[Allergology on the European scale].
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Academies and Institutes↗
Biomedical subjects
C Molina
Publications and source records attributed to C Molina.
The cylindrical or tubiliform glands of Nephila clavipes.
The cylindrical or tubiliform glands of the spider Nephila clavipes have been studied and compared to the large ampullates on which we have previously reported. The three pairs of cylindrical or tubiliform glands secrete the fibroin for the organism's egg case. Their solubilized luminar contents migrate as a homogeneous band in Sodium dodecyl sulfate polyacrylamide gel electrophoresis and turn out to be a larger protein than that produced by the large ampullates. The excised cylindrical glands remain metabolically active for several hours in a simple culture medium, where fibroin synthesis can be monitored through the incorporation of 14C alanine. The glands' response to a fibroin production stimulus does not reach the magnitude displayed by the large ampullates, but this is to be expected since their products supply different functions in this organism. This fibroin also seems to be elongated discontinuously. Translational pauses have been detected in the secretory epithelium of cylindrical and large ampullate glands of Nephila as well as in the silk glands of Bombyx mori. Since these glands produce the fibroin for the females egg case, they should prove to be an interesting model system.
Alanine↗
[Value and limits of bronchial biopsy in asthmatics].
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Adult↗
Effect of low oral doses of disopyramide and amiodarone on ventricular and atrial arrhythmias of chagasic patients with advanced myocardial damage.
Low-dose (7 mg/kg per day) disopyramide administration to arrhythmic chagasic patients decreased the frequency of ventricular extrasystoles in 4 of 17 patients (24%) and suppressed most complex ventricular arrhythmias in 12 of 15 patients (80%). This assessment was made from 72-h continuous Holter monitoring recorded during the course of this double blind, placebo-controlled randomized crossover study. Seven patients (41%) complained of anticholinergic side effects, but no contractile or conduction system depression was seen. Amiodarone (200 mg) given on a single blind, placebo-controlled basis to 9 of these patients reduced the frequency of ventricular extrasystoles in 6 of 9 patients (67%) and suppressed complex ventricular ectopy in 6 of 7 patients (85%). One patient was unable to tolerate this drug (11%). Both drugs seemed less effective in controlling supraventricular arrhythmias, although disopyramide eliminated paroxysms of supraventricular tachycardia in 9 of 13 (69%) and amiodarone in all 6 patients with this arrhythmia. Amiodarone appears to be a better antiarrhythmic drug for chagasic patients, due to its greater effectiveness and lower incidence of side effects.
Administration, Oral↗
Life expectancy analysis in patients with Chagas' disease: prognosis after one decade (1973-1983).
We studied the evolution of chronic Chagas' disease in 107 patients with a positive Guerreiro-Machado reaction and 22 non-chagasic, non-heart disease control subjects for a follow-up period of 3 to 10 years (mean follow-up of 4.9 years). After completion of invasive and non-invasive studies, chagasic patients were classified into four groups: IA (normal ECG, without heart disease; 18 patients); IB (normal ECG, early left ventricular segmental abnormalities; 13 patients); II (abnormal ECG, advanced myocardial damage, no signs of heart failure; 42 patients); and III (abnormal ECG, end-stage, congestive heart failure; 34 patients). One out of five group IA patients re-studied with invasive methods evolved to group IB (20%); 4 group IB patients evolved to group II (33%) and 6 group II patients evolved to group III (15%). The life expectancy of patients in groups IA and IB (normal ECG) was similar to that of our control group, whereas in groups II and III it was significantly decreased (P less than 0.001). Nine group II patients (23%) and 28 group III patients (82%) died during the follow-up period. Main terminal events were refractory congestive heart failure, sudden death and systemic thromboembolism. Our findings suggest that chronic Chagas' disease follows an evolutionary course from asymptomatic, normal ECG group I stage to arrhythmic (II) and congestive (III) stages. Subjects with a positive Guerreiro-Machado reaction showed a significantly lower life expectancy than our control group, but only when clinical and/or ECG abnormalities were identified.
Adult↗
Usefulness of skin test in Farmer's lung.
