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Biomedical subjects

A Fabre

Publications and source records attributed to A Fabre.

At least 19 recordsLinked to original sources
PubMed2001

Intraductal acinar cell carcinoma of the pancreas.

We describe a purely intraductal acinar cell carcinoma involving branch ducts of the pancreas in a 74-year-old man, which presented as recurrent episodes of acute pancreatitis. Endoscopic ultrasound examination revealed an intraductal mass bulging into the main pancreatic duct suggesting, pre-operatively, an intraductal mucinous papillary tumour. Gross examination showed several dilated branch ducts that contained haemorrhagic tumour material without any solid or true cystic formation within the pancreatic parenchyma. Using histology, a purely intraductal acinar cell carcinoma was observed, involving branch ducts only, associated with foci of carcinoma in situ in adjacent exocrine parenchyma. The main pancreatic duct was free of disease except for its communication with a cancerous branch duct. A concomitant neuroendocrine microadenoma was incidentally found during slide screening. Immunohistochemistry performed on the intraductal proliferation confirmed zymogen secretion with positive staining for alpha-1 anti-chymotrypsin and anti-trypsin and the persistence of diastase-periodic acid-Schiff positive granules in the apical pole of the tumour cells. Neuroendocrine markers were negative in the acinar cell carcinoma and positive in the neuroendocrine microadenoma. To our knowledge, this is the first report of an intraductal acinar cell carcinoma of the pancreas involving branch ducts and sparing the main pancreatic duct.

Aged↗
PubMed2000

Krukenberg tumor: a clinico-pathological study of 15 cases.

Krukenberg tumor clinically mimics primary ovarian cancer. We report a series of 15 cases of Krukenberg tumor. The patients' age range from 13 to 71 years. Most ovarian tumors (14/15) were bilateral. A primary digestive tumor was diagnosed pre-operatively in 3 cases, per-operatively in 3 cases and post-operatively in 4 cases. No primary tumor was identified in the 5 other cases. Histological diagnosis of Krukenberg tumor is usually easy either on paraffin or frozen sections. Mucin stains are helpful. Two main histological types were found in our series : the classic form with sarcoma-like storiform tumoral stroma and an alternative cellular-acellular pattern. Mucinous carcinoid was microscopically challenged in two cases. Most patients died within 2 years (median survival 14 months). Nor surgery, neither chemotherapy is efficient but bilateral oophorectomy should be proposed in post-menopausal women with gastric linitis removed surgically.

Adolescent↗
PubMed2000

[Disseminated mucormycosis in AIDS].

Mucormycosis is a rare often fatal opportunistic condition. It mainly occurs in immunocompromised subjects but rarely in AIDS patients. An eighteen-year-old HIV+ man from Zaire died rapidly from disseminated mucormycosis with pulmonary, cardiac, renal, hepatic, splenic and gastric involvement. Fungi were observed in all these organs with a particular vascular trophism. Rhizopus orizae was identified on cultures. Rapid microscopic diagnosis, in the localized stage, could improve the poor prognosis of this infection.

AIDS-Related Opportunistic Infections↗
PubMed1999

Loss of heterozygosity of the Wilms' tumor suppressor gene (WT1) in in situ and invasive breast carcinoma.

The Wilms' tumor suppressor gene (WT1), a nuclear transcription factor, regulates the expression of the insulin-like growth factor (IGF) and transforming growth factor (TGF) systems, both of which are implicated in breast tumorigenesis. WT1 allelic integrity was examined by loss of heterozygosity (LOH) studies in formalin-fixed, paraffin-embedded (FFPE) ductal carcinoma in situ (DCIS, n = 20) and fresh frozen primary invasive breast carcinomas (n = 24). Loss of heterozygosity (LOH) at the WT1 locus (11p13) was examined by PCR evaluation of an Hinf1 restriction fragment length polymorphism (RFLP) and correlated to tumor stage (in situ and invasive). After identification of the heterozygous/informative breast lesions, 1 of 12 (8.3%) DCIS (high-grade micropapillary) and 3 of 14 (21.4%) of infiltrating carcinomas (high grade) showed loss of one allele, suggesting that LOH of the WT1 locus is a rare genetic event in early breast cancer, becoming more common in invasive and in high-grade lesions.

Breast Neoplasms↗
PubMed1995

[Flaps of the gastrocnemius muscles].

The authors expose different techniques and maneuvers used for dissection of gastrocnemius flaps with reference to the data reported in the literature and to the anatomical vascular basis. The use of muscular and myocutaneous gastrocnemius flaps and some modifications of the standard surgical technique aiming to gain more versatility are described, so that, the range of these flaps can be planned to cover the greatest part of the lower extremity of the leg.

Humans↗
PubMed1994

[The styloid bone and carpal protuberance].

Dorsal carpal protuberance of the wrist is frequently caused by the presence of a styloideum bone. We report a case illustrating this pathophysiological hypothesis. This pathology is often confused with synovial cyst emphasizing the importance of a lateral view of the hand in 30 degrees supination. Computed tomography sections are also helpful showing the exact nature of the protuberance. A cuneiform resections of the joint line can leave to complete symptom relief.

Adult↗
PubMed1988

[Inoperable cancers of the upper respiratory and digestive tracts. Value of chemotherapy: 185 cases].

A series of 185 squamous cell carcinomas of the head and neck was retrospectively analyzed. Induction chemotherapy was systematically administered. The overall tumour response rate was 38 per cent, and 39 tumours (22.4 per cent) became resectable after chemotherapy. The survival of complete responders was statistically higher than that of non or partial responders. Complete responders treated either by radiation therapy or surgery had similar survivals. Surgery improved the prognosis and reduced the rate of local and regional failures in non responders, including poor responders (less than 50 per cent).

