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Biomedical subjects

M Kambouchner

Publications and source records attributed to M Kambouchner.

35 records · Page 2Linked to original sources
PubMed1999

Replacement of a tracheal segment by a mixed graft (aorta and prosthesis): an experimental study in rabbits.

OBJECTIVE: To develop a new graft and to verify its technical feasibility, viability, and ability to reduce the risk of infection by interposition of an aortic segment between the airway and the prosthetic component of the graft. DESIGN: Experimental study. SETTING: Multicentre study, France. ANIMALS: 38 New Zealand rabbits. INTRODUCTION: A 1 cm aortic segment was obtained from the thoracic aorta of a rabbit and cryopreserved or stored at +4 degrees C. The aortic segment, surrounded by a ringed expanded polytetrafluoroethylene (ePTFE) prosthesis was used to replace 1 cm of cervical trachea in two groups of rabbits, either with cryopreserved or fresh aorta. MAIN OUTCOME MEASURES: Macroscopic, microbiological, and histological studies four months later. RESULTS: 12/20 animals in the cryopreserved group survived and 13/18 in those had had fresh aorta inserted. Partial or total necrosis of the aortic muscular layer was replaced by connective tissue, which was a guide for epithelialisation from the anastomoses. CONCLUSION: This new graft is worthy of further investigation, as it is technically feasible and easy to insert.

Animals↗
PubMed1999

Bilateral hemothorax revealing mediastinal parathyroid adenoma.

We report the case of a 63-year-old woman admitted to hospital because of bilateral hemothorax associated with acute respiratory failure and laterotracheal neoformation. A right thoracoscopy biopsy revealed a paratracheal parathyroid adenoma which was responsible for bilateral hemothorax and primary hyperparathyroidism. A curative resection was successfully performed by cervicotomy.

Adenoma↗
PubMed1998

Langerhans cells in Langerhans cell granulomatosis are not actively proliferating cells.

Pulmonary Langerhans cell granulomatosis (LCG), also called histiocytosis X, is a disorder of unknown etiology characterized by the presence of destructive granulomas containing numerous Langerhans cells (LCs). The process may be localized or multifocal, and it remains unclear whether the same pathogenic mechanism is involved in all forms of the disease. It is often assumed that the massive accumulation of LCs at the sites of the lesions results from the abnormal proliferation of these cells, although it has been suggested that LCG in adults, at least in the lung, could be a reactive disorder initiated by activated LCs. Little is known, however, concerning the mechanisms responsible for the accumulation of large numbers of LCs in the course of the disease, and the relative contribution of recruitment and local proliferation of these cells remains to be established. To investigate this question, the proportion of replicating LCs was evaluated in biopsied granulomas from patients with localized or diffuse form of LCG by means of several histopathological techniques currently used in assessment of cell proliferation. The findings demonstrate that, except for proliferating cell nuclear antigen (PCNA), all parameters measured are low in all forms of the disease. They are similar to those of renewing epithelial cells and clearly less than those of neoplastic cells. These data strongly suggest that LCs in LCG granulomas are not a rapidly dividing cell population and that local LC replication makes only a minimal contribution to granuloma maintenance. Caution appears to be necessary in the use of PCNA as a marker of growth fraction.

Adenocarcinoma↗
PubMed1997

Cytokine patterns in tuberculous and sarcoid granulomas: correlations with histopathologic features of the granulomatous response.

Cytokines play an important role in granuloma formation, but the extent that cytokine profiles are similar in different granulomatous diseases and whether differences in the histopathologic features of the granulomatous response results from differences in cytokine production have not been evaluated. To investigate these questions, we used RT-PCR to quantify the expression of mRNAs coding for 16 cytokines in granulomatous lymph nodes from patients with tuberculosis and sarcoidosis and from control tissues, and we sought correlations between the level of expression of these cytokines and the histopathologic features of the granulomas. Expression of mRNAs coding for a number of cytokines (IL-1beta, IFN-gamma, TNF-alpha, granulocyte-macrophage (GM)-CSF, IL-12 (p40), and lymphotoxin-beta) was increased in tuberculous and sarcoid granulomas compared with that of control tissues. All sarcoid granulomas were shown to express a Th1 pattern of cytokine mRNAs, while tuberculous lymph nodes expressed either a Th1 or a Th0 profile. GM-CSF and lymphotoxin-beta mRNAs were more abundant in sarcoid than in tuberculous granulomas, whereas IL-8 mRNA was strongly expressed only in tuberculous lymph nodes. Strong expression of GM-CSF, TNF-alpha, and IL-8 by granulomas was shown to be correlated, respectively, with the presence of florid granulomatous lesions, the absence of central necrosis, and the presence of neutrophil infiltration. These results demonstrate that the formation of tuberculous and sarcoid granulomas in humans is associated with the expression of characteristic cytokine profiles and indicate that the expression of certain cytokines is associated with the development of specific pathologic features in the resulting granulomas.

