Contralateral chylothorax: one more complication of subclavian venous puncture.
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Biomedical subjects
Publications and source records attributed to B Polla.
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The sensitivity and specificity of scanning with 57Co-labelled bleomycin for the diagnosis of lung cancer were determined from a prospective study involving a large group of patients with an abnormal chest roentgenogram. A semi-quantitative analysis of the scintigram was obtained by defining an index in terms of the excess isotope uptake within the tumour. Malignant pulmonary lesions were found in 121/175 patients and 113 had a positive scan. Benign pulmonary disorders were found in 54 patients, 45 of whom had a negative scan. The sensitivity and specificity were therefore 93% and 83% respectively. Bayes' theorem was then used to determine the predictive value of this test, either positive or negative, when the prevalence of disease varied from 10 to 90%. A receiver operating characteristic curve permits the choice of an appropriate value of the tumour uptake index to minimize the false positive fraction without classifying too many true positives as false negatives.
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57Co-bleomycin scanning dates from the early 1970s, when the first results were presented by Renault et al. Since then there have been numerous publications concerning the high sensitivity of this type of study in the detection of pulmonary or cerebral neoplasms. In the region below the diaphragm, however, sensitivity was poor due to hyperactivity of the kidney, liver and bladder. To eliminate this problem the authors have used single photon emission computerized tomography (SPECT), and their department is currently investigating the sensitivity of this technique for the detection of neoplasms. Two typical cases are described which illustrate the value of this method in the detection of cancer.
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Bleomycin is the term for a group of antibiotics produced by cultures of the fungus Streptomyces verticulus, the anti-tumor cell potential of which was shown by Umezawa. Use of this property as a tumor specific marker radiolabelled with cobalt-57 was recognized by Renault in 1971. Since then there have been numerous publications concerning the good sensitivity of this type of study in the detection of neoplasms. Our department is currently investigating the sensitivity and specificity of this technique for the detection of pulmonary tumors. We describe here two typical cases illustrating the interest of this method in the diagnosis and staging of lung cancer.
After intense exposure to herbicides and insecticides, a farmer developed a rapidly progressive anti GBM glomerulonephritis, which led to terminal renal failure without pulmonary involvement. The etiologic role of the toxic compounds is suggested by the close temporal relationship between the exposure and the nephritis and further supported by the occurrence of similar cases after solvent exposure and by epidemiological studies. The diagnosis of rapidly progressive glomerulonephritis should be considered in the presence of toxic acute renal failure.
This study aimed to investigate whether milrinone effect on cardiac muscle contractility undergoes to age-related changes. Experiments were carried out on papillary muscles isolated from right ventricle of Brown Norway rats belonging to two different age groups: 2 month old and 18 month old. The effect of milrinone (10-100 microM) on rat cardiac muscle in vitro preparations was characterized by a reduction of peak developed tension and of contraction duration. Furthermore, the recovery of contractility after a contractile cycle, i.e. the mechanical restitution was faster in the presence of milrinone than in control conditions. All these effects were reduced in preparations from 18 month old rats compared to preparations from 2 month old rats. The decrease of milrinone effect on the mechanical restitution was particularly pronounced. The reduction of the milrinone effects is likely connected with the reduction of the maximal effect of adrenergic stimulation, although the molecular basis of this link is not yet clearly understood.