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Biomedical subjects

M Raphael

Publications and source records attributed to M Raphael.

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

An application of mathematical morphology to analysis of the size and shape of nuclei in tissue sections of non-Hodgkin's lymphoma.

Using principles from the theory of mathematical morphology, a semiautomatic analysis of the size and shape of cell nuclei on tissue sections was carried out on a Leitz Texture Analysis System (Leitz-TAS). The four parameters proposed here are more discriminatory than conventional shape evaluation by the form factor (FF), which is based on the ratio of perimeter squared to area. The parameters quantified, respectively, nuclear elongation (ND), narrow (R1) and wide (R2) irregularities, and the distribution of R1 and R2 along the nuclear contour (ID). The properties of these parameters were tested nucleus-by-nucleus on 24 nuclear models. The methodology was then illustrated by a study of lymph node nuclei in non-Hodgkin's lymphoma (NHL). Prior to analysis, 45 lymphomas were classified into five categories of nuclear size and shape according to the International Working Formulation (IWF). Two hundred nuclei were measured on each lymph node section. Statistical interpretation was based upon an analysis of the nuclear surface area on sections and upon the mean values of R1, R2, and ND, the standard deviations of R1 and R2, and the percentage of cleaved nuclei detected by ID. The mean value of R2 discriminated best between the two sets of populations with regular and irregular nuclear contours, respectively. Parameters R1, ND, and ID permitted the distinction of certain NHL cases among populations with irregular nuclei. Nuclear invaginations decreased in depth as the nuclear area became greater. The median surface area was well correlated to the IWF, and the skewness coefficient (third statistical moment of the nuclear surface area distribution) was related to the number of nuclear size or shape subpopulations.

Analog-Digital Conversion↗
PubMed1986

Prognostic significance of a morphometric study of lymph node biopsies in chronic lymphocytic leukaemia.

In 18 chronic lymphocytic leukaemia (CLL) and 2 diffuse, well-differentiated lymphoma (DWDL) lymph node biopsies, morphometric results analysing nuclear area distribution curves by the skewness coefficient were compared to histological findings, clinical stage and survival. Lymphocytic proliferation was subclassified according to the number and the distribution of large lymphoid cells. All cases with a component of large lymphoid cells had a right deviation of the nuclear area distribution curve and a positive value of the skewness coefficient in contrast to those where lymphocytic proliferation was monomorphous. Good correlation was observed between histological findings, morphometric analysis and survival: most patients with a right deviation of nuclear area distribution curve and positive skewness coefficient are clinically stage C, or died within 2-44 months, in contrast to patients with a symmetric distribution of nuclear area curve who are clinically stage A or B and still alive. The results indicate that in CCL and DWDL the lymph node biopsy with quantitative analysis has prognostic significance.

Biopsy↗
PubMed1986

Incidence of spasm at the site of previous successful transluminal coronary angioplasty: effect of ergometrine maleate in consecutive patients.

The incidence of coronary artery spasm at the site of previous successful angioplasty and its importance in leading to subsequent restenosis or recurrence of symptoms are unknown. Fourteen consecutive patients with single vessel coronary artery disease who had undergone successful percutaneous transluminal angioplasty were studied. All patients were given ergometrine maleate (ergonovine maleate) intravenously during repeat cardiac catheterisation six weeks to three months after angioplasty. Five patients demonstrated excessive luminal reduction (spasm) at the site of previous angioplasty that led to luminal stenoses ranging from 50% to 79%. Two of these patients developed chest pain and ST segment changes during ergometrine maleate provocation and they also showed maximal vasoconstriction. The remaining nine patients did not develop important luminal change at the site of angioplasty after ergometrine maleate. Ergometrine maleate administration resulted in less than or equal to 20% reduction in lumen diameter of adjacent apparently normal sections of the coronary arteries in all but two patients. At the site of previous angioplasty in the five patients with spasm, however, the lumen was constricted by a mean (SD) of 51 (12)%, whereas in the nine patients not demonstrating spasm mean reduction was 12 (7)%. Thus hypersensitivity to ergometrine maleate at the site of previous successful angioplasty was demonstrated in over a third of consecutive patients with single vessel coronary artery disease. The importance of this finding to long term results of coronary angioplasty needs to be investigated further.

Angioplasty, Balloon↗
PubMed1986

[Biological aspects of chronic lymphoid leukemia].

The present study is concerned with clinical prognostic classifications of chronic lymphocytic leukemia derived from numerous statistics and multivariate survival analysis. We analyse the prognostic significance of some biological patterns: bone marrow histological studies, lymph node biopsies, size, structure and doubling time of blood lymphocytes, tumoral markers and karyotype analysis. The problem of the monoclonal clone origin is discussed: differentiation abnormality or proliferation of a physiological clone.

