Biomedical subjects

L Crampette

Publications and source records attributed to L Crampette.

At least 37 records · Page 2Linked to original sources

PubMed1999

Modified subtotal laryngectomy with cricohyoidoepiglottopexy--long term results in 81 patients.

BACKGROUND: Standard treatment of early glottic carcinoma is radiotherapy, but involvement of the anterior commissure leads to a reduced cure rate. We investigated retrospectively whether our modified subtotal laryngectomy had improved results for early glottic carcinomas involving the anterior commissure, without causing excessive disability to laryngeal functions. METHODS: Eighty-one patients with T1 or T2 glottic carcinoma involving the anterior commissure were reviewed. Follow-up was at least 3 years. Speech was assessed by subjective evaluation and a computer-assisted voice analysis device. RESULTS: Three-year overall survival rate and 3- and 5-year actuarial survival rates were, respectively, 90.1%, 95%, and 90.8%, with no difference between the different T stages involved (p > 0.46). The local recurrence rate was 7.4%. Speech recovered in all patients and was evaluated as satisfactory in 86% of cases. CONCLUSION: For early glottic carcinomas involving the anterior commissure, subtotal laryngectomies appear to be more effective than radiotherapy, and our modified technique simplifies the procedure.

Adult↗

PubMed1999

[Imaging of the hypopharynx, oropharynx and parapharyngeal spaces].

Progress in upper aerodigestive imaging improved pathologic staging and therapeutic choices. Imaging, especially CT scan is now indispensable for staging the upper aerodigestive cancers. Some anatomic areas must be explored with special attention because of their importance for therapeutic decision.

Humans↗

PubMed1999

[Pleomorphic adenoma of the nasal septum: a case report].

We report on a case of pleomorphic adenoma involving the nasal septum, in a caucasian woman aged 23, who presented with nasal obstruction and epistaxis. A swelling of the anterior part of the nasal septum was observed and a biopsy demonstrated the existence of a pleomorphic adenoma. CT scan and MRI investigation showed the lesion to be limited, and removal was therefore possible using an endonasal approach. No recurrence has been found after 22 months.

Adenoma, Pleomorphic↗

PubMed1998

Expression of cyclo-oxygenase 1 and 2 proteins in upper respiratory mucosa.

BACKGROUND: Cyclo-oxygenases 1 (Cox-1) and 2 (Cox-2) catalyse the conversion of arachidonic acid to prostaglandin endoperoxides, leading to the formation of prostaglandin and thromboxane mediators of inflammation. The involvement of these enzymes in inflammatory disorders such as sinusitis and nasal polyps is unknown although this may be relevant to their pathophysiology. METHODS: We studied Cox-1 and Cox-2 immunoreactivities in nasal polyp, maxillary sinus, and turbinate biopsies obtained from eight patients with chronic allergic rhinitis and sinusitis and/or nasal polyps, 15 patients with chronic non-allergic rhinitis and sinusitis and/or nasal polyps and five control subjects (patients requiring nose surgery not related to sinusitis or nasal polyps). RESULTS: Both Cox- and Cox-2 were mainly expressed in the epithelium (basal, ciliated) and were found in 16/28 and 25/28 subjects for Cox-1 and Cox-2 respectively. We did not find any differences between the patient populations. There were no correlations between any of the clinical parameters studied nor the pathological patterns and the presence and characteristics of the Cox immunoreactivities. CONCLUSION: Both cyclo-oxygenase enzymes are expressed in normal human upper respiratory epithelium and are not upregulated in chronic sinusitis nor in nasal polyposis, possibly suggesting that Cox products do not have an important role as mediators of the chronic upper airway inflammation.

Adolescent↗

PubMed1998

ICAM-1 expression in upper respiratory mucosa is differentially related to eosinophil and neutrophil inflammation according to the allergic status.

