[Pulmonary lymphangiomyomatosis. Apropos of 6 cases].
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Biomedical subjects
Publications and source records attributed to M Oury.
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Flow DNA analysis was performed on samples from 71 surgically removed lung cancers and from 145 patients undergoing bronchoscopy. Abnormal DNA stem lines, characterized by their DNA index (DI), were frequently observed in operated lung carcinomas (87%). Two or three abnormal DNA stem lines were discovered simultaneously in 10% of the samples. The mean DI of all abnormal tumor stem lines was lowest for rare tumor cell types and highest for adenocarcinomas. Intermediate mean DI values were found for epidermoid and small cell carcinomas, which were among the most proliferative tumors. The high rate of false negative results suggests poor diagnostic reliability of flow DNA analysis on bronchoscopic samples. However, the method appears to provide a promising objective tool capable of evaluating tumor behavior and prognosis.
The authors report 2 cases, in which recurrent and reversible atelectasis of the left lung was the only manifestation leading to a diagnosis of post-traumatic aneurysm of the thoracic aorta at an early stage (D + 5). Other classically described signs were absent. These 2 cases demonstrate the need to seek an aortic aneurysm following any severe trauma. They emphasize the importance of bronchial endoscopy in this type of trauma. They confirm the value of CAT scan investigation.
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The measurement of respiratory resistance by forced oscillations, a theory known for over 20 years, has found a practical application by a simplification of the method. The comparison with the plethysmographic measurement of the resistance of airways in 27 healthy children shows a good correlation (r = 0,73), similarly with F.E.V1 (r = 0,78) and peak flow (r = 0,61). This technique does not require the forced expiration demanded by the measurement of F.E.V1 and peak flow and it does not need the costly equipment of body plethysmography. In this technique the causes of error are easy to detect. Its rapid execution and the absence of discomfort should make it a choice method in the functional respiratory tests in the child.
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In a retrospective study of 112 observations, the authors studied the sequelae on respiratory function in pulmonary tuberculosis bacteriologically cured. With the help of a standardized clinical enquiry they defined three groups of patients: groupe I, 31 patients with parenchymatous sequelae but free of bronchopathy and parietal sequelae; groupe II, 45 patients presenting besides parenchymatous sequelae signs of chronic bronchopathy; group III, 36 patients with parietal sequelae. Complementary examinations confirmed the frequency and degree of functional respiratory alterations: --ventilatory handicap in 87% of cases; --scintigraphic lacunae much wider than the radiological images, in more than half of the cases; --hematosis disorders in 65% of the 73 patients tested; --pulmonary arterial hypertension, at least in effort, in 62% of the 58 patients examined by microcatheter. The study by groups showed the particular severeness of an association of tuberculosis sequelae with chronic bronchitis. The existence of parietal sequelae is an additional feature of severeness. The presence of functional deficiences, all the more serious that they are evaluated late; suggests a progressive worsening of these patients' respiratory condition.
The authors report two cases of Löfgren's syndrome, preceded by febrile polyarthritis with rise in antistreptolysin titer. The relationship between sarcoidosis and rheumatic fever is discussed. A review of the literature concerning Löfgren's syndrome with joint pain, permitted the authors to follow the course of present pathogenic concepts which haveled to the present opinion of the sarcoidosis nature of Löfgren's syndrome, when the latter is accompanied by erythema nodosum. The prolonged rise in antistreptolysin 0 titer which might suggest rheumatic fever, was not explained, but as the streptococcus was never found in throat swabs, it is probable that this was a non-specific phenomenon. However, certain authors believe that streptococcal infection, where it exists, may play a role, if not in the etiology of the sarcoidosis, at least in the Löfgren's syndrome which may lead to its discovery.
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