The skin test with hay extract or with Micropolyspora faeni (MF), is not commonly used in the diagnosis of Farmer's lung (FL), as it is not considered specific. In our study, we have applied the intracutaneous test with these antigens in 26 patients affected with FL; 18 of them were still in contact with the antigen and the remaining eight had not been in contact with the hay during the previous year. Twenty-five asymptomatic farmers (AF) served as a control group. In the first group and with hay extract, the immediate reading (I) was positive in 15 of 18 (83.3 percent), the late reaction (L) in 18 of 18 (100 percent), and the delayed one (D) in eight of 18 (44.4 percent). In the 25 AF, the results were as follows: I, seven of 85 (28 percent); L, 17 of 25 (68 percent); and D, one of 25 (4 percent). Consequently, the differences between both groups were significant: I, p less than 0.01; L, p less than 0.05; and D, p less than 0.01. Using MF as an antigen, the test is somewhat less effective: p less than 0.02, p less than 0.02, and p less than 0.2, respectively. These results suggest that the intradermal injection with hay extract is an easy, effective test in the diagnosis of FL, and at the same time, a better means of distinguishing FL patients from AF than the precipitation test.
Antigens, Bacterial↗
[Intravascular bronchioloalveolar tumor or I.V.B.A.T. Apropos of a case and review of the literature].
Intravascular bronchioloalveolar tumor is a rare tumour of the lung. Having observed a case detected during systematic examination in a 44-year old woman, the authors compare the radiological, clinical, histological and evolutive signs of the disease with those reported in the 40 cases published since the first description by Dail and Liebow, in 1975.
Adenocarcinoma, Bronchiolo-Alveolar↗
[Tissue immunopathology methods for the diagnosis of bronchopulmonary diseases].
The authors draw attention to the diagnostic value of tissue immunopathology methods in numerous bronchopulmonary diseases. Having emphasized the strict technical requirements and difficulties of these methods--all obstacles that are necessary for an accurate evaluation of the lesion--they use concrete examples to demonstrate the usefulness of extra-thoracic, skin or muscle biopsies to diagnose some systemic diseases, such as lupus erythematosus or Churg and Strauss syndrome. They also refer to bronchial biopsies which provide information on the aetiology and pathogeny of adult asthma, and to the prognostic and therapeutic value of collagen studies in idiopathic pulmonary fibrosis.
Aged↗
[Protected distal aspiration in the identification of pathogenic microorganisms in pneumologic intensive care].
To identify the micro-organisms responsible for bronchopulmonary infections in intensive care patients is an absolute prerequisite to successful treatment. Numerous techniques of specimen collection have been used to facilitate this bacteriological diagnosis. In this study, which involved 27 intensive care patients selected according to various criteria of infection, endotracheal aspiration (a commonly used but not very specific technique) was compared with protected distal brushing under fibroscopy and with protected distal aspiration. The latter method, still seldom used, proved as specific as protected distal brushing (hitherto regarded as the reference method), but it also presents the enormous advantages of being rapid, non-traumatic, devoid of side-effects and easily performed in hospital routine by paramedical staff.
Adult↗
[Long-term radiology and respiratory function study following exposure to asbestos].
During the supervision of 93 workers in an asbestos factory pulmonary function tests and radiographs were performed using the same equipment and by the same team, at 5 yearly intervals. The assessment of radiographic changes was judged by following both the reader of the films and the technique used (either un-named films or simultaneous films at 5 yearly intervals). On reading un-named films the appraisal of parenchymal abnormalities was variable from one reader to another; on the other hand they were less marked for simultaneous readings made by the same observer. Progressive pulmonary function tests showed that the fall in vital capacity and of VEMS in 5 year intervals was more rapid when there was a parenchymal abnormality, when the duration of exposure was long or the subject was older when first exposed. The results showed that in spite of ceasing to be exposed the parenchymal abnormalities progressed.
Adult↗
[Lessons from a long-term survey on the effects of massive occupational exposure to asbestos. The AMISOL affair 10 years later].
For the past 10 years the authors have followed up a cohort of workers who had been massively exposed to dust in an asbestos textile factory which closed down in 1974. They report on the difficulties of all kinds they encountered during this epidemiological survey. The most original result is that they were able to establish that the radiological and functional manifestations of asbestosis pursue their course after the subjects have ceased to be exposed. Another important point is the early development of lesions in peripheral bronchioles, detected by volume-flow loops. The authors insist on the psycho-social problems at the site of work or in daily life which arise from the use of asbestos or of fibres with similar properties. Social protection, at present well organized, should suppress the risk of asbestosis in Western countries. However, a number of problems remain to be solved, notably those concerning the long-term risk of pleural mesothelioma, the mode of action of the fibers and the immune reactions they induce, and the economic and social consequences of a hypothetical ban on asbestos--a material very difficult to replace. This study embodies, in miniature, all the problems of society associated with asbestos during this second half of the XX th century.
