Search PubMed⌕ Search

Biomedical subjects

J Palou

Publications and source records attributed to J Palou.

At least 55 records · Page 3Linked to original sources
PubMed1998

Systemic xanthohistiocytoma: a variant of xanthoma disseminatum?

We present a 66-year-old man who had maculopapular pigmented lesions on the skin of the head, neck and trunk suggesting generalized eruptive histiocytoma (GEH). These lesions had a yellowish centre in a target-like pattern that has not been previously described. The patient suffered from diplopia and had a severe sensorimotor polyneuropathy causing progressive paresis of the limbs. The explorations performed disclosed the presence of specific xanthomatous infiltrates in the skin, lungs, respiratory tract, peripheral nerves and meninges, suggesting xanthoma disseminatum (XD) or juvenile xanthogranuloma. Multiple osteolytic lesions of large bones were also found. The infiltrate was CD68, MAC 387 and factor XIIIa positive and S-100 and CD1 negative. Some cells contained worm-like bodies visible by electron microscopy. Our patient presented clinical and immunohistochemical findings suggestive of GEH, juvenile xanthogranuloma or XD, supporting the idea of a wide spectrum of non-Langerhans cell histiocytosis. These specific target-like xanthomatous lesions seem to be unique for this new variant of XD.

Aged↗
PubMed1998

Mid-arm sentinel lymph nodes showing surprising drainage from a malignant melanoma in the forearm.

A 51-year-old man with a malignant melanoma in his left forearm was studied to detect the sentinel lymph node and to assess the possibility of micrometastases in regional lymph nodes. Lymphoscintigraphy demonstrated two sentinel lymph nodes in the midarm. Two other nodes in the same location as well as in the left axilla were also observed. The exact location of the sentinel lymph nodes was identified with a gamma-ray detector. At the time of surgery, blue dye was injected around the primary lesion and the two sentinel lymph nodes on the inner side of the left arm were resected. Both lymph nodes were pigmented black. The histopathologic study demonstrated metastases from malignant melanoma in both nodes. This case reflects the main role of lymphoscintigraphy in identifying draining lymph nodes in unusual locations as observed in this patient.

Axilla↗
PubMed1998

Sclerosis and the Nd:YAG, Q-switched laser with multiple frequency for treatment of telangiectases, reticular veins, and residual pigmentation.

BACKGROUND: The combination of low concentrations of sclerosing solution and the Nd:YAG, Q-switched laser with multiple (quadruple) frequency provides good results in the treatment of telangiectases and reticular varicose veins of the lower extremities, as well as pigmentation that may appear during sclerotherapy. OBJECTIVE: This paper is based on a series of patients with telangiectases and reticular veins who were treated with sclerotherapy and the Nd:YAG, Q-switched laser with quadruple frequency. METHODS: Patients with telangiectases and reticular veins received two or three treatment sessions with polydocanol and the Nd:YAG, Q-switched laser with quadruple frequency. Then, they were assessed a clinical score corresponding to the level of improvement achieved. Residual hematic pigmentation lesions were also eliminated with the laser. RESULTS: Excellent improvement was evident in 90% of the patients with minimal residual lesions. CONCLUSIONS: The combined technique of sclerosing solution and the Nd:YAG laser with multiple frequency is a valid alternative for the elimination of telangiectases and reticular veins of the lower limbs. This technique has several advantages, such as the use of low concentrations of sclerosing solution, high patient acceptance levels due to minimal disturbances, and the fact that local anesthesia is unnecessary. Good results are obtained without complications and minimal residual pigmentation. These mild pigmentation can be treated with the Nd:YAG laser.

Adult↗
PubMed1998

Primary bladder carcinoma in situ: assessment of early BCG response as a prognostic factor.

OBJECTIVES: To evaluate the prognosis of primary bladder carcinoma in situ (CIS) according to the response to bacillus Calmette-Guerin (BCG). PATIENTS AND METHODS: Twenty-six cases of primary CIS were treated with BCG. Mean, median and minimum follow-up periods were 47, 56 and 24 months. At 6 months, the patients were evaluated endoscopically and the response was classified as complete, partial or failure. RESULTS: Twenty-one patients (80.8%) showed complete response to BCG, 3 did so after a second course; 28.5% relapsed or progressed at a mean of 44 months. Five patients (19.2%) did not respond initially and all progressed in a period of 6 months. Early response to BCG was the only significant prognostic factor (p < 0.005). CONCLUSIONS: A high- and a low-risk group of bladder CIS can be differentiated according to the response to BCG. CIS of the bladder has a poor prognosis, and the number of patients who developed progressive disease is significantly higher among the nonresponders.

