Search PubMed⌕ Search

Biomedical subjects

J Wechsler

Publications and source records attributed to J Wechsler.

At least 235 records · Page 13Linked to original sources
PubMed1984

Asymptomatic encephalic intraparenchymatous neuroepithelial cysts.

The authors report three cases of intraparenchymatous neuroepithelial cysts, which did not communicate with the ventricular system and the subarachnoid space. They were located in (1) the right frontal lobe, (2) the left cerebral peduncle and pons, and (3) the right cerebellar hemisphere. All of them were asymptomatic, despite their volume and location, and presented as incidental autopsy findings. A developmental origin is likely for these non-neoplastic cysts.

Aged↗
PubMed1984

[Acquired immunodeficiency syndrome, Kaposi's disease and cerebral toxoplasmosis in a young man. Review of the literature apropos of a case].

We report a new case of acquired immune-deficiency syndrome (AIDS) in a 43 year-old white homosexual man, characterized by the association of disseminated cutaneo-mucous Kaposi's sarcoma and cerebral toxoplasmosis. This man had Kaposi's sarcoma for about 10 years but evolution became quickly extensive in July 1981. Chlorambucil was prescribed at that time and was the cause of a pancytopenia. Death occurred in July 1982 due to a cerebral mass identified as toxoplasmosis on a left temporal biopsy. This observation is typical of AIDS, a new syndrome which suddenly developed in the last 2 years in the United States in homosexual men, Haitians and hemophiliacs, and is characterized by disseminated Kaposi's sarcoma and/or opportunistic infections, with a very high mortality rate. Severe toxoplasmosis of CNS has been reported in AIDS and appears to result from defects in cellular immunity which permit recrudescence of latent infection. Cerebral biopsy is necessary for the diagnosis of cerebral toxoplasmosis as seroconversion occurs infrequently in immuno-suppressed hosts. AIDS appeared in Western Europe in 1982. Most of the cases were reported in France, Denmark, Belgium and Great Britain. These cases differ from reported cases in the USA: fewer drug or poppers users, fewer homosexual men, an important number of people having lived or travelled in the Kaposi's endemic area (Mediterranean basin and Central Africa). The immunological profile of patients presenting AIDS in Europe doesn't seem to differ from the american profile: serious cellular immunodeficiency and marked increase in the suppressor/cytotoxic cell population. As in the United States, one may suspect, among several hypotheses, that it is caused by one or several transmissible agents now present in France. The nature of these agents, transmissible by sexual contacts and blood, is not yet known: the role of the CMV is now less probable and most of the studies look for the role of other factors such as the HTLV.

Acquired Immunodeficiency Syndrome↗
PubMed1984

[Contact dermatitis from hexamidine].

Twenty patients with contact dermatitis to hexamidine, a commonly used antiseptic solution are reported. They have been collected during a 7 months period, thus suggesting that this contact allergy is not infrequent. Hydroalcoholic solution applied on epidermless skin is most frequently responsible for the contact dermatitis. Clinical features are very peculiar with papular semi-spheric and papulo-vesicular lesions being more frequently seen than classical vesicular eczema lesions. Due to this peculiar aspect, contact dermatitis to hexamidine is frequently misdiagnosed. The delay between onset and diagnosis has been sometimes longer than one year. It is four months as a mean. Pathologic aspect of these lesions is unusual too: dermal vasculitis either lymphocytic or with pycnotic polymorphonuclear is the most frequent aspect (14 out of 23 histological sections). Epidermal spongiosis is infrequent (5 cases). Contact dermatitis has usually a long standing evolution despite removal of the allergen and topical cortico-steroid treatment. Patch-test to hexamidine are frequently followed by a worsening of cutaneous lesions. One case of anaphylaxis following patch-testing has been reported. Clinical and pathological features of this contact dermatitis, suggests that humoral immune mechanisms play a key-role in its pathogenesis.

Anti-Infective Agents, Local↗
PubMed1984

[Lymph node localization of epidermotropic T malignant lymphomas (mycosis fungoides and Sézary's syndrome)].