Female↗
PubMed1986

[Intra-epithelial carcinoma of the pancreas. Study of a case and review of the literature].

The authors report the case of a 74 year-old woman who was hospitalized for severe abdominal pain. The patient had epigastralgia for many years. Biology revealed hyperamylasemia and computerized tomodensitometry showed that the pancreas head was enlarged. At retrograde wirsungography a short stenosis was visible in the pancreatic duct, 2 cm from the papilla. This was considered to be a tumor and surgery was performed. Histological sections of the pancreatic head showed strictly intraductal carcinoma "de novo" or associated with ductal epithelial hyperplasia. Although very rare, in situ carcinoma should be considered when clinical features are unexplained in order to perform radical surgery.

Aged↗
PubMed1986

[Lymphomas and AIDS].

We report 21 cases of lymphomas associated with AIDS. Sixteen cases are Non Hodgkin's lymphomas of high grade malignancy. Immunoblastic B cell lymphomas are frequent: 11 cases/16, especially with extra nodal localisations. Three cases are Burkitt's lymphoma; 2 cases are large non cleaved cell lymphoma. Five cases of Hodgkin's disease are associated with AIDS related complex syndrome (ARC) showing the interest of lymph node biopsy in such patients. We analyzed 6 cases with lymphoid bone marrow infiltration and discuss the relationship between prelymphomatous states and low grade malignant lymphomas in AIDS or ARC patients.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Herpes simplex virus antigen detection in human acute encephalitis: an immunohistochemical study using avidin-biotin-peroxidase complex method.

Autopsy specimens from six patients with clinically diagnosed herpes simplex virus (HSV) encephalitis were studied. Since immunocytochemistry has been reported to be a more reliable and successful method to identify HSV as the etiologic agent, antitype 1 HSV (HSV1) and antitype 2 HSV (HSV2) and the avidin-biotin-peroxidase complex (ABC) method were applied to brain paraffin sections. Positive immunostaining was observed in front-orbital, mediobasal temporal lobes, cingulate gyrus, and insula. The staining was bilateral but predominant on one side. In neurons, the cytoplasmic staining was prominent in perikarya and processes, less often observed in nuclei, rarely seen in nuclear inclusions. The positive staining was intense in oligodendrocytes and macrophages, in both nuclei and cytoplasm. In two cases astrocytic processes were stained strongly. Perivascular lymphocytes were always negative. Positive reactions were obtained with both anti-HSV1 and anti-HSV2 but weaker with anti-HSV2. This results suggests that, because of its high sensitivity, ABC method permits viral antigen detection not feasible with other methods. However, this method lacks of accuracy for HSV typing mainly because of probable antigens changes resulting from tissue processing.

Adolescent↗
PubMed1985

[Significance of trial vacuum extraction in the framework of obstetric surgery in vertex presentation].

On the basis of a clinical study of 76 infants born by trial vacuum extraction from the pelvic inlet, 57 infants were examined retrospectively with regard to early and late morbidity after "successful" trial vacuum extraction. In 34 cases surgery was indicated because of fetal distress; in 23 children the operation was performed because of a standstill at the pelvic inlet. The results were compared with a group of infants delivered by vacuum and forceps extraction from the centre of the pelvis (or the pelvic floor) or cesarean section in consequence of fetal distress. The results indicate the high risk for children born by trial vacuum extraction, especially in cases of fetal distress. In addition to statistically significant lower Apgar scores and a statistically significant higher acidosis morbidity (p less than 0.05) as compared to other obstetric operations, there is also a statistically significant greater number of "striking" and "injured" children as opposed to those delivered by vacuum or forceps extraction from the centre of the pelvis (or the pelvic floor) or by cesarean section in consequence of fetal distress. These neurological deviations represent primarily the static-motoric and speech development, and are analogous to late morbidity after births from breech presentation. The findings confirm the clinical impression that trial vacuum extraction-especially in cases of fetal distress at the pelvic inlet-represent an additional risk to the child. In such cases cesarean section is the only alternative method of delivery.

Apgar Score↗
PubMed1985

The role of percutaneous transluminal angioplasty for atherosclerotic disease of the lower extremities.