BACKGROUND: Chronic non-infectious sinusitis is an inflammatory disease sharing numerous features with both allergic and non-allergic rhinitis and asthma. METHODS: In an attempt to analyse the underlying mechanisms of sinus and nasal inflammation, we assessed ICAM-1 immunoreactivity on maxillary sinus, nasal polyp and turbinate biopsies obtained surgically from 21 patients with sinusitis and chronic allergic rhinitis (AR), 23 patients with sinusitis and chronic non-allergic rhinitis (NAR) and 17 non-atopic control subjects. We compared ICAM-1 expression with both eosinophil (EG1) and neutrophil (NP57 elastase) infiltrates. RESULTS: In nasal turbinates and polyps, ICAM-1 was broadly distributed within the epithelium, on ciliated and basal epithelial cells and in the submucosa on endothelial and inflammatory cells. ICAM-1 was rarely expressed in the mucosa of the sinus, compared with polyps (P < 0.01) and turbinates (P < 0.0001). Submucosal and epithelial eosinophils were increased in both sinus and nasal biopsies from AR by comparison with NAR (P=0.003 and P=0.02) and non-atopic control subjects (P<0.0001 and P=0.014). Submucosal and epithelial neutrophil numbers were increased in the two chronic rhinitis groups and correlated with ICAM-1 submucosal expression in NAR only (P<0.01). On the other hand, epithelial eosinophil numbers correlated with ICAM-1 epithelial expression in AR only (P = 0.002). CONCLUSION: This study further characterizes sinus and nasal granulocyte inflammation in chronic non-infectious sinusitis and rhinitis and suggests a differential role for ICAM-1 in neutrophil and eosinophil recruitment according to the allergic status.

Adult↗

PubMed1998

Inhibition of mediator release from dispersed nasal polyp cells by cyclosporin A.

The mechanisms of action of cyclosporin A require further elucidation since this drug includes anti-inflammatory properties unrelated to its previously documented effect of T cells. A study was performed using enzymatically dispersed cells from nasal polyps of 7 subjects to examine the effects of cyclosporin A on the release of histamine, leukotriene C4/D4 (LTC4/D4) and thromboxane (TxB2) following stimulation by anti-IgE. Cells were resuspended and preincubated with cyclosporin A (0.1, 1 and 10 microM) or 0.1% DMSO (the vehicle used to dissolve cyclosporin A) for 20 min prior to challenge with 10 microgram/ml epsilon-chain-specific anti-IgE for 45 min at 37 degrees C. Histamine, LTC4/D4 and TxB2 were measured using EIA. Cyclosporin A significantly inhibited the release of histamine, LTC4/D4, and TxB2 in a concentration-dependent manner. IC30 values, histamine (5.1 microM), LTC4/D4 (7.8 microM) and TxB2 (6.2 microM), were determined. These data demonstrate new antiallergic properties of cyclosporin A using a novel in vitro model which mimics more closely allergic inflammation.

Cells, Cultured↗

PubMed1998

[Pyolaryngocele: a rare cause of respiratory distress].

Pyolaryngocele is an unusual diagnosis, occurring as a complication of a laryngocele, witch may be discovered because of an episode of acute respiratory distress needing urgent medical care. This is a case report with confirmation of the diagnosis by CT scan, which needed surgical treatment.

Adult↗

PubMed1998

Maxillary sinus mucocoeles--10 cases--8 treated endoscopically.

Maxillary sinus mucocoeles are rare, but may cause significant problems outside the sinus including diplopia and cheek swelling. We present 9 patients suffering from maxillary sinus mucocoele, including one patient with bilateral involvement, representing 10 involved sinuses. Eight sinuses were treated endoscopically and followed-up for 3 to more than 6 years; one of these developed a recurrence. Two sinuses were treated using a classical external approach (Caldwell-Luc), one at the beginning of our series, and one as the endoscopic technique was difficult to perform due to loss of anatomical landmarks. One of these two sinuses developed a recurrence and was then successfully treated endoscopically. We discuss the aetiology, pathogenesis and appropriate treatment of this unusual condition. Endoscopic treatment appears to be effective and leads to minimal recurrence. The aim is to perform a wide removal of the medial wall of the maxillary sinus including most of the inferior turbinate, immediately posterior to the lachrymal duct leaving intact the sinus mucosa. In some cases, however, the endoscopic technique can be difficult to perform due to loss of essential anatomical landmarks and in these cases recourse to an external approach may be necessary.

