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P Reynaud

Publications and source records attributed to P Reynaud.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Rare tumors of the cervix: three case reports: rhabdomyosarcoma, granulocytic sarcoma and lymphoma].

Three rare cases of tumours of the cervix are reported: embryonal rhabdomyosarcoma, granulocyte sarcoma and lymphoma. There were particular problems with diagnosis in each case requiring histochemistry, immunohistochemistry and ultrastructure examinations. Embryonal rhabdomyosarcoma is a uncommon tumour in the adult. Clinically, there is a vegetative formation but no botryoid aspect. Striated muscle cell proliferation, suggested by the morphology of the malignant cells was confirmed by immunohistochemistry which demonstrated desmine and vimentine and by the ultrastructural study which demonstrated Z lines in the cytoplasm of the malignant cells. Granulocyte sarcoma is characterized by a non-tumoural non-destructive infiltration of inflammatory-like cells. Their granulocyte nature is confirmed by histochemistry, the Leder's reaction on frozen samples, immunohistochemistry (expression of NP57). Electron microscopy can also be used. The diagnosis of lymphoma is difficult due to the non-tumoural nature of the lymphomatous infiltration which can simulate inflammatory reaction. In our case, the diagnosis was made on the tumoural aspect of the biopsy made in the deep infiltration zone of an adjacent organ (bladder). Immunohistochemistry demonstrated the lymphoid nature of the tumour and identified a B phenotype. The ultrastructural study gave little information.

Adolescent↗
PubMed1995

[Pulmonary embolectomy in pulmonary embolism: surgery and endoluminal techniques].

Since Trendelenburg's first attempts in 1908, the techniques of embolectomy have progressed considerably. The reference method remains embolectomy under cardiopulmonary bypass, the development of which has reduced the operative mortality to 30-40% instead of 60% when embolectomy was performed without cardiopulmonary bypass. In the last few years, several techniques have been developed to perform embolectomy by percutaneous endoluminal methods. These procedures are difficult to initiate, little experimented in humans or still at the experimental stage in animals. Advances in the medical treatment of massive acute pulmonary embolism have reduced the indications of embolectomy which has become the exception reserved for the most seriously ill patients in whom the other methods are contraindicated or have failed.

Animals↗
PubMed1994

Perforin and granzyme B expression is associated with severe acute rejection. Evidence for in situ localization in alveolar lymphocytes of lung-transplanted patients.

To evaluate rejection episodes in lung-transplanted patients, we analyzed 31 bronchoalveolar lavage specimens for lymphocyte levels and lymphocyte expression of two intracytoplasmic activation markers, perforin, the pore-forming lytic protein, and granzyme B, a member of the serine esterase family. Using anti-human granzyme B and perforin mAbs, we show that their expression in alveolar lymphocytes is correlated with the severity of rejection as assessed by histological parameters and the patients' clinical status. The presence of these molecules may provide a prognostic parameter that will facilitate the patients' monitoring, particularly in cases with minimal acute lung rejection susceptible to rapid progression to severe rejection.

Biopsy↗
PubMed1993

Tracheobronchial amyloidosis with hilar lymphadenopathy associated with a serum monoclonal immunoglobulin.

We report a case of amyloidosis, restricted to the lower respiratory tract, with prominent tracheobronchial involvement and bilateral hilar lymphadenopathy, associated with a monoclonal serum protein of the immunoglobulin G (IgG) lambda type. The careful search for an extrathoracic site of involvement was negative. This particular association has not been reported previously.

Adult↗
PubMed1993

[Uterine metastases originating from breast cancer. Apropos of 12 cases].

The authors report a retrospective clinicopathologic analysis based on 12 cases of uterine metastases from breast cancer. The myometrium was more often involved than the endometrium, and a metastatic lesion occurred in an interstitial leiomyoma in one case. Bilateral ovarian involvement was associated in 11 cases. The histopathological type was predominantly represented by invasive lobular breast cancer in 10 cases: in this series, 3 subtypes were identified, the solid variant (6 cases), the classical variant (2 cases), and the alveolar variant (2 cases). The steroid receptor status in the tumor specimens was found to be constantly positive. The literature concerning the pathologic diagnosis was reviewed: most breast cancers metastasizing to the female genital tract and to the peritoneal surface appeared to be invasive lobular cancers.

