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Biomedical subjects

G Barnéon

Publications and source records attributed to G Barnéon.

At least 19 recordsLinked to original sources
PubMed2004

Sonographic diagnosis of colitis in children.

To assist the radiologist in differentiating the colitis in children, this review proposes a systematic US approach to the disease, presents the US aspect of the normal colon and describes three distinctive US patterns reflecting the intramural extension of the histopathological changes. Each pattern corresponds to one or several diseases producing alterations in the same layer(s). Stratified thickening suggests an inflammatory mucosal process resulting from infection (as in advanced appendicitis or in infectious colitis) or to inflammation (as in IBD). Nonstratified thickening with loss of the haustral folds reflects a marked submucosal infiltrate. Color Doppler is required to distinguish between an inflammatory disease (as advanced CD or neutropenic colitis) and an ischemic colitis (HUS in children). Nonstratified thickening with preservation of the length of the haustral folds is the sign of an intraluminal deposit due to PMC. Correlating the sonographic pattern and the anatomic distribution of the disease with the clinical and laboratory findings often permits to propose a specific diagnosis.

Adolescent↗
PubMed2000

[Extensive primary cutaneous mucinosis associated with refractory anemia with excess of blast].

BACKGROUND: We describe an original case of a primary cutaneous mucinosis, associated with a refractory anemia with excess of blast. CASE REPORT: A 65 year-old female consulted for erythematous-purple blush reticulated and large plaques that progressively developed on the trunk and limbs. Biopsies showed abundant dermis mucin deposits with a perivascular lymphocytic infiltrate. The epidermis was normal. Laboratory evaluation showed refractory anemia with excess of blast, associated with cytogenetic abnormalities. After two years course, the progressive aggravation of the myelodysplastic syndrome was associated with a progressive extension of the cutaneous mucinosis. DISCUSSION: This is the first report of an atypical primary diffuse and extensive cutaneous mucinosis. Primary cutaneous mucinosis may be associated with systemic diseases. To our knowledge, the association with refractory anemia with excess of blast has not been described previously. Mucine deposits may be considered as a consequence of neutrophilic dysfunction that are observed in myelodysplastic syndromes.

Aged↗
PubMed1999

The expression of peripheral benzodiazepine receptors in human skin: the relationship with epidermal cell differentiation.

The peripheral benzodiazepine receptor (PBR) is a protein of mitochondrial outer membranes utilizing porphyrins as endogenous ligands. PBR is part of a heteromeric receptor complex involved in the formation of mitochondrial permeability transition pores and in the early events of apoptosis. PBR may function as an oxygen-dependent signal generator; recent data indicate that these receptors may preserve the mitochondria of haematopoietic cell lines from damage caused by oxygen radicals. To identify PBRs in human skin, we used a specific monoclonal antibody directed against the C-terminus fragment of the human receptor. PBR immunoreactivity was found in keratinocytes, Langerhans cells, hair follicles and dermal vascular endothelial cells. Interestingly, confocal microscopic examination of skin sections revealed that PBR expression was strongly upregulated in the superficial differentiated layers of the epidermis. Ultrastructurally, PBRs were distributed throughout the cytoplasm but were selectively expressed on the mitochondrial membranes of epidermal cells. The elevated level of PBRs in the spinous layer was not associated with an increased number of mitochondria nor with an increased amount of mRNA as assessed by in situ hybridization on microautoradiographed skin sections. The present work provides, for the first time, evidence of PBR immunoreactivity in human skin. This mitochondrial receptor may modulate apoptosis in the epidermis; its increased expression in differentiated epidermal layers may represent a novel mechanism of natural skin protection against free radical damage generated by ultraviolet exposure.

Adult↗
PubMed1996

Granulomatous mycosis fungoides presenting as sarcoidosis.

This report describes the case of a woman who developed cutaneous granulomatous infiltration during childhood that was initially considered to be sarcoidosis and, after 27 years of evolution, was determined to be caused by granulomatous mycosis fungoides transforming to Ki-1-positive anaplastic large-cell lymphoma of T-cell type. We discuss the differential diagnosis, especially granulomatous slack skin and the interest of immunohistochemical and genotypic studies in this case.

Adult↗
PubMed1995

[Multiple cutaneous carcinoma and chronic lymphoid leukemia].

INTRODUCTION: Skin cancer occurs more readily in more aggressive forms in immunodepressed subjects. We report the case of a patient with chronic lymphoid leukaemia and multiple skin carcinomas complicated with carcinomatous lymphangitis. CASE REPORT: A 63 year-old man with chronic lymphoid leukaemia, stage A in the Binet classification, had multiple epidermoid carcinomas on the trunk and face. The skin tumours were complicated with cervical lymph mode metastases, then a prethoracic carcinomatous lymphangitis with a rapidly fatal clinical course. DISCUSSION: Chronic lymphoid leukaemia and lymphomas are associated with a high incidence of skin carcinoma. The immunodepression inherent in the haematologic disease would appear to favor aggressive skin cancers. Our case was particularly severe since the carcinomatous lymphangitis was rapidly fatal.

