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Biomedical subjects

G Lebreuil

Publications and source records attributed to G Lebreuil.

At least 19 recordsLinked to original sources
PubMed1992

[Survival after gastrectomy for cancer. 209 cases].

The long-term results of 209 gastrectomies performed for adenocarcinoma, including 117 which were prospectively collected, are presented. Resection was curative in 154 cases (73.6 percent). The TNM distribution of the tumours was: stage I (TxNOMO) 75 cases, stage II (TxN1MO) 46 cases, stage III (TxN2MO) 33 cases and stage IV (TxNxM1) 55 cases. Lymph node involvement was more frequent in the prospective than in the retrospective study. With a more than 5 years' follow-up of 80 percent of the patients operated upon, the actuarial survival rate at 5 years (operative mortality included) was 38 percent for all lesions, 52 percent for curative resection and 2 percent for palliative resection. Following curative resection, the survival rates for tumours of the upper, middle and lower thirds of the stomach were 40, 60 and 55 percent respectively. These rates were 60 percent for stage I tumours, 54 percent for stage II tumours and 25 percent for stage III tumours. The results obtained in this series, where most of the curative gastrectomies included excision of N1 and N2 lymph nodes, show that lymph node involvement has no significant importance for the prognosis when it is proximal (N1) and is not incompatible with prolonged survival when it is pedicular (N2).

Actuarial Analysis↗
PubMed1991

[Anatomo-pathology of cholesteatoma].

The authors, from their own histopathological studies and from an overview of otological literature focus the controversial problems about the so-called disease cholesteatoma. The history of cholesteatoma has been marked out by pathologic data which, initially caused the cholesteatoma to be identified as a keratinized squamous tumor. This misnomer will however be retained because of it long-established usage. "Skin in the wrong place" in the middle ear summarizes this clinical entity. Electron microscopic observations provide arguments in favour of the migratory theory and the invasion of the epidermis from the bottom of the external ear canal into the middle ear cavity (identical fine morphology between skin and cholesteatoma, presence of Langerhans and Merkel cells, sharp junction between the advancing front of the cholesteatoma and the middle ear mucosa). Recent immunohistological techniques allow consideration of cholesteatoma as a self-induced inflammatory process in response to tissular and cellular conflicts. A cholesteatoma could be merely a non-healing wound process and a disease of epidermal growth control occurring in the middle ear space. The logical principles governing cholesteatoma surgery, suggested by these biological considerations, are: total removal of cholesteatoma matrix, prevention of cholesteatoma recurrence by a careful respect of the barrier separating the middle ear mucosa from the skin-lined bony external ear canal, maintenance of good healing conditions for both mucosa in a closed well-ventilated middle ear and epidermis in a harmonious anatomical external canal.

Cell Movement↗
PubMed1990

Primary malignant melanoma of the esophagus.

This report describes a case of primary malignant melanoma of the esophagus in a 66-year-old man treated by esophagogastrectomy. Radiographic, endoscopic, echoendoscopic and histological features are given and a short review of the literature is presented.

Aged↗
PubMed1990

[Retraction pockets, pathological entity?].

Retraction pockets are not a pathological entity per se but take after various ear diseases, with which they share the same morphological eardrum alterations. The authors believe that any holistic evaluation of retraction pockets, as though these were forming a single group of like pathogenic origin, i.e., tubal dysfunction, would be artificial and raise therapeutic problems. The statistical analysis of the causes for retraction pocket formation provides little information. Otologists are still looking into chronic otitis media and cholesteatoma as a possible, long-suspected, unproved etiology. Electron microscopy and, more particularly, istological-enzymological analyses of mounts prepared by the authors have shown, in some cases, the anomalous presence, in the pocket, of Langerhans' cells, which the authors consider as strongly indicative of cholesteatoma. While confirming the clinical diagnosis, anatomopathological examination allows to differentiate poor-prognosis retraction pockets from benign ones. The pathogenesis of these pockets is still poorly understood. It is the authors' contention that tympanic invagination is more likely traceable to some biopathological/biochemical phenomenon than to occupational mechanical disorders involving the tube. The clinical characteristics of retraction pockets are the basis for their classification into three groups, according to their evolutional tendency. Thus, developing cholesteatomas bear a poor prognosis; sequelae of benign otitis are associated with small risk; lastly, there is a small group of pockets the evolution of which is hard to specify. The authors believe that such differentiation between retraction pockets is mandatory to have a clear picture of therapeutic indications, and to assess the various outcomes.

