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Biomedical subjects

G Akoun

Publications and source records attributed to G Akoun.

At least 55 records · Page 3Linked to original sources
PubMed1988

Efficacy of intravenous spiramycin in the treatment of severe Legionnaires' disease.

Spiramycin is a 16-membered macrolide that has been shown in cell and animal models to be active against Legionella spp. The activity of the injectable form of spiramycin was evaluated in the treatment of severe Legionnaires' disease in seven immunocompromised and three previously healthy patients. Seven of the ten patients were cured. Three patients died primarily from the underlying disease or from intercurrent complications. This result and the better tolerance of spiramycin compared with 14-membered macrolides suggest that spiramycin may be a suitable alternative to erythromycin for the treatment of Legionnaires' disease.

Adult↗
PubMed1988

[Thoracic metastases of ependymoma. Apropos of a case and review of the literature].

A 27-year old woman with occipital ependymoma treated by surgery and radiotherapy for multiple recurrences developed a right lymphocytic pleural effusion. After 3 inconclusive needle biopsies of the pleura, pleurectomy was performed. Pathological examination with a specific immunohistochemical marker provided a diagnosis of pleuro-pulmonary metastases from the ependymoma. This rare case of extraneuraxial metastasis from a cerebral ependymoma is discussed in the light of published data. Its originality lies in that a positive diagnosis of pleural metastases was obtained with an immunohistochemical marker, the gliofibrillary antiprotein serum (anti-GFAP) specific of glial tissue.

Adult↗
PubMed1988

[Lung diseases during therapeutic aplasia: diagnostic and therapeutic strategy].

Lung diseases that occur in patients with drug-induced bone marrow aplasia are part of a wider group of lung diseases in immunocompromised patients. Their most common causes are infections due to Gram-negative bacilli, staphylococci or Aspergillus spp. and intra-alveolar haemorrhages. Their diagnostic approach is often limited by disorders of coagulation, risks of infection by bronchial or pulmonary seeding during endoscopy and the lethal risk of mechanical ventilation after bronchoalveolar lavage in patients with respiratory failure. The therapeutic approach is frequently empirical due to the fact that antibiotic therapy cannot be delayed, even for a few hours, and to the aforementioned diagnostic problems. In practice, the diagnostic and therapeutic approaches usually result from a rational compromise depending on whether the lung disease has occurred at the onset or at the end of an episode of bone marrow aplasia.

Humans↗
PubMed1988

Evidence for a cytotoxic T-lymphocyte alveolitis in human immunodeficiency virus-infected patients.

A T8 lymphocyte alveolitis occurs in HIV-positive patients, even in the absence of any lung infections or tumors. Using the monoclonal antibody (MAb) D44, the CD8+ T cells can be further subdivided into two functional subsets of cytotoxic T lymphocytes (CTL; CD8+, D44+) and suppressor T cells (CD8+, D44-). A dual fluorescence analysis of alveolar and peripheral lymphocytes has been used in HIV-positive patients without lung infections or tumors to reveal a dramatic increase in alveolar T8 lymphocytes (83%), compared to peripheral values (52%), which was mainly composed (89%) of CD8+ D44+ CTLs. Functional studies confirmed the cytolytic activity of these phenotypically defined alveolar CTLs on autologous alveolar macrophages used as target cells, excluding a natural killer-like activity. An immuno-enzyme analysis concomitantly revealed the co-expression of the p18 HIV antigen and the CD4 molecule on the autologous alveolar macrophages. These data suggest that CTL alveolitis occurs during HIV infection and is directed against HIV-infected alveolar macrophages which are presumably the targets of the locally recruited lung CTLs.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Pulmonary aspergilloma appearing early].

A 62-year old smoker and alcoholic woman with chronic obstructive lung disease was admitted for suppurative pneumonia with cavitation and developed an intracavitary aspergilloma less than 2 months after the first signs of pneumonia. In view of the short time elapsed between the aspergilloma and the onset of suppurative pneumonia, 2 possibilities are discussed: either an aspergilloma developed unusually early in the cavity of a recent pulmonary abscess, or the patient had a chronic necrotizing pulmonary aspergillosis diagnosed at an early stage, which would account for all the manifestations observed.

