Biomedical subjects
Publications and source records attributed to T Cruel.
We describe an unusual case of pulmonary neuroendocrine carcinoma of intermediate cell type, revealed by calcified metastatic nodules of the brain in a 49-year-old man. Histological examination of the brain lesions disclosed necrosis and calcification in the center with small and medium-sized carcinoma cells. Pathophysiological mechanisms of such calcifications in metastasis lesions are reviewed.
We report a case of neuritic borderline tuberculoid leprosy with lingering insidious growth disclosed by a brutal reversal reaction. Inflammatory polyarthralgia and sensory and motor loss in the median and ulnar territories, without skin lesions, suggested vasculitis. A few weeks later, inflammatory skin lesions developed leading to the diagnosis of biopsy proven leprosy. Leprosy should be considered as a possible diagnosis in patients with multineuritis, especially when associated with rheumatic or cutaneous manifestations. Early skin biopsy in neuritic leprosy is discussed.
The authors report a case of discontinuous splenogonadal fusion diagnosed after left orchidectomy. Ectopic spleen in the scrotum is a rare congential anomaly frequently associated with other anomalies, especially limb defects. The diagnosis is difficult. Preoperative isotope scanning and intraoperative pathological examination can be performed to avoid unnecessary orchidectomy.
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In 1995, we isolated a strain of Bacillus thuringiensis serotype H34 from severe human tissue necrosis. This bacterium was able to induce myonecrosis in immunosuppressed mice after cutaneous infection. Its potential pathogenicity for immunocompetent hosts was investigated in a mouse model of pulmonary infection. Mice infected intranasally by a suspension containing 10(8) spores died within 8 h in a clinical toxic-shock syndrome. In the same conditions, infection with a mutant without crystalline toxin, with the supernatant from a culture containing 10(8) bacteria ml(-1) and by the insecticidal strain serotypes 3a3b or H14 led to identical results. Lower inocula simply induced a local inflammatory reaction with bacterial persistence observed during the course of 10 days.
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We present a case of severe war wounds infected by Bacillus thuringiensis serotype H34 and describe the experimental protocol used to demonstrate its ability to infect mice after cutaneous inoculation. This case is interesting because B. thuringiensis is considered to be a contaminant in laboratories and receives inadequate attention.
With the objective of further improving the reliability of microvascular anastomoses, several different procedures are now available to microsurgeons, including eversion-stapling by VCS forceps. The authors start by presenting the technique, emphasizing the need for specific instruments and compliance with certain principles determining the success of these anastomoses. In the context of an experimental protocol in the pig, on vessels measuring an average of 2.5 mm in diameter, 80 anastomoses were performed by VCS stapling-eversion and studied clinically, histologically and ultrastructurally, comparing the results to those of conventional anastomoses by approximation-suture with needle and suture. In light of the results, eversion-stapling anastomoses appear to be more reliable due to the absence of intraluminal foreign body, permanent endothelial continuity and effective re-endothelialisation before day 7.
A rare case of epithelioid sarcoma of the coccyx is described. A 23-year-old man had coccidynia for 2 years, becoming permanent. The patient underwent an "en bloc" excision including a resection of the extremity of the coccyx. Postoperatively, six cycles of a chemotherapy combining ifosfamide and adriamycine were alternated with a 60 Gy external beam radiotherapy. The patient remains free of disease 9 months after the operation. We review the clinical characteristics and treatment of epithelioid sarcoma.
One case of giant cell tumor located in the mandibular condyle is reported. This case was revealed by a progressive mandibular deviation. Frequency, localization, etiopathogenesis and histological feature are discussed.
A case of angiosarcoma in the small bowel is reported. There were multifocal lesions in the duodeno-jejunum with peritoneal metastasis, revealed by an hemorrhagic syndrome. This tumor rare in the gastro-intestinal tract was epithelioïd. The authors present an histochemical and immunohistochemical study with a review of the literature.
A patient with a filarial infection due to Loa loa, received single oral dose of ivermectin A few hours after, he has presented a severe renal impairment. Native of the Cameroons, he was also treated for malaria. A renal biopsy has been done, because of chronic proteinuria. It has showed microfilariae in glomeruli, thickening of the basement membrane and a segmental and focal mesangial hyalinosis. By immunofluorescence microscopy there were granular deposits of IgM and C3 along this membrane. Electron microscopy has showed subepithelial electron- dense deposits. This suggests that the renal disease is immunologically induced. During the therapy, adverse reactions seemed to be related with massive liberation of filarial antigens. This is well known with diethylcarbamazine but also now, sometimes with ivermectin.
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A case of desmoplastic melanoma in a 72-year-old patient is reported. In the light of this case, the authors review the literature and analyse the therapeutic implications.