[Dysfunction of the vocal cords simulating asthma].
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Adolescent↗
Biomedical subjects
J P Courtin
Publications and source records attributed to J P Courtin.
[Respiratory manifestations of leptospirosis. A retrospective study of 91 cases (1978-1984)].
Leptospirosis, an ubiquitous zoonotic disease, is a systemic infection usually producing fever with hepatorenal involvement, meningoenephalitis, and hemorrhage. Respiratory manifestations are less well known but have been described in certain regions such as Southeast Asia or the Reunion Island. From January 1978 through December 1994, 154 cases of documented leptospirosis were admitted to the South Reunion Hospital Center. Pulmonary involvement was observed in 91 of these cases (59.1%) with hemoptysis (37.4%) and radiological evidence of bilateral reticulonodular infiltration (40%). Extra-pulmonary manifestations in most cases suggested leptospirosis at admission. Thirteen consecutive patients underwent endoscopy explorations with bronchoalveolar lavage: intra-alveolar hemorrhage was evidenced in all cases. This highly typical pattern of cytolysis would emphasize (20.8%) when the classical extra-pulmonary signs are too discrete to suggest the diagnosis. In this series, 10 patients required ventilatory assistance and 2 were given corticosteroid boluses for massive hemoptysis. Mortality due to leptospirosis is two-fold higher in cases with pulmonary involvement.
Adolescent↗
[Patent and occult intra-alveolar hemorrhage in leptospirosis].
PURPOSE: Pulmonary involvement (PI) is common in leptospiral infection, usually characterized by hemoptysis and diffuse bilateral infiltrates on chest radiographs. Alveolar haemorrhage (AH) has already been proved by autopsy and some case-reports with fiberoptic bronchoscopy (FB) and bronchoalveolar lavage (BAL). The purpose of this study was 1/to evaluate the incidence of AH in leptospirosis 2/to define the impact of BAL on the early diagnosis of the infection. PATIENTS AND METHODS: FB with BAL were performed in 23 consecutive patients with leptospirosis (13 patients with patent signs of PI: group 1, 10 patients without: group 2). AH was defined by a percentage of siderophages > or = 20% and/or a Golde score > 100 and/or an haemorrhagic aspect of BAL fluid. Culture tests were performed on specific medium. RESULTS: We diagnosed AH in all patients of group 1 and in 7 patients of group 2. Filaments were seen in 6 specimens of BAL fluid, initially thought to be leptospires, but culture tests were negative. CONCLUSION: AH is identified in all cases of leptospirosis with PI. Occult AH often occurs to patients without any respiratory symptom. Physicians should consider leptospiral infection in the differential diagnosis of AH. Culture-tests for leptospirosis in BAL do no help in diagnosing leptospirosis.
Adult↗
[Pulmonary complications disclosing polymyositis. 2 new cases].
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Adult↗
Plasma DNA as a marker of cancerous cell death. Investigations in patients suffering from lung cancer and in nude mice bearing human tumours.
Plasma DNA that circulates mainly as mononucleosomes is a cell death marker. Its significance and prognostic value in cancer as compared to other tumour markers was investigated in 68 patients hospitalised for lung cancers. Prognostic values of the various studied parameters were evaluated using the Cox's model. The cellular origin of plasma DNA was further investigated in nude mice transplanted with human lung adenocarcinoma. Plasma DNA concentrations were increased in cancer patients as compared to normal subjects (P < 0.01). They were higher in patients with extended (Stage 4) disease than in patients with limited stage disease (P < 0.05). Plasma DNA concentrations, serum lactate dehydrogenase activities and neuron-specific enolase concentrations were correlated all together in small cell lung carcinoma (SCLC) and in non-SCLC. Similar relationships were found between survival and each of these three cell death/tumour markers (P < 0.02-0.005). Plasma DNA from mice bearing human tumour hybridised with both mouse and human plasma DNA, while plasma DNA from endotoxin-injected mice hybridised only with mouse plasma DNA. In conclusion, in patients suffering from lung cancer, plasma DNA as well as LDH and NSE represent cell death markers that are correlated with survival. At a time when apoptosis pathways appear to be potential targets for cancer therapy, plasma DNA is a cell death/tumour marker that should be taken into account in studying the cancerous process in human diseases.
Adenocarcinoma↗
[Diffuse alveolar hemorrhage and myositis in icterohemorrhagic leptospirosis. Rapid control by a single bolus of corticoids].
Leptospirosis is one of the commonest causes of diffuse alveolar haemorrhage. Despite good sensitivity to penicillin and current techniques of ventilation, there remains a considerable mortality which is particularly linked to the initial pulmonary disease at presentation. The authors describe a new case of a gravely ill patient with leptospirosis and sever hypoxaemia. There was diffuse alveolar haemorrhage and myositis thus a bolus of corticosteroids was used over the first 24 hours complementary to the traditional treatment.
Adrenal Cortex Hormones↗
[Efficacy of octreotide acetate in the treatment of a pancreatic-pleural fistula. Apropos of a case].
Diseases organs below the diaphragm should be considered in the aetiologic diagnosis of liquid effusion in the pleura. We observed a cases of pleuritis resulting from chronic pancreatitis and present here the diagnostic methods and therapeutic protocol undertake for cure. The level of amylase (including the isoforms) should be measured in the pleural effusion. The effectiveness of octreotide acetate in the treatment of pancreatico-pleural fistula was confirmed in this case.
Aged↗
[Pneumorenal syndrome induced by d-penicillamine: Goodpasture's syndrome or microscopic polyarteritis?].
Diffuse alveolar haemorrhage associated with glomerulonephritis is a rare but serious complication of d-penicillamine therapy. A case is reported which illustrates the usefulness of bronchoalveolar lavage and kidney needle biopsy for the early diagnosis of this condition. A search for antiglomerular basement membrane antibodies in serum was negative, whereas antigranulocyte cytoplasmic antibodies were present. These immunological results differentiated the disease from Goodpasture's syndrome to which it is clinically related and placed it in the same category as microscopic polyarteritis. After treatment with corticosteroids, cytostatic drugs and plasmapheresis, the outcome was favourable in contrast with the usually poor prognosis.
Aged↗