenic keratocyst and ameloblastoma. The purpose of this study was to study some possibly significant variations in levels of activities of oxidative enzymes, diaphorases, acid phosphatases and Naphthol esterases in such lesions (normal oral mucosa and epidermis serving as controls). In the lesions of the oral mucosa, these histoenzymological variations were not sufficiently characteristic to contribute to histological diagnosis. In lichen planus, some vacuolated or necrotic basal cells lacked enzyme activities, whereas in the upper layers, enzyme activities were irregularly present. Benign hyperkeratosis showed enzymatic activities similar to those of the normal epidermis, namely high oxidative activities particularly prominent in basal cells and in granular layer, and esterase activity beneath the keratinized layer. In severe epithelial dysplasia, carcinoma in situ and epidermoid carcinoma, numerous variations of activities of oxidative enzymes, esterases and acid phosphatase were seen from one cell to the other. In cystic diseases of jaws, enzymatic activities were equally nonspecific in the epithelial lining of the radicular cyst and the odontogenic keratocyst (activities similar to those of normal oral epithelium and epidermis, respectively). But in common ameloblastoma, there was diffuse uniformly low oxidative enzymatic activities in the epithelium and high widespread activity of alkaline phosphatase in the stroma. The latter may be useful in differentiating the cystic acanthomatous variety of ameloblastoma from odontogenic keratocysts of the jaws.

Ameloblastoma↗
PubMed1985

Kidney and cancer: results of immunofluorescence microscopy.

Kidneys obtained at autopsy were studied by immunofluorescence in order to detect the presence of glomerular deposits in 129 patients who had presented with solid tumors, and in 55 patients without carcinoma utilized as controls. Deposits were observed in 22 of the neoplastic patients (17%), but only in 3 of the others (5.4%) (p less than 0.05). Among all solid tumors, glomerular deposits were most often observed in digestive carcinoma (p less than 0.02). These deposits were usually mesangial and they were never subepithelial. IgG and/or IgM and/or C3 deposits were demonstrated in 14 of 22 patients, IgA deposits were present in the 8 others (36%). Thus malignant neoplastic diseases should be taken into account as a possible etiologic factor in IgA nephropathy and they should be looked for in older patients with Berger's disease.

Adult↗