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J M Vergnon

Publications and source records attributed to J M Vergnon.

At least 55 records · Page 3Linked to original sources
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

[Analysis by broncho-alveolar lavage of the pulmonary uptake of gallium 67 in idiopathic diffuse interstitial fibrosis and sarcoidosis].

The pulmonary fixation of Gallium 67 has been studied by broncho-alveolar lavage (LBA) in a group of 10 cases of stage II pulmonary sarcoid, proven histologically, and in a group of 11 cases of idiopathic diffuse interstitial fibrosis (FID). The pulmonary activity of Gallium 67 was measured in vitro in a quantitative manner on a centrifuged clump and a supernatant of LBA as well as on the serum and in vivo in a semi-quantitative manner by the Line index. The alveolar Gallium activity has been correlated with different cytological and biochemical parameters of the lavage liquid. There was a narrow correlation in the serum between the Gallium 67 activity and the level of circulating transferrin. The fixation of Gallium in the cellular clump of LBA depends on the number of macrophages present in the clump and the total available radioactivity. The macrophages of the sarcoid and fibrosis cases picked up the gallium in a similar fashion, with an affinity all the more important as the total available radioactivity was weak. The radioactivity of the supernatant of the lavage liquid was quantitatively important and narrowly tied to the diffusible proteins present in the lavage. There was no correlation between the semi-quantitative Line index and the cytological or biochemical data in the fibrosis cases. In the sarcoid cases there was an inverse correlation with the polymorphonuclear leukocyte count. The semi-quantitative index was only correlated with alveolar gallium fixation level in the fibrosis group.(ABSTRACT TRUNCATED AT 250 WORDS)

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)

Aged↗
PubMed1987

[Tracheobronchial lipomatosis. Apropos of a case].

A case of tracheo-bronchial lipomatosis is reported. Bronchial lipomas are benign fatty tumours which frequently result in bronchial superinfection or dyspnoea. The radiological image is often one of atelectasis, and the diagnosis is made at endoscopy. Treatment, rendered necessary by destruction of the underlying lung, is either endoscopic or surgical. Multiple localizations are exceptional and raise special therapeutic problems.

Bronchial Neoplasms↗
PubMed1986

[Pulmonary metastases in medullary cancers of the thyroid. Study of 4 cases. Originality of the lymphangitic form with amyloid stroma].

We studied the clinical and radiological features of pulmonary metastases present in 4 out of 22 patients with medullary carcinoma of thyroid. Two patients presented with common metastases: macronodules in one, and micronodules in the other one. The other two patients presented initially with reticulonodular perihilar lesions on chest X-ray, leading to the diagnosis of sarcoidosis in both of them. The observation of such pulmonary metastases is original: initially latent, they progress very slowly, and they correspond to a lymphangitic spread of the tumour with amyloid deposition in peribronchovascular structures without alveolar involvement, as shown in one of our cases with pathologic study.

Adult↗
PubMed1986

[Technics for the exploration of pulmonary arteriovenous shunts in liver cirrhosis. Apropos of 2 cases].

Pulmonary arterio-venous shunts represent a rare cause of hypoxia in cirrhosis. We present two cases, the first was an alcoholic cirrhotic with anthracosilicosis. This patient rapidly developed a picture of significant hypoxaemia with a raised alveolar-arterial oxygen gradient. The presence of this shunt was confirmed by a scintigraphic analysis. A porto-pulmonary localisation was excluded by a changing angiographic picture. Death supervened after refractory hypoxaemia. Post mortem microangiographic studies confirmed the pulmonary nature of the shunt and its pre-capillary localisation. The second patient was alcoholic, with a compensated cirrhosis and developed severe hypoxaemia which progressed to death in less than two months, when he was being treated effectively with corticosteroids for a diffuse interstitial pulmonary fibrosis confirmed histologically. The pulmonary localisation of the shunt was confirmed by an analysis of the angioscintigraphs. The different techniques for the investigation of intra-pulmonary shunt are discussed, as well as the patho-physiological mechanisms involved. The hormone levels measured (sex hormones, serotonin, prostaglandins, intestinal hormones) remained normal. The therapeutic trials tried out (oestrogen, CPD Choline, indomethacin) were ineffective.

