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J Luboinski

Publications and source records attributed to J Luboinski.

At least 19 recordsLinked to original sources
PubMed2003

[Ganglions of the wrist: proposals for topographical systematization and natural history].

PURPOSE OF THE STUDY: We looked for the anatomic origin and mechanism of constitution of the so-called "ganglions" of the wrist. MATERIAL AND METHODS: Fifty-nine formations considered to be synovial ganglions were dissected and removed according to the same protocol by the same surgeon. Eleven were re-examined by a pathologist. All ganglions were extra-articular but had intra- and extra-capsular components. The extra-capsular part was the clinically palpable main cyst. The intra-capsular part was composed of the cystic stalk and its base of implantation. An intra-capsular stalk was present in 58 cases. The stalk was situated between the joint synovium and the capsula which it perforated at a weak point between two ligaments, forming a collar before expanding outwardly. Based on our findings, we propose a topographical systematization and natural history of ganglions of the wrist. RESULTS: The stalk's implantation base was always located on bone and found in the intermediate area of Colomniati and Soubbotine, which lies outside the articular cartilage between the synovium and the ligamentous capsula. This area is exposed to mechanical stress initiating histological degenerative lesions, particularly mucoid degeneration. At the radiocarpal joint, the stalk's base of implantation was located at the distal end of the lateral dorsal or volar edge of the lunate bone or at the corresponding part of the scaphoid. The collar of the proximal ganglions was situated between the dorsal radiocarpal and transverse scaphotriquetral ligament. The collar of distal dorsal ganglions was situated between the transverse scaphotriquetral and the trapezotriquetral ligament. The collar of the lateral ganglions was situated between the lateral collateral and the transverse ligament. The collar of the volar ganglions was situated between the stylocarpal ligament and the radiolunotriquetral ligament, or between the different stylocarpal ligaments. At the level of the scaphotrapezal joint, the stalk's base of implantation was located near the collateral edge of the distal surface of the joint with the collar between the distal scaphoidal ligaments. The palmar cysts exhibited a collar between the stylocarpal ligaments and the radiolunotriquetral ligament or between the different stylocarpal ligaments. DISCUSSION: At pathology examination, the lesions were not found to be different from those observed in other connective tissues exposed to overuse or repeated microtrauma (sports, occupational exposure). Anatomic conditions inside the joint capsula excluded extension of the mucoid degeneration transversally. The only issue was through the capsula, allowing the mucus enclosed in the connective tissue fibers to form the main cyst. CONCLUSION: Knowledge of these different processes enabled a topographical systematization useful for complete surgical or arthroscopic removal of the ganglion. Complete resection would prevent recurrence.

Adolescent↗
PubMed1996

[Functional diarrheas are not, in most cases, minor clinical forms of lymphocytic or collagenous colitis].

AIM: The aim of the study was to test the hypothesis that some patients with functional diarrhea could actually suffer from a mild clinical pattern of collagenous or lymphocytic colitis. PATIENTS AND METHODS: Twenty consecutive patients with chronic diarrhea were included in the study if the colonic mucosa appeared normal during colonoscopy. From multiple colonic biopsies were established a conventional histological diagnosis and a quantitative histological diagnosis. This latter diagnosis was based on the semiquantitative evaluation of epithelial morphological alterations and lamina propria monocellular infiltration, and on the determination of both intraepithelial lymphocyte count and subepithelial collagen layer thickness. Multiple colonic biopsies from 12 control patients without diarrhea were analyzed according to the same protocol. RESULTS: Among the 20 patients with diarrhea, the quantitative diagnosis of collagenous colitis was made in 3 patients (thickness of the collagen band between 11 and 26 microns) and the diagnosis of lymphocytic colitis in one (21% of intraepithelial lymphocytes). The percentage of intraepithelial lymphocytes did not differ between the 16 remaining patients and the controls (12 +/- 5% and 9 +/- 4%, respectively). Similarly, the score of surface epithelial damage and the score of lamina propria infiltration in patients with diarrhea (1.2 +/- 1.0 et 1.7 +/- 1.5) were not different from the values in the control group (1.3 +/- 1.3 et 1.5 +/- 1.2). The mean fecal weight in patients with diarrhea but without colitis was 161 +/- 130 g/d. All the values of fecal weight were below 300 g/d, except in one patient with a past history of truncular vagotomy. CONCLUSIONS: These results suggest that most of the patients with functional diarrhea do not suffer from mild clinical patterns of collagenous or lymphocytic colitis.

