Biomedical subjects

L Gilain

Publications and source records attributed to L Gilain.

At least 55 records · Page 3Linked to original sources

PubMed1997

[Laryngo-tracheal involvement in chronic atrophic polychondritis. X-ray computed tomographic aspects].

CT patterns of a relapsing polychondritis affecting the laryngeal cartilages are reported in a 42-year-old man with a 10-year medical history of this disease, corresponding to an irregular enlargement of the cricoid, thyroid cartilages and tracheal rings, with a moderate endoluminal narrowing. CT is useful to differentiate this rare inflammatory disease from others causes of airway narrowing, and could help in certain cases of diagnosis of beginning polychondritis.

Adult↗

PubMed1996

Increased epithelial cell proliferation in nasal polyps.

OBJECTIVE: To detect, quantify, and compare respiratory epithelial cell proliferation in nasal mucosa and polyps from patients with nasal polyposis. DESIGN: Cohort study. SETTING: Patients and samples were selected at the Hôpital Intercommunal de Créteil (France). Flow cytofluorometry and immunohistochemistry were performed at Hôpitaux Tenon and Mondor (Université Paris [France] VI et XII). PATIENTS: Twenty-one patients undergoing endoscopic ethmoidectomy for treatment of nasal polyposis. METHODS: In 10 cases, epithelial cells were removed from frozen inferior turbinate mucosa and polyps by mechanical disaggregation and were then analyzed by flow cytofluorometry, providing the cell DNA content (propidium iodide labeling) and the percentage of S-phase cells. In 11 cases, inferior turbinate mucosa and polyps were fixed in formaldehyde and embedded in paraffin. Proliferating cell nuclear antigen expression in the epithelium was quantified by immunohistochemistry; a proliferating cell nuclear antigen index was calculated for each sample in the basal area, suprabasal area, and full height of the epithelium. RESULTS: All cell populations studied were diploid, and percentages of S-phrase cells were significantly higher in nasal polyps than in mucosa. Proliferating cell nuclear antigen indexes were significantly higher in nasal polyps than in the suprabasal area and full height of the mucosal epithelium. CONCLUSION: Cell proliferation is increased in epithelium from nasal polyps. Epithelial damage caused by inflammatory mediators could induce this increased cell proliferation via epithelial repair processes. Inflammatory cells could up-regulate epithelial cell proliferation by secreting growth factors.

Cell Division↗

PubMed1996

Modified epithelial cell distribution in chronic airways inflammation.

Although airway epithelium is known to be modified during chronic respiratory diseases, epithelial cells have rarely been precisely quantified. We therefore intended to evaluate epithelial cell distribution in inflammatory airways, using a cytological approach. Nasal airway cells in 12 patients with nonallergic chronic rhinitis were sampled by brushing, quantified after cytocentrifugation and compared to those from eight controls. Cell populations were quantified after May-Grünwald Giemsa staining and alpha-tubulin immunolabelling to demonstrate ciliary differentiation. When compared to controls, rhinitis patients exhibited lower percentages of ciliated cells (59 +/- 4 versus 32 +/- 2%, respectively), and higher percentages of goblet (24 +/- 3 versus 37 +/- 2%) and basal cells (9 +/- 1 versus 18 +/- 2%). After tubulin immunolabelling, positive staining was specifically detected in cells with cilia (LC+), and in the cytoplasm of some small round cells without obvious cilia (LC-). Fewer immunolabelled cells were detected in rhinitis patients than in controls (with significantly lower percentages of LC+ and higher percentages of LC-). Nasal brushing is an effective technique for quantification of airway epithelial cells. Tubulin immunolabelling is useful to detect ciliated cells and distinguishes another cell population, possibly preciliated cells. These cytological findings suggest the presence of modifications of epithelial differentiation and proliferation, possibly related to local chronic inflammation.

Adult↗

PubMed1996

Sleep fragmentation as a risk factor for hypertension in middle-aged nonapneic snorers.