Humans↗
PubMed1986

[Severe subglottic edema caused by bird breeder's disease?].

A 44-year old female farmer and pigeon-breeder presented with paroxysmal attacks of dyspnoea caused by recurrent subglottic laryngeal oedema. The symptoms disappeared under corticosteroid therapy but returned after discharge from hospital. The avian origin of the disease, suggested by a strongly positive search for avian precipitins, was confirmed when the attacks ceased after antigen exclusion. A realistic inhalation challenge test performed on two occasions with pigeon's feathers and droppings as antigens resulted, within 15 minutes, in a 4-hour long attack of paroxysmal laryngeal dyspnoea. The dyspnoea was caused by subglottic laryngeal oedema visualized, 15 minutes after the inhalation, by pharyngeal and bronchial fibroscopy. Nasal manifestations have been reported in patients with hypersensitivity of the lung, but it seems that no case of subglottic oedema in pigeon-breeder's disease has yet been published.

Adult↗
PubMed1986

[Difficult diagnosis of a rapidly developing post-traumatic tumor of the thymus region. Encysted hematoma or intracystic hemorrhage?].

We report a case of rapidly developing (subacute) post-traumatic mediastinal haematoma which initially suggested a malignant tumour of the thymus region. The lesion, discovered on the basis of non-specific signal symptoms 2 months after a mild chest injury, consisted of a voluminous tumour of the thymus region associated with pericardial effusion. At angiography, the mass proved to be extravascular. CT scans of the thorax showed that it surrounded, but did not compress, the mediastinal vessels. Surgery revealed an organized encysted haematoma of the thymus region that had ruptured into the pericardial cavity containing a blood collection. The possibility of an intracystic haemorrhage in a cystic tumour preexisting to the trauma is discussed, but a more likely diagnosis would be chronic haematoma, especially since a similar case independent of any injury has already been published.

Adult↗
PubMed1985

[Respiratory function and alveolar biological changes under the effect of CDP-choline in pulmonary interstitial pathology: pulmonary fibrosis and sarcoidosis].

Various anomalies of pulmonary surfactant have been described in relation to acute respiratory distress syndromes, hypersensitivity lung disease and pulmonary sarcoidosis. Phosphatidylcholine (PC) is the essential phospholipid component of pulmonary surfactant. Cytidine diphosphocholine (CDP-choline) is an essential intermediary in the biosynthesis of PC. The authors studied two groups of patients: one group consisted of diffuse interstitial pulmonary fibrosis and the other consisted of pulmonary sarcoidosis with parenchymal involvement. They observed quantitative and qualitative abnormalities of the phospholipid fractions of surfactant and more particularly of PC. The finding of a marked decrease in this phospholipid, especially in the cases of pulmonary fibrosis, justified the study of the therapeutic effects of CDP-choline. After one month of treatment with this substance, at a dose of 1 g I.M. per day, the PC fraction had returned to normal and, at the same time, there was an improvement in the PaO2 at rest and after exercise. Long term administration of CDP-choline appears to be valuable in the maintenance of the phospholipid equilibrium of pulmonary surfactant and in the improvement of the quality of alveolar gas exchange.

Adult↗
PubMed1985

Pulmonary sarcoidosis: flow cytometry measurement of lung T cell activation.

Lung T cell activation is considered a major factor in the pathogenesis of pulmonary sarcoidosis. Our study was designed to investigate several parameters of T cell activation among blood and alveolar cell populations, including expression of HLA-DR or MLR antigens, increased cell size, and presence of dividing cells. Blood sampling and bronchoalveolar lavages were performed in 20 patients with pulmonary sarcoidosis. Cell populations were analyzed by flow cytometry using immunofluorescence labeling with monoclonal antibodies to lymphocyte differentiation or activation antigens. Cell types were identified by their light-scattering properties. Cell cycle analysis was done after staining with acridine orange. Bronchoalveolar lavage contained a higher proportion of small T4-positive lymphocytes, and large cells of the same phenotype were detected in three patients. T cells bearing HLA-DR antigens were detected in six of 14 bronchoalveolar lavage samples. A marked increased of MLR-positive cells was found in the peripheral blood of eight of eight patients and in the bronchoalveolar lavage of five of seven patients. Increased percentages of cells in the S + G2 + M phases were found in blood lymphocytes from three patients and in half the bronchoalveolar lavage samples. Therefore, a variety of activation markers may be expressed by alveolar T cells. Their qualitative and quantitative assessment may provide additional criteria for staging the intensity of the alveolitis, and the possible relationship between these markers and disease progression or activity deserves long-term clinical investigation.