Administration, Intravesical↗
PubMed1998

The Q-switched neodymium (Nd):YAG laser with quadruple frequency. Clinical histological evaluation of facial resurfacing using different wavelengths.

BACKGROUND: The Q-switched neodymium (Nd):YAG laser with quadruple frequency is very effective for the treatment of tattoos, pigmented lesions, and vascular, benign lesions. It is also an option for treating rhytides, scars, and facial pigmentations. OBJECTIVES: This paper is based on a series of patients with periocular and perioral rhytides, postacne scars, and melanic and vascular eyelid pigmentation who were treated with the Q-switched Nd:YAG laser with quadruple frequency. METHODS: The patients were divided in three separate groups: facial wrinkles, postacne scars, and eyelid pigmentation. All were biopsied before and after the laser treatment. Different wavelengths (1064, 650, 585, and 532 nm) were used in order to study the clinical improvement and the histological changes that occurred several weeks following the laser treatment. Additionally, these biopsies aided in observing specific histological characteristics related to applying the different wavelengths by evaluating them along with the clinical results. RESULTS: Very good results were achieved in the 22 facial wrinkle cases with two treatments. Excellent results were achieved in the 28 postacne patients, and the outcome of the 16 patients with pigmentation of the eyelids were considered good. CONCLUSION: The Q-switched Nd:YAG laser with quadruple frequency can be classified as a valid alternative for facial resurfacing. The results obtained are comparable to those with the pulsed carbon dioxide lasers, plus it has the advantage of being effective on vascular lesions.

Acne Vulgaris↗
PubMed1998

[Detection of sentinel lymph nodes by lymphatic gammagraphy and intraoperative gamma-ray probe in patients with malignant melanoma. Initial results].

In the last years there has been an arising concern in the sentinel lymph node identification, the first lymph node to receive direct draining from the primary tumour, specially in malignant melanoma (MM). We studied 20 patients with MM: 10 with palpable regional lymph nodes and 10 without palpable LN by performing a lymphoscintigraphy using 99mTc-nanocolloid and a gamma-ray detecting probe during the surgery to locate the sentinel lymph node. In patients with palpable LN, 13 sentinel lymph nodes were identified. Ten of them were MM involved. Furthermore, 82 LN were harvested from involved lymph basins and 30 of them were positive for MM. In patients without palpable LN, 14 sentinel lymph nodes were identified (3 positives and 11 negatives for MM) and other 76 LN were resected (all of them negative). There were not < > in any patient. These preliminary results support the utility of the technique for the diagnosis and lymphadenectomy selection in patients without palpable LN but which could be involved by micrometastases.

Adult↗
PubMed1997

T-cell population of primary and secondary cutaneous B-cell lymphomas does not express the cutaneous lymphocyte-associated antigen (CLA).

Primary cutaneous B-cell lymphomas (CBCL) are a group of malignant lymphomas with apparently distinct clinicopathological and immunophenotypical features. As in other B-cell lymphomas, the accompanying benign cell population in CBCL includes a variable number of T lymphocytes whose role is not well understood. In the present study we characterized the immunophenotype of these T cells and compared it with that of the reactive T-cell population in specific skin involvement by noncutaneous B-cell malignancies. Our results indicated that most T cells in both primary and secondary B-cell lymphomas were CLA+ memory/effector helper T cells which differed from the currently known CLA+ memory/effector helper T lymphocytes of the skin-associated lymphoid tissue (SALT) system. However, the endothelial CLA ligand, E-selectin, was expressed on dermal vessels. These results suggest that a B cell environment and/or a lack of epidermal involvement promote(s) the recruitment into the skin of a different, apparently less specific, subset of memory helper T cells from those seen in T-cell-mediated dermatoses.

Antigens, CD7↗
PubMed1997

It's like a pain in the ... perineum: a surgical clip protruding into the urethra through the urethrovesical anastomosis after radical prostatectomy.

A 69-year-old male underwent a radical retropubic prostatectomy for prostate cancer. He presented severe perineal pain that prevented him from sitting normally after removal of the urethral catheter. Cystography and echography disclosed a possible aetiology that was later confirmed by cystoscopy: a metal clip protruding into the urethra through the urethrovesical anastomosis.

Aged↗
PubMed1997

Immunohistochemical study of alpha, mu and pi class glutathione S transferase expression in malignant melanoma. MMM Group. Multidisciplinary Malignant Melanoma Group.