In this paper are reported the different histological variants of Mycosis Fungoïdes (M.F.) observed in 48 lymph node positive biopsies providing from 98 lymph nodes obtained from 94 patients with M.F. A partial destruction of the lymphoïd architecture was required for attesting M.F. involvement. The remaining 50 lymph nodes demonstrated dermopathic non specific lesions. A partial lymph node involvement is often observed with a persistent sinusal pattern and residual germinative follicles (39 from 48 cases or 80%). The tumoral infiltration begins in the deep cortex and in the interfollicular areas. Some reactive lesions of dermopathic lymphadenopathy are frequently associated. The main histological feature is the cellular pleomorphism. Nevertheless 4 cytological variants may be described according to the predominant proliferating cells: a small cell variant, a large cell variant, a mixed cell variant comprising an equivalent proportion of small medium and large-sized cells, an immunoblastic variant with majority of immunoblasts and some Sternberg-like tumoral cells. Any form may be associated with granuloma which increase polymorphism. In some histological variants, so-called Lutzner cells are numerous and facilitate the diagnosis of epidermotropic malignant T lymphoma. Nevertheless, some cases may be discussed with centrocytic or centroblastic centrocytic lymphomas, with Pinkus multilobulated T lymphoma or with convoluted lymphoblastic lymphoma. More difficult is the distinction from Lennert T - zone lymphomas and from adult T-cell lymphoma/leukemia described in Japan. The immunoblastic variant may be mistaken with some high-grade malignant non-Hodgkin lymphoma, with an angio-immunoblastic lymphadenopathy, even with a metastatic carcinoma. The evidence of granuloma with numerous eosinophiles frequently observed in the Hodgkin-like variant is a cause of confusion with Hodgkin's disease. A good help would be supplied by the discover of some Lutzner cells among the granuloma. No correlation was found between these histological variants and the M.F. evolution. Evidence of reactive inflammatory cells do not interfere with the prognosis.

Biopsy↗
PubMed1984

[Melanoma and dysplastic nevus after 8 years of topical Caryolysine].

A 48-year-old woman with poikiloderma atrophicans vasculare was treated with topical mechlorethamine, applied three times weekly, for eight years. After five years treatment she developed nine melanocytic naevi on covered skin. The naevi spread for the next three years and a surgical excision was performed. Pathological examination revealed one level II SSM, one level I SSM and seven junctional naevi with focal dysplasia or melanocytic hyperplasia. The development of melanoma and dysplastic naevi after topical mechlorethamine has not been previously reported. However it seems likely that mechlorethamine was the causative agent. As for the mechlorethamine's imputability in this case, we have used a method combining intrinsic identification of adverse drug responsibility's score, based on the clinical case and on extrinsic identification based on literature evaluation. We suggest that mechlorethamine could act as UV light.

Administration, Topical↗
PubMed1983

[Kaposi's disease. Form with lymph node manifestation in a young African. Difficulty in the initial diagnosis and relation to dysimmune lymphadenitis].

The authors report a case of Kaposi's sarcoma in a 38-year-old Malian. Onset occurred one year after an episode of febrile polyadenopathy with histologic features suggestive of immune dysfunction lymphadenitis. Diagnosis of Kaposi's sarcoma was firmly established only following occurrence of secondary skin lesions. This case exemplifies the diagnostic problems raised by those forms of Kaposi's sarcoma which present as lymph node involvement. In the index case, the authors discuss the significance of the initial polyadenopathy, and speculate whether it was an initial stage of Kaposi's sarcoma or an immune dysfunction lymphadenitis preceding onset of the sarcoma. If the second hypothesis is correct, this case would be comparable to reports of Kaposi's sarcoma arising in hosts with immune dysfunction.

Adult↗
PubMed1983

[Association of a melanoma and a spinocellular epithelioma on a burn scar of the scalp].

A thirty-nine-year-old caucasian man presented with an ulceration of the scalp, developing on an alopecia. The scalp indeed had been burnt by boiling water when the boy was two. During childhood and youth microtraumatisms induced superficial wounds which always healed easily. Nine months ago, a new ulceration followed a new trauma; the wound did not heal, and lay on a dark brown area. A biopsy diagnosed a malignant melanoma. The whole alopecic area was resected, under the ulceration and the pigmented area, as well as the external surface and the diploe. The defect was covered with a free transplant of omentum, revascularized by microsurgical anastomoses to the external carotid artery and the external jugular vein in the parotid bed. The omentum was immediately covered with split-thickness skin grafts. Histologic investigations demonstrated the association of a melanoma developing on a Hutchinson melanotic freckle and a squamous cell carcinoma.

Adult↗
PubMed1983

Investigation of intercellular matrix macromolecules involved in lichen sclerosus.

Dermal changes of the vulva in lichen sclerosus were compared with control vulvar samples using ultrastructural and immunofluorescence techniques. Collagen degeneration and regeneration were observed ultrastructurally in the superficial dermis of lichen sclerosus with increased amounts of ground substance. These processes appeared to alter the affinity of collagen fibres for the anticollagen antisera types I, III, IV. A decrease in elastin content was observed by electron microscopy. A loss of fibronectin was discovered at the dermo-epidermal junction, which looked normal ultrastructurally. The linear laminin pattern at the dermo-epidermal junction was also altered. These results suggested an enzymatic process in the pathogenesis of lichen sclerosus. Amidase activity could be determined in 6 normal and 6 pathological biopsies, though higher in the pathological samples (p less than 0.01).

Atrophy↗