Adult↗
PubMed1997

Erdheim-Chester disease with prominent pulmonary involvement associated with eosinophilic granuloma of mandibular bone.

We report a patient with eosinophilic granuloma localized to the left mandible who was subsequently shown to have Erdheim-Chester disease involving the lower extremities, omentum and lung. The diagnosis of eosinophilic granuloma was based on the presence of typical CD1a+ Langerhans' cell granulomas in a biopsy of mandible. The diagnosis of Erdheim-Chester disease was established on the basis of the pattern of radioisotopic uptake by long bones, seen on a technetium bone scan, and the presence of characteristic histopathological features in biopsies of lung and peritoneum. The pathological findings in lung were compatible with the abnormalities observed by tomodensitometry, but strikingly different from those seen in Langerhans' cell granulomatosis. The differences in the histological features of pulmonary involvement seen in the two diseases, and the possible relationship between Langerhans' cell granulomatosis and Erdheim-Chester disease, are discussed.

Biomarkers↗
PubMed1997

Absence of DNA from mycobacteria of the M. tuberculosis complex in sarcoidosis.

To evaluate the role of mycobacterial infection in the pathogenesis of sarcoidosis, several groups have attempted to identify mycobacterial DNA in clinical samples from these patients by polymerase chain reaction (PCR), but widely divergent results have been obtained. It has been suggested that differences in the sensitivity of the procedures used may explain these discrepant results. To test this possibility, the presence of mycobacterial DNA was sought in biopsies from patients with sarcoidosis using sequence capture-PCR, a procedure that is 100-fold more sensitive in detecting mycobacterial DNA in paucibacillary samples than standard PCR protocols. Using this approach, DNA corresponding to two different sequences specific for organisms of the Mycobacterium tuberculosis complex (the 1S6110 insertion element and the DR region) could not be detected in any of the 15 biopsies from patients with sarcoidosis, whereas a high proportion of positive results was obtained for tissue biopsies and other clinical samples from patients with active tuberculosis, including samples that were smear-negative/culture-positive and smear-negative/culture-negative. These results support prior studies suggesting that M. tuberculosis does not play a pathogenic role in sarcoidosis in most patients.

Biopsy↗
PubMed1996

Codon 12 Ki-ras mutation in non-small-cell lung cancer: comparative evaluation in tumoural and non-tumoural lung.

Ki-ras activation by point mutation on codon 12 has been reported in non-small-cell lung carcinomas and in various models of experimental lung tumours induced by chemical carcinogens. The cellular targets for carcinogenic compounds of tobacco smoke are usually considered to be the cells of the bronchial mucosa or alveolar epithelium. However, little is known about preneoplastic events in bronchopulmonary carcinogenesis. The hypothesis of the presence of widespread target cells containing Ki-ras mutation was investigated by evaluating concurrent neoplastic and non-neoplastic bronchial and alveolar samples from 51 patients with non-small-cell lung carcinomas. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method used can detect one cell with a mutation on codon 12 among 10(2) normal cells. In tumour samples, a mutation was detected in 20% of adenocarcinomas, but in none of the adenosquamous or squamous cell carcinomas. No mutation was detected in the non-neoplastic bronchial or parenchymal samples. When using an enriched PCR-RFLP method detecting one mutated allele among 10(3) normal alleles a mutation was detected in 23% of adenocarcinomas. In conclusion, Ki-ras activation by mutation on codon 12 was not observed in non-neoplastic bronchial or parenchymal tissues in patients with bronchopulmonary cancers and does not appear to be a genetic event present in non-malignant epithelial target cells exposed to tobacco smoke.

Carcinoma, Non-Small-Cell Lung↗
PubMed1995

Migratory bronchiolitis obliterans organizing pneumonia after unilateral radiation therapy for breast carcinoma.

We report the case of a 59 year old woman who developed cough, dyspnoea and fever with patchy migratory airspace infiltrates, 2 months after right breast radiation therapy for breast carcinoma. Lung infiltrates were initially localized in the irradiated area and spread to the contralateral lung. Lung biopsy, performed in an unirradiated area of the contralateral lung 9 months after completion of radiotherapy, revealed a typical histological pattern of bronchiolitis obliterans organizing pneumonia. No cause of bronchiolitis obliterans organizing pneumonia other than radiation was found. Treatment with corticosteroids resulted in rapid clinical improvement and complete resolution of airspace opacities. This case suggests that localized lung irradiation might trigger the development of a bilateral lung disease, with a histological pattern of bronchiolitis obliterans organizing pneumonia.

