[Muscle lesions. Conservative treatment].
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Biomedical subjects
Publications and source records attributed to F Joris.
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The surprisingly long survival of patients with inoperable gastric lymphoma has led to the identification of pseudolymphoma, i.e. isolated or ulcer-related lymphoid reaction of an organ. We report six years follow-up of a patient suffering from a chronic gastric ulcer associated with lymphocytic follicular gastritis with germinal centers. The preoperative diagnosis of pseudolymphoma is difficult, since typical clinical signs as well as specific endoscopic and radiologic criteria are lacking. The diagnosis of pseudolymphoma can be established only on the basis of precise histological and immunochemical investigations. The association of lymphomatous foci with pseudolymphoma on gastrectomy specimens suggests the malignant potential of the lesion and its uncertain prognosis. Discovery of lymphomatous transformation by repeated biopsies is an indication for surgery.
After swallowing a non-sterilised pH electrode a 25-year-old medical student developed an influenza-like illness followed by hypo- and achlorhydria for several weeks, acute leukocyte-gastrititis, and epithelial defects of the antrum. This possibly represents an infectious disease which can be transmitted by contaminated electrodes or probes.
Heart reactive antibodies have been found with direct and indirect immunofluorescence in patients with congestive cardiomyopathy. The authors therefore investigated by direct immunofluorescence 25 patients with aortic valve disease and 11 patients with congestive cardiomyopathy who underwent diagnostic heart catheterization and left ventricular endomyocardial biopsy. The left ventricular biopsies were fixed by bouin, formaline and freeze-drying. A first analysis was performed to determine auto- or formaline-induced fluorescence. A second analysis was performed to identify myocardial structures with positive fluorescence using 5 different anti-sera or patient's serum. The results showed positive fluorescence with anti-IgG-antibodies in patients with aortic valve disease (23%) and with congestive cardiomyopathy (73%). The immunoglobulin deposits were located mainly in the subendocardial connective tissue. These deposits showed also slight fluorescence with anti-IgM, anti-C1q and anti-C4 antibodies. However, a correlation between the hemodynamic and immunologic findings was not demonstrated. It is concluded that the myocardial immune complexes appear to be reactive and do not play an essential role in the pathogenesis of congestive cardiomyopathy.
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A simple technique is described for the autoimplantation of splenic tissue in the peritoneal cavity of rats. The effect of splenic implants on irradiated splenectomised rats was investigated, by following the evolution of the implants both microscopically and macroscopically. The effect on haemopoiesis was also observed. The dose of irradiation given was sublethal, do not think it necessary to put in, and non lethal.
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The influence of aging on the myosin type, and on the fibre composition of both the slowly contracting ("red") M. soleus and the fast ("white") M. longissimus dorsi was examined in the rabbit. For myosin characterization isolated myofibrils were electrophoresed on SDS-polyacrylamide gels, and the fibre pattern within the respective muscles was analyzed with an immunocytochemical method. Antisera against either fast or slow rabbit myosin were collected from guinea pigs after longterm immunization. After incubation of the paraformaldehyde-fixed muscle thin sections the fibres containing either fast or slow myosin could be distinguished from each other by indirect immunofluorescence. The soleus muscles of 1 day old rabbits were composed of 25% slow and 75% fast fibres. In young-adult (5--8 mo.) rabbits the fibres were mostly slow (over 90%), while in old age (4--7 y.) again up to 50% of the soleus fibres contained fast myosin. In contrast, in the longissimus dorsi muscle constantly around 95% of the fibres contained fast myosin. In accordance with the immunocytochemical finding of an increase of fast fibres in the aging soleus muscle, the presence of fast myosin could also be demonstrated electrophoretically. With this method, soleus myofibrils from young-adult animals were observed to contain virtually slow myosin only. No slow, but only fast myosin was identified in SDS-gels of longissimus dorsi myofibrils at all ages. These results are discussed in relation to the well known metabolic alterations occurring in the mammalian skeletal muscle during aging.
