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Biomedical subjects

H Mary

Publications and source records attributed to H Mary.

At least 19 recordsLinked to original sources
PubMed1992

[Tracheal neurofibroma and Recklinghausen's disease].

Neurogenic tumours arising in the trachea are rare; the association with Von Recklinghausen's disease is exceptional. Only two cases of tracheal neurofibroma with neurofibromatosis have been reported. We report on another patient, a thirty year old man, who presented with acute shortness of breath; laser resection was performed via an endotracheal approach, then, a few days later, resection of the exotracheal tumor and tracheal segment was performed. Postoperatively, the patient did well for nine years without any respiratory complaint or neurofibromatosis relapse.

Adult↗
PubMed1991

[An unusual miliary pattern].

Syndromes presenting with interstitial radiological signs are often difficult to diagnose aetiologically. Surgical biopsy prevents certain rare cases being neglected notably when there are atypical manifestations. We describe a case of bronchiolitis obliterans with an organising pneumonia which was classical as regards the histology and its response to treatment but unusual as regards the clinical presentation and the aetiology.

Adult↗
PubMed1991

[Pleural involvements in thymoma. Apropos of 5 cases and review of the literature].

The authors report five cases of pleural involvement in patients with thymoma. In 3 cases these sites were not directly related to the primary and in 1 case they constituted the first event in the disease. CT and MRI allow effective assessment of these pleural lesions ... provided this phenomenon, reported in the literature, is well known by the radiologist.

Adult↗
PubMed1990

Pilot study of neoadjuvant ifosfamide, cisplatin, and etoposide in locally advanced non-small cell lung cancer.

33 patients with locally advanced non-small cell lung cancer entered a study of neoadjuvant chemotherapy to evaluate the response rate with ifosfamide/cisplatin/etoposide and the complete resection rate and safety of surgery following chemotherapy. Chemotherapy with cisplatin 25 mg/m2, ifosfamide 1.5 g/m2, and etoposide 100 mg/m2 was given on days 1-4 of a 21 day cycle and repeated for three cycles. For responders, surgery was done 15-20 days after haematological recovery. Chemotherapy induced 5 complete responses (15%) and 18 partial responses (55%). 77% of the 33 patients had grade 3-4 neutropenia and 60% grade 3-4 thrombocytopenia. 1 patient died with a central nervous system haemorrhage. Thoracotomy was done in 21 patients but resection was only possible in 20 (61%). A complete resection was achieved in 18 patients (55%). Histology was negative for the 5 complete responses. Surgery induced no morbidity. A high response rate may be obtained with ifosfamide, cisplatin and etoposide neoadjuvant chemotherapy allowing a high complete resection rate.

Adult↗
PubMed1990

[Role of modern imaging (CT-MRI) in the preoperative evaluation of bronchial cancers. Results in 202 cases].

The authors present the results of a comparative prospective study of the staging 202 bronchogenic carcinomas (T and N) before surgery. The results of CT (202 cases) and MRI (64 cases) were compared with surgical evaluation and pathologic findings. CT and MRI were part of the decisive criteria for therapeutic-surgery choice and were interpreted before surgery. The results showed poor sensitivity for the T and N but better specificity. MRI is superior to CT with the 3 dimensional demonstration and T1 T2 weighted sequences, but its utility remains limited. The authors give their preferred indications for MRI investigation after CT staging. Staging by CT (and MRI) is of great value to avoid impossible thoracotomy and to confirm the findings of mediastinoscopy (suspected N2 and even more N3).

Adult↗
PubMed1989

Phenotypic heterogeneity studied by immunohistochemistry and aneuploidy in non-small cell lung cancers.

Non-small cell lung cancers (non-SCLC) differ from small cell lung cancers (SCLC) by many clinical features and prognosis. However, recent studies suggest that lung cancer heterogeneity frequently leads to the association of SCLC and non-SCLC in the same tumor. This phenotypic heterogeneity can be analyzed by immunohistochemistry using monoclonal antibodies (Mab) raised against differentiation related antigens. It may have clinical relevance inasmuch as the diversification of malignant cells is a well-known factor of tumor progression and may be due to chromosomal instability because inappropriate gene expression leads to the formation of antigens unrelated to cell lineage. Chromosomal instability in cancer leads to aneuploidy detectable by cell DNA content analysis. In a prospective study, we analyzed, in parallel, the expression of neuroendocrine related antigens by immunohistochemistry and the cell DNA content in frozen specimens from 40 patients who underwent complete surgical resection of primary non-SCLC in an attempt (a) to characterize the phenotypic heterogeneity and (b) to determine whether this heterogeneity is correlated with aneuploidy and clinical staging. Three Mabs were used in association as a marker of neuroendocrine antigen expression (S-L 11.14, MOC-1, and NE-25); reactivity of these Mabs in 9 SCLC and 3 lung carcinoid tissue sections was used as positive control. All SCLC and 2 of 3 lung carcinoids tested were homogeneously positive with Mabs S-L 11.14, MOC-1, and NE-25; 13 of 40 non-SCLC were homogeneously positive and 11 additional specimens focally positive with Mabs S-L 11.14, MOC-1, and NE-25. The frequency of this abnormal phenotype was significantly higher in poorly differentiated squamous cell carcinomas (chi 2 10.08; P less than 0.005), in clinical stage III non-SCLC (chi 2 5.93; P less than 0.02), and in tumors involving mediastinal lymph nodes (chi 2 5; P less than 0.03). The percentage of cells in the modal DNA of G0-G1 phase was significantly lower in non-SCLC homogeneously positive with Mabs S-L 11.14, MOC-1, and NE-25 [27.4 +/- 10.3% (SD)] in comparison with non-SCLC negative with these same Mabs [56.8 +/- 21.3%; P less than 0.01, Mann-Whitney U test]. We conclude that (a) mixed SCLC-non-SCLC differentiation is frequent and can be assessed by immunohistochemistry, (b) neuroendocrine differentiation in non-SCLC is mainly observed in poorly differentiated tumors and in advanced clinical stages, and that (c) this heterotopic phenotype is correlated with aneuploidy and has clinical implications.