A consecutive series of 62 patients (74 symptomatic limbs) were admitted with atherosclerotic disease of the legs in a 6-month period from 1st July 1982. All patients had an arteriogram under local anaesthetic the day after admission and if possible a transluminal balloon dilatation was performed. If dilatation failed an operation was performed the following day. Dilatation was successful in 13 of 23 lesions above the inguinal ligament and significantly improved the Doppler foot pressures from 84 to 120 mmHg. Dilatation was only successful in 17 of 51 lesions below the inguinal ligament and 40% of these had re-occluded within 6 months. Transluminal dilatation is an important advance for stenotic lesions of the distal aorta and iliacs but its place is limited for the more common lesions in the superficial femoral artery.

Adult↗
PubMed1985

Lymphadenopathy in patients at risk for acquired immunodeficiency syndrome. Histopathology and histochemistry.

Lymph node biopsies of 12 patients at high risk for acquired immunodeficiency syndrome (AIDS) with generalized lymphadenopathy (AIDS-related complex [ARC]) and seven controls with conventional lymph node hyperplasia were examined by light microscopy and immunohistochemical staining of frozen tissue. The immunohistochemical results were quantified by planimetric means. Our findings show that the T helper/T suppressor-cytotoxic (Th/Tsc) ratio in lymph nodes from ARC patients is significantly decreased with respect to controls and that this decrease precedes the change in the Th/Tsc ratio in peripheral blood. Our findings distinguish between lymphadenopathy from patients with ARC and other forms of hyperplasia; the relation to AIDS is discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Morphometric characterization of nuclei in non-Hodgkin's malignant lymphoma.

In addition to the nuclear area and a form factor, four morphometric parameters of nuclear shape (ID, R1, R2 and ND), obtained by the application of the principles of mathematical morphology, were used to characterize the nuclear contours in non-Hodgkin's malignant lymphomas. The values for each parameter were determined in 58 cases of non-Hodgkin's lymphoma categorized according to the Kiel and National Cancer Institute classifications. Small-cell, mixed and large-cell lymphomas could be distinguished on the basis of the mean nuclear area. The shape parameters R1, R2 and ID were efficient discriminators of the large centrocytic (cleaved-cell) lymphomas. Neither size nor shape factors could distinguish between centroblastic and immunoblastic tumors. The good correlation between the morphometric findings and the histopathologic categories suggest that morphometry may provide a quantitative and objective method for grading lymphomas.

Biopsy↗
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

[Malignant histiocytosis. An anatomic study of 6 cases with atypical clinical manifestations].

The six cases of malignant histiocytosis reviewed in this article all presented with unusual manifestations (muscular masses, renal failure, dysenteriform syndrome, neurological symptoms, or isolated splenomegaly). With one exception, correct diagnosis was only made post mortem. In addition to the usual hematological localizations, the autopsy revealed unusual topographical features in each case, explaining the atypical clinical manifestations.

Adult↗
PubMed1983

An assessment of long saphenous venography to evaluate the saphenous vein for femoropopliteal bypass.

A long saphenous venogram was performed on a consecutive series of 42 patients (5 bilateral) though in 4 the vein was not satisfactorily demonstrated. In all cases the long saphenous vein was dissected out and its suitability for use for a femoropopliteal bypass compared to the radiological findings. Eleven veins were unusable for a bypass and radiologically these were narrower (mean diameter 2.8 mm) than the veins which functioned satisfactorily (mean diameter 5.0 mm), and had more tributaries (mean 5) than the suitable veins (mean 2). Preoperative venography is a useful technique to identify veins that will be unsuitable for a femoropopliteal bypass and thereby save an unnecessary dissection.

Evaluation Studies as Topic↗
PubMed1983

Angiographic identification of primary coronary anomalies causing impaired myocardial perfusion.

The origin and early branching of the coronary arteries is fairly constant. Anomalous origin of the coronary arteries, which produced significant abnormalities of myocardial perfusion, were documented in 13 adult patients undergoing investigation because of chest pain. All underwent surgical treatment with relief of the presenting symptoms. They can be divided into four groups: (1) Origin of the left anterior descending branch of the left coronary artery (LCA) from the pulmonary artery (PA) (three cases); (2) origin of the LCA from the anterior sinus. Acute angulation of the ostium and compression of the intramural segment of this coronary produced severe myocardial ischaemia in three patients. (3) Origin of the LCA from the right coronary artery with its proximal segment closely related to the noncoronary sinus (one patient) in whom relief of symptoms was obtained by surgery. (4) Origin of the LCA from the PA with reversal of coronary flow and left to right shunting (six patients). It is concluded that anomalies of the origin of the coronary arteries are rare, but can produce specific clinicopathological entities that can be diagnosed with confidence and corrected surgically. Moreover, the study emphasises the need for angiographic awareness of these coronary anomalies, even in adult patients in whom atherosclerotic disease would be the most likely finding at cardiac catheterisation.

Adolescent↗