Aged↗
PubMed1992

Rejection in lung transplantation--an immunohistochemical study of transbronchial biopsies.

The number, distribution, and phenotype of mononuclear cells infiltrating the allograft lung transplant were determined immunohistochemically with monoclonal antibodies directed against cellular antigens (CD3, CD4, CD8, CD22, CD25, CD16, CD56, CD68, HLA-DR) on frozen sections of transbronchial biopsies. Seventy-two transbronchial biopsies from 21 patients undergoing lung or heart-lung transplantation were evaluated histologically and immunohistologically in a prospective study. Four major results were obtained in the graft lung parenchyma: (1) whatever the histological grading of rejection, T lymphocytes expressing CD3 were present and in a significantly higher number than in control subjects (P < 0.0005); (2) there was a positive correlation between histological rejection and the number of CD3+, CD8+, CD25+, CD16+ cells (P < 0.01); (3) the CD4/CD8 ratio was inverted (0.52 +/- 0.04), with no correlation with the histological rejection; and (4) the number and location of CD3+, CD25+ cells did not correlate with CMV identification in bronchoalveolar lavage. Immunohistochemical criteria could be used for diagnosis of rejection in the management of heart-lung transplantation.

Adolescent↗
PubMed1991

Pulmonary embolectomy by catheter device in massive pulmonary embolism.

From 1982 to 1989, ECD was performed on 18 patients suffering from poorly-tolerated massive pulmonary embolism, for whom classic treatments (fibrinolytics and surgery) were impossible. Eleven of these 18 patients immediately improved (S group). This procedure was unsuccessful in other seven patients (F group). Thirteen patients survived (72 percent). The time lag between the first episode of pulmonary embolism and ECD was significantly shorter in the S group than in the F group (4.7 +/- 5.4 days vs 18.3 +/- 6.9 days, p = 0.0004). So was the elapsed time between the onset of hemodynamic impairment and ECD (13 +/- 12 hours vs 59 +/- 38 hours, p = 0.003). We conclude that ECD should be considered when other treatments are impossible especially when the first symptoms date back less than 15 days and the hemodynamic impairment less than 48 h.

Adult↗
PubMed1990

[Subcutaneous tunnelization of the subclavian vein. A bacteriological study of 400 catheters in hematologic intensive care].

Infectious complications are the highest risk in hematology. In this study, subclavian approach and tunnellization are reviewed. Four hundred (400) catheters were evaluated by the Isolator Culture method. Catheters are left in place a long time (mean time 30 days). Colonization occurs rarely (about 10.5%). In hematology, subclavian tunnelized catheter occurs to be a safe and reliable central venous catheter.

Adult↗
PubMed1990

A new series of antiarrhythmic procainamide derivatives: toxicity and activity-simulated passive absorption relation.

Several compounds derived from benzamidines and nicotinic pyridinic amidines with a structure similar to that of procainamide, exhibit notable antiarrhythmic properties after injection into animals. The diffusion rate of these different compounds through a solid lipidic artificial membrane was studied with Dibbern's apparatus. A statistical relation was established between the diffusion rate and the principal pharmacological parameters obtained after intraperitoneal injection (toxicity and anthiarrhythmic activity). Essential structural elements seem to determine a better bioavailability than procainamide: character of the substitution (in para) of the benzenic cycle; length of the lateral chain.

Absorption↗
PubMed1990

[Severe suicides: short- and long-term outcome. Assessment of their quality of life].

From January 1977 to December 1982, 160 patients (10 to 55 years old) were admitted in a traumatic Intensive Care Unit after serious attempted suicides. Hospital mortality rate was about 34%. A questionnaire was sent to alive patients in 1983 (median delay between attempted suicide and questionnaire: 3.5 years); 68 were alive in 1983, 46 answered to questionnaire, 3 were died (two according to a new suicide); 32 could not be found; 85% of contacted patients answered (they were comparable in age, sex and means used in their suicide attempts, to the others). One patient about two must be rehospitalised one or more times. One patient about two must be always take drugs; 85% worked. Over 50% of the patients considered they had returned to their former way of life but 50% presented increased difficulty to work, and 25% said that they had no sequelae. Any of these 46 patients had made an other attempt suicide.

Adolescent↗
PubMed1990

[Complementarity of transthoracic and transesophageal Doppler echocardiography in the diagnosis of thrombosis of a mitral prosthesis. Apropos of 3 cases].