Adult↗
PubMed1989

[A rare pulmonary tumor: pneumoblastoma. Apropos of a case and review of the literature].

A case of pneumoblastoma concerning a 33 year old man, incidentally discovered on a systematic chest X Ray, is reported. The radiologic findings include a voluminous and peripherical mass with necrotic zones. The pathologic findings in optic microscopy and the special technics consist in the three cellular contingents which form the pneumoblastoma: clusters of indifferentiated cells, epithelial cells and spindle cells. All the features show clearly a blastomatic character very similar to a foetal lung which allows to differentiate the pulmonary blastoma from carcinosarcoma. The authors, through a review of the literature, demonstrate the rarity (less than 100 cases reported), the malignant evolution which metastasis and the age (strong majority of adults) which characterize this pathology.

Adult↗
PubMed1988

Juvenile fibromatosis resembling aponeurotic fibroma and congenital multiple fibromatosis. One case with pleuropulmonary involvement.

This article deals with a young school boy born in 1971 with a tumor in the palm of his right hand. We have considered this a juvenile aponeurotic fibroma. This tumor has recurred several times, leading to unavoidable amputation of the right wrist and hand. Seven years after the initial diagnosis, the axillary area became involved, then the pleura and lung. Such an unusual process leads to reconsidering the diagnosis and to regard this case as an intermediate form between Keasbey's juvenile aponeurotic fibroma and generalized fibromatosis.

Child↗
PubMed1988

[Pulse oximetry and thoracopulmonary surgery].

Arterial blood gases are invasive and they provide intermittent information only. On the other hand, pulse oximetry is non invasive, providing continuous monitoring of SaO2 (SpO2). A study was therefore carried out in twelve patients undergoing lung and intrathoracic surgery to determine whether pulse oximetry was a reliable method of monitoring. The SpO2 values obtained using a Physiocontrol Oximeter (Lifestat 1600) were compared with those given by blood gas measurements (SaO2). When ventilation was switched to one-lung ventilation, PaO2 fell in all cases, whatever the method of monitoring, with PaCO2 remaining constant. 46 paired values of SaO2 were compared using linear regression analysis. Correlation between the two methods was good (r = 0.95; p less than 0.001). Pulse oximetry would therefore seem to provide a reliable method of continuous noninvasive and accurate monitoring of oxygenation during lung surgery.

Adult↗
PubMed1988

[Long-term survival of surgically treated lympho-epithelial thymomas].

The authors report the results of a multi-centre trial on 500 cases of lymph-epithelial thymoma (TLE) treated by 14 surgical teams. Most typically a tumour of the adult in the fifth decade, occurring most commonly in women (60%), one in every two cases of TLE occurs in auto-immune disease: usually myasthenia. Most often (3 times out of 4) the disease is latent and occupies the middle (40%) or superior mediastinum (30%). In 15% of cases the pulmonary radiograph is normal. Radical surgery is possible in 75% of cases, otherwise it is incomplete or even reduced to a simple biopsy. The 15 year prognosis obtained using actuarial survival curves is based on the surgical-anatomical classification of the study group of thymic tumours (GETT) giving: for stage I: a survival of 80% for stage II to IVA of 40% and for stages III to IVB of around 10%. Finally it should be noted that existence of a recurrence after a complete surgical excision (stage I) poses the problem of post-operative radiotherapy and the associated total thymectomy. Also, the identical prognosis after biopsy or incomplete surgery (IIIA and IIIB) with an increased morbidity for incomplete surgery. Finally the confirmation that pleural involvement (IVA) is not as adverse a factor as one would have supposed.

Adolescent↗
PubMed1987

[Pericardial mesothelioma. Apropos of a case].

A 74 year old woman without previous cardiovascular disease presented with pericardial effusion and tamponade. Two-dimensional echocardiography displayed a pericardial mass, but a diagnosis of tumour was not envisaged. Pericardiocentesis produced an exudative fluid with lymphocytes but no malignant cells. Pericardial biopsies through axillary thoracotomy indicated chronic progressive pericarditis. As the patient's haemodynamics deteriorated, sternotomy was carried out showing diffuse pericardial sclerosis corresponding, at histology, to a mixed, predominantly fibroblastic pericardial mesothelioma. The authors describe the main clinical characteristics of pericardial mesothelioma, always discovered belatedly at surgery or necropsy. They insist on the value of non-invasive methods (two-dimensional echocardiography, computed tomography) to diagnose a pericardial tumour, and on the poor prognosis of mesotheliomas, treatment still being uncertain due to the small number of cases and to the early occurrence of cardiac complications.

Aged↗