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Biomedical subjects

R Viraben

Publications and source records attributed to R Viraben.

At least 19 recordsLinked to original sources

[Simultaneous detection by non-isotopic in situ hybridization of human papilloma viruses and Epstein-Barr virus during the lytic cycle in oral hairy leukoplakia lesions].

Oral hairy leukoplakia is almost only described in patients infected by the human immunodeficiency virus. Epstein-Barr virus, sometimes associated with human papillomavirus, is always involved in the occurrence of these lesions. We have investigated two cases of oral hairy leukoplakia with the goal of detecting EBV and HPV by using both in situ hybridization and immunohistochemistry. EBV genome was detected with biotinylated BamHI W cDNA probe in the two cases. Furthermore, EBV was found to be in lytic phase as demonstrated by the strong signal observed with FITC-labelled anti-sense BHLF1 oligonucleotide probes. This finding was further supported by the absence of labelling with EBV-latent-cycle markers such as EBER1/2 oligoprobes and anti-latent membrane protein 1 antibody. In addition, these two cases were positive for HPV genomes: 31-33-51 (n = 1) and 31-33-51 plus 6-11 (n = 1) as detected by in situ hybridization using different sets of biotinylated probes. The signal obtained with in situ hybridization (both HPV and EBV) was localized to the upper layers of epithelial cells. The mechanism of oral hairy leukoplakia remains still unknown, but this work emphasizes the value of in situ hybridization with nonisotopic probes in the detection of viral nucleic acids on routinely processed tissue sections. The fact that these lesions seem to precede the AIDS phase emphasizes the clinical implications of this diagnosis in HIV infected patients.

Adult

Stage I cutaneous malignant melanoma: risk factors of loco-regional recurrence after wide local excision and clinical perspectives.

Two hundred and nineteen patients admitted to the Centre Claudius Regaud over a 14-year period for a stage I cutaneous malignant melanoma were retrospectively evaluated for loco-regional recurrence rates, risk factors and survival rates following wide primary excision. Five and 8 year survival rates corrected for deaths owing to concurrent illness were 77% and 73%. The loco-regional control rate was 69% (151/219). Distant metastases occurred in 59% (40/68) of patients who had a loco-regional recurrence, versus 11% (16/151) of patients when loco-regional control was obtained (P < 0.001). Multivariate analysis was used to ascertain which risk factors act independently as predictors of poor loco-regional control. Anatomical location of the primary ('head and neck-trunk-hands and feet' vs 'proximal limb') and thickness formed the best model in this respect among 11 prognostic factors studied. Since loco-regional recurrence may be associated with an increased risk of distant metastatic disease, we advocate the use of elective regional lymph node dissection in stage I patients at high risk of loco-regional recurrence in the hope that a portion of these patients may have increased survival owing to lack of development of widespread metastases.

Actuarial Analysis

Laugier's disease.

Pigmented macules of the malpighian mucous membranes have been described under numerous names since the first description by P. Laugier in 1970 of the 'pigmentation mélanique lenticulaire essentielle de la muqueuse jugale et des lèvres'. In this paper, we show that (1) the lesions may occur in all malpighian mucous membranes, (2) are easily distinguished from melanoma both clinically and if necessary by histology, and we suggest (3) that, whichever the localization is, the condition should be called Laugier's disease.

Adult

Immunohistochemical profile of cutaneous B-cell lymphoma on cryostat and paraffin sections.

Thirty cases of primary (23 cases) and secondary (seven cases) cutaneous B-cell lymphoma (CBCL) were studied by immunohistochemistry using a selected monoclonal antibody (MoAb) panel on both cryostat and paraffin sections. On cryostat sections all CBCL so tested were positive for surface membrane immunoglobulins (IgMk most often) and B-cell antigens (CD22+, CD37+) with a variable T-cell-reactive component identified by MoAbs against T-cell antigens (CD2, CD3, CD4, CD5, CD8). CD4-positive stromal T-cells were usually more numerous than CD8-positive cells. A strong (50-75% of total cells) stromal T-cell (CD2+, CD3+) reaction was found in centroblastic-centrocytic lymphoma. Small numbers of CD1+ Langerhans cells were found in most cases, but they were present in large numbers in follicular lymphoma. On paraffin sections, a combination of MoAbs against B-associated antigens (LN-1, MB2) identified B-cell lineage in virtually all cases of CBCL. CBCL was negative for MoAbs against T-associated antigens (MT1, UCHL1) with rare exceptions (two cases). However, MT1 and UCHL1 combined identified the T-cell nature of all cases of nonepidermotropic, nonmycosis T-cell lymphoma, which were initially predictive of B-lineage by histologic pattern.