Adult↗

PubMed1998

[Repeat surgery for thyroid nodules (excluding cancer and hyperthyroidism)].

Second procedures for recurrent thyroid disease are known to carry a high risk of iatrogenic damage, particularly to the inferior laryngeal nerves and parathyroid glands. This risk has been clearly evaluated for the primary procedure, but is less clearly for second procedures. A series of 117 patients with solitary or multiple cold thyroid nodules were evaluated (excluding those patients re-operated for recurrent thyroid carcinoma or goitre associated with hyperthyroidism) to determine the operative risks. The level of transient and permanent recurrent laryngeal nerve palsy was 2.56% and 1.7% respectively. The level of transient and permanent hypocalcaemia was 12.9% and 4.62% respectively. The frequency of re-operation for recurrent disease involving the pyramidal lobe following total thyroidectomy (6 cases) highlights the importance of removing it during the primary procedure. The number of cases of cancer discovered at re-operation was 4.3% (5 cases out of 117).

Adult↗

PubMed1997

Myeloperoxidase and interleukin-8 levels in chronic sinusitis.

We have recently phenotyped inflammation in non-infectious allergic and non-allergic chronic maxillary sinusitis using sinus biopsies and lavage fluids. In this first paper, we have concentrated our work on the eosinophil, T cell, mast cell and macrophage infiltrates. However, many unresolved questions remain and particularly the role of neutrophils needed to be addressed. In the present study, we focused on the neutrophilic inflammation: myeloperoxidase (MPO) and interleukin-8 (IL-8) were measured by immunoassays and neutrophils were enumerated by conventional staining in the sinus lavage fluids of 16 patients with chronic sinusitis and six control subjects. Both MPO and IL-8 levels were significantly higher in patients than in controls (P < 0.01 and 0.005, respectively). There was a significant correlation between MPO levels and neutrophil numbers, and between MPO and IL-8 levels in the sinus lavage fluid (P < 0.0001, Spearman rank correlation). The presence of high levels of IL-8 in the lavage fluids of patients suffering from chronic sinusitis, levels which correlate with those of MPO, suggests that this cytokine may activate neutrophils in this chronic disease.

Adolescent↗

PubMed1996

Inhibition of mediator and cytokine release from dispersed nasal polyp cells by terfenadine.

The mechanism of action of H1-blockers requires elucidation because they may possess properties unrelated to the blockage of histamine at its receptor level. A study was performed with enzymatically dispersed cells obtained from nasal polyps to examine the effect of terfenadine (0.1-10 mumol) on the release of leukotrienes (LT) (LTC4/D4 and LTB4) after stimulation by anti-IgE, and on the spontaneous release of cytokines (granulocyte/macrophage-colony stimulating factor [GM-CSF] and tumor necrosis factor-alpha [TNF-alpha]) released from cells cultured for 6 h. Terfenadine inhibited significantly, and in a dose-dependent manner, the release of LTC4/D4, LTB4, TNF-alpha, and GM-CSF. IC50 values were determined for LTC4/D4 (8 mumol), LTB4 (9.9 mumol), TNF-alpha (6.1 mumol), and GM-CSF (4 mumol). Terfenadine was found to possess new antiallergic properties with a novel in vitro model which mimics more closely inflammatory cells of allergic rhinitis or asthma.

Adolescent↗

PubMed1996

Overview of allergic mechanisms. Ebastine has more than an antihistamine effect.

