PubMed Health⌕ Search

Biomedical subjects

J M Vergnon

Publications and source records attributed to J M Vergnon.

72 records · Page 4Linked to original sources
PubMed1984

Cryptogenic fibrosing alveolitis and Epstein-Barr virus: an association?

13 patients with cryptogenic fibrosing alveolitis (CFA) and 12 with interstitial lung disease (ILD) of known cause were studied for their humoral response to herpes simplex virus (HSV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). Serum antibodies to HSV and CMV were within the normal range in all patients. 10 patients with CFA had raised serum antibodies to EBV, and IgA against viral-capsid antigen (VCA) was detectable in all 13. In the other 12 patients EBV serological profiles were normal and IgA against VCA was detectable in only 1 patient. The EBV antibody levels did not correlate with the level of circulating immune complexes, the presence of rheumatoid factors, or the cytological findings of the alveolitis. The presence of IgG against VCA in 5 CFA patients suggests local production of EBV-specific immunoglobulins. Elevated IgG and IgA against EBV in CFA may indicate non-specific depression of cell-mediated immunity or that EBV plays a part in the aetiology of CFA.

Adult↗
PubMed1984

Lactic dehydrogenase isoenzyme electrophoretic patterns in the diagnosis of pleural effusion.

The relative value of each lactic dehydrogenase isoenzyme (iso LDH) was measured by electrophoretic separation in the serum and the pleural fluid of 100 patients. In each case, the cause of the pleural effusion was known. Two types of LDH isoenzyme pattern were found in the serum: a normal type with a low value of LDH 5 and an abnormal type with a high value of LDH 5. This high LDH-5 level is due to an impaired liver function. In the pleural fluid, the electrophoretic patterns of five LDH isoenzymes were found by computerized processing. During congestive heart failure (28 cases) the electrophoretic pattern of the LDH isoenzymes was always similar in the serum and in the pleural fluid (transudative pleural effusion). During thoracic empyema, the relative values of the isoenzymes in the pleural fluid were regularly increasing from LDH 1 to LDH 5. In this situation, the evaluation of LDH 5 appeared to emanate from the increased granulocytes in the pleural fluid. In 22 inflammatory pleural effusions, the relative values of the five isoenzymes were equal. During malignant effusions (35 cases) a high level of LDH 5 was found in 21 patients. LDH 5 is known to be secreted by malignant tissue, and the authors confirmed it by finding a high level of LDH 5 in biopsy specimens of patients with mesothelioma or epidermoid lung cancer (7 cases). Conversely, the level of LDH 5 was low in biopsy specimens from normal lung tissue or benign inflammatory pleuritis (6 cases). Among the 14 patients with low levels of LDH 5 in the pleural fluid during malignant pleural effusion, the authors found the malignant lymphomas (three cases) and the small cell lung carcinoma (five cases). In these cases, the low level of LDH 5 was in agreement with the result of a low level of LDH 5 found in the biopsy of a metastatic liver localization of a small cell lung carcinoma. So the electrophoretic determination of LDH isoenzymes pattern in pleural fluid is a sensitive tool for the management of pleural effusion.

Carcinoma, Squamous Cell↗
PubMed1984

Activated lung lymphocytes in hypersensitivity pneumonitis.

T-lymphocyte activation was investigated in peripheral blood and bronchoalveolar lavage (BAL) of four patients with hypersensitivity pneumonitis. The study was performed by flow cytometry with the use of immunofluorescence labeling with monoclonal antibodies to lymphocyte differentiation or activation antigens. Simultaneous measurement of DNA and RNA content by acridine orange staining was used for cell-cycle analysis. The various cell types were identified by their light-scattering properties. T cell activation was demonstrated in the BAL of all patients by the presence of T cells (OKT3 positive) bearing class II histocompatibility antigen (HLA-DR) and activated T cell markers (MLR 1-3). Lymphocyte proliferation was evidenced in BAL but not in blood of patients by an increased percentage of cells in S + (G2 + M) phases. In addition, T-lymphocyte subsets analysis revealed no abnormalities in the blood and no major imbalance in the BAL despite a slightly increased OKT4/OKT8 ratio. The finding of T cell activation and lymphocyte proliferation in hypersensitivity pneumonitis alveolitis is consistent with the contribution of a local type IV immune reaction to the pathogenesis of this disease.

Alveolar Process↗
PubMed1984

[Exclusive demonstration of creatine phosphokinase BB isoenzyme in serum, pleural fluid and neoplastic tissue in a case of small-cell pulmonary neoplasm].