Adult↗
PubMed1994

Etiology and management of toxic megacolon in patients with human immunodeficiency virus infection.

We report six cases of toxic megacolon in patients with human immunodeficiency virus (HIV). One case, at an early stage of HIV infection, mimicked a severe attack of Crohn's disease, with a negative search for infectious agents. Subtotal colectomy was successfully performed with an uneventful postoperative course. The five other cases concerned patients with acquired immunodeficiency syndrome at a late stage of immunodeficiency. They were related to Clostridium difficile or cytomegalovirus (CMV) intestinal infection in two and three patients, respectively. One case of CMV colitis presented macroscopically and histologically as pseudomembranous colitis. Emergency subtotal colectomy, performed in the first four patients with acquired immunodeficiency syndrome was followed by a fatal postoperative outcome. The last patient treated conservatively by colonoscopic decompression, in association with anti-CMV therapy, had a favorable short-term outcome. From the experience of our series and data from the literature, we discuss the best diagnostic and therapeutic approach to toxic megacolon in patients with HIV.

Adult↗
PubMed1994

Drug induced lymphocytic colitis.

Three cases are presented of lymphocytic colitis with chronic diarrhoea concurrent with longterm use of Cyclo 3 Fort, a phlebotonic drug used in France. The histological and immunopathological features of lymphocytic colitis are described. We show that lymphocytic colitis is drug induced, particularly in one patient where the immunopathological features of mucosal immune cell activation were induced by drug rechallenge. It is concluded that lymphocytic colitis may be drug induced, secondary to a chronic activation of the mucosal immune system by one or several components of the drug.

Aged↗
PubMed1994

[Reconstruction of the medial collateral ligament of the knee in rats using a free autogeneic transplant of fascia lata, ligament or tendon].

After resecting the lateral collateral ligament of the knee in 56 male mature rats, the authors replaced it by an autogenous transplant of the same size, made of fascia lata, ligament or patellar tendon. The authors then studied this transplant after an evolution of 2 days to 5 1/2 months. This lapse of time can be divided into three stages: an initial stage (first week), marked by transplant necrosis and acute inflammation--an early stage (from the second to the fourth week), which shows the migration of the cells from the host to the transplant and the rebuilding of collagen fibers. Tissues with a loose, extensible, but weak texture, such as the fascia lata, are totally colonized by the fibroblasts. Tissues with a dense, strong, but less extensible texture, as the patellar tendon, are soon destroyed and recolonized at the periphery, whereas their center is destroyed and recolonized by fibroblasts later and more irregularly--a late phase of consolidation (from the second to the fifth month), which shows the rebuilding of a dense collagen network and its reorientation. In fascia lata transplants, this new collagen is homogeneous and is made of parallel bundles. In tendon transplants, the network is not homogeneous. It has a persistent nodular aspect at the periphery and well-oriented bundles, separated by calcified or granulomatous foci at the center. In the case of ligament transplants, the new collagen network shows an intermediate aspect between the two described above. The weakest regular connective tissues are the best for ligamentoplasties, and tendons are the worst.

Animals↗
PubMed1993

[Leiomyoma of the anal canal. A case].

We report a case of leiomyoma of the anal canal, a very rare benign tumour, which was followed up for more than 7 years. With only one exception (10 years), the 14 cases previously published were watched during a short period. This tumour is characterized by the lack of absolute pathological criteria of benignity, even in the total of operative specimens examined, and by a tendency to recurrence, perhaps due to an insufficient local excision. This simple surgical operation seems to be justified, provided the patient remains under close supervision during 5 to 10 years.

Aged↗
PubMed1993

[Aponeuroses and superficial fascia. Mechanical and structural properties].

