[Pathology and cytology of virus diseases of the uterine cervix (author's transl)].
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Adult↗
Biomedical subjects
G Aftimos
Publications and source records attributed to G Aftimos.
[Allergic granulomatous angiitis in the Churg-Strauss syndrome. Two case reports].
The Churg-Strauss Syndrome (CSS) or allergic granulomatosis and angiitis is a relatively unusual disease. It is a subset of the group of systemic necrotizing vasculitis and the clinical manifestations involve multiple organ system. The CSS is characterized typically by three phases, asthma or atopic disease, peripheral eosinophilia and ultimately, vasculitis. The authors report two cases of CSS. The first patient presented allergic rhinitis and asthma for 19 years when she developed acute abdominal pain, mononeuritis of her right leg, pulmonary infiltrates and hypereosinophilia. The lung biopsy showed extravascular granulomas and eosinophilic infiltration. The second patient presented asthma for two years when she developed a mononeuritis of the left leg and then a hypereosinophilia with cutaneous eruption of hands and feet, and a myo-pericarditis. In both cases, treatment with prednisolone produced a dramatic improvement in symptoms and eosinophilia.
Adult↗
Transfusion associated graft versus host disease in immunocompetent patients. Report of two cases.
Transfusion graft versus host disease (TGVHD) in immunocompetent patients is a recently recognized disease, reported mainly after open heart surgery, and almost always fatal. We report two cases of TGVHD in immunocompetent patients after open-heart surgery. The disease is characterized by the occurrence of fever, skin rash, liver failure and pancytopenia. Preventive measures include exclusion of first- and second-degree relatives as blood donors, and/or irradiation of blood to be transfused.
Adult↗
[Breast cancer: prognostic value of flow cytometry and hormone receptors. Apropos of a Lebanese series of patients].
OBJECTIVES: This study has three objectives. 1) First to establish the influence of flow cytometry and hormone receptors on overall survival and disease free survival of stage I to IIIA breast cancer patients. 2) Second to search for associations between the classical prognostic factors: age, menopausal status, histological and nuclear grading, tumor diameter, node metastases, stage, estrogen and progesterone receptors (ER, PR), as well as ploidy and S phase fraction. 3) And third to evaluate the effect of flow cytometry and hormone receptors on the response to neoadjuvant chemotherapy in stage IIIB and IV patients. MATERIAL AND METHODS: The series is composed of 150 patients with primary invasive breast cancer (149 females and one male), diagnosed at the St George Hospital Pathology Department and in whom an evaluation of the hormone receptors and a measuring, by flow cytometry, of ploidy and S phase fraction (SPF) were performed. Among them, 68 were followed for a mean period of 45 months. The disease free survival and the overall survival were recorded as well as the response to neoadjuvant chemotherapy. RESULTS: The authors did not find any statistically significant difference in survival between diploid and aneuploid tumors, tumors with SPF above and below 8%, those who are ER+ and ER- and those who are PR+ and PR-. But it seemed that diploid, low SPF and positive hormone receptors tumors had a tendency toward a better disease free survival. The multivariate analysis using the Cox proportional hazards identified the tumor diameter as being the only independent prognostic factor (p = 0.046). The nuclear grade reached a limit of significance (p = 0.08). Diploidy, low SPF and positivity of ER and PR were associated one to the other and to low histologic and nuclear grades. Finally, neither flow cytometry parameters nor hormone receptors were predictive of a susceptibility to neoadjuvant chemotherapy.
Adult↗
[Simultaneous bilateral spontaneous rupture of the quadriceps tendon. Apropos of a case of a hemodialysis patient with hyperparathyroidism and review of the literature].
The bilateral simultaneous spontaneous rupture of the quadriceps tendons is a rare condition. Of the pathologies associated with this condition, in the literature, chronic renal failure with hyperparathyroidism is of special interest. In this context, the frequency of this lesion is related to the chronicity of the renal disease. We report a case treated surgically with a good functional result in a patient under dialysis with hyperparathyroidism.
Adult↗
[Stereotaxic excisional biopsy of non-palpable breast lesions by the ABBI(Advanced Breast Biopsy Instrumentation) technique. Advantages. Disadvantages. Indications. Apropos of 67 cases].
OBJECTIVES: Introduce briefly: the classification of the American College of Radiology for non palpable breast lesions; and the different techniques used for stereotactic breast biopsies. Evaluate the efficiency of the ABBI technique for non palpable breast lesions and its role in breast biopsies, on the base of 67 cases. SUBJECTS AND METHOD: Sixty-seven stereotactic excisional biopsies on dedicated prone tables were performed using the ABBI technique for 21 probably benign and 46 indeterminate non palpable breast lesions seen on mammograms. Twenty-five cases were densities, architectural distortions or radial scars, and 42 were microcalcifications. RESULTS: In our hands, the technique is 100% specific and sensitive. This high percentage of success is related to a team work between radiologists, surgeons or gynecologists. The specimen represent the whole lesion. Ductal carcinoma in situ (DCIS) and atypic ductal hyperplasia (ADH) are diagnosed with accuracy. Twelve carcinomas are found, three of them DCIS. ADH was encountered in two cases. Complications are minor, hematomas of small and moderate volume were encountered in eight cases (12%). CONCLUSION: ABBI technique replaces surgical biopsies after wire hook localisation for solitary lesion smaller than two cm in diameter; and stereotactic Tru-cut biopsies, even with vacuum aspiration, for small cluster of microcalcifications, architectural distortion and radial scar, where the percentage of failure is higher. For malignant lesions, surgery must follow, even when the margins are free.
