PubMed Health⌕ Search

Biomedical subjects

P H Thoreux

Publications and source records attributed to P H Thoreux.

13 recordsLinked to original sources
PubMed1996

Necrotizing sarcoid granulomatosis with and without extrapulmonary involvement.

Three cases of necrotizing sarcoid granulomatosis (NSG) are reported. All 3 patients had pulmonary lesions; one of them had additional extrapulmonary lesions which were ophthalmologic (dacryoadenitis) and digestive (ulcerative colitis). This patient was followed for 5 years and developed several respiratory, ophthalmologic and digestive recurrences. In 2 cases the diagnosis of NSG had been initially overlooked and the authors emphasize the difficulties of this histologic diagnosis in terms of the differential diagnosis with other necrotic and granulomatous pulmonary diseases such as tuberculosis and Wegener's granulomatosis. They stress the possibility of extrapulmonary lesions in NSG and discuss the relationship between NSG and sarcoidosis.

Adult↗
PubMed1995

A computer-assisted case report and diagnosis system: sharing the knowledge database ADM and using hypermedia techniques.

The practice of medicine is characterized by its great variability and by many rare diseases. When the medical students work in hospital units, they must learn the general medical practice in the care of the patient. The purpose of this work was to present a French multifunction decision aid system using artificial intelligence techniques and Hypercard tools for different modules. Through an ergonomic interface, the system assists the user in the construction of medical observations, suggests diagnostic hypothesis, provides documentation and helps the user perform retrieval tasks. The knowledge comes from senior experts and from the pre-existent and large knowledge database, ADM.

Computer Peripherals↗
PubMed1993

[Pneumoblastoma. Apropos of a case].

The authors report a case of pulmonary blastoma, a rare type of pulmonary malignant tumour. The patient was treated by pneumonectomy combined with chemotherapy and radiotherapy. The outcome was favourable, and during an 11-year follow-up there was no sign of recurrence.

Combined Modality Therapy↗
PubMed1991

[The diagnostic value and therapeutic perspectives of monoclonal antibodies in bronchopulmonary cancer].

Monoclonal antibodies (AcM) have opened up new perspectives in the study of cancer. The production of murine AcM has been well described in the past. The characterisation of the antigen which they recognise and their in vitro and in vivo biological properties has led to their use in diagnosis and in due course to therapeutic possibilities. The specificity of AcM "vis a vis" certain molecules or tumour associated antigens enables their utilisation for diagnosis and their widespread use for the labelling of tumour markers. AcM may in difficult cases be more accurate in specifying the histological type of a bronchopulmonary or pleural tumour; by coupling the antibody to a radio isotope and injecting it into the circulation. This enables the detection of tumours in vivo by immunoscintigraphy. The numerous problems linked to the technique and above to biology of AcM limits its clinical value in assessing the degree of extension either locally or regionally of bronchopulmonary tumours. The therapeutic applications are at this stage experimental and above all studies have shown the limits of AcM used alone or coupled to a radio isotope, a toxin or a drug. The limits of the technique are linked to numerous factors, such as accessibility of the antigen site, the heterogeneity of tumour markers and non specific fixation and immunogenicity of the AcM. The experimental clinical stage should be continued in order to define the most effective utilisation of AcM in therapy which will doubtless be complementary to other forms of treatment.

Animals↗
PubMed1990

The hyperimmunoglobulinaemia E and recurrent infections syndrome in an adult.

A 27 year old white woman with a history of chronic eczema and episodes of serious infection of the chest, skin, and bone presented with acute respiratory failure. She was found to have a spontaneous right pneumothorax and a pneumatocele in the left upper lobe. Despite a left upper lobectomy she was left with chronic respiratory failure, bullous lung disease, and bilateral bronchiectasis. The hyperimmunoglobulinaemia E and recurrent infections syndrome was diagnosed only in adult life.

Adult↗
PubMed1989

[Post-intubation right paratracheal abscess. Apropos of a case].

We report the case of a young woman who had undergone a difficult emergency intubation and rapidly developed a mediastinal collection of pus. Mediastinoscopy, requested for diagnostic purposes, was also therapeutic as it drained the abscess. The patient received a course of antibiotics and was cured without sequelae. Accidents of tracheal intubation are severe, especially when unrecognized. They often include perforation of the oesophagus resulting in mediastinitis or abscess with an estimated 30 to 40% mortality rate, and they constitute a medico-surgical emergency. In the case reported here mediastinoscopy was crucial, but the theoretical value of computerized tomography must be stressed since this method not only detects the lesion but is also used to perform a guided drainage.