Eleven superficial aponeuroses have been examined in order to study their biomechanical and structural properties. Specimens were taken from 5 fresh cadavers, 3 males, 2 females with a mean age between 40 and 60 years. The study was done by two methods: biomechanical and histological. Aponeuroses can be classified in 2 biomechanical and histological groups that match perfectly. The first group has biomechanical and histological properties similar to those of tendons, and the second group similar to those of tendons, and the second group similar to those of ligaments. Ignoring the biomechanical and histological properties of tendons, ligaments and aponeuroses can be the cause of failure of a number of ligament and tendon plasties. The surgeon has an important role in choosing the transplants according to the histological properties (thickness, length of structures, bundle orientation) and biomechanical properties (solidity and extensibility).

Adult↗
PubMed1992

[Extension of the fingers. III. Morphologic and structural study].

The volar fascicles of the interosseous muscles possess two separate components: the proximal and glenoidal one, the distal and aponeurotic other. The armature of the dorsal aponeurosis is constituted the deep, the central and the collateral expansions of the extensor digitorum muscles, and the interosseous muscles, whom are added the lumbrical muscles. The deep expansions are constant and are fixed respectively at the basis of the first phalanx. The central and the collateral expansions constitute equally the central and the collateral, then terminal tendons, which are respectively fixed at the basis of the second and at the third phalanx. The unitive structures: dossiere, triangular and retinacular ligaments are intricate with this of the armature and render jointly the whole. All the concerned fascicles have the mechanical and histological characteristics of the tendon.

Biomechanical Phenomena↗
PubMed1991

Detection and typing of human papillomaviruses in cervical smears by an original application of the polymerase chain reaction.

The detection and typing of human papillomaviruses on cervical smears were performed by means of a new application of the polymerase chain reaction allowing easier and faster detection of the amplification product. This application consisted of a combination of two series of amplifications and the use of primers labelled with biotin and with 125 iodine on a reporter group for the second amplification. The final amplification product was detected by counting the radioactivity after incubation of the media in avidin-coated tubes. This test was compared with conventional methods of detection by electrophoresis and Southern blot and its specificity was confirmed. The study of a series of 52 patients demonstrated a higher prevalence of type 16 in relation to type 6/11 and 18 and a correlation between the degree of dysplasia and the frequency of oncogenic types 16 and 18. This new application could facilitate studies of the prevalence of HPV in large series of cervical smears.

Avidin↗
PubMed1990

Properties of the fibrous structures of the wrist.

Every fibrous structure of ten wrists of fresh cadavers has been the object of an elastometric study. The opposite wrists have been studied surgically and then histologically with the optical microscope. Comparison between the two shows a close relationship between the mechanical features and the morphology of the bundles, which proved also to be perfectly measurable. It also displays the great differences between ligaments and tendons. Histological study of the tendons and ligaments of four other wrists subjected to manoeuvres of axial loading, rupture and bending, reinforces these statements. The therapeutic consequences are considered.

Biomechanical Phenomena↗
PubMed1989

Subcutaneous granuloma caused by Phialophora richardsiae: case report and review of the literature.

A phaeomycotic cyst in a 47-year-old man, caused by Phialophora richardsiae, was treated successfully by excision. A critical review of the literature indicates that the pathological course of P. richardsiae infections usually follows a similar pattern to that of the present case, viz. generation of a well-defined and limited nodule following traumatic subcutaneous introduction of the fungus. The nodule typically accumulates a viscous yellow fluid. The infection remains localized, often being encapsulated by a fibrous layer; adenopathy is not observed. Concomitant bacterial infections are also common; in the present case Pseudomonas stutzeri was identified. Neither bacterial nor fungal infection recurred after surgery.

Dermatomycoses↗
PubMed1988

[Peroperative colposcopic examination of conization tissue. Determination of the complete or incomplete nature of the cone].

The authors describe an original technique which makes it possible for them to determine during the operation whether conisation has been complete or incomplete. The tissue removed is examined during the operation colposcopically after it has been stained with an aqueous solution of toluidine colour blue. Pathological epithelium can be recognized easily and it is possible to measure the distance between the edge of this epithelium and the tissue that has been removed. If it is inadequate more can be cut out immediately. The distance should be at least 5 mm from the edge of the pathological epithelium.

Carcinoma in Situ↗