[Pathologic diagnosis of mediastinal lymph nodes].
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Biopsy, Needle↗
Biomedical subjects
P Pierard
Publications and source records attributed to P Pierard.
[Pleural effusion].
A Spanish man is diagnosed with a non-small cell lung cancer with pleural extension. A chemotherapy combining cisplatin and gemcitabine allows obtaining an excellent partial remission. A contralateral pleural effusion is noted in a context of weight loss and fever. The differential diagnosis of pleural effusion is discussed.
Carcinoma, Non-Small-Cell Lung↗
Synchronous roentgenographically occult lung carcinoma in patients with resectable primary lung cancer.
OBJECTIVE: To assess the prevalence of synchronous roentgenographically occult lung carcinoma (ROLC) in patients with resectable roentgenographically visible lung cancer (RVLC). METHODS: Patients undergoing surgery for RVLC in the same University Hospital were prospectively evaluated before surgery by fluorescence bronchoscopy under local anesthesia to detect synchronous ROLC. All abnormal areas, with the exception of the RVLC, had biopsies made. RESULTS: From June 1996 to January 1999, 43 patients (male/female ratio: 1.7/1.0) were evaluated before lobectomy (n = 34) or pneumonectomy (n = 10) for 44 primary RVLC. There were 10 T1N0, 19 T2N0, 1 T1N1, 9 T2N1, 1 T3N0, 3 T1N2, and 1 T3N1 lesions. The histologic type was mainly squamous carcinoma (n = 21) and adenocarcinoma (n = 14). All but two patients were smokers or ex-smokers (mean +/- SD, 48 +/- 28 pack-years). A total of 177 endobronchial biopsies were performed (4.1 +/- 2.5); 8 were too small to be informative, 43 showed non-preneoplastic alterations, and 50 were normal. There were 7 basal cell hyperplasias, 56 metaplasias, 9 dysplasias, and 4 carcinomas in situ (CIS). All the dysplasias and CIS lesions were observed in eight subjects. The synchronous CIS were treated by surgery (n = 1) or localized therapeutic modalities (n = 3). CONCLUSIONS: The high prevalence of synchronous early lung cancers (9.3%) as well as metaplasia and dysplasia in this series of patients with resectable RVLC suggests that fluorescence bronchoscopy may be a useful adjunct in the preoperative evaluation of lung cancer.
Adenocarcinoma↗
Detection of bronchial preneoplastic lesions and early lung cancer with fluorescence bronchoscopy: a study about its ambulatory feasibility under local anaesthesis.
BACKGROUND: Autofluorescence bronchoscopy (AB) enhances the bronchoscopist's ability to diagnose bronchial preneoplastic lesions and early cancer. We undertook a study to assess its feasibility and performance under local anaesthesia on a real ambulatory mode. METHODS: Thirty-four consecutive patients at very high risk for lung cancer were prospectively studied by AB under local anaesthesia, without any sedation. Lidocaine doses, time, oxygen saturation, peak expiratory flow (PEF) and the number of cough episodes were measured. Continuous assessment of the respiratory sensation was obtained with a visual analog scale. A total of 172 biopsies were performed in abnormal and normal areas. RESULTS: The procedure was long-lasting (mean +/- SD: 26.6 +/- 6.0 min), required high total doses of Lidocaine (660 +/- 107 mg) without any significant side effect, and was associated with significant decreases in O2 saturation from 98.5 +/- 1.4 to 96.1 +/- 2.5% and in PEF from 380 +/- 96 to 310 +/- 78 l/min. However, the cough counts were moderate and the majority of patients reported no respiratory discomfort. 62 hyperplasia, metaplasia, dysplasia and carcinoma in situ (CIS) were detected and the relative sensitivity of AB +/- white-light bronchoscopy (WLB) versus WLB alone was 3.75 for intraepithelial lesions corresponding to moderate dysplasia or worse. CONCLUSIONS: AB, a procedure that increases our ability to recognize preneoplastic lesions and early lung cancer, can be performed under local anaesthesia, without systemic sedation in patients at very high risk for lung cancer.
Ambulatory Care↗
[Diagnosis and treatment of early-stage bronchial cancer: current status].
Lung cancer is the cancer with the largest mortality in Belgium. Nowadays, the most potent risk factor for lung cancer, tobacco smoking, is increasing, principally in teenagers. It is therefore necessary to intervene more efficiently in the natural history of the disease. This aim can be achieve by the early detection and the local treatment of small size lung cancer and in situ carcinoma. Interestingly, pulmonary preneoplastic lung lesions have been identified and characterized in the central airways as well as in the peripheral lung parenchyma. These preneoplastic lesions can evolve to invasive cancer or regress after tobacco smoking cessation or chemoprevention treatment. A new autofluorescence based endoscopy technique is described, that allows to detect preneoplastic pulmonary lesions and radio-occult lung cancer. These small sized lesions can be cured with endoscopic local treatment such as photodynamic therapy.
Adolescent↗
[Occupational asthma caused by isocyanates].
The aim of our study is to find whether the percentage of RAST positives to isocyanates within a company is a reflection of the exposure of the workers. Specific IgE was sought in 199 workers from ten companies where isocyanates were used. Twenty of them were followed for some time (june 87 to september 90). A non-exposed reference group was used for comparison. Measurements were made by the Pharmacia RAST-ELISA Method. In some cases, controls were made by RAST-RIA and CAPS ELISA/RIA. Results show that the proportion of positive RAST varies from one organisation to another and is probably a measure of the type and intensity of the exposure; the improvement of the working conditions to reduce the ambient concentration reduces, in time, the proportion of positive RAST; there were no positive RAST in the reference group; the conditions of taking and storage of blood samples before analysis influences the result. In conclusion, measurement of specific IgE may be an useful alternative to measurement of ambient concentration for following workers exposed to isocyanates.
Antibody Specificity↗
[The effect of 300 mg ranitidine, 800 mg cimetidine and a placebo administered after the evening meal on 24-hour gastric pH in duodenal ulcer].
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Adult↗
[The role of serology in the diagnosis of Helicobacter (Campylobacter) pylori infection].
The purpose of the communication is to review the different aspects of the Helicobacter (Campylobacter) pylori infection. The first part of the communication is devoted to the description of the different gastric pathologies induced by the Helicobacter pylori infection and to the different methods used for the detection of this infection. Today a consensus assesses a causal role to Helicobacter pylori in the development of chronic active gastritis (or type B gastritis), in the pathogenesis of duodenal ulcer, and a major contributing factor in the development of peptic ulcer disease. The possible role played by this bacterium in the development of non-ulcer dyspepsia is still unclear. H. pylori infections can be detected using different methods including invasive methods--requiring an endoscopy (e.g.: culture of the micro-organism, urease test, microscopy) and non-invasive methods (e.g.: breath test, serology). Each of these methods has advantages but also some disadvantages, and none shows an absolute sensitivity and specificity. The second part of the presentation analyses the results obtained with a serologic method using a specific fractioned and purified antigenic complex extracted from Helicobacter pylori. This report demonstrates a good correlation with the other detection methods. Serology appears also as a useful tool for the therapeutical monitoring of infected patients. Serological results must however be interpreted in the light of the complete clinical examination of the patient.
Antibodies, Bacterial↗