Basal Cell Carcinoma↗
PubMed1994

[Scleroderma of the shoulders after treatment with combined bleomycin and radiotherapy].

INTRODUCTION: There are many causes of scleroderma. We observed a case of scleroderma involving the shoulder and neck area after combined bleomycin and radiotherapy. CASE REPORT: After six cycles of a CHOP-bleo protocol followed by radiotherapy for lymph node lymphoma, a female patient presented scleroderma involving the shoulders and neck area. Total bleomycin dose was 252 mg. DISCUSSION: Among the imputable factors, particularly extrinsic factors, in a series of 33 cases of different chemotherapy protocols published by Peters et al. in 1988, we retained the bleomycin radiotherapy administration sequence as the cause of this complication. Given after bleomycin, radiotherapy could increase the risk of scleroderma.

Adult↗
PubMed1993

Mast cells' contribution to the fibrosing alveolitis of the scleroderma lung.

Fibrosing alveolitis is frequently seen in scleroderma. Although usually causing progressive symptomatology, it may be found in patients reporting no respiratory symptoms. Mast cells may play a role in the pathogenesis of skin fibrosis in scleroderma. We determined the mast cells and other cellular content, as well as measuring the inflammatory mediators in the bronchoalveolar lavage fluid (BALF) in 17 scleroderma patients and nine control subjects to correlate BALF features with fibrosing alveolitis as determined by lung function testing and high-resolution computed tomographic scans. Bronchoalveolar lavage cells were enumerated after May-Giemsa-Grünwald (MGG), alcian blue, and safranine blue staining. Histamine, tryptase, eosinophil cationic protein, hyaluronic acid, and neutrophil-specific myeloperoxidase were measured by radioimmunoassay. In comparison with normal subjects the BALF of scleroderma patients showed an increased percentage of mast cells (p < 0.002, Mann-Whitney U test), and increased levels of histamine (p < 0.005), tryptase (p < 0.02), and hyaluronic acid (p < 0.004). The BALF of the eight scleroderma patients with an abnormal chest X-ray had a significantly greater number of mast cells (p < 0.04, Mann-Whitney U test), and significantly higher levels of histamine (p < 0.03, Mann-Whitney U test) and tryptase (p = 0.02, Mann-Whitney U test) than the nine scleroderma patients with a normal chest X-ray. This study demonstrates the importance of mast cells and mast-cell activation in the pathogenesis of the fibrosing alveolitis of scleroderma.

Adult↗
PubMed1993

[Failure factors of guided puncture of hepatic masses].

This study was carried out to assess the failure factors of guided hepatic mass puncture in 320 biopsies. Results of the puncture, follow-up or surgery allowed us to divide 320 biopsies into true positives or false negatives. Compared with the group of true positive diagnosis, the group of false negative diagnosis revealed a significantly higher percentage either of lesions less than 2 cm (52.5% versus 34%), of benign tumors (19% versus 5%), or of pseudotumors (24% versus 1.5%). Compared with the group with cytology and histology diagnosis, the group in which only histology established the diagnosis revealed a significantly higher percentage of hepatocellular carcinoma (52.5% versus 34%) and of benign tumors (21% versus 0%). A diameter less than 2 cm, a histology of benign tumors or pseudotumors, are failure factors of guided biopsy. The use of histology is useful for the diagnosis of benign tumors and increases the accuracy of diagnosis for hepatocellular carcinoma.

Biopsy, Needle↗
PubMed1993

[Carcinomatous degeneration of chronic osteomyelitic fistulae. 4 cases].

The occurrence of epidermoid carcinoma on fistulae of osteomyelitis has been known since the 19th century, and the four cases reported here show that this complication is still present. CASE-REPORTS. Four new cases developed on the tibia 33 to 54 years after the formation of fistulous osteomyelitis are presented here. The patients were three men and one woman, aged from 58 to 78 years. The lesions observed were ulcero-granuloma in three cases and common superficial ulceration in the fourth patient. In two out of four cases the diagnosis was difficult to ascertain and required deep surgical biopsy. The bone was invaded in three cases, but no regional or visceral metastases could be found. All patients were amputated, after failure of conservative radiotherapy in two of them. No recurrence was observed after a 2 to 3 1/2 years' follow-up. DISCUSSION. The frequency of this late complication cannot be measured precisely, but it has been estimated at 0.5 p. 100 of fistulous osteomyelitis. The warning signs are often not specific and delay the diagnosis; they consist of unusual pain, ulceration, granulation and discharge. The diagnosis rests on histology and requires a deep and wide surgical biopsy involving the entire sinus tract, but uncertainties sometimes persist concerning atypical pseudoepitheliomatous hyperplasia. The best treatment is amputation with removal and biopsy of regional lymph nodes when present, but it does not always avoid the occurrence of metastases which appear in 20 p. 100 of the cases, usually during the first three years following diagnosis. CONCLUSION. These four cases exemplify the need to consider this diagnosis in all patients showing changes in an old fistulous osteomyelitis and to confirm it by deep and wide biopsy.