The presence of circulating CPK BB isoenzyme is not as rare as was originally supposed. Theoretically damage of organes containing CPK activity should release soluble enzyme into the general circulation. So CPK BB has been reported in sera of patients with brain injury, prostate resection or with gastrointestinal malignant diseases. We present one case of small-cell lung carcinoma associated with 100% of CPK activity type BB in serum. This enzyme pattern was found also in malignant pleural effusion and in the biopsy of the malignant tumour tissue. In this tissue total CPK activity was found markedly more than in normal lung tissues or in epidermoid lung cancers. Brain type CPK is the fetal form of the enzyme and it is possible that our findings is yet another example of tumour expression of a fetal marker in the case of this very undifferentiated tumour.

Carcinoma, Small Cell↗
PubMed1984

[Amiodarone: a new etiology of diffuse interstitial pneumopathy? Apropos of 2 personal cases and 10 cases from the literature].

Diffuse Interstitial Pneumonia (PID) is probably, although rarely, a complication of Amiodarone therapy. We describe two new cases and review 19 from the recent literature. The first patient was a man treated solely with Amiodarone for three years (total dose 185 g). He presented clinically with a picture of PID with slight dyspnoea, weight loss of 4 kilos and a dry cough. There were pulmonary crackles on auscultation, diffuse reticulo-nodular shadows radiographically and compatible pulmonary function tests. Broncho-alveolar lavage (LBA) was lymphocytic (30%). Stopping Amiodarone without resorting to steroids led to the disappearance of the clinical signs within 15 days and the return to normal of the LBA and pulmonary radiograph within six months though the pulmonary function was unchanged. The second case was a 78 year old man treatment with Amiodarone for six months (total dose 20 g). He presents acutely with grade IV dyspnoea and low grade fever. There were pulmonary crackles on auscultation and a bilateral pulmonary infiltrate on the chest radiograph. The pulmonary function tests were compatible with PID showing a restrictive ventilatory defect, a reduced Carbon Monoxide transfer (single breath) and hypoxia. The diagnosis was confirmed by a transbronchial biopsy showing a parieto-alveolar infiltration with increased cellularity and collagen formation. The LBA was predominantly polymorphonuclear. Stopping the Amiodarone associated with steroid treatment produced a normal chest radiograph within six weeks, whilst moderate dyspnoea and less severe restrictive ventilatory defects persisted. The clinical, radiological, functional and histological features of our patients were comparable to those 19 cases reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

[Diffuse pulmonary carcinomatous lymphangitis. Study of respiratory function in 18 cases].

Respiratory function studies were carried out in 18 patients with diffuse and isolated pulmonary lymphangitis (LCP) diagnosed on radiological and cyto-histological grounds. Restrictive ventilatory defects were found in 17 out 18 cases CPT: 75,3% (DS = 5), CV: 56.7% (DS = 14,5). The Tiffeneau coefficient was less than 65% in 50% of cases but the DEM/CV was reduced in 77% of cases, evidence of the great frequency of airflow obstruction. The measure of the (formula; see text) was normal in 5 out of 17 cases, implying the absence of an alveolar neoplastic lesion or obliteration by arteritis or capillaritis in LCP. The alveolar-arterial oxygen gradient on hyperoxia was normal (less than 27 kPa) 14 times out of 18 and slightly increased in 4. Important hypoxaemia at rest was present 17 times out of 18; PaO2: 8 kPa (DS = 1). There was no patient with alveolar hyperventilation: PaCO2: 4.3 kPa (DS = 0.5). On exercise, hypoxaemia remained stable 4 times, improved 5 times and worsened 9 times. A pathophysiological interpretation was given for each disturbance of respiratory function. In conclusion, a characteristic respiratory function profile of LCP is proposed, with a restrictive ventilatory disturbance or moderate mixed picture, a DLCO/VA ratio generally normal, almost constant hypoxaemia at rest and improvement or worsening on exercise. CPT = Mean total lung capacity. CV = Mean vital capacity. DS = Standard deviation.

Aged↗
PubMed1983

[Lymphomatoid granulomatosis and hypersensitivity pneumopathy. Clinical and biological study (serum and alveolar) toward a new pathogenic hypothesis of the disease].

The authors discussed the malign form of lymphomatoid granulomatosis on the basis of two cases and consider the possible role of an aerocontaminant which is usually responsible for the extrinsic allergic type of alveolitis. A detailed biochemical and cytological study of the alveolar fluid from one of these patients is presented in parallel with immunofluorescent histology and electron microscopy of the lung. The observed biochemical abnormalities in the alveolar fluid could be superimposed on those formed in certain types of hypertensive lung disease. On the other hand the cytology was different, the cytofluorimetric technique revealed a mononuclear cell population rich in RNA whose role in the genesis of the disease of malign nature are discussed. The hypothesis of a hypersecretion of IgA by this malign process is raised by immunofluorescent studies of the lung. The role of IgA in lymphomatoid granulomatosis and bird fanciers lung is discussed in the light of recent work on pigeon IgA.

Adult↗
PubMed1982

[Indexing protein determinations in bronchoalveolar lavage fluids to a reference substance. Value of alveolar potassium].

