Search PubMed⌕ Search

Biomedical subjects

G Huchon

Publications and source records attributed to G Huchon.

At least 73 records · Page 4Linked to original sources
PubMed1988

[Broncho-alveolar lavage in pulmonary involvement in rheumatoid arthritis].

This study was designed to investigate by bronchoalveolar lavage (BAL) the characteristics of lung involvement in rheumatoid arthritis (RA). Twenty six patients with RA were included; ten were active smokers. Chest X Ray, pulmonary function tests and BAL were performed in all patients. Bronchiolitis was found in 7% of cases, pleurisy in 30% of cases. 83% of patients were found to have diffuse alveolar and/or interstitial disease, 17% rheumatoid nodules. Functional evaluation showed a restrictive pattern and a significant reduction in the carbon monoxyde diffusing capacity. Smokers had elevated BAL macrophages and decreased lymphocytes compared with non-smokers: respectively 89% vs 62.9% and 7.3% vs 18.9%. Patients with bronchiolitis had lower FVC than others: 38 +/- 14% vs 61 +/- 3%, and their BAL neutrophils were increased: 71 +/- 23% vs 7.5 +/- 2%. There was an inverse correlation between neutrophil counts and FVC in non-smokers, and diffusing capacity. We conclude that BAL inflammatory cells profiles are abnormal in RA and modified by a smoking history and the existence of a bronchiolitis.

Arthritis, Rheumatoid↗
PubMed1986

Exophytic endobronchial epidermoid carcinoma.

Exophytic endobronchial epidermoïd carcinoma is a rare clinical entity. The authors describe and systematically analyzed 34 cases, collected during 35 years. There was a preponderance of male patients; the mean age at presentation was 58 years. The tumors were nearly always at the T1N0 stage, and their prognosis was not better than that for other Stage I bronchogenic carcinomas. The findings suggest that they are a special subvariety of bronchogenic carcinoma, rather than tumor detected at an early stage.

Bronchial Neoplasms↗
PubMed1986

Comparison between theophylline analysis by nephelometric inhibition immunoassay and high performance liquid chromatography.

Rate nephelometric inhibition immunoassay (NIIA) was used to determine 94 serum theophylline concentrations, and these results were compared with those obtained using high performance liquid chromatography (HPLC) as a reference method. The measurements obtained by the nephelometric method were, on the average, 20% higher than those obtained by the chromatographic method (p less than 0.001). The coefficient of variation of the nephelometric method was 12.3%, compared with 3.9% for the chromatographic reference method. In the group of subjects having a serum concentration of caffeine greater than or equal to 0.5 microgram ml-1, the difference in serum theophylline concentration found between NIIA and HPLC correlated with serum caffeine concentration (r = 0.3755, df = 46, p less than 0.01). NIIA theophylline concentration was 8.8 +/- 3.2 micrograms ml-1 in serum from six additional patients receiving theophylline 9.1 +/- 3.4 micrograms ml-1 after adding 10 micrograms caffeine (NS), and 13.1 +/- 3.5 micrograms ml-1 after adding 10 micrograms 1,3-dimethyluric acid (p less than 0.001). We conclude that (a) the results obtained by the NIIA method are more variable and consistently higher than those obtained by the HPLC method and (b) 1,3-dimethyluric acid (a caffeine and theophylline metabolite) is responsible for this overevaluation.

Adult↗
PubMed1986

[Etiological factors of asthma and their relation with bronchial hyperreactivity].

As asthma is nearly always associated with non-specific bronchial hyperreactivity, this factor has been considered to be an essential requirement for the development of symptomatic asthma. Some factors appear to be inducers of bronchial hyperreactivity and others promotors of asthmatic symptoms. In clinical practice, it is very difficult to classify aetiological factors as inducers or promotors: there is evidence to support the fact that the same factors may cause both bronchial hyperreactivity and asthmatic symptoms; conversely, the evidence for hereditary non-specific bronchial hyperreactivity is hardly convincing. These observations suggest that non- specific bronchial hyperreactivity is more a marker of bronchial asthma than a true aetiological factor.

