Biomedical subjects
Publications and source records attributed to H Pequignot.
Natural history of pulmonary embolism observed during a 4-year period in a non-discriminayory Department of Internal Medicine, with reference to 7,843 admissions : 2 per cent of patients, 9 per cent of deaths, 22 per cent of post-mortem examinations. Value of various paraclinical examinations, more especially ECG, lung scintigraphy and determination of blood gases.
Clinical, radiological and electrocardiographic abnormalities found at cardiovascular examination of 140 patients in their nineties admitted into hospital, were listed and a systematic comparison was established between 36 subjects in their nineties in a home for the aged and subjects in their eighties in the same home. Comparison with previous similar series.
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Incidence and features of the disorders of the supraventricular rhythm and of the atrioventricular conduction seen in 429 patients with a 20-months follow-up, the patients being aged 60 to 99. Nature of the associations was described and compared with other similar series.
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The two cases reported here show intestinal obstruction may occur by coagulation of lymph around the loops. They permit us to better understand the physiopathology of blockage of the lymph vessels whether congenital as in the first case or traumatic as in the second case. Traumatic rupture of the cisterns chyli is exceptional. The histological lesions observed on clamped biopsies show clearly the pathology of protein-losing enteropathy.
On the basis of a personal case in which two successive diagnoses of sarcoidosis and Whipple's disease were made at an interval of four years, the authors discuss the possible association or relationship between these two disorders, both diffuse, affecting the reticulo-histiocytic system and diagnosed on a histological basis. Review in the literature of 54 cases of Whipple's disease with pleuro-pulmonary lesions makes it possible on the one hand to associate with the latter numerous examples of extra-intestinal involvement, the histological appearance of which of a non-specific epithelioid granuloma does not indicate the diagnosis during the long pre-intestinal phase, and on the other hand to explain that during this period, the presence of pleuro-pulmonary lesions leads to an initial diagnosis of the probability of sarcoidosis. The practical consequences are as follows: The appearance of intestinal signs during "sarcoidosis" should lead to intestinal or mesenteric node biopsy to seek the macrophages with highly PAS positive cytoplasm characteristic of Whipple's disease. Their discovery necessitats long term antibiotic therapy which has recently transformed the outlook in this disease, invariably fatal in the past.
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