Adult

Necrobiotic xanthogranuloma: a case without paraproteinemia but with transepithelial elimination.

We report a female patient, now aged 60, followed for 20 years for lesions originally diagnosed as necrobiosis lipoidica diabeticorum. In fact, the anatomical and clinical features of her disorder correspond to the new entity described as necrobiotic xanthogranuloma. Two elements distinguish this from earlier cases: 1) two examinations failed to reveal paraproteinemia; 2) there was transepithelial elimination of cholesterol crystals and degenerated xanthomatous cell debris via hair follicles. This demonstrates the characteristic histology of the disorder and indicates that the diagnosis of necrobiotic xanthogranuloma should be considered even in the absence of paraproteinemia.

Cholesterol

[Basal lamina with a garland-like pattern in a case of sclero-atrophic lichen. Ultrastructural study].

The basal lamina stands at the heart of dermal-epidermal interactions. Its formation and pathology are more or less directly related to the basal keratinocytes, so that any lesion of these cells, such as vacuolar alterations of the interface, results in pathological changes in the basal lamina. Images of rupture, discontinuities, multiplications, festooning and budding of the basal lamina have been reported in psoriasis, lichen planus, lupus erythematosus and lichen sclerosus and atrophicus. We present a case of lichen sclerosus and atrophicus of the glans penis. Histopathological examination was performed, using the routine technique, the semi-thin large area sections technique and electron microscopy. Histological changes in the basal lamina were particularly pronounced, with garlands penetrating deeply into the dermis. Electron microscopy showed that the basal lamina contained immature collagen fibres, but no anchoring fibres. This garland-like pattern undoubtedly represents an extreme degree of the festooning and budding classically described in the diseases listed above. A pathogenic theory is offered to explain the formation of that pattern.

Adult

Natural IgM and IgG autoantibodies to epidermal keratins in normal human sera. I: ELISA-titration, immunofluorescence study.

This paper presents a study of autoantibodies (autoAB) to keratins and to epidermis by a double approach associating a specific immunoenzymatic technique and immunofluorescence. The existence of natural autoAB to keratins in all normal human sera was asserted and the heterogeneity of natural autoAB to the epidermis explored. By a sensitive enzyme-linked immunosorbent assay we detected natural IgM and IgG autoAB to keratin polypeptides extracted from human plantar stratum corneum (SC) in 60 randomly selected normal human sera. The interindividual variation factors of their titers were about 100X in IgM and 50X in IgG antikeratin (AK) autoAB. The IgM and IgG AK autoAB titers varied independently. By a semiquantitative indirect immunofluorescence assay we detected in these sera IgM and IgG autoAB that labeled normal epidermis according to various morphologic patterns. The IgG autoAB labeled SC and suprabasal layers (SBL) in 57.4% of sera, SC in 20.4% and SBL in 7.4%. The IgM autoAB labeled SC and SBL in 52% of sera, SC in 24%, SC and SBL plus basal layer (BL) in 18%, and SBL in 2%. Like the titers, the patterns of IgM and IgG autoAB to epidermis were found to be unrelated. The IgG AK autoAB titers were found to significantly correlate only with the IgG autoAB directed to SC + SBL; the IgM AK autoAB titers only with the IgM autoAB directed to SC + SBL + BL. This showed that these patterns of labeling are typical for AK autoAB and that autoAB to SC, which could not be related to AK autoAB, exist in some normal sera. Antikeratin and antiepidermis IgM autoAB titers were found to be strongly correlated to total amounts of IgM assayed by radial immunodiffusion, indicating that the synthesis of these natural IgM autoAB vary in the same way as that of general IgM synthesis. For the AK and antiepidermis IgG autoAB, however, the same correlation to total serum IgG was found to be much weaker.

Adult

[Virus diseases and cancer of the vulva].

The study of cancers of the vulva, first of all, attempts to classify precancerous lesions of the external genital apparatus. The proceedings of the ISSVD were carried out here in 1975. Clinical, epidemiological and viral arguments of HPV and HSV have been considered in order to demonstrate their responsibility in neoplasms of the vulva. However, HPV seems the main cocarcinogen. Cancers of the vulva appear, therefore, as a true sexually transmitted disease and the authors emphasize a simultaneous monitoring of the cervix and the male genital apparatus.

Adult