Cholesteatoma↗
PubMed1990

[Wegener's granulomatosis. Contribution of computed tomography and nuclear magnetic imaging].

Amongst the endothoracic forms of Wegener's granulomatosis, tracheal, bronchial and above all mediastinal localisations are unusual. Such a case having a bad outcome is reported here. Computed Tomography (TDM) was used to assess the extend of pulmonary parenchymal involvement. Magnetic Resonance Imaging (MRI) was superior to TDM for showing transmural infiltration of the tracheal and the origin of main bronchi.

Bronchial Diseases↗
PubMed1989

Eosinophilic pustular folliculitis (Ofuji's disease): efficacy of isotretinoin.

The case of a 30-year-old man with a 6-year history of eosinophilic pustular folliculitis (EPF) is reported. Isotretinoin (1 mg/kg/day) led to a dramatic improvement of all the lesions within 2 weeks. The withdrawal of the drug was followed by a recurrence after 10 days of the papulopustular, follicular and pruritic lesions. Reintroduction of isotretinoin was successful. The benefits of isotretinoin in the treatment of EPF have, to the best of our knowledge, never been reported previously. The mechanisms underlying this efficacy may involve the inhibition of the eosinophilic chemotactic factors thought to be present in sebaceous lipids and in the stratum corneum of patients suffering from EPF.

Adult↗
PubMed1989

[Celiac disease, autoimmune cirrhosis, chronic pancreatitis: apropos of a triple association].

We report the case of a 60 year old lady suffering from celiac disease and autoimmune cirrhosis who developed exocrine pancreatic insufficiency with canalicular lesions consistent with chronic pancreatitis. Celiac disease is known to be associated with either pancreatic insufficiency or liver disease, but association of all three diseases has not yet been described. We suggest that chronic pancreatitis be added to the list of idiopathic inflammatory pancreatitis of possible autoimmune origin, enabling to explain the pathophysiology of all three disorders with one hypothesis.

Autoimmune Diseases↗
PubMed1985

[Melanic proliferations of the conjunctiva. Histopathologic study of a series of 40 cases].

A retrospective study of 40 melanocytic conjunctival tumors (22 naevi and 18 malignant melanoma) is reported. Cases of non-degenerated conjunctival melanosis were not observed. The particular aspects of diagnosis and the prognostic behaviour of these proliferations are discussed and compared with their cutaneous homologues. Epithelial inclusions within tumor cell proliferation are considered as the best criterion of benignity. Because conjunctival melanomas are rather uncommon and technical difficulties in their study are very frequent (poor quality of tissue samples, small size of specimens) many reports are contradictory. Some diagnostic signs are specific for this kind of tumor in the conjunctiva: nevertheless, the particular conjunctival anatomy makes it impossible to classify according to criteria defined for cutaneous malignant melanoma. No criteria would have a predictive value. The severe prognosis of conjunctival melanoma (44% deaths in the present series over 10 years after diagnosis) has been underestimated. Most often carcinologic therapies have not been used in previously reported cases.

Adolescent↗
PubMed1984

[Peritoneal splenosis disclosed by infectious mononucleosis in an adolescent. Contribution of scintigraphy].

This article does not deal with the general problem of splenosis, but with the pathology of splenic nodules implanted in the peritoneum. This condition is uncommon, and chiefly hematological and infectious in the index case. Although this issue is debated, functional activity of these nodules is substantiated, leading to consider therapeutical applications in some exceptional cases.

Adolescent↗
PubMed1983

[Verrucous carcinoma. Apropos of a case report with palpebral localization].

The authors present a case of "verrucous carcinoma" of the eyelid. Such a location never seems to have been described in the literature. As the histological features of the tumor are highly differentiated the exact diagnosis can be ascertained, only upon examination of a large biopsy specimen or of the operative specimen. Clinical, histological and evolutional features are recalled. The therapeutic means of curing this locally malignant and potentially recurrent lesion are discussed. In most cases, recovery depends on early treatment, particularly on surgery.

Aged↗