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Biomedical subjects

A Emonot

Publications and source records attributed to A Emonot.

At least 19 recordsLinked to original sources
PubMed1997

[An unusual cause of aorto-bronchial fistula: tuberculosis aortitis].

The aortic rupture in the pulmonary parenchyma or the bronchi rarely results in an haemoptysis. It means in most of the cases the rupture of an aortica aneurysm. We relate the observation of a aorto-bronchial fistula from a tuberculosa origin in an old woman case. Although the tuberculosa aortitis is becoming very exceptional, it still remains the cause of aorta rupture, with the formation of a false aneurysm which is rapidly fatal and so, it is important to search for it before any capricious haemoptysis.

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PubMed1996

[Mediastinal adenopathies metastatic from a basocellular skin carcinoma].

Skin basocellular carcinoma is very frequent, and does not usually cause distant metastasis. However, a few cases of distal lymph node, pulmonary, bone metastasis have been described in the literature. In the present case, we report a basocellular mediastinal lymph node metastasis. Some precise histological characteristics described by Lattses must be present to admit authenticity of these metastasis. The treatment of such cases is based on surgery, radiotherapy and chemotherapy containing cisplatinum. However, the overall prognosis of these metastases remains poor.

Biopsy↗
PubMed1995

Efficacy of tracheal and bronchial stent placement on respiratory functional tests.

Stent placement is the only available treatment in patients presenting either a localized external compression or a malacia of the tracheobronchial tree. To assess the functional benefit of prosthesis insertion in these indications, we compared functional respiratory values before, immediately after (48 h), and at sometime after (mean, 10.1 months) operation in 24 patients presenting with a bronchial lesion (B group, n = 5) or a lesion of the intrathoracic part (ITT group, n = 9) or of the extrathoracic part of the trachea (ETT group, n = 10). Before treatment, airflow was severely impaired in most patients without significant differences among the groups. After prosthesis insertion, airflow parameters increased [change in forced expiratory volume in 1 s (delta FEV1 = 440 mL; delta peak expiratory flow (PEF) = 0.92 L.s-1; delta maximum expiratory flow 25/75 (delta MEF25/75) = 0.47 L.s-1; and delta forced inspiratory volume in 1 s (delta FIV1 = 310 mL)] and airway resistances (Raws) decreased (delta Raw = -0.43 kPa.s-1.s-1) without any significant variation in either forced vital capacity (FVC) or total lung capacity. Airflow improvement was more apparent in ITT and ETT groups than in the B group. Moreover, inspiratory flow increase and decrease of FEV1/PEF ratio were only observed in the ETT group. This airflow improvement was maintained for a long time after and was associated with a good clinical tolerance. This study supports the clinical and functional benefits of prosthesis placement both in benign and malignant airway compressions for palliative treatment.

Adult↗
PubMed1995

[Study of chemosensitivity in patients believed to have sleep apnea syndrome].

We performed polysomnography and measured hypoxic ventilatory (HVR), hypercapnic ventilatory responses (HCVR) in 42 patients (60 +/- 11 years) with obesity and a clinical suspicion of sleep apnea syndrome (SAS) in order to determine whether an altered chemosensitivity was associated with SAS. The apnea/hypopnea index was 38 +/- 20 events per hour of sleep in 28 patients (SAS+ group) and less than 10 in the 14 others (SAS- group). The 2 groups differed only by a lower waking PaO2 in SAS+ as compared to SAS- (71.0 +/- 9 vs 77.4 +/- 8 mmHg, p < 0.05). HVR and HCVR were not significantly different in the 2 groups (0.82 +/- 0.58 vs 0.86 +/- 0.37 l.min-1.%-1; 1.41 +/- 0.81 vs 1.40 +/- 0.67 l.min-1.mmHg-1, respectively). In SAS+ group, HVR or HCVR did not change 3 or 12 months after continuous positive airway pressure (CPAP) therapy while both polysomnography and PaO2 returned to normal. We conclude that in patients with mild obesity and SAS there is no difference in chemosensitivity due to the presence of sleep apnea and that CPAP therapy does not alter these measurements. These results suggest no direct effect of SAS on chemosensitivity in the population studied.

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PubMed1993

[Acquired hypogammaglobulinemia and multifocal granulomatosis].

In adult acquired hypogammaglobulinaemia multi focal granulomas have often been described and have regularly led to the hypothesis of an association with sarcoidosis. We present a case of this type in a man aged 29 who was a smoker with a hypoglobulinaemia involving IgG, IgA and IgM and which was discovered following pneumococcal pneumonias. He presented with a significant hepatosplenomegaly and absent cutaneous reactions to T dependent antigens with an elevated ACE activity. Histological examination of the splenectomy specimen and of the liver biopsy showed an infiltration by epithelioid follicles and confluent giant cells without necrosis. The pulmonary studies showed a normal chest radiograph but the bronchial biopsy again found a granulomatous infiltration. The broncho-alveolar lavage was cytologically normal and a very slight and paradoxical reduction of the alveolar immunoglobulins was noted implying either an active intra-alveolar concentration of immunoglobulins or a local synthesis. In the light of the few reported cases it seems that the diagnosis of sarcoidosis should be dismissed here in favour of multi focal granulomatosis with hypogammaglobulinaemia. In hypogammaglobulinaemia there is no clinical or biological method (IDR tuberculin, ACE, Kveim, histology) to confirm a superadded diagnosis of sarcoidosis.

Adult↗
PubMed1992

Raynaud's phenomenon of the lung. A reality both in primary and secondary Raynaud syndrome.

Vasospasm of RP is thought to occur in the lungs. To assess pulmonary vasospasm, we analyzed the early and late Dsb variations after a digital CPT. Sixteen normal volunteers and 20 patients (7 with primary, 13 with secondary RP) were included. A clinical RP was conducted on ten patients, nine with secondary and one with primary RP. The Dsb analysis showed: no significant variations in control subjects, a quick and short fall in primary RP significant after 15 min and a delayed fall in secondary RP significant after 45 min. A Dsb decrease was noticed even if no clinical RP occurred. The pallor phase of RP was associated with a concomitant decrease in the DCO and the hyperemic phase, with a Dsb increase. These results agree with those of previous studies with a few differences.

Adult↗
PubMed1992

Initial combined cryotherapy and irradiation for unresectable non-small cell lung cancer. Preliminary results.

In unresectable non-small cell lung cancer (NSCLC) with a patent mainstem bronchus, some studies of obstructive tumors, showed (1) a poor role for irradiation in obtaining efficient debulking and (2) an interest in preliminary laser treatment in these patients. Cryotherapy is another method to obtain debulking. Moreover, several studies showed that cryotherapy would increase the radiosensitivity of a tumor. We performed a preliminary protocol combining successively initial cryotherapy followed by irradiation in inoperable NSCLC (either for local or functional contraindications). Thirty-eight patients were included and treated first by cryotherapy performed under general anesthesia and then with external irradiation in a curative intent. The efficiency of cryotherapy assessed on bronchoscopy was found to be volume-efficient (VE) in 26 of the 38 patients and non-volume-efficient (NVE) in the other 12 patients. After irradiation in the VE group, 17 of the 26 patients had no bronchial residual tumor (NRT). In contrast, all of the patients in the NVE group had a bronchial residual tumor (RT). Survival in the VE group (median, 397 days) was significantly higher than the survival of the NVE group (median, 144 days). Survival was found to be independent of the surgical contraindication (local or functional). The best survival was associated both with the efficiency of the initial debulking (VE) by cryotherapy and with the local control (NRT) induced by the irradiation (median, 560 days). Local control was obtained in 65 percent (17/26) of the cases in the VE group and was never observed in the NVE group. In our study the VE group's local control is better than the 35 percent usually reported after irradiation alone. These results argue for the efficient potentiation of irradiation by cryotherapy.

Adult↗
PubMed1992

[A case of congenital pulmonary varices].

Pulmonary varices are rare disorders (only 72 published cases), and are most often congenital in origin, asymptomatic and have a benign outcome. In some cases the appearance of varices is favoured by pulmonary venous hypertension which is most often related to mitral valve disease, or it is associated with other vascular or bronchial malformations. We present a new case of isolated pulmonary varices occurring in an asymptomatic young woman aged 20. The pulmonary radiological abnormality was confirmed using computed tomography which showed that the abnormality was both of vascular origin and of venous composition. Digital subtraction angiography during the venous phased confirmed the diagnosis. There was no associated cardiomyopathy, nor any bronchial or vascular malformation. No surgical intervention was taken, nor was there any clinical or radiological change observed during follow-up over one year. The diagnosis of pulmonary varices is an important one to make, particularly to avoid an unnecessary thoracotomy, but there should always be a systemic search for associated anomalies.

Adult↗
PubMed1990

[Small cell lung carcinoma. Value of the evaluation of extension for the therapeutic strategy].

Small-cell lung carcinoma can be distinguished from other histological types of lung cancer because of its high metastatic potential. Initial staging procedures divide the patients into two main prognostic groups: the so-called "limited" (to the thorax) and the extensive disease patients. Based on the results of a prospective pilot study involving 182 patients and on a review of the literature, the authors discuss the usefulness of initial staging in increasing the number of detectable metastases, assessing tumour burden, evaluating treatment results and identifying prognostic factors. Complete tumour staging at the time of diagnosis appears to be very helpful for a better knowledge of the disease and better therapeutic decisions.

Adrenal Gland Neoplasms↗
PubMed1987

[The bone in non-corticoid-treated sarcoidosis. A histomorphometric study].

The sarcoidosis granuloma secretes 1-25 dihydroxyvitamin D (1-25(OH)2 D) at the origin of the hypercalcemia found in about 20 p. cent of sarcoidoses. Its mechanism was considered exclusively of a digestive nature, but the activity of osteoclastic stimulation of 1-25(OH)2 D must consider an associated bony origin. Nine patients with bouts of non-steroid sarcoidosis were studied by osseous histomorphometric analysis. In a patient with hypercalcemia and radiographic manifestations, a high degree of bone remodelling is demonstrated, with stimulation of osteoclastic and osteoblastic activity. In eight patients with normocalcemia, two subgroups are individualized: two patients present intramedullary sarcoidosis granulomas with increased contact resorption; six patients present a normal marrow: the total areas of resorption remain increased. It is concluded that the activity of osteoclastic resorption is increased in sarcoidosis, which may explain partially the hypercalcemia. The absence of titration of 1-25(OH)2 D in our study does not permit to precise the role of this enzyme in the genesis of hyperosteoclastosis, although this seems quite plausible.

Adult↗
PubMed1987

[Intratracheal destruction of tumor lesions: laser or cryotherapy? A preliminary analysis].

Intrabronchial laser has become the reference method for palliative destruction of intrabronchial tumours. Cryotherapy, which destroys tumours by cold-induced lesion at -89.5 degrees C, has recently been introduced. Over a 3-month period, 8 patients with malignant or benign proliferative stenosis of the main bronchi and trachea were treated by laser through a flexible Bronchoscope, under general anaesthesia. During the same period, 8 patients were treated by cryotherapy through a non-rigid probe passed into a bronchoscope, under general anaesthesia; 5 of these patients had malignant intrabronchial lesions and 3 had benign or low-malignancy lesions (hamartochondroma, cylindroma, benign carcinoid). Destruction by laser was relatively or absolutely contra-indicated in these 8 patients on account of total bronchial stenosis, prolonged infiltrating stenosis or previous failure of laser. Satisfactory bronchial recanalization was obtained by laser in 3 out of 8 patients, but this technique partially failed in 5 patients with prolonged or partially infiltrating stenosis; 2 of these 5 patients were successfully treated by cryotherapy. Among the 8 patients treated by cryotherapy, 6 were significantly improved, with total bronchial recanalization and destruction of the tumoral nodules. In 1 case tumoral destruction was too incomplete for re-ventilation, and in the last patient the multiplicity of lesions made objective assessment of the results impossible. No major side-effect ascribable to cryotherapy was observed. Cryotherapy performed through a non-rigid probe therefore seems to be as safe and effective method of bronchial recanalization. It is relatively inexpensive, mobile and painless, but its effects are delayed by 8 to 10 days.(ABSTRACT TRUNCATED AT 250 WORDS)

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