The diagnosis of partial thrombosis of mitral disc valve prostheses is particularly difficult because the clinical presentation is often atypical and the motion of the two hemi-discs is hard to analyse by transthoracic echocardiography. The authors report three cases of partial thrombosis of mitral double-disc valve prostheses. It was not possible to analyse the motion of the two hemi-disc correctly in any of the three patients. The mitral transprosthetic flow recorded by continuous wave Doppler was abnormal with respect to the reference postoperative recording. In addition, in one case, an abnormal echo was observed floating in the left ventricular inflow tract and was suggestive of a thrombus. Transesophageal echo showed abnormal motion of one of the hemi-discs. In two patients this consisted in immobility of the hemi-disc in the semi-closed position; in the other patient, limited excursion of the hemi-disc was recorded. Abnormal retrograde flow in the left atrium was observed in 2 cases and abnormal echoes on the atrial surface of the valve were recorded in one case. After fibrinolysis the transthoracic and transesophageal Doppler echocardiographic parameters returned to normal. These three cases underline the complementarity of transthoracic and transesophageal echocardiography in the diagnosis of dysfunction of mitral disc valve prostheses.

Adult↗
PubMed1990

[Value and limitations of transthoracic Doppler echocardiography in the diagnosis of thromboses of mechanical valve prosthesis. Report of 19 cases].

The diagnosis of thrombosis of a valvular prosthesis is difficult especially in cases of partial thrombosis. The authors report 19 cases of partial thrombosis of mainly (16 cases) mechanical valve prostheses confirmed by radioscopy and treated either by reoperation or fibrinolysis. Mitral Valve Prostheses: 14 cases (6 Björk, 7 SJM, 1 Carbomedics). All but one case showed significant prolongation of the pressure half time compared with the postoperative reference value. In one case, however, the functional parameters of the prosthesis were normal; the diagnosis was made from the finding of a mobile thrombus on the ventricular surface of the prosthesis. Aortic Valve Prostheses: 5 cases (3 Björk, 1 SJM, 1 Duromedics). Continuous wave Doppler showed significant increases in the velocity of transprosthetic blood flow with respect to the postoperative reference values. Accurate analysis of the mobile elements of the prostheses was usually impossible. These results show that transthoracic Doppler echocardiography remains an excellent method of study and surveillance of mechanical valve prostheses but the limitations of the technique should be familiar to all operators.

Aged↗
PubMed1990

[Two-dimensional echocardiography in the diagnosis of intracardiac metastases].

The authors describe the echocardiographic features of 19 cases of intracardiac metastatic tumours diagnosed over a 5-year period. The cardiac appearances were very varied: pericardial effusion alone or associated with an intrapericardial tumour (9 cases), myocardial infiltration (9 cases), immobile or mobile intracavitary tumour sometimes simulating a myxoma (15 cases). In 18 out of the 19 cases, the tumour mass was hyperechogenic which made it easy to diagnose. However, in one case of right atrial tumour, the mass was hypoechogenic and the diagnosis could only be made by contrast echocardiography. This study illustrates the important role that two-dimensional echocardiography plays in the non-invasive diagnosis of intracardiac metastatic tumours but physicians should be aware of the potential pitfalls and limitations of the technique.

Aged↗
PubMed1990

[Value and limitations of the measurement of the jet diameter in aortic insufficiency using Doppler color. Report of 68 patients].

The aim of this study is to specify the feasibility and value of the diameter measurement of the jet of aortic insufficiency (AI) in colour Doppler. 68 consecutive patients had a supra-sigmoid angiography and a colour echo-Doppler. An aortic insufficiency was revealed 58 times by the angiography and Doppler. In all the cases except four, it has been possible to measure the jet diameter at the origin in para-sternal incidence in colour TM by confronting the images in great and small axis section. The Doppler results have been compared to the angiographic score in 4 grades according to Sellers classification. The jet diameter at the origin in colour TM is significantly different in groups I, II, III-IV. In the group III-IV, it is always higher or equal to 13 mm. The failures of quantification of the AI jet in colour Doppler are linked with the very eccentric nature of the jet or to the poor quality of the echo-Doppler imaging. On the whole, the jet diameter measurement proves to be a very useful element in the assessment of the gravity of an AI, particularly when it is a central and circular jet.

Adult↗