Although a high prevalence of hypertension has been observed in snorers, whether there is a direct link between hypertension and snoring remains controversial. It has recently been demonstrated that an abnormal amount of breathing effort during snoring is responsible for sleep fragmentation even in the absence of sleep apnea syndrome criteria. We hypothesized that sleep fragmentation during snoring may be a direct risk factor for the development of hypertension. On the basis of polysomnographic data, 105 nonapneic patients between 40 and 65 years of age referred for snoring with social impairment were selected and categorized as snorers with (n=55) or without sleep fragmentation (n=50) based on whether the arousals index was 10 or greater or less than 10/h of sleep, respectively. Sleep distribution did not differ between the two groups, except for a longer duration of wake after sleep onset (58 +/- 43 min vs 42 +/- 38 min) and a shorter duration of slow-wave sleep in the group with sleep fragmentation (72 +/- 34 min vs 97 +/- 34 min). Although there were no statistically significant differences between the snorers with and without sleep disruption in terms of age (51.3 +/- 7.7 vs 48.6 +/- 6.0 years), body mass index (26.9 +/- 4.0 vs 27.2 +/- 5.5 kg/m2), sex ratio, respiratory indexes during sleep, daytime sleepiness, and daytime tiredness, prevalence of systemic hypertension was significantly higher in the sleep-fragmented group (20/55 vs 7/50). This significant difference persisted (16/51 vs 6/49) when patients using antihypertensive drugs with possible effects on the CNS were excluded. Our data suggest that sleep fragmentation is common in patients who seek medical help for snoring with social impairment and may play a role in the development of hypertension.

Adrenergic beta-Antagonists↗

PubMed1996

Acquired ciliary abnormalities of nasal mucosa in marrow recipients.

Respiratory symptoms are frequent after bone marrow transplantation (BMT). Most studies focus on lesions of the lower respiratory tract. However, sinusitis is also common in this setting, especially after allogeneic BMT. The nasal respiratory epithelium is the first line of airway defense and is very similar to the bronchial epithelium, especially in terms of ciliary beat frequency and ultrastructural pattern of ciliated cells. We have prospectively studied the nasal respiratory epithelium of 20 marrow recipients (four autologous, 16 allogeneic) with or without sinusitis, by brushing and biopsy of the median turbinate between 2.5 and 148 months after transplant. Samples were studied for ciliary beat frequency, cytology, ultrastructural pattern and HLA-DR expression. We found that 17 of our 20 patients had abnormalities of their nasal epithelium, mainly consisting of either squamous metaplasia or heterogeneous axonemal defects of peripheral and central microtubules. No relationship between these findings and the presence of acute or chronic sinus infection, previous irradiation, graft-versus-host disease or immunosuppressive therapy could be demonstrated in this preliminary study. These abnormalities probably have multiple causes. Prospective studies are needed to determine the respective roles of treatments, infections and immune disorders associated with BMT in these abnormalities, and to know their natural evolution over time and their impact on the occurrence of upper or lower respiratory tract infections.

Acute Disease↗

PubMed1996

[Postoperative pain evaluation in the surgery of head and neck cancers].

UNLABELLED: Postoperative pain has rarely been assessed after ENT surgery for cancer. Its evaluation is difficult because of the frequent lack of speech after this type of surgery. OBJECTIVES: to assess postoperative pain after pharyngeal and laryngeal surgery for cancer. PATIENTS AND METHOD: prospective study in 13 men (38-71 ans) operated on by total laryngectomy with or without partial pharyngectomy. A standardised treatment using propacetamol and nalbuphine was systematically prescribed. Pain, anxiety and relief were assessed with the help of visual analogue scales (VAS). Heart rate, mean blood pressure and respiratory rate were evaluated too. RESULTS: mean postoperative pain was maximal just after recovery (6,64 +/- 2,14 cm) then decreased regularly. Initial mean score of anxiety was 3,14 +/- 3 cm and then was decreasing too. Anxiety and pain did not correlate except in 2 cases. None of the 3 objective parameters correlated with pain. CONCLUSION: postoperative pain can be assessed reliably after pharyngolaryngeal cancer surgery and is probably underrated. Its high initial score indicates that efforts must be focused on pre-emotive analgesia. Its high individual variability let us hypothesise that PCA systems should be effective.

Adult↗

PubMed1995

Endoscopic and CT-scan evaluation of rhinosinusitis in cystic fibrosis.

In order to obtain an accurate evaluation of nasal and paranasal sinus disease in cystic fibrosis patients, 75 patients with a proven cystic fibrosis diagnosis have been investigated using the following standard techniques: questionnaire, ENT examination, endoscopical examination, sinus X-rays, and in 31% of the cases a CT scan. The analysis of results shows that nasal obstruction is the most frequent symptom (32%) and that nasal polyps are present in 43% of the cases. Endoscopic examination seems to be of great interest in giving a more accurate picture of nasal and paranasal sinus disease. Analysis of CT scan images leads the authors to describe a new and specific entity in nasal and paranasal sinus disease in cystic fibrosis patients: the pseudomucocele. In this report, the authors discuss the various aspects of pseudomucocele, attaching particular importance to the CT scan results.