Adult↗
Value of duodenal endoscopic markers of villous atrophy.
UNLABELLED: Several endoscopic aspects of duodenal mucosa have been described in patients with villous atrophy (VA) and celiac disease. We assessed the accuracy of three endoscopic markers in patients referred for duodenal biopsy. METHODS: From January 1992 to June 2000 all patients undergoing upper gastrointestinal (UGI) endoscopy by a single operator (n = 4102), had the second part of the duodenum examined, without any magnification technique or addition of vital dye staining, for the presence of three markers of VA, (1) reduction or loss of Kerkring's folds, (2) scalloped configuration of the duodenal folds, and (3) mosaic appearance of the mucosa. Biopsy samples were taken from those in whom the mucosa was abnormal (n = 51), and from those in whom it was normal but where biopsy was indicated (n = 230). RESULTS: None of the 230 endoscopically normal controls had VA. Seven out of 51 patients (14%) with an abnormal mucosa had a normal histology, the remaining 44 (86%) had some degree of VA confirmed at histology, partial VA in 11 patients (25%) and subtotal or total VA in 33 patients (75%). 63% of the patients with only one endoscopic marker had VA confirmed at histology whereas the coexistence of more than one marker was always associated with histological villous atrophy. The overall sensitivity, specificity, positive and negative predictive values of the endoscopic markers were respectively, 100%, 97%, 86%, and 100%. CONCLUSION: The appearance of the second part of the duodenal mucosa as assessed during routine UGI endoscopy, is a sensitive and specific indicator of the presence of VA on biopsy, and should alert the endoscopist to the possibility of a celiac disease.
Adult↗
Local application of IGF1 on dental pulp mechanically exposed; in vivo study on rabbit.
IGF1 (Insulin Growth Factor, 1) was intentionally applied onto pulp tissues, aiming to provoque a dentine regeneration process through the stimulation of the dentinoblasts' potententials. 72 cavities were hence performed on rabbit molars, intentionally exposing the dental pulp. Different concentrations of IGF1 were then applied; The histo and anatomo-pathological observations showed persistent vitality of the pulp without any sign of necrosis, even 6 weeks after the IGF1 application. Dentinoblasts layers (as an indication of the regeneration activity) were counted, according to a pre-established protocol, at days 7, 14, 22, 28 and 42. The type of the applied IGF1, was carefully selected to be "Binding Protein Resistant" (IGF-BPR), so to avoid any inhibition of the IGF1 action by the endogenous binding proteins (Hochscheid and coll). The results were conclusive in indicating the IGF1 as an efficient dental pulp capping product.
Animals↗
[Extra-articular cervical synovial sarcomas. Review of the literature apropos of 2 cases].
Two cases of extra-articular synovial sarcoma are reported together with a review of the literature. The analysis of 44 cases shows that this tumor appears among young people particularly between 10 and 30 years of age and is twice more frequent among males. There can be metastasis mostly in lungs (11 times), which can sometimes appear much later (more than 10 years after the first diagnosis). The 5-year survival rate is here, 13/18; this is higher than for similar tumors located in the juxta-articular area. The great size of the tumoral nodule (more than 5 centimeters) is of a bad omen for the prognosis. As regards therapy, isolated surgical exeresis seems to have given results at least as good as these of surgery associated to radiotherapy. In all cases, the diagnosis is based on a light microscopic study which shows two tightly linked histological patterns: a proliferation of fusiform cells and glandular like formations. This feature is not definitely pathognostic and is very similar to tumors of glandular origin, with myoepithelial proliferation. Some examples could indeed be classified as extra-articular cervical synovialo-sarcoma. They could originate in pharyngeal and laryngeal mucous glands. This histogenetic hypothesis could account for the highly favorable evolution of some cases which were reported as synovialo-sarcoma.
Adolescent↗
[Bilateral malignant exophthalmia as a manifestation of IgM multiple myeloma].
The authors report a case of IgM myeloma revealed by bilateral malignant exophtalmia, only the third case to be published in the world. This exophthalmia was due to plasma cell infiltration of the periorbital fat, and not to primary involvement of the orbit. Other rare localisations were found on autopsy: ovarian, pleuro-pulmonary and, above all, epicardiac. This was an IgM myeloma (0.5% of myelomatous disease) and not Waldenstrom's macroglobulinemia. In fact the patient had no adenopathy, no hepato or splenomegaly, and the tumour contained only plasma cells.
Exophthalmos↗