Aspergillosis↗
PubMed1988

[Immunological studies in hypersensitivity pneumopathies].

In immunological investigations in hypersensitivity pneumonia some have a diagnostic value for the clinician but many others are essentially of interest in research and in analysing the pathophysiology. Unfortunately, skin tests with the responsible antigens are often positive in patients but also in exposed subjects without the lung disease. Studies on peripheral blood require a search for IgE immediate hypersensitivity which is rarely positive and above all a search for precipitating antibodies by the different standard tests available: there again, positive findings occur often enough in exposed but asymptomatic subjects; the sensibility and specificity of cell-mediated hypersensitivity tests seem much more reliable. The study of cell populations in broncho-alveolar lavage fluid generally shows an inverted T4:T8 lymphocyte ratio; a functional analysis seems to show a high degree of lymphocyte activation, which may be of T4 or T8 phenotype whilst cytotoxic lymphocyte activity would be exclusively found in the patients and not in asymptomatic exposed subjects. The provocation test, as long as it is positive, is one of the firmest elements in a diagnosis, above all if one takes care to couple this with a study of the lavage. Finally, the satisfaction of the immuno-histological criteria is currently rarely required to confirm the presence of hypersensitivity pneumonitis.

Alveolitis, Extrinsic Allergic↗
PubMed1987

Extensive T8-positive lymphocytic visceral infiltration in a homosexual man.

Lymphocytic visceral infiltration has recently been noted in association with lymphadenopathy-associated virus infection. A homosexual man, who had clinical and immunologic features of the acquired immune deficiency syndrome (AIDS)-related complex, is described. The patient presented not only with peripheral blood lymphocytosis but also with extensive lymphocytic infiltration involving lungs, lymph nodes, nerves, muscles, and esophagus. Lymphocyte subset immunostaining analysis showed that the lymphocytes were T8-positive. Thirty months after the clinical onset of the disease, no evidence of progression to AIDS was seen. Moreover, clinical improvement was observed, even though the patient did not receive long-term treatment. The clinical history of this patient suggests that lung T8-positive lymphocytic infiltration is associated with an increased risk of infectious episodes such as pneumonia and bronchitis.

AIDS-Related Complex↗
PubMed1987

[Isolated pulmonary lymphoma in a patient with acquired immunodeficiency syndrome].

We report the case of a male patient with AIDS who had been hospitalized for various opportunistic infections, from which he recovered, and was readmitted on account of a round opacity in the lower lobe of his right lung. There was no evidence of extrapulmonary pathology. Transtracheal aspiration, alveolar lavage and transbronchial biopsy failed to identify the lesion. Lung biopsy after thoracotomy resulted in a diagnosis of malignant lymphoma type B with anti-IgA and anti-kappa antibodies. Despite chemotherapy the patient died within one month, the lymphoma having spread to both lungs.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Surgery of microcellular bronchial cancer: retrospective multicenter study apropos of 110 cases].

The results of a multicentric retrospective study of 110 cases of small cell bronchial cancer are reported. In 57 of these patients the histological diagnosis was unknown before surgery. Among the remaining 53 patients, 22 were operated upon immediately and 31 after chemo-and/or radiotherapy (12 full responders, 10 partial responders, 5 no change and 4 in relapse). Operative data were as follows: 100 excisions and 10 exploratory thoracotomies; 19 perioperative complications, including 12 deaths; excision considered complete in 78 cases; pericardial involvement in 14 cases; invasion of the hilar lymph nodes in 57 cases, of the mediastinal lymph nodes in 39 cases; positive bronchial section in 16 cases. Overall median survival was 13.8 months for all patients and 18.3 months (perioperative deaths excluded) for patients whose tumour had been excised. At the moment, 46 patients have relapsed with recurrence at the initial site of malignancy alone in 6 cases (13%) and both at this site and at one or several metastatic sites in 10 cases (21.7%). Nineteen patients have survived for more than 2 years. An analysis of the subgroups in this population showed that the longest survivals were obtained in patients who had undergone preoperative chemotherapy.

Adult↗