Carcinoma, Squamous Cell↗
PubMed1988

[Chemotherapy and partial surgery in epithelioma of the pharyngo-larynx].

On the basis of a series of 185 patients, the authors evaluate the results of the therapeutic sequence chemotherapy-partial surgery in carcinomas of the pharyngolarynx. The action of chemotherapy is confirmed (80% clinical responses greater than 50%, 55% residual tumours or in complete histological regression). The therapeutic sequence chemotherapy-surgery gave 25% local failures and 1% lymph node failures. The development of the therapeutic strategy in carcinomas of the pharyngolarynx is considered in relation to the action of current modalities of chemotherapy.

Actuarial Analysis↗
PubMed1988

[Tumor and lymph node response to chemotherapy. Prognosis in cancer of the pyriform sinus and the lateral laryngeal margin].

The prognostic value of the tumoural and lymph node response to chemotherapy was studied in cancers of the piriform sinus and the lateral laryngeal margin. 102 operable patients were selected and were operated after chemotherapy. The incidence of loco-regional failures and visceral metastases was significantly higher in the absence of any lymph node response.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1988

[Pharyngo-esophageal diverticula. Treatment and results].

27 patients were seen in the ENT department of Hopital Laennec for pharyngo-oesophageal diverticulum between 1970 and 1987. 25 patients were operated: diverticulectomy in 14 cases, diverticulopexy in 10 cases. Cricopharyngeal myotomy was performed in every case. In one case, myotomy was the only treatment. The postoperative course and the functional results were analysed in the 3 groups. The operative indications are discussed. The functional results were excellent regardless of the technique used (95.8% in the present series).

Aged↗
PubMed1988

[Continuous ambulatory chemotherapy in cancer of the upper respiratory and digestive tract].

Chemotherapy of the upper respiratory and gastrointestinal tracts is currently based on Cis-platinum-5 FU administered by continuous infusions which, up until 1985, were performed in hospital during a 4 days admission. These infusions can now be administered on an outpatient basis over a period of 6 days. More than 600 patients have been treated in this way. The improvement in the results observed on a population of 86 operable patients confirms the value of prolonged continuous infusions. The clinical and psychological acceptability of this method, which allows the patient to maintain his autonomy and sometimes his occupation, is an important advance which could promote extension of this approach, particularly in view of its economic advantages.

Ambulatory Care↗
PubMed1988

[Hemipharyngolaryngectomies. Functional and carcinologic results].

A retrospective study of 260 hemilaryngopharyngectomies performed between 1964 and 1986 defines the functional and oncological results of these operations and the improvement in the oncological results and survival when neoadjuvant chemotherapy is used.

Actuarial Analysis↗
PubMed1988

[Vocal rehabilitation after total laryngectomy by musculomucous tracheo-esophageal fistula. Results apropos of 27 cases].

Twenty seven cases of Myomucosal Tracheoesophageal shunt following total laryngectomy performed at Laennec Hospital are presented. The surgical technique which was initially reported by M. Strome is summarized. The advantages of this procedure as compared to other tracheoesophageal fistulas are discussed. The first sixteen cases of this series failed: 12 stenoses occurred and 4 flaps necrosed. The eleven last Myomucosal shunts of this series are functioning. Aspiration was only problematic in one case. Six of the eleven functioning shunts have excellent voicing; three other patients are able to voice before completion of speech therapy and one patient has a too short follow-up for voice evaluation. The authors emphasize the contra-indications for the procedure. Medical conditions that can potentially lead to flap necrosis include: arteritis, diabetes mellitus, and gastrointestinal reflux.

Female↗
PubMed1988

[Partial surgery of epithelioma of the glottic area].

Technical aspects are described for partial vertical surgery used in 286 patients with epithelioma of vocal cords. Results and limitations are discussed and the place of partial vertical or partial supracricoid horizontal surgery with cricohyoidoepiglottopexy defined. Progress in therapeutic strategy is outlined and the value of induction chemotherapy emphasized.

Carcinoma↗
PubMed1988

[Esophagectomy and pharyngectomy in cancers of the upper respiratory and digestive tracts and the esophagus. Results apropos of 16 cases].

A series of 16 squamous cell carcinomas of the pharynx with an extension to the cervical esophagus, or multiple primaries of the pharynx and esophagus is presented. The surgical procedure consisted of an oesophagectomy associated with either total pharyngolaryngectomy, or partial pharyngectomy, or transmandibular resection. 13 patients received neo-adjuvant chemotherapy: CDDP-5-FU. Postoperative complications occurred in less than 20% without any postoperative death. One-year and five-year actuarial survival rates were respectively 20% and 13.3%. The mean survival was 9.5 +/- 3.7 months. 75% of the deaths were due to local or cervical lymph node recurrences. Neo-adjuvant chemotherapy could improve the prognosis of these pharyngo-oesophageal carcinomas.

Adult↗
PubMed1988

[Partial supracricoid laryngectomies: techniques, indications and results].

The authors present results of a retrospective study on 99 patients who underwent a partial supracricoid laryngectomy. Indications included carcinomas developed on the laryngeal vestibule, in the ventricle or at the glottic level. This represents an alternative to total laryngectomy. Surgical techniques and functional results are discussed. Ninety-eight percent of patients could be decanulated and a regular diet was possible in 94%. The survival rates are 76% after three years and 68% after five years. Local recurrences occurred in 3% of cases and cervical metastases were not controlled in 13%. The authors comment on indications for surgery according to the site of involvement. Contra-indications are massive invasion of the pre-epiglottic space, extension away from the superior aspect of the cricoid and arytenoid fixation.

Cricoid Cartilage↗