Human pi, mu and alpha class glutathione S transferases (GST) have been localized immunohistologically in normal skin, naevi and melanoma. Pi GSTs were found principally in the stratum basalis and, to a lesser extent, in the superficial layers. Normal melanocytes showed strong nuclear and cytoplasmatic staining. Distribution of GST mu in the epidermis showed that only the stratum basale, where melanocytes are located, stained well but with weak nuclear staining. Normal melanocytes were also well stained. The alpha GSTs were relatively abundant in the upper strata and to a lesser extent, in the basal layers. The absence of nuclear staining gives these cells a target appearance. Normal melanocytes showed strong cytoplasmatic staining. The pi GSTs seem to be most persistently and strongly expressed in malignant melanoma (MM), but mu GSTs are also found, whereas the alpha GSTs were only occasionally present. The finding of the GST mu in the melanocytes of the basal layer raises new questions regarding the role of GST mu in these cells because of the inherent risk of MM in individuals with a congenital deficiency of this isoenzyme. The role of GSTs in the resistance of cells to chemotherapy is also discussed.

Cell Nucleus↗
PubMed1997

[Squamous cell carcinoma of the penis: treatment protocol according to our 14 years of experience].

OBJECTIVE: The management of lymph nodes and the determination of prognostic factors are matters of controversy in the treatment of squamous cell carcinoma of the penis. We attempted to establish an approach based on the different types of lymphadenectomies and biopsies we have performed and to evaluate local stage and grade of cellular differentiation as prognostic factors. METHODS: 81 cases treated at our institution between 1980 and 1994 were reviewed. The results of the different lymphadenectomies and biopsies performed were analyzed. Tumors were staged according to the Jackson and TNM classifications; in 62 cases the pathological samples were reexamined by the same pathologist to determine the grade of cellular differentiation according to the Broders classification. A p value of < 0.05 was considered significant. RESULTS: We did not obtain reliable results with the biopsies done and variable results in the lymphadenectomies performed. The grade of cellular differentiation and local stage were both statistically significant with respect to the presence of positive lymph nodes. We found statistically significant differences for survival according to the stage of the positive lymph nodes. CONCLUSION: We have established three approaches in management of squamous cell carcinoma of the penis according to the local stage and grade of cellular differentiation.

Adult↗
PubMed1997

Grade, local stage and growth pattern as prognostic factors in carcinoma of the penis.

OBJECTIVES: To assess the management of adenopathies and the determination of prognostic factors in the treatment of squamous carcinoma of the penis. MATERIALS AND METHODS: We reviewed 81 cases treated at our Institution between 1980 and 1994. In 62 cases, we review the pathologic samples according to the growth patterns proposed by Cubilla et al. RESULTS: We find that both the grade of cellular differentiation and the local stage of the tumor are statistically significant with respect to the presence of positive adenopathies. We obtain results similar to Cubilla's work and different survival rates for the patterns of tumor growth. CONCLUSIONS: On the basis of our results, we propose 3 differentiated follow-up and treatment groups. We suggest that the new growth pattern classification is useful as prognostic factor in carcinoma of the penis. We corroborate that prophylactic lymphadenectomy is indicated in tumors of vertical growth, while a conservative management should be considered in tumors of verrucous growth.

Adult↗
PubMed1996

In situ transitional cell carcinoma involvement of prostatic urethra: bacillus Calmette-Guérin therapy without previous transurethral resection of the prostate.

OBJECTIVES: Bacillus Calmette-Guérin (BCG) has demonstrated both the efficacy in patients with carcinoma in situ (CIS) of the bladder and the penetration in the prostate (granulomas) after endovesical treatment. We treated patients with CIS of the prostatic urethra with bladder instillations of BCG without previous transurethral resection to assess the local therapeutic effect. METHODS: Eighteen patients with CIS of the prostatic urethra (15 multifocal CIS and 15 associated to superficial bladder carcinoma) were treated with endovesical instillations of 81 mg of BCG Connaught weekly for 6 weeks. RESULTS: After a mean follow-up of 31 months, 14 of 18 patients had complete response, 3 had progression (2 in the prostate and 1 in the bladder); diffuse CIS of the bladder persisted in 1 patient. Three patients required cystectomy and 1 underwent palliative transurethral resection. Fifteen patients are alive with no evidence of disease, 2 patients died due to progression of the disease, and 1 is alive with tumor. CONCLUSIONS: The presence of CIS in the prostatic urethra can be managed with endovesical BCG as initial treatment with fairly good success. There is no need for transurethral resection, even though a loop biopsy may have to be obtained at the first control examination to make sure there is no stromal invasion.

Administration, Intravesical↗