Abscess↗
PubMed1989

[Adult respiratory distress syndrome, a manifestation of severe pneumococcal infection].

A retrospective study analyzing the case notes of 49 hospitalized adults, either in intensive care (n = 26) or in thoracic medicine units (n = 23), for acute bacteriologically proven pneumococcal pneumonia based on samples obtained other than by sputum examination. The mortality was 54% in intensive care and 17% in the thoracic medicine unit. This significant difference may be explained in part by a respiratory distress syndrome in whom there were adequate criteria on admission for 7 patients in the intensive care group. Among these latter only one patient had had a splenectomy. The others did not have underlying disorders (three were chronic alcoholics); 7 patients were shocked on admission, four with a leukopenia less than 5,000/mm3 and six had a thrombocytopenia less than 100,000/mm3; finally 6 had a temperature of less than 38 degrees C. 7 patients died in less than four days (mean 2 days) in a clinical context of refractory hypoxemia. The significance of the respiratory distress syndrome is probably very different from the usual pneumonia; it seems rather to be an integration of the toxins induced by the pneumococcus. Its presentation can be particularly misleading as regards the diagnosis; the prescription of antibiotics once a diagnosis is obtained would seem insufficient by itself in this context to obtain a cure.

Adult↗
PubMedDate not supplied

Influence of the teleradiology technology (N-ISDN and ATM) on the inter-hospital management of neurosurgical patients.

We set out to assess the influence of a teleradiology network on the relations between a general hospital and a 100 km distant university hospital in the context of neurosurgical emergencies, and compared a commercially available technology, N-ISDN (Narrowband Integrated Service/Digital Network), to an emerging technology, ATM (Asynchronous Transfer Mode). The evaluation was conducted using records of advice request calls and patient transfers. Three phases were considered: without teleradiology, with transfer of digitized images over N-ISDN at 64 kbps, and with an experimental ATM network at 10.5 Mbps with DICOM image transfers and videoconferencing. Additionally, staff meetings over ATM videoconferencing were set up. To assess the ATM service, we used log files and questionnaires, 108 advice requests were studied over a 18 month period. The average transmission time for one examination was 38 s with full DICOM image resolution over ATM, versus 150 s with 10:1 JPEG (Joint Photographic Expert Group) compression over N-ISDN. Up to 50% unnecessary patient transfers were avoided. Advice requests increased fourfold, and non-urgent advice requests increased from 0 to 21%. Despite the experimental configuration of the ATM network, the service gave satisfaction to all the physicians. Videoconferencing was unanimously regarded as a prominent tool to improve the quality of interaction. It was particularly useful for non-urgent cases and distant staff meetings. Teleradiology can improve the relations between hospitals through an increase of urgent and non-urgent advice requests. Asynchronous transfer mode is an efficient way for fast transfer of radiological examinations in DICOM format and for discussing them through high-quality videoconferencing.

Brain Neoplasms↗
PubMedDate not supplied

A microcomputer teaching and decision-support system for emergency medicine: use of hypermedia and artificial intelligence in combination.

Hospital emergency units are submitted to a continuous intensive and polyvalent practice of medicine. In addition to the few experienced physicians, the medical staff is often made up of young and unskilled students and residents. The ability to reach at any time a wide and flexible knowledge is of the utmost importance to improve the quality of care given to patients and to perfect bedside teaching. The purpose of this work was to present a computerized system, a kind of shell, using, in combination, artificial intelligence and hypertext/hypermedia tools. A modular architecture is presented integrating two entities: an illustrated encyclopedic hypertext network and several expert modules based on production rules concerning well-limited fields of medicine (basic clinical problem-solving, metabolic and acid-base disorders). An interface using the World Wide Web (WWW) will soon be proposed.

Artificial Intelligence↗
PubMedDate not supplied

[Pleural thymoma. Apropos of a case and review of the literature].

The authors report a case of pleural tumor discovered in case of thoracic pain in a 72 year old woman. This lesion, discovered on chest X-Ray, developed in the left costo-vertebral groove and was seen as a homogeneous opacity, multilobate, well-defined. CT confirmed the pleural origin, showed a thickening of posterior pleural, a polylobate tumor well-defined on its lung side, non-invasive and of tissue density. Histopathological examination of the operative specimen showed it to be a thymoma with an exceptional localization.

Aged↗