It is well known that a reference substance is required to determine accurately the protein content of broncho alveolar lavage but there has been disagreement as to the ideal reference substance. We studied the relative usefulness and reproductibility of potassium and albumin as reference substances in determining protein content in 8 normal subjects and 10 patients with stage 11 sarcoidosis or extrinsic allergic alveolitis. Two successive lavages were performed intentionally using different volumes of injected normal saline. The use of potassium as a reference substance not only permitted a better reproductibility in determination of protein content of sequential broncho-alveolar lavages but also a significantly better discrimination between normal and abnormal subjects.

Albumins↗
PubMed1981

[Multifocal sarcoma associated with Paget's disease of bone. Effects of dichloromethylene diphosphate (author's transl)].

A 68-year-old man with old-standing Paget's disease of bone developed in 1975 an isolated sarcoma of the left elbow confirmed by biopsy. The sarcoma responded to irradiation and multiple chemotherapy. In August 1979, pain started along the right sciatic nerve. Clinical examination revealed a tumour deep in the right gluteal region, which was found to be another sarcoma close to the sacro-iliac joint, Cobalt irradiation produced little symptomatic improvement, and the patient died four months later, presumably of metastases. Since January 1979 the Paget's disease had been treated with dichloromethylene diphosphate with satisfactory clinical, biochemical and histological results, but the drug did not influence the course of the sarcoma.

Aged↗
PubMedDate not supplied

[Interstitial pneumopathies caused by busulfan. Histologic, developmental and bronchoalveolar lavage analysis of 3 cases].

Busulfan-induced diffuse interstitial pneumonia is a rare but serious disease attributed to a direct toxic effect of busulfan (an alkylating antimitotic drug) on alveolar cells. We report three new cases explored by repeated bronchoalveolar lavages and lung biopsies. All patients had circulating immune complexes, abnormalities at capillaroscopy and above all lymphocytic or mixed alveolitis at bronchoalveolar lavage. The clinical outcome was favourable with regression of the alveolar lesions in the patient with pure lymphocytic alveolitis. It was unfavourable in patients showing severe alveolitis with polymorphonuclear cells. Histology revealed constant abnormalities of type I pneumocytes and rarefaction of type II pneumocytes, together with interstitial oedema and pulmonary fibrosis in which tissue mast cells could not be identified. The immunological disturbances observed in busulfan lung might enhance an initial toxic reaction and account for the often unfavourable outcome, even after withdrawal of busulfan.

Bronchoalveolar Lavage Fluid↗
PubMedDate not supplied

Alveolar macrophage membrane phospholipid methylation in sarcoidosis and hypersensitivity pneumonitis.

Methylation of phospholipids seems to be an essential step in the recognition and transduction of regulatory signals by eukaryotic cells. Phosphatidylethanolamine methylation was compared in alveolar macrophage membrane from patients presenting with pulmonary sarcoidosis or hypersensitivity pneumonitis and control subjects. Phosphatidylethanolamine methyltransferase (PMT1) activity was determined by various measures of incorporation of tritiated methyl group from (3H) S-adenosyl-L-methionine in membrane phospholipids. Tritiated methyl group incorporation in macrophage membrane was higher in some patients presenting with sarcoidosis or hypersensitivity pneumonitis, than in controls. PMT1 activity was found to be higher in sarcoidosis patients with a positive gallium lung scan. As lipids play an important role during macrophage activation and cell interaction, although a wide heterogeneity was observed in PMT1 activity, increased membrane phospholipid methylation seems to be an important feature in pulmonary diseases where macrophages are involved.

Adult↗
PubMedDate not supplied

[Angiotensin converting enzyme at different stages of extrinsic allergic alveolitis. Serum and alveolar study].

Angiotensin converting enzyme activity (ACE), albumin, potassium, and alpha1-antitrypsin were measured in the serum and in the bronchoalveolar lavage fluid (BAL) of 10 normal control subjects and of 19 cases of extrinsic allergic alveolitis (EAA). Among these 19 patients, 6 had a acute form of extrinsic alveolitis, 8 a subacute or chronic form, and 5 received a steroid therapy. Serum ACE is not increased in the acute forms of extrinsic alveolitis, but is significantly lower than control values in the subacute and chronic forms (p less than 0.04) and in patients under steroid therapy (p less than 0.002). The ACE/albumin, ACE/potassium, ACE/IgG and ACE/alpha1-antitrypsin ratios were measured in sera and BAL fluids. The results suggest that ACE is selectively transported across the alveolar capillary septum into the alveolar space. This transport, very important in control subjects, decreases in the subacute and chronic forms and in patients under steroid therapy. In the acute forms, the high level of ACE in BAL fluid is not due to an increased secretion of ACE, but is the result of an increased passive transudation of ACE from the vascular compartment across the inflammatory alveolar capillary septum.

Acute Disease↗