Histamine antagonists together with topical steroids are the treatment of choice in allergic rhinitis. Many of these histamine antagonists exhibit effects in addition to blockade of the histamine receptor. In this study we have investigated the effects of ebastine and carebastine on the release of eicosanoids and cytokines from human dispersed polyp cells and the effect of these compounds on the release of inflammatory mediators into nasal lavage fluid after allergen challenge. Ebastine was shown to block the release of anti-IgE-induced prostaglandin D2 (PGD2) and leukotriene C4/D4 from human nasal polyp cells (IC30 values of 2.57 and 9.6 mumol/L, respectively) and to inhibit the release of cytokines. Carebastine inhibited the release of PGD2 (IC30 8.14 mumol/L) but had little effect on cytokine release. When patients underwent nasal provocation tests with allergen, ebastine significantly increased the mean number of pollen grains required to induce an allergic response. In addition, the drug inhibited the release of granulocyte-macrophage colony-stimulating factor but had no effect on any other mediators measured.

Adolescent↗

PubMed1996

[Horizontal supraglottic laryngectomy. Technique, indications, oncologic results and early functional results. Apropos of 87 cases].

In this article, we advocate supraglottic laryngectomy with bilateral neck dissection for the treatment of supraglottic carcinomas with preserved laryngeal mobility. Post-operative results and follow-up of 87 patients are discussed. This technique allows an excellent loco-regional control of the disease with preservation of laryngeal function. Radiation therapy is preserved for treatment of metachronous (2nd primary) in cases with satisfactory local control without neck metastases. All stage 5-year overall survival rate was 55% with a 68.5% disease survival rate. Five-year local control of the disease and regional control of neck nodes were respectively 94% and 92%. Five-year disease survival rate for N- population was 71% Vs 61% for N+ population. Five-year disease survival rate according to the tumor classification was 70% for T1, 75% for T2, 69% for T3 and 54% for T4. In the post-operative follow-up, the median of time to decanulation was 17 days, that of nasogastric tube removal was 19 days, that of hospital stay 38 days.

Adult↗

PubMed1995

Stimulation of dispersed nasal polyp cells by hyperosmolar solutions.

It has been suggested that hyperosmolarity may be one of the stimuli that provoke exercise-induced asthma and rhinitis. We investigated whether changes in osmolarity could result in increased levels of mediator release from nasal cells. Cells were dispersed from nasal polyps by enzymatic digestion and were incubated for 15 minutes with solutions of varying osmolarity obtained by the addition of mannitol to Hanks' balanced salt solution. After incubation was performed, cell supernatants were removed, and the release of 15-hydroxyeicosatetraenoic acid, prostaglandin2 leukotriene B4, and fibronectin was measured. Lactate dehydrogenase was measured to assess cell viability. Epithelial cells made up 40% to 60% of cells and mononuclear cells 40% to 65%. At 900 mOsm/kg H2O, which has been suggested as the osmolarity of the fluid lining the airways during exercise, we observed a significant increase (Wilcoxon W test) in the release of 15-hydroxyeicosatetraenoic acid (p < 0.008), leukotriene B4 (p < 0.008), and prostaglandin2 (p < 0.008), but no significant increase in the release of fibronectin was seen. No significant increase was seen between lactate dehydrogenase and 15-hydroxyeicosatetraenoic acid release, suggesting that the increase in mediator levels was not caused by cell death. These results show that hyperosmolar solutions can induce activation of nasal cells, which may at least partly explain rhinitis caused by exercise.

Adolescent↗

PubMed1995

Inhibitory activity of loratadine and descarboethoxyloratadine on expression of ICAM-1 and HLA-DR by nasal epithelial cells.