Adolescent↗

PubMed1994

[Functional endoscopic surgery of sinusal mucocele].

The treatment of paranasal sinus mucoceles must assure complete removal and prevention of recurrence. In order to clarify the precise indications for endoscopic management, a retrospective study was undertaken on 16 patients with paranasal sinus mucoceles treated by this method. All of the patients underwent endoscopic exploration with or without an associated bicoronal approach. The follow-up period varied between 3 months and 46 months with a mean of 24. The results were considered satisfactory if the patient's symptoms disappeared and follow-up endoscopy revealed persistence of sinus permeability. Functional endoscopic surgery can be considered as an alternative method in treatment of sinus mucoceles. Only mucoceles confined to the lateral wall of the frontal sinus, and the extended mucoceles, seem to be an out of the way place to endoscopic sinus surgery alone. In these cases, the access has to be completed by an external approach. Concerning adequate recanalization of the nasofrontal duct, results seem encouraging, however a long-term follow-up is necessary to obtain an accurate assessment of the results.

Adult↗

PubMed1994

[Value of imaging in sphenoidal pathology. Role of magnetic resonance].

The authors use case studies to illustrate the respective benefits of CT and MR imaging in the management of sphenoid sinus disease. Because the sphenoid sinus is located deep in the skull base adjacent to vital neurological and vascular structures, surgery involves a certain risk. The improved quality of imaging now available provides essential information on which to base therapeutic options. Since CT and MR findings make it possible to increase the precision of the pretherapeutic evaluation and to determine neurological and vascular involvement, these imaging studies have become an integral part of the successful management of sphenoid sinus disease.

Evaluation Studies as Topic↗

PubMed1994

[Evaluation of the brushing technique in nasal cytology].

Analysis of nasal cytology provides useful information for the diagnosis of rhinitis. This analysis represents an interesting tool for objective assessment of nasal pathology. The purpose of this study was to describe the brushing method for obtaining nasal cytologic specimen. Samples were carried out from nine adult patients with chronic nasal obstruction. In all cases, the cytologic specimen had a good amount of well-preserved cells, easy to identify on morphological criteria. A differential cell count was performed on the different epithelial cell types present in the specimen and the results are reported in the present study. In conclusion, brushing method is non invasive and allows to precisely evaluate both epithelial and inflammatory cells present in the nasal mucosa.

Adult↗

PubMed1993

Studies on human porin. IX. Immunolocalization of porin and CFTR channels in human surface respiratory epithelium.

The expression of the voltage-dependent anion channel (VDAC) "Porin 31 HL" and its cellular and subcellular immunocytochemical localization in the human respiratory epithelium were studied with monoclonal and polyclonal antibodies using immunofluorescence and immunogold labelling with light (LM) and transmission electron microscopy (TEM), respectively. Porin was identified in the apical domain of the ciliated cells and in the basal cells of the respiratory epithelium. Immunogold labelling was present in the apical plasma membrane and subapical vesicles of the ciliated cells. In pre-embedded freshly dissociated surface epithelial cells, porin could also be identified with TEM at the outer part of the plasma membrane of basal cells. By LM double immunolabelling, both porin and cystic fibrosis transmembrane conductance regulator (CFTR) were identified in the apical domain of ciliated cells but not in basal cells where CFTR was never identified. On Western blots of solubilized total membrane protein preparations from the same frozen surface epithelial respiratory cells, the antibodies recognized a group of 3 proteins of 31, 60 and 130-140 kDa with a strong reactivity for a 31 kDa protein, corresponding to the porin and a protein of 170 kDa which is consistent with mature CFTR. These results suggest that porin might be part of a multi-component chloride channel complex which could interact with CFTR.

Antibodies↗

PubMed1993

Nasal epithelial cell culture as a tool in evaluating ciliary dysfunction.

