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P Farisse

Publications and source records attributed to P Farisse.

At least 19 recordsLinked to original sources
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↗
PubMed1989

[Atrioventricular block, a complication of radiotherapy of the mediastinum].

Cardiac complications of mediastinal irradiation usually concern the pericardium, the ventricular myocardium and the coronary arteries. We report the case of a 42-year old woman who experienced a syncopal atrioventricular (AV) block 12 years after irradiation of a mediastinal Hodgkin's lymphoma. Electrophysiological recordings showed infranodal conduction disturbances. A review of the literature yielded only 12 cases of syncopal radiation-induced AV block. This case highlights the risk of syncopal AV blocks occurring a long time after mediastinal irradiation and leading to severe damage of the His bundle and its branches. The presence, as in our patient, of an associated right ventricular outflow tract stenosis confirms the importance and severity of radiation-induced cardiac lesions.

Adult↗
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↗
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↗
PubMed1985

[Yield of the thoracoscopic biopsy in experimental pulmonary infections in the immunosuppressed rabbit].

Using thoracoscopy lung biopsy we investigated the bacteriological diagnostic yield in immunodepressed and/or infected NZ rabbits. 84 rabbits were used: 18 controls, 30 immunodepressed rabbits and 36 rabbits immunodepressed and then infected with Aspergillus fumigatus. Candida albicans or B.C.G. The thoracoscopy technique was the one we designed for humans, the instruments were adapted to the size of animals. Thoracoscopy biopsy results were compared to those of surgical biopsies made in the same animals. The results of both techniques were similar: indeed, the sensitivity of thoracoscopy biopsy was 88.9% in immunodepressed rabbits (versus 100% with surgical biopsies), 86% in the group of rabbits infected with B.C.G. (versus 86%), 90.1% in rabbits infected with Aspergillus fumigatus (versus 100%) and 88.9% in rabbits infected with Candida albicans (versus 100%). The indications for thoracoscopic lung biopsy in immunodepressed patients with infectious lung diseases are drawn from these experimental data, from our experience and the known mortality and morbidity of surgical lung biopsy.

Animals↗
PubMed1981

Thoracoscopy in malignant pleural effusions.

In a consecutive series of 1,000 patients admitted since 1970 for pleural effusions, 215 with undiagnosed chronic effusions (with previous negative cytologic and needle biopsy results) underwent thoracoscopy. The investigation was usually performed under general anesthesia, originally with a 9-mm diameter cold light laparoscope, but, since 1978, with a 7-mm diameter thoracoscope of our design with biopsy forceps connected to a diathermocoagulating device. Thoracoscopy diagnosed 131 of 150 malignant effusions in the series. We observed no false positive results. A repeat pleural cytology and needle biopsy performed the day before thoracoscopy yielded only 41% positive results. The higher yield by our new thoracoscope (97% positive results, versus 78% with the laparoscope) can be accounted for by a better visualization of the pleural space, easier handling of biopsy material, and the systematic use of diathermocoagulation. Complications were rare, minor, and not life-threatening.

Biopsy, Needle↗
PubMed1981

[Current indications for thoracoscopy].

Thoracoscopy is performed at best with a rigid apparatus and a cold light source using a single or double site of entry into the chest. Biopsy under direct vision requires a double-spoon biopsy forceps that can be connected to diathermy to insure haemostasis and prevent any air leak age. Some authors prefer a local anaesthesia but a light general anaesthesia with or without intubation allows a safe and painless examination. Numerous biopsies can be obtained for subsequent examinations, like light or electron microscopy, immunofluorescence, bacteriology and mineral studies as well as search for hormonal receptors sites on tumours. Complications are rare and fatalities exceptional (4 cases in a review of the literature covering 3.384 cases. 2 of which occurred in a small series of 150 cases). In chronic pleurisies secondary to cancer, a diagnosis was made in 92% of cases. In suspected pleural mesothelioma, thoracoscopy allows both diagnosis and staging. In pleural tuberculosis, a diagnosis is obtained in 93% of cases. Talc pleurodesis in the treatment of chronic recurrent malignant pleural effusions is successful in 80%. In the treatment of spontaneous pneumothorax with a mean follow up of 10 years, only 6.6% recurred after talc poudrage, and functional sequelae were minimal; no talcomas induced mesotheliomas were seen in a review of 151 cases. Thoracoscopic lung biopsy has an 87 to 94% success rate depending on series, and is thus comparable to surgical biopsy with a markedly smaller morbidity and mortality. It should thus be used more widely by pneumologists.

Biopsy↗
PubMed1979

[Thoracoscopy in pleural mesothelioma. Diagnostic, prognostic and therapeutic interest (author's transl)].

Thoracoscopy with a single opening was carried out under general anesthesia with a cold light thoracoscope of 7 mm in diameter. Biopsies were taken under visual control for optical and electron microscopic examination. In a series of 40 mesotheliomas, 30 patients with pleural effusion underwent 36 thoracoscopies. In 29 patients the macroscopic lesions were compatible with the diagnosis of mesothelioma. The most specific aspects consisted in white-yellowish nodules, almost translucent, arising from the parietal pleura (9 patients). Another typical pattern, a dense pleural thickening, was found in 10 patients. In the remaining patients, the lesions observed were less specific. The biopsy was positive in 35/36 thoracoscopies (97%). A talc poudrage was carried out in 10 patients: their mean survival was 458 days. In ten matched mesothelioma patients who underwent pleurectomy the mean survival was only 395 days. In 12 patients at an early stage, the visceral pleura was not involved by the tumor: their mean survival was 636 days. In 11 patients both parietal and visceral pleura were involved by the tumor: their mean survival was 138 days: (p less than 0,001). It is concluded that in mesothelioma pleural effusions, thoracoscopy is a safe and efficient procedure in order to reach a precise diagnosis, prognosis and efficient palliative treatment of the effusion.