Nasal epithelial cells represent the first barrier against noxious agents and allergens. In allergic rhinitis, these cells are activated and histamine may be involved in this activation. Loratadine and one of its active metabolites, descarboethoxyloratadine, were studied for their ability to reduce the activation of nasal epithelial cells by histamine. Nasal turbinates or polyps were removed during surgery from 19 subjects, and nasal epithelial cells were recovered after enzymatic digestion. The in vitro activation of epithelial cells with histamine using an optimal dose (1 microM) and an optimal time (24 h) of incubation was studied, and the effect of loratadine or descarboethoxyloratadine (10 microM) was investigated. The expression of membrane markers (intercellular adhesion molecule-1 (ICAM-1) and a human leukocyte class II antigen (HLA-DR) was assessed by immunocytochemical analysis using an alkaline-antialkaline phosphatase (APAAP) system. The spontaneous expression of both markers was not significantly different in cells recovered from nasal turbinates or polyps, and there was a highly significant increase in the numbers of cells expressing ICAM-1 and HLA-DR following incubation with histamine. Loratadine or descarboethoxyloratadine significantly blocked these effects. This study shows a new possible antiallergic effect of H1-blockers and suggests that their effects on epithelial cells may be relevant in vivo.

Adult↗

PubMed1995

Sphenochoanal polyp in children. Diagnosis and treatment.

Two cases of sphenochoanal polyp (SCP) in children are reported. SCPs originate in the sphenoid sinus cavity, and extend into the choanal via the ostium. Symptoms associated with the syndrome include nasal blockage and headaches. Endoscopical examination reveals the presence of a choanal polyp, and the sphenoid origin of the polyp can be determined by CT scan. In cases where the middle meatus is obstructed, an opacity of the maxillary sinus is often observed. SCPs cannot be distinguished from antrochoanal polyp (ACP) by histological means. The treatment of the SCPs involves surgical removal and enlargement of the sphenoid sinus ostium. Ignorance surrounding the existence and the treatment of this syndrome may result in insufficient treatment and the consequent recurrence of the disorder.

Child↗

PubMed1995

[Ectopic lingual thyroid. Apropos of 3 cases].

Lingual thyroid is a rare cause of upper airway obstruction, dysphagia or hypothyroidism symptoms. This report describes three cases of lingual thyroid arising in women. One was in pregnancy and developed a lingual goiter and hemorrhages with hypothyroidy. The second case have been diagnosed because of a dysphagia and the third was asymptomatic and have been diagnosed during physical examination for cervical nodes. Diagnosis and possible therapeutic options are discussed regarding these three cases. Surgical therapy is appropriate for patients with clinical signs of upper airway obstruction or when malignant degeneration is suspected. Without of clinical sign, substitutive therapy with thyroid hormone allows the stabilization or the regression of the ectopic thyroid.

Adult↗

PubMed1994

Assessment of inflammation in noninfectious chronic maxillary sinusitis.

BACKGROUND AND AIM: Pathologic examination of the sinus mucosa and titration of inflammatory mediators in the sinus fluid were carried out to characterize inflammation in chronic sinusitis and determine whether patients with chronic allergic rhinitis (CAR) and sinusitis differ from patients with chronic nonallergic rhinitis (CNAR) and sinusitis. METHODS: Nine control subjects (patients requiring ear, nose, and throat surgery not related to sinusitis), 12 patients with CAR and sinusitis, and 13 patients with CNAR and sinusitis were investigated. Eosinophil cationic protein, tryptase, myeloperoxidase, histamine, and prostaglandin D2 were measured in the sinus lavage fluids, and cells were enumerated. The cellular infiltrate was studied by immunohistochemistry with monoclonal antibodies against eosinophil cationic protein (eosinophils), tryptase (mast cells), neutrophil elastase (neutrophils), CD3 (lymphocytes), CD68 (macrophages), and proliferating cell nuclear antigens. RESULTS: Neutrophils were not increased in sinusitis. In comparison with control subjects, patients with CAR and CNAR with sinusitis showed significant increases in eosinophils and macrophages in biopsy specimens and in eosinophil cationic protein in sinus lavage fluids. In comparison with patients with CNAR, patients with CAR had an increased number of intraepithelial mast cells and lymphocytes. CONCLUSIONS: These findings suggest that patients with CNAR and sinusitis can be distinguished from patients with CAR and sinusitis, which resembles nonallergic rhinitis with eosinophilia syndrome.

Adolescent↗