Biopsy↗
PubMed1994

[Necrotizing sarcoid granulomatosis. Apropos of 4 cases].

Necrotizing sarcoid granulomatosis (NSG) was first described by Liebow in 1973 among the heading "pulmonary angeitis and granulomatosis". We reported four cases of NSG. The diagnostic was made by open lung biopsy in all, and the distinctive features were those described by Liebow: presence of numerous sarcoid-like granulomas, foci of fibrinoid necrosis and granulomatous vasculitis. Clinical, radiological, and clinical course characteristics allow the reasonable conclusion that NSG is the histopathological substratum of a variety of sarcoidosis affections termed "nodular sarcoidosis".

Adult↗
PubMed1994

[Sarcoidosis and non-Hodgkin's lymphoma. A non-fortuitous association].

The simultaneous disclosure of a lymphoblastic B cell lymphoma and sarcoidosis is reported herein. The initially undiagnosed sarcoidosis leads to discuss the differential diagnosis of a sarcoid-like reaction associated to the lymphoma. The association of sarcoidosis and malignant lymphoproliferative disease is not fortuitous; nevertheless the simultaneity of the two diagnoses, the lymphoblastic type of the lymphoma and the colocalization of granulomatous and lymphomatous lesions in lung and liver are unusual features.

Diagnosis, Differential↗
PubMed1993

[Chronic diffuse interstitial pneumonia associated with chronic active hepatitis. 2 cases].

Two cases of chronic active hepatitis associated with diffuse interstitial pneumonia (lymphoid in one patient, lymphoid and fibrosing in the other) are reported. Histopathological data from the lungs, together with the parallel course of pulmonary and hepatic manifestations observed under corticosteroid therapy, suggest that these two diseases shared a common dysimmune pathogenesis. A few cases identical with these have been found in the literature. The clinical, laboratory and histopathological elements obtained from these cases also suggest an immune cause in most patients.

Adolescent↗
PubMed1993

Tracheobronchial amyloidosis with hilar lymphadenopathy associated with a serum monoclonal immunoglobulin.

We report a case of amyloidosis, restricted to the lower respiratory tract, with prominent tracheobronchial involvement and bilateral hilar lymphadenopathy, associated with a monoclonal serum protein of the immunoglobulin G (IgG) lambda type. The careful search for an extrathoracic site of involvement was negative. This particular association has not been reported previously.

Adult↗
PubMed1993

[Pulmonary lymphangioleiomyomatosis and sex hormones].

The authors having prepared for a case of pulmonary lymphangioleiomatosis point out the diagnostic boundaries of this condition with benign metastasizing intravenous leiomyomas of the uterus, pulmonary localisation of Bourneville's tuberous sclerosis and the important aetio pathologic role of sex hormones. Finally they deal with the therapeutic management and the various uses of hormones to inhibit oestrogenic activity.

Biopsy↗
PubMed1993

[A rare ovarian pseudotumor: massive edema of the ovary].

The authors report a case of massive ovarian edema which declared itself by pain in the abdomen and pelvis and an ovarian mass measuring 13 cm in diameter, occurring in a 22-year-old woman. Since it was not possible to make a diagnosis by any frozen-section examination, histology was carried out on the ovary that had been removed. This showed that the stroma of the ovary had become separated by massive edema preserving the albuginea and the superficial cortex. This case history of massive edema of the ovary shows the characteristics of this ovarian pseudotumour as described in the literature. The principal differential diagnoses of the condition are oedematous fibroma, and myxoma of the ovary. Apart from the fact that torsion of the adnexae can occur in some of these cases, the pathogenesis is still unexplained. When an ovarian tumour is found in a young woman a frozen-section examination must be carried out to make the diagnosis and perhaps avoid oophorectomy, particularly when untwisting a torsion can lead to resorption of the edema.

Adult↗
PubMed1992

Pulmonary Langerhans' cell granulomatosis (histiocytosis X).

Pulmonary Langerhans' cell granulomatosis is usually classified among the lung diseases of unknown origin. Better appreciation of the characteristic clinical features of this disease, more detailed description of the pathologic lesions, and recent advances in the basic biology of Langerhans' cells have provided new insights into the pathogenesis of this process.

Cell Transformation, Neoplastic↗