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Biomedical subjects

G Akoun

Publications and source records attributed to G Akoun.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Respiratory manifestations of mycosis fungoides. Apropos of a case].

Mycosis fungoides is today classified amongst the cutaneous T lymphomas. The course of the disease is slow, first strictly dermatological, then with polyvisceral spread most often presenting as lymphadenopathy. Pulmonary involvement, with a poor prognosis, is often recognised only at autopsy. The differential diagnosis between pulmonary involvement by the disease and isolated or associated opportunistic infectious pathology is virtually impossible during the patient's lifetime except by surgical lung biopsy. The case reported here illustrates these data and has the particular feature of the onset of pulmonary involvement during cutaneous remission of the disease, contrasting with the visceral spread found at autopsy.

Autopsy↗
PubMed1983

[Aneurysm of the subclavian artery: an unusual cause of mediastinal pseudotumor].

A 62 year old woman presenting with dyspnoea was found to have a large right superior mediastinal opacity compressing neighbouring anatomical structures: trachea, esophagus and superior vena cava. Thoracic ultrasonography suggested a liquid mass which was non-pulsatile. At surgery, however, this was found to be a subclavian artery aneurysm, a diagnosis confirmed by arteriography. The lesion was opened and vascular continuity reestablished by prosthetic grafting. Only five other cases appear to have been reported. The clinical, radiological and etiological aspects are discussed.

Aneurysm↗
PubMed1982

[Acute respiratory failure disclosing bilateral diaphragmatic paralysis].

In the case of three patients an acute respiratory failure with alveolar hypoventilation is related to bilateral diaphragmatic paralysis apparently isolated from any other neurologic abnormalities. The current initial diagnosis of pulmonary embolism leading to admission in an intensive respiratory care unit, because of the severity of the acute respiratory failure, has to be rectified then. Bilateral diaphragmatic paralysis is suspected on account of the absence of any patent etiology, on increasing dyspnea in supine position and paradoxic movements of the upper abdomen (whether spontaneously or in attempted weaning of ventilation support). Bilateral diaphragmatic paralysis is asserted by electromyogram with measurement of nerve conduction velocities of the two phrenic nerves. In the first case, it appears early in the course of an amyotrophic lateral sclerosis; in the second case, it occurs before the presence of a herpes-zoster becomes patent. In the third case, paralysis seems to be idiopathic. Evolution is promising in the last two cases, owing to the reversibility of the lesions. The difficulty of diagnosis, the varying nature of etiology and prognosis encountered in these three cases are also apparent in the 15 cases published in medical literature. The small number of cases published up to now, contrasting with the cases we have witnessed over the last 3 years, leads us to think that this disease must exist more often and may remain unknown to us.

Adult↗
PubMed1980

[Pulmonary emphysema, hepatic lesions, and insulin-dependent diabetes in a patient with alpha-1-antitrypsin (Pi ZZ) deficiency (author's transl)].

A 47-year-old patient with panlobular emphysema and insulin-dependent diabetes had an alpha-1-antitrypsin phenotype Pi ZZ deficiency. Liver function tests were abnormal, and postmortem examination of the liver demonstrated abnormal intrahepatocytic globules of A1AT (a typical finding when the allele Z is present), but also fibrosis with steatosis. The patient's sister, Pi ZZ, had neither diabetes nor bronchopneumopathy, and no anomalies in liver function. Needle puncture biopsy of the liver had not been conducted. The phenotype Pi ZZ is typically associated with panlobular emphysema in adults, and cholestatic hepatitis in children. From reports in the published literature, it appears that isolated hepatic lesions or those associated with emphysema are rare. The fortuitous association of diabetes and hepatic lesions in this typical case of pulmonary affection in an adult is discussed.

Diabetes Complications↗
PubMed1978

[Isolated cystic lymphangioma in the mediastinum].

Cystic lymphangioma localized only in the mediastinum is a rare type of primitive tumour (less than 1% of the mediastinum primitive tumours). These three new observations concern lymphangiomas with an anterior position ; therir anatomical connections with the lymphatic system are difficult to show. Treated by surgery these benign tumours have a good prognosis and only a few cases of local recurrences have been reported.

Adult↗
PubMed1977

[Extrinsic allergic alveolitis of drug origin].

Extrinsic allergic alveolitis of drug origin is now a better known branch of respiratory pathology. The symptoms and course of these cases resemble in many ways those of extrinsic allergic alveolitis in general with a few differences. The list of drugs responsible is longer every day, and it is important to be aware of it. The diagnosis of these diseases is not always easy, as there are certain similarities between them and other long diseases either iatrogenic or not, but not immuno-allergic. Our physiopathological knowledge is based on already known data concerning allergic alveolitis, but includes many theories which still have to be verified. It is important for the clinician to be aware of this new type of respiratory disease as the treatment includes withdrawal of the responsible drug as soon as possible, failing which irreversible pulmonary fibrosis develops.

Alveolitis, Extrinsic Allergic↗
PubMed1976

[Paraneoplastic hypercalcemia in primary bronchial cancer].

Paraneoplastic hypercalcemia is frequently observed in squamous cell carcinoma of the bronchus. Clinically, apart from the general symptoms which are always very marked, neurological signs are the most common. This hypercalcemia, accompanied by hypophosphatemia, is of sudden onset and immediately very high. Metabolic alkalosis, with hypokalemia and hypochloremia, differentiates it from true hyperparathyroidism. Symptomatic treatment is only transiently effective. However, the obvious effect of mitramycin may be useful before surgical operation, which alone produces a lasting normalisation of serum calcium. Inappropriate secretion of a parathormone substance by the tumour may be demonstrated by radio-immunoassay, and this explains a large number of cases of hypercalcemia but this does not exclude other possible factors in the etiology. Finally, hypercalcemia originally attributed to bony lysis, may be explained in some cases by a paraneoplastic process.

Acidosis↗
PubMed1976

[Pickwickian syndrome and hypersomnia with periodic respiration].

A classical definition of Pickwickian syndrome associates alveolar hypoventilation, obesity and hypersomnia with periodic breathing. Obesity in itself is enough to explain the alveolar hypoventilation and some of the sleep disorders, but in fact all three elements of this syndrome are intricated. Obesity, whether associated with a Pickwickian syndrome or not, affects ventilatory mechanics similarly. With the cause of sleep disorders are associated central ventilatory pauses, appearing periodically followed by phases of apnoea secondary to buccopharyngial hypotony. The alveolar hypoventilation is therefore the consequence of obesity and periodic apnoea. It also results from a low respiratory frequency considering that the tidal volume is also decreased. These different elements suggest some disorder of the centers controling ventilation. One can describe different nosological forms, all having as a common factor hypersomnia with periodic respiration, the latter being a determining factor in the diagnosis. Therapy, including weight reduction and symptomatic treatment of alveolar hypoventilation, is now augmented by new drugs acting on the central nervous system.

Circadian Rhythm↗