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Different parameters of the immunologic response have been studied in young and aged subjects before, during and after administration of increasing doses of tuberculin purified protein derivative (PPD). In both age groups, a considerable increase in skin reaction was observed with the progression of antigen administration. This is particularly striking among old subjects, who before the treatment had either no reaction to tuberculin or a very weak one. Increased production of circulating antibodies to tuberculin was also consistently observed. The treatment resulted, especially in the old patients, in an increase in the lymphocyte sensitivity to phytohemagglutinin. The production of migration inhibitory factors was studied with lymphocytes from 6 treated subjects, in all cases this production was of the same degree as the one obtained from lymphocytes of PPD-positive untreated subjects. Lymphocyte cultures done during the treatment showed an absence of response in the presence of tuberculin, and in young patients only a slight increase in the spontaneous synthesis of desoxyribonucleic acid in the absence of tuberculin. These results demonstrate that in old people the depression of cellular immunity seems to be small. Adequate and prolonged antigenic stimuli are able to reactivate to approximately normal levels many features of this altered function.
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AIMS AND BACKGROUND: The reproducibility of histologic diagnoses, and in particular of the distinction between basal and squamous cell forms, has been evaluated in the framework of a multicenter case-control study (in Italy, France, Spain and Switzerland) aimed to assess the causes of non-melanocytic skin cancers. METHODS: A panel composed of 10 pathologists from the collaborating centers was appointed. A total of 1,774 slides of routine diagnoses were blindly reviewed by a second panelist; discordant diagnoses underwent a third examination. Controversial and interesting cases were discussed during general sessions. RESULTS: The results showed a high degree of concordance (99.5%), with a Cohen's kappa of 0.85 (95% CI, 0.77-0.94) in the assessment of malignancy of lesions. The concordance in the distinction between large morphologic groups, basal cell carcinoma and squamous cell carcinoma was also high (Cohen's kappa = 0.85; 95% CI, 0.82-0.89). The assessment of histologic subtypes, degree of invasion and differentiation showed a lower degree of concordance, presumably as a consequence of a weaker consistency in the relevant classifications. CONCLUSIONS: The reproducibility study has therefore validated the epidemiologic study and in particular allowed to correct some misclassifications that could have lessened the analysis of the case-control study. In general, because of its characteristics (number of pathologists and variety of their origins, the large number of cases examined, blind examination of histologic slides), the conclusions of the study may show a certain degree of generalization, at least with regard to the countries represented. Routine histologic diagnoses of cutaneous carcinoma showed a high degree of reliability with reference to the assessment of malignancy and the distinction between basal and squamous cell carcinoma morphotypes.
AIMS AND BACKGROUND: Non-melanocytic skin cancers are the most common cancers in white populations. Studies on populations of Anglo-Saxon and Mediterranean origins highlighted different patterns of risk of basal-cell carcinoma and squamous-cell carcinoma in relation to sunlight exposure, skin characteristics and phenotype susceptibility. In Sion, and in Switzerland as a whole, the high incidence suggests the possible presence of additional risk factors or of a different pattern of exposure to solar radiation as well as different composition of pigmentary traits and skin sensitivity to sun. METHODS AND STUDY DESIGN: We conducted a case-control study of 146 cases (73% of eligible cases) and 144 controls (81% of eligible subjects) to further evaluate the relationship between nonmelanocytic skin cancer and risk factors in the Sion population. Interviews were conducted by trained interviewers with a standardized questionnaire. RESULTS: Pigmentary characteristics such as blonde and red hair as well as tendency to sunburn without tanning and number of sunburns showed a statistically significant and independent risk increase in basal-cell carcinoma. Sun exposure during recreational activities (outdoor sports) showed a risk increase in basal-cell carcinoma with borderline statistical significance. Analysis of squamous-cell carcinoma risk was limited by the small number of cases, but it was positively associated with lifetime exposure to sun during outdoor work and with skin characteristics. CONCLUSIONS: Results confirmed previous suggestions of a different mechanism leading to malignant transformation of target cells from the basal and squamous epidermal layers, mediated by different phenotypes, and conditioning the ability to develop an effectively protective tan.