Asbestosis↗
[Extrinsic allergic alveolitis and hematologic diseases (lymphoproliferative syndromes)].
The authors report 2 cases of hypersensitivity pneumopathy associated with haematological abnormalities: benign lymphoproliferative syndrome in one case, and malignant lymphadenopathy with fatal outcome in the other case. Such cases, now observed with increasing frequency, can be regarded either as chance associations of 2 types of disease, or as the results of immune disorders with repercussions on the blood.
Adult↗
[Respiratory manifestations in hereditary angioneurotic edema].
Hereditary angioneurotic oedema is an autosomal dominant state associated with a quantitative, and sometimes purely functional, deficiency of C1 esterase inhibitor (C1 INH). The clinical manifestations may begin during adulthood or childhood; they are periodical and of varying severity. Beside oedema of the skin and digestive disorders, respiratory disorders are bound to attract attention. They consist of laryngeal oedema, which may end in lethal asphyxia if tracheotomy is not performed, or, exceptionally, of pulmonary oedema requiring assisted ventilation, as in the case reported here. The diagnosis, suspected in the presence of a decrease in CH50 and C4, is confirmed by a quantitative assay of C1 INH, which is low, and/or by the Fong and Good's functional tests. The physiopathological mechanisms are complex. They involve complement activation through the classical route, and activation of the coagulation system contact phase. Patients with severe attacks now benefit from treatment with preparations of C1 INH in high concentrations. The best treatment, however, is prophylactic, using testosterone derivatives, danazol and stanozolol, which can be prescribed for long periods taking into account their usually moderate side-effects.
Acute Disease↗
[Bronchoalveolar cancer and Clara cells].
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Adenocarcinoma, Bronchiolo-Alveolar↗
[The contribution of ultrastructural analysis to the diagnosis of bronchoalveolar cancers].
The authors discuss comprehensive observations on three cases of broncho-alveolar cell carcinoma covering different anatomo-clinical aspects. The first case was diffuse and characterised radiologically by soft nodular shadows bilaterally, the second had lobar opacities and in the third the tumour was locally limited. Histological study showed two cellular types, in variable proportion according to the case, namely 1. mucus cells and 2. cells containing rounded osmiophilic secretory granules, identified on ultra-structure as Clara cells. In the diffuse form mucus cells predominated. They were absent in the third case where the tumour consisted solely of Clara cells. Thus, the Clara cell seemed to be the characteristic cell of alveolar cell carcinoma. Alveolar cell carcinoma can be diagnosed today by fibre-optic bronchoscopy with transbronchial biopsy and it is fundamental to arrive at a precise cellular diagnosis, which can only be achieved by ultra-structural studies.
Adenocarcinoma, Bronchiolo-Alveolar↗
[Left ventricular function in mitral stenosis].
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Adult↗
[Hypersensitivity pneumopathies].
The diagnosis of hypersensitivity lung diseases in an agricultural, urban or occupational environment is established in two stages: (a) the environmental allergens likely to affect the alveoli and interstitial tissue are identified, and (b) the disease is diagnosed by clinical and radiological examinations but also by methods exploring respiratory function and immune mechanisms. Respiratory function tests show alveolar lesions, and the frequent involvement of the small bronchi is demonstrated by studies of respiratory mechanics. An important component of routine diagnosis is the presence in the serum of precipitating antibodies directed against the causative allergen and above all, bronchoalveolar lavages, which explore the deep lung, reveal distinctive cytological features (infiltration by T-lymphocytes) and lipidic features (fall in lecithins and increase in phosphatidyl-inositol and phosphatidyl-ethanolamine). High microviscosity of the alveolar fluid can be demonstrated by fluorescence polarization methods. A more rational treatment and, most important, measures aimed at preventing the development of a disabling and irreversible pulmonary fibrosis can be based on these findings.
Agricultural Workers' Diseases↗