Asthma↗
PubMed1985

[Treatment of pleuropulmonary tuberculosis in 1985].

The treatment of pulmonary TB due to bacilli sensitive to antituberculous treatment should lead to 100 p. 100 therapeutic success. However, this result implies a good bacteriological knowledge of the Koch bacillus, of antituberculous drugs, of therapeutic strategy, of the duration of treatment and, finally, of the reasons for failure. The association of isoniazide (5 mg/kg/day), rifampicin (10 mg/kg/day) and ethambutol (20 mg/kg/day for the first two months) sterilizes tuberculous lesions in 9 months. The introduction of a fourth antituberculous drug, pyrazinamide (35 mg/kg/day for the first two months) enables the duration of treatment to be reduced to 6 months without any loss of efficiency. Tuberculous relapses, sometimes due to polyresistant bacilli, pose difficult problems requiring detailed bacteriological studies of antibiotic sensitivity. Specific measures have to be taken (adaptation of dosage, contra-indications of certain drugs) with respect to the individual patient (elderly patients, pregnant or lactating women). Surgery has a role to play, especially in the treatment of sequellae. Admission to a sanatorium is reserved for infectious cases at the beginning of treatment and for patients living in poor conditions. The cover of social security is essential for successful treatment. Tuberculous is a compulsory notifiable disease.

Aminoglycosides↗
PubMed1985

[Pharmacology of mucociliary transport].

Muco-ciliary transport is only effective because of the coordination of the ciliary beats (metachronous) and the harmony between mucus and cilia. The tip of the cilia is in contact with a jellyform layer of mucus propelled to the oropharynx. This jellyform layer has a complex rheological behaviour: it flows like a liquid and shapes like solid elastic. When the rheological properties of bronchial secretion are abnormal, mucociliary transport becomes inefficient. However, the most fluid secretions are not necessarily best transported, because the elasticity and viscosity to guarantee efficient muco-ciliary transport can only vary within defined limits. The mechanism regulating the ciliary beats is poorly understood; the bronchial secretions conduct impulses through the autonomic nervous system as well as mediators such as histamine and the metabolites of arachidonic acid. Mucociliary function may be studied either, directly through mucociliary transport or through mucociliary clearance. A fall in mucociliary activity can be produced by a primary ciliary disorder, by bronchial disease or the consequences of respiratory infection. General anaesthetics and Atropine slow mucociliary transport but Ipratropium bromide does not; Theophylline and sympathomimetics speed it up. The expectorants are mucolytics (proteolytic enzymes, N-acetyl-cysteine), there are agents to correct hydration anomalies of the bronchial secretion (water, hypertonic sodium chloride) iodides, antifibrins by substitution, anti-inflammatory agents and mucoregulatory agents (S-carboxymethylcysteine, bromhexine). The efficacy of the greater part of these expectorants has not been established in vivo by controlled therapeutic trials.

Anesthetics↗
PubMed1984

Processing of lung lavage fluid causes variability in bronchoalveolar cell count.

To study the effects on cell counts of different ways of processing bronchoalveolar lavage (BAL) fluid, we performed 77 BAL in 19 healthy control subjects and in 58 patients with sarcoidosis. We investigated the role of readers, hemocytometers, mode of identification of macrophages, cell washing, and speed of cytocentrifugation. No significant effect of reader or hemocytometer was observed. The percentage of macrophages, determined as large cells stained with neutral red in a Malassez hemocytometer (63.9 +/- 24.6%, mean +/- SD) was lower than the percentage of macrophages determined by May Grunwald Giemsa staining (76.3 +/- 19.2%, p less than 10(-9)). Cell counts decreased 34% after 2 washings (p less than 0.001), and more lymphocytes were counted after cytocentrifugation at 90 g (