Adult↗
PubMed1985

[Chronic idiopathic eosinophilic pneumopathies. A study of 16 cases].

We report 16 cases of chronic idiopathic interstitial pneumonia (P.C.I.E.). P.C.I.E. has well defined clinical, radiological and biological characteristics which enable the eosinophilic pulmonary infiltrates to be recognised and the diagnosis to be confirmed without histological proof. The data from broncho-alveolar lavage (L.B.A.) show that besides the radiological infiltrates, there is a diffuse alveolar eosinophilia; sometimes confirming the pulmonary function results, which show a similar pattern to diffuse interstitial pneumonia (P.I.D.). The frequent association of asthma (50%) and extra-pulmonary signs (30%) may suggest a vasculitis or more particularly the Churg-Strauss syndrome, all the more so without a lung biopsy; however the evolution of the disease and the response to low dose steroid therapy is against the latter two being considered in the differential diagnosis. The prognosis for P.C.I.E. is good in the short and medium term; nevertheless during the period under observation (mean 6.3 years) steroid therapy could only be stopped in 3 out of 16 patients. The other patients were stable with a low dose of Cortisone. No patient with P.C.I.E. associated with asthma or hypergammaglobulinaemia or extra-pulmonary signs could be weaned from steroids. The authors advocate that the dose of steroids should be adjusted as low as possible to maintain an eosinophilia below 500/mm3.

Adult↗
PubMed1985

[Pneumopathy caused by hypersensitivity to isocyanates. Value and dangers of a realistic provocation test].

Organic isocyanates are responsible for bronchial pathology and in rare cases of hypersensitivity pneumonia. We present a new observation supported by a complete lung function assessment, histology of a transbronchial biopsy and a positive bronchial challenge test. The progress of the disorder was followed by repeated lung function measurements and bronchoalveolar lavage. The alveolar response at first showed an alveolar leukocytosis, then a mixed picture, finally becoming a pure lymphocytosis. The activity of the alveolar cells was assessed for T lymphocytes by cytofluorimetry, the presence of DRa like and LMR antigens and lastly for macrophages with Gallium scans. The inflammatory response was followed by analysing the proteins in the lavage liquid. The value of studying alveolar cell-activity and equally alveolar protein content is underlined in this study and reminds one of the character, sometimes unpredicted and dangerous, of challenge tests using isocyanates.

Bronchi↗
PubMed1985

[Comparative clinical trial of cefoperazone versus ampicillin + tobramycin in severe bronchopulmonary and pleural infectious pathology].

This study involved an open trial with parallel randomised series receiving either cefoperazone (2 g/d) or a combination of ampicillin (6 g/d) and tobramycin (3 to 4 mg/kg/d). The 30 patients included were of both sexes (male predominance), hospitalised, aged 62 +/- 11,5 years and suffering from a severe bronchopulmonary or pleural infection. Underlying pathology was serious (neoplasm, C.O.D.L., bronchiectasis, cardiac pathology). No significant difference was seen in the sampling of the two populations. Cefoperazone was prescribed in 2 infusions per 24 hours. Ampicillin was given as 3 infusions, followed by tobramycin administered by a similar number of injections. The duration of treatment was 16.8 +/- 9 days (cefoperazone) and 11,8 +/- 6,5 days (ampicillin + tobramycin). Overall evaluation (clinical, radiological and laboratory criteria) showed 88% (cefoperazone group) and 71% (ampicillin + tobramycin group) recovery and improvement rates. There were two failures in the cefoperazone group and 6 failures in the other group. These results were not statistically different. Three of the 6 failures could be attributed to resistance of the initial bacteria or selected by one or other type of treatment. None of the antibiotics prescribed raised any acceptability problems.

Aged↗