Humans↗
PubMed1978

Inorganic cytoplasmic inclusions in alveolar macrophages. The role of cigarette smoking.

A case of tobacco-associated pulmonary fibrosis, with the results of histological, ultrastructural, and spectrometric analysis is reported. Abnormalities of the alveolar macrophages, which are particularly affected by tobacco inhalation were found. The size of the macrophages was increased and many large, polymorphous inclusions, including fat vacuoles and granular deposits, which were either homogeneous or electron lucent vacuoles, were seen in the cytoplasm. A few laminar structures were observed. All of these lesions are frequently found in cigarette smokers. Still more interesting was the discovery of numerous fiber-, needle-, or laminar-like inclusions that varied in size from 0.2 to more than 2 mu. The digestions of the inclusions with potassium hydroxide confirmed the presence of various metals, such as sodium, magnesium, potassium, iron, sulfur, and especially, aluminum, and silicon; these last two elements correspond to the presence of kaolinite in the tissue, as has been previously described, and can be considered as evidence of the use of tobacco.

Aged↗
PubMed1977

[Abdominal echotomography in a pneumology department].

In the last years, echotomography has become an essential element in the diagnosis of a number of diseases. In pleuro-pulmonary pathology, echotomography is also valuable for diagnosing pleural diseases and in some pathological conditions affecting at the same time thorax and abdomen. Echotomography of the abdomen is advised in a number of cases. The diaphragm and regions above and below it should be tested when there are deformations of the cupolae and radiological images in the pulmonary bases. Liver is investigated to trace any possible hepatic localization of broncho-pulmonary cancers or any chest hydatidosis. Echographic investigation of pancreas is advisable when a tumour of glandular origin is diagnosed. For patients with mesotheliomas, it should be associated to a retro-peritoneal investigation.

Abdomen↗
PubMed1976

[Value of echotomography in pleuro-pulmonary pathology].

Echotomography based on the use of ultrasound as a diagnostic tool, little used until now in pleuropulmonary pathology, seems interesting and valuable and diserves to be counted amongst the various paraclinical examinations. Out of a hundred patients, we obtained the following results: -- 91.7% success in the needle biopsies done after echotomography. -- 84.4% success in exploring peripheral pulmonary tumor. -- 100% success in plotting: pleural thickening in which figures obtained with ultrasounds are very close to those obtained directly by needle. Echotomography in pleuropulmonary pathology has the following indications: -- for pleura effusions, pleural thickening and tumors; -- for pulmonary parenchyma: evolving or stable, solid or liquid masses, that are close enough to the thoracic wall; -- for mediastinum: lesions localized in the anterior mediastinum and related to the sternocostal wall. In all these cases echotomography brings valuable complementary information, sometimes allowing the location of fibrohyalin pleural plaques of asbestosis invisible on X rays. By combining a wider experience and the perfectioning of the equipment, this method could become a common practice in pleural pathology and thoracic oncology.

Asbestosis↗
PubMed1975

[Benign asbestosic pleurisies (apropos of 3 cases)].

Report is made on three cases of benign asbestosic pleural effusions that occured in subjects of more than 60 years in age that had had moderate but long occupational contact with asbestos (between 18 and 40 years). We are dealing here with pleural effusions that have an insidious onset and a chronic course, serofibrinous in nature for the three cases, moderately exsudative, with a relatively few accelerated blood sedimentation rate, a level of protids between 34 and 58 g/l and a level of dextrose between 0,70 and 1,15 g/l. Relapses were noted in two of the patients. In two of these cases existed associated pleural calcifications. Important sequelae persist after the cure that consist in pachypeuritis, and one of these cases was submitted to surgery. Confirmation of the diagnosis was found in the surgical material that contained asbestosic bodies; the sputum of the same patient contained also ferruginous bodies. The research of an occupational contact with asbestos has to be systematically performed in the case of subjects that exhibit, after a certain age, an apparently cryptogenetic pleural effusion.

Aged↗
PubMed1975

[Pleural biopsies: complications and current value of Abram's needle biopsy. Apropos of 1,000 samples. Value of pleuroscopic biopsy].

The frequency of incidents resulting from Abrams needle biopsy is very low provided certain contraindications are respected : pneumothorax, 3.1% of cases ; hemorrhages, 1.3% ; neoplastic contamination of the bioptic tract, 1.9%. Serious accidents are rare. We only observed 2 serious hemorrhages, one in 1964, the other in 1968. In the latter case, the pleural hemorrhage caused a very serious respiratory insufficiency. The delayed functional reaction is still not well known. However the occurrence of immediate accidents could reflect on radiological sequelae. The value of this examination seems today to decrease slightly at the same time as the frequency of pulmonary tuberculosis decreases. Indeed pulmonary tuberculosis is the main indication for this method because of the history and because of the possibility of culture on Loewenstein medium. In cancer, needle biopsy has two drawbacks, that of being blind and yielding only small samples, while pleuroscopy is free of them. In a series of 77 examinations including 45 cancers, the positivity reached 80%. In only 2 cases did pleuroscopy give a falsely positive result. In the remaining cases there was no neoplastic invasion of the pleura.

Biopsy, Needle↗