Aged↗
PubMed1992

Acute colitis associated with prolonged administration of neuroleptics.

We describe a 29-year-old patient who developed acute colitis limited to the sigmoid and left colon with features mimicking ischemic injury after a prolonged administration of trifluoroperazine and levomepromazine, two phenothiazines in association with haloperidol, another neuroleptic, and biperidene, an anticholinergic compound. The discontinuation of these drugs was followed by a prompt and complete recovery, and no other cause of acute colitis was found. The subsequent administration of sultopride, a neuroleptic from the benzamide family and then the readministration of haloperidol were well tolerated. No colonic disorder occurred for the following months. This case strongly supports the view that neuroleptic agents, in particular phenothiazines, may induce acute colitis and that haloperidol, a butyrophenone derivative, or sultopride, a benzamide-related neuroleptic, can be administered thereafter without recurrence of the disease.

Adult↗
PubMed1991

[An unusual miliary pattern].

Syndromes presenting with interstitial radiological signs are often difficult to diagnose aetiologically. Surgical biopsy prevents certain rare cases being neglected notably when there are atypical manifestations. We describe a case of bronchiolitis obliterans with an organising pneumonia which was classical as regards the histology and its response to treatment but unusual as regards the clinical presentation and the aetiology.

Adult↗
PubMed1990

Eosinophilic inflammation in asthma.

BACKGROUND AND METHODS: The importance of eosinophils in the pathogenesis of bronchial asthma is not established. In an attempt to evaluate the role of eosinophilic inflammation in asthma, we compared 10 normal subjects with 43 patients with chronic asthma, 19 of whom had severe disease as assessed by a clinical scoring method described by Aas and by pulmonary-function tests. Eosinophils were counted in peripheral blood and bronchoalveolar-lavage fluid, and in biopsy specimens obtained from the patients and post mortem from 8 subjects without asthma, but not from the 10 normal controls. Eosinophil cationic protein was titrated by radioimmunoassay in the bronchoalveolar-lavage fluid from all subjects and studied by immunohistochemistry in the biopsy specimens. RESULTS: There was a significant increase in the number of peripheral-blood eosinophils in the patients that was correlated with the clinical severity of asthma (P less than 0.001) and pulmonary function (P less than 0.03). Levels of eosinophils and eosinophil cationic protein were increased in the bronchoalveolar-lavage fluid from the patients and were also correlated with the severity of asthma (P less than 0.001 and P less than 0.002, respectively). Hematoxylin-eosin staining of bronchial-biopsy specimens showed that intraepithelial eosinophils were present only in patients with asthma. Immunohistochemical analysis of eosinophil cationic protein revealed that normal subjects had only a few nondegranulated eosinophils deep in the submucosa, whereas all the patients had degranulated eosinophils beneath the basement membrane and among epithelial cells. In some patients there was a relation between the presence of degranulated eosinophils and epithelial damage. CONCLUSIONS: Eosinophilic inflammation of the airways is correlated with the severity of asthma. These cells are likely to play a part in the epithelial damage seen in this disease.

Adult↗
PubMed1990

Interstitial pulmonary disease induced by occupational exposure to paraffin.

An occupational interstitial pulmonary disease was observed in a 59-year-old workman after five years of massive exposure to aerosolized paraffin. Histologic studies of open-lung biopsy showed a lipoid pneumonia characterized by (1) alveolitis involving large lipid-laden macrophages and (2) interstitial fibrosis. Electron microscopy of AMs disclosed features of paraffin-laden cytoplasmic vacuoles. Successive treatments included prednisolone and cyclophosphamide. Despite these treatments and withdrawal from exposure, the pulmonary function became impaired progressively, resulting in restrictive syndrome and severe exertional dyspnea. Concomitantly, PMNs harvested by BAL increased, whereas initial lymphocytosis decreased. This is the first case observed of occupational interstitial fibrosis in which electron-microscopic findings clearly established a relationship with an exposure to paraffin. This observation also emphasizes the switch from alveolitis to fibrosis in the pathogenesis of interstitial pulmonary disease.

Humans↗