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J R Viallat

Publications and source records attributed to J R Viallat.

At least 19 recordsLinked to original sources
PubMed1992

[Diseases of the pleura. Materials used and study technics].

Pleural diseases frequently pose problems to the pulmonary physician. The clinical and radiological approaches are often insufficient and it is necessary to resort to techniques which enable a precise morphological diagnosis of the pleural lesion. Starting with a needle puncture and biopsy, the medical investigation of the pleura has been enriched by thoracoscopy which enables visualisation of not only the parietal and visceral pleura and the lung but also the mediastinum and the pericardium. Using this technique the diagnostic yield and the harmless nature of the technique are of the first importance. After recording traditional techniques of investigation of lung disease (puncture, needle biopsy) the equipment, the technique, the indications and the risks and the diagnostic results from thoracoscopy are discussed.

Biopsy, Needle↗
PubMed1991

Activity of intrapleural recombinant gamma-interferon in malignant mesothelioma.

Twenty-two consecutive patients with malignant diffuse pleural mesothelioma were treated with recombinant gamma-interferon by the intrapleural route. Diagnosis was made by thoracoscopic examination and all cases were confirmed by the French Mesothelioma Panel of Pathologist. Patients were staged based on thoracoscopic examination and computed tomography (CT) scan: 12 patients were classified as Stage I and 10 were Stage II. A solution of gamma-interferon (40 X 106 U) was infused twice a week over 2 months. Every patient experienced fever. One patient had a Grade 2 leukopenia and one patient suffered from pleural empyema. Response evaluation was based on the following: (1) CT scan performed 2 weeks after treatment ended, and (2) repeat thoracoscopic examination with histopathologic verification in nine patients who had demonstrated a stabilization or a regression of the disease on CT scan. From the original group, 19 patients could be evaluated. Four complete thoracoscopic histopathologic responses and one partial response were observed in Stage I patients (56%). One partial response was observed in Stage II patients.

Alkaline Phosphatase↗
PubMed1991

[Kaposi's sarcoma in AIDS. 70 cases].

Although Kaposi's sarcoma is the most frequent of malignant diseases associated with AIDS and one of the first recognized manifestations of the syndrome, its management has not yet been standardized. This study concerns 70 AIDS patients with Kaposi's sarcoma followed up in the author's hospital department between june 1985 and december 1989. Most of these patients were homosexual or bisexual males. The mean time elapsed between the finding of a positive HIV test and the discovery of Kaposi's sarcoma was 15 +/- 3.2 months. Systematic evaluation disclosed visceral lesions in 50 percent of the patients. Chemotherapy was used in 55 cases, interferon-alpha in 23 cases and radiotherapy in 13 cases. The presence of visceral lesions clearly reduced survival time, although deaths were mainly due to opportunistic infections. Atypical forms of Kaposi's sarcoma sometimes make its diagnosis difficult, but the main problem is that of treatment, in view of the underlying immunodepression. The authors advocate the setting up of multicentre trials aimed at determining the best therapeutic approach in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Epidemiology and etiology of mesothelioma].

The early diagnosis of mesothelioma rests on very common clinical evidence, including pleuritis of recent onset, history of contact with asbestos chest pain, often moderate loss of weight and slight changes in old pleural images. The sensitivity of formal diagnostic examinations is 23 p. 100 for pleural fluid cytology, 24 p. 100 Adams' needle biopsy and 93 p. 100 for thoracoscopy, where the only negative results are obtained in patients with adhesive pleuritis. Prognosis depends on several factors, the most favourable ones being the histological type of the lesion (epithelial or mixed), the fact that it is limited to the parietal or diaphragmatic pleura and, on the patient's side and accessorily: female sex, lack of exposure to asbestos, age under 50, good general condition and absence of chest pain.

Asbestos↗
PubMed1990

[Diagnosis and prognosis of malignant mesothelioma].

The early diagnosis of mesothelioma rests on very common clinical evidence, including pleuritis of recent onset, history of contact with asbestos, chest pain, often moderate loss of weight and slight changes in old pleural fluid cytology, 24% for Adams' needle biopsy and 93% for thoracoscopy, where the only negative results are obtained in patients with adhesive pleuritis. Prognosis depends on several factors, the most favourable ones being the histological type of the lesion (epithelial or mixed), the fact that it is limited to the parietal or diaphragmatic pleural and, on the patient's side and accessorily: female sex, lack of exposure to asbestos, age under 50, good general condition and absence of chest pain.

Adult↗
PubMed1990

[Treatment of mesothelioma with interferon gamma and interleukin 2].

Interferon gamma was first used in 10 patients with mesothelioma in doses of 20 x 10(6) IU administered intrapleurally twice a week for 2 months without success, then in 25 patients (12 in stage I, 11 in stage II or IV) in doses of 40 x 10(6) IU. Out of 20 assessable patients, 4 showed complete response (CR) confirmed at thoracoscopy or thoracotomy; 1 stage I patient and 1 stage II patients showed partial response (PR). Interleukin 2 was administered by continuous intrapleural infusion in increasing dosage. Out of 3 stage I patients, 1 showed CR and 2 showed PR; 4 partial responses were observed in 11 stage II, III or IV patients. The 5/15 CR rate at stage I is exceptional in mesothelioma. In stage II patients the effectiveness and modalities of treatment require further investigations.

Adult↗
PubMed1989

Bilateral pleural plaques in Corsica: a marker of non-occupational asbestos exposure.

In north-east Corsica, asbestos outcrops are a source of environmental pollution, as assessed by airborne concentrations of chrysotile and tremolite that are significantly higher in the north-east than the north-west. For this reason we compared the frequencies of patients with asbestos pleural plaques in these 2 regions by checking the X-rays of 1721 patients born in north Corsica who had not undergone any occupational exposure to asbestos. The percentage of plaques was respectively 3.7% in the north-east, and 1.1% in the north-west (p less than 0.05). The relative risk of 3.3 demonstrates a strong relationship between environmental asbestos and the pleural plaques found in north-east Corsica.

Aged↗
PubMed1989

[The frequency of Kaposi's bronchial sarcoma in AIDS. Personal experience in 1987].

In 1987 we carried out 87 broncho-alveolar lavages in 58 HIV positive patients: of these 17 suffered from AIDS and Kaposi sarcoma. Amongst the latter we noticed signs suggestive of bronchial Kaposi sarcoma on five occasions: this is a frequency of 29.5% for the AIDS + Kaposi sarcoma group and of 8.6% for the group overall.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Pleural plaques and an asbestos environment in Northern Corsica].

As opposed to North-West Corsica, North-East Corsica is rich in asbestos outcrops and a source of environmental pollution as can be seen in the airborne concentration of chrysotile and above all tremolite. We have composed the frequency of asbestos pleural plaques occurring in subjects in the two regions starting with a retrospective analysis of the radiological records of 1,721 patients born in Northern Corsica and having no occupational exposure to asbestos. The frequency is 3.8% in the North-East and 1.1% in the North-West (p less than 5%). The relative East-West risk, which is 3.3%, shows the existence of a link between pleural plaques and environmental exposure to asbestos in North-East Corsica.

Aged↗
PubMed1986

[Study of 2 markers, keratin and neuron-specific enolase, in bronchial cancers].

In an immunohistochemical study 31 patients with bronchial cancer (squamous cell 9, large cell 4, small intermediate cell 11 and oat cell 7) were investigated for keratin and NSE. Keratin seems to be a valuable marker since only oat cell cancers and 45% of small intermediate cell cancers were negative. In contrast, marking with NSE seems to be non-discriminating. The low value of NSE as marker was confirmed by 133 serum NSE assays performed in 39 bronchial cancer patients. Although NSE values were significantly higher in oat cell cancer, in any given patient serum assays can, at best, detect relapses.

Bronchial Neoplasms↗
PubMed1986

[Thoracoscopic talc poudrage in pleurisies of blood diseases].

A total of 20 patients aged 50.5 +/- 4.5 years with 24 chronic pleural effusions associated with lymphomas underwent 24 thoracoscopic talc poudrages. Effusions were serofibrinous (32%), hemorrhagic (41%), or chylous (27%). The mean volume of pleural liquid evacuated by repeated thoracenteses before thoracoscopy was 5.2 +/- 0.6 l. Thoracoscopic biopsies confirmed a lymphomatous infiltration of the pleura in 95.5% of cases. A definitive pleural symphysis was obtained in all cases but 2 (92% positive results): in 1 case, a further single thoracentesis of 400 ml was necessary, and in the 2nd case the patient died within 6 days from an acute evolution of her Hodgkin's disease. The mean drainage time was 4.8 +/- 0.2 days. Overall results are thus identical to those obtained in solid tumor-related pleural effusions (91% positive results).

Adolescent↗
PubMed1986

[Pleurisy in blood diseases: value of thoracoscopic poudrage].

Twenty-five pleural effusions which occurred in 21 lymphoma patients (mean age: 50.6 +/- 4.6 years) were treated by pleural poudrage during thoracoscopy. The effusion was either serofibrinous (32%) or haemorrhagic (41%) or chylous (27%). The mean amount of fluid removed before poudrage was 5.2 +/- 0.6 litres. Thoracoscopy confirmed direct pleural invasion in 95.5% of the cases. Permanent pleural symphysis was obtained in all but 2 patients: one who required one single puncture withdrawing 400 cc, the other with mesothelioma on cured Hodgkin's disease, which was a failure. The mean duration of drainage was 4.8 +/- 0.2 days. The results obtained were identical with those reported with pleurisy in solid tumours.

Adolescent↗
PubMed1986

[Asbestos and cancer of the larynx].

Two hundred subjects were evaluated using a standardised questionnaire in order to determine possible exposure to asbestos: 50 patients with a carcinoma of the larynx (mean age: 59.2 +/- 1.6 years), 50 patients with a carcinoma of the bronchus (mean age 61.2 +/- 1.5 years) and 100 controls. Rates concerning exposure to asbestos were 27.8%, 23.4% and 4% respectively. The difference between the carcinoma patients and the controls was significant (p less than 0.001). The mean time lapse between the first exposure to asbestos and the development of malignant disease was shorter for the larynx (28.5 +/- 4 years) than for the lung (46.2 +/- 4.2): p less than 0.01. This study confirms the aetiological role of asbestos in the pathogenesis of carcinoma of the larynx as well as carcinoma of the lung, and raises the problem of their medicolegal compensation.

Alcoholism↗
PubMed1986

Bilateral pleural plaques in Corsica: a non-occupational asbestos exposure marker.

The North-East quarter of Corsica being rich in asbestos deposits, we checked the chest radiographs of 1721 patients born in North Corsica, without occupational exposure to asbestos, in order to show an excess of asbestos pleural plaques in those born in the N.E. quarter. Of the 56/1710 patients with bilateral plaques, 53 were born in N.E., and three in N.W. The incidence of plaques was thus respectively 3.7% and 1.2% (p less than 0.05). The site of birth of these 56 patients was compared to that of 213 matched control patients without plaques, born in North Corsica. The percentage of patients with plaques born in villages with asbestos deposits was 94.6 per cent, versus 58.2 per cent for the control patients; the relative risk index is 12.7. This work is the first report of environmental asbestos plaques in Western Europe.

Aged↗