Biomedical subjects
Publications and source records attributed to M Meysman.
We present the case of a 74-year-old male patient with granulomatous nephritis due to sarcoidosis. We review the different possibilities of renal involvement in sarcoidosis and treatment modalities are discussed.
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The brown bowel syndrome is a rare disorder caused by vitamin E deficiency occurring in malabsorption syndromes. In patients with celiac sprue and chronic pancreatitis, the death rate from malignancy is high. We believe that vitamin E deficiency is responsible for the development of the brown bowel syndrome and may be partially responsible for the high incidence of malignancy in patients with celiac sprue and chronic pancreatitis. We report such a patient, and review the literature.
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We present a patient acutely ill from severe tuberculous meningo-encephalitis, in whom acute hepatic and renal failure, due to intercurrent septic shock, precluded the administration of full systemic dosage of antituberculous drugs. Daily direct intraventricular administration of 5 mg rifampicin, via a subcutaneous Ommaya reservoir connected to a catheter placed in the right lateral cerebral ventricle, resulted in rapid improvement without neurological sequelae. Intraventricular rifampicin administration for 50 consecutive days was well-tolerated without local or systemic side-effects. In well-selected patients with severe tuberculous meningo-encephalitis, intraventricular rifampicin may safely and highly effectively be added to systemic antituberculous therapy.
We report a case of aspergilloma in a necrotic small cell lung cancer, where poor pulmonary function and performance status of the patient precluded surgical treatment. High dose Itraconazole, a new oral anti-mycotic drug, was given for 13 months. During this treatment there was a decrease of the fungus ball size and no haemoptysis. Moreover control of the aspergilloma allowed chemotherapeutic treatment of the underlying bronchocarcinoma.
Little is known about the indications, safety and clinical usefulness of bronchoalveolar lavage (BAL) in elderly patients. In order to address these issues, we reviewed our last 200 consecutive BAL procedures, of which 23 (11.5%) were performed in patients older than 75 years (range 75-90, mean age 80.7 years, 13 men and 10 women). All procedures were well tolerated and no complications were observed. In 17 of the 23 patients (74%), BAL results were compatible with or diagnostic for infectious pneumonia (6 cases), idiopathic pulmonary fibrosis (5 cases), lung cancer (2 cases), hypereosinophilic syndrome (2 cases), chronic eosinophilic pneumonia (1 case) and lymphoma (1 case). In 6 of the 23 patients (26%), BAL yielded no specific diagnostic information. These data indicate that BAL is a safe procedure with a high diagnostic yield in an elderly population with pulmonary disease of unknown origin.
We present a 56-year-old woman with an infiltrate in the right middle lobe secondary to obstruction of the right middle lobe bronchus by extensive submucosal fibrosis. This unique stenotic lesion of a central bronchus was caused by a domestically acquired localised central obstructive bronchitis due to the inhalation of mixed dust fibers, in the absence of advanced silicosis. This complication is a rare presentation of the myriad of pulmonary diseases associated with mineral dust inhalation.
Our preliminary experience with the bronchoscopic application of cryotherapy using rapid decompression of liquid nitrous oxide as cooling agent is reported. Seventeen applications through rigid bronchoscopy in twelve patients were performed. A single cryotherapy session was successful in the debulking of obstructive malignant lesions of the central airways in five patients (four non-small cell carcinoma, one renal cell cancer metastasis), and in the treatment of a capillary haemangioma (one patient). Two sessions were successful in the treatment of a metastatic melanoma (one patient) and benign granulation tissue (one patient). Cryotherapy was also successful in the treatment of early bronchial cancer (carcinoma in situ) in four patients, requiring repetitive sessions in two. There were no complications or side-effects. These preliminary findings confirm the safety and efficacy of bronchoscopic cryotherapy in a variety of airway lesions.