Cultures of respiratory epithelial cells were obtained from nasal polyps collected in patients with and without primary ciliary defect. The ciliary beating frequency and the ciliary beating heterogeneity were determined on native and cultured tissues. We observed a significantly higher (p < 0.01) ciliary beating frequency of cultured ciliated cells, when compared with ciliated cells from the native tissue. The ciliary beating frequency of the cultured ciliated cells from the patient with primary defect (7.9 +/- 2.1 Hz) was significantly lower when compared with the beating frequency of the ciliated cells from the control subject (12.4 +/- 2.0 Hz). In addition, the percentage of ciliated cells characterized by a beating frequency lower than 8 Hz was 90.7% in the native tissue and 47.5% in the cultured tissue from the patient with ciliary primary defect. In the patient without ciliary primary defect, 90% of the cultured ciliated cells had a homogeneous ciliary beating, whereas in the patient with primary ciliary defect, only 47% of the ciliated cells had a homogeneous ciliary beating. These results suggest that the culture of respiratory cells associated with the functional activity measurement of the ciliated cells represent another way of precisely determining the extent of the primary ciliary dyskinesia defect.

Adult↗

PubMed1993

[Value of imaging in sphenoid sinus diseases. Role of magnetic resonance].

Aspergillosis↗

PubMed1993

[Human papillomavirus and nasosinusal inverted papilloma].

Eight inverted papillomas were evaluated for the presence of human papillomavirus (HPV) DNA. The techniques used were Southern Blot Hybridization in five cases and Polymerase Chain Reaction (PCR) in three cases. All eight lesions contained the characteristic features of inverted papillomas. Two lesions showed areas of dysplastic change and one lesion contained koilocytes. In three patients, invasive squamous cell carcinomas were found. The presence of HPV was noted in one of these specimen of inverted papilloma with squamous cell carcinoma. Specific testing for HPV types 6, 11, 16, 18 and 33 on this specimen was negative, thus indicating that the specimen is associated with a different HPV type. The results of this study, with only one case of positive HPV testing, leads us to question the precise role of HPV as an etiological agent in nasal inverted papillomas. The fact that this single positive case did not test positive for the HPV type 16 suggest that this is not the only "high risk" HPV type associated with the progression of inverted papilloma to a carcinoma.

Adult↗

PubMed1993

[Oral manifestations of zona. Apropos of a case].

Oral manifestations of herpes zoster are very less common than cutaneous. Only a few cases of oral herpes zoster in children had been already described. Authors report a case of maxillary superior nerve's herpes zoster. Oral lesions are encountered in case of viral disease of the second and third branch of trigeminal nerve (VII, VIII). Dental pain is usually the first sign and can induce misdiagnosis. The diagnosis is based on the specific ulcerative lesions, strictly unilateral, developed in the field of sensitive innervation of the maxillary nerves. The use of antiviral drugs seems to be actually the best treatment.

Acyclovir↗

PubMed1993

[Aspergillosis of the sphenoid sinus. Apropos of 4 cases].

Aspergillosis of the sphenoid sinus is a rare entity. The authors report four cases of non invasive aspergillosis sinusitis, three isolated cases and one with nasal polyps. All cases were treated by functional endoscopic surgery. Good results were noted with a mean follow-up of 18 months. Frequency, clinical features, treatment, and etiopathogenesis of sphenoidal aspergillosis are discussed.

Aged↗

PubMed1993

[Value of hyperbaric oxygen therapy in the treatment of malignant otitis externa. Apropos of a case].

The authors report the case of a 75 years old insulin dependent diabetic man presenting a malignant otitis externa with facial nerve paralysis. Despite prolonged, adequate parenteral antibiotic therapy, the patient's clinical status did not improve. The addition of hyperbaric oxygen as a complementary treatment was followed by the regression of clinical signs and the resolution of infection. Based upon a review of the literature, the authors discuss the indications for this therapy and the problems involved in defining the criteria of cure in malignant otitis externa.

Aged↗

PubMed1992

[Results of the treatment of aspergillosis of the maxillary sinus by exclusive middle meatotomy approach].

Over a 3 year period the authors have managed 12 immune competent patients with aspergillosis of the maxillary sinus by intranasal sinus surgery using only a middle meatal approach. An enlarged middle meatal window was formed by resection of the superior surface of the inferior turbinate. especially designed curve suction tubes and forceps were used to reach all areas of the maxillary sinus in order to perform a macroscopically complete resection of all lesions. On no occasion Aspergillus was the alternative use of an inferior meatal window or a Caldwell-Luc approach necessary. The authors conclude that the use of a middle meatotomy for the surgical treatment of aspergillosis of the maxillary sinus makes it possible to assure complete resection, to adapt post-operative care and to permit prolonged aeration of the sinus.

Aspergillosis↗