Disseminated Mycobacterium avium intracellulare infection without predisposing conditions.
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Biomedical subjects
Publications and source records attributed to B Epardeau.
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A man was admitted for severe autoimmune hemolytic anemia with a mediastinal mass. He required corticosteroid treatment, which altered the first histological examination. Laparosplenectomy was performed and all histological sections were negative, but the hemolytic anemia was not improved. Finally, thoracotomy was performed when the mediastinal mass increased after reducing the corticosteroid treatment. Pathological examination revealed Hodgkin's disease associated with Castleman's disease. After chemotherapy and radiotherapy, the patient remains in complete remission.
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The authors report a case of a 30 year old woman with juvenile laryngeal papillomatosis (JLP) who subsequently developed intra-alveolar papillomas. These papillomas demonstrated a marked pseudo-neoplastic loco-regional invasive activity, but did not possess the histological criteria of malignancy and were treated by pneumonectomy and lobectomy.
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In a new case of alveolar microlithiasis we report the diagnostic value of two non-invasive examinations. In agreement with the histo-chemical date, scintigraphy with technetium shows an abnormal pulmonary fixation as evidence of the presence of intra-pulmonary calcium. The demonstration of micro-lithiasis in the alveolar lavage liquid, which requires a particular technique, confirms the diagnosis and avoids an open lung biopsy.
A new case report of alveolar micro-lithiasis shows the diagnostic interest of two non invasive explorations to affirm a radiologic suspicion. Technetium showed calcium in the lung. The broncho-alveolar lavage, realised with a big quantity of fluid, removed the microliths. These two technics together avoid pulmonary biopsy.
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Results of a collaborative study carried out in three different hospitals by nine surgeons are reported. Activity of a new scrub applied according to a standardized protocol was compared with that of the different scrubs and/or antiseptics customarily used by participating surgeons with their habitual method. Activity of products was evaluated by bacterial counts in gloves. Statistical analysis of results demonstrates the value of this trial design which compares scrubs under real conditions of use.
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Rapid increase in growth of a pulmonary metastasis following incomplete excision of a malignant mediastinal embryoma was treated by multiple chemotherapy combining platinum derivatives, actinomycin B, bleomycin, and vincaleucoblastin. Complete remission was obtained. These extremely rare tumours have a histological appearance close to that of testicular tumours. Until recently, their prognosis was such that therapy appeared to be of no avail, but this has been modified by new chemotherapy schedules including, more particularly, the use of platinum.
Report in a 68 years old man of the association of erythermalgia and malignant thymoma. Improvement of erythermalgia after resection of the thymoma is demonstrative of paraneoplasic syndrome. Tumoral secretion of serotonine is suggested by ultrastructural features of the tumour and increasement of urinary 5 HIAA.
An inaugural pericardiac tamponade performed on a 39 years old man, reveals a lympho-epithelial thymoma. The anatomic diagnosis first suggested by the radiography after evacuation of the effusion, is confirmed by the swab taken during the retroxiphoidal drainage. A 57 Gray cobaltotherapy was then performed. 18 months later, a satisfactory general state, allowed the patient to return to his professional activity. The evaluation of a tumourous residue by a tomodensitometry, is discussed at the light of a comparable observation confirming the efficiency of cobaltotherapy but, at the same time, its agressivity for such an important target volume. A previous surgical reduction, whenever possible, is then considered; an unthinkable eventuality in the reported observation.
After a new observation, the authors make as complete a review as possible of the literature on this disease right up to the end of June 1974. They counted 104 observations and analyzed 91 of them. They think the clinical description could be enlarged to include the extra-thoracic signs. Similarly they point at biological peculiarities which unfortunately have only been looked for in a small number of the observations. Out of 77 cases they draw the main evolutive lines of the disease treated or untreated, debating on the reaction to corticosteroids. Finally they debate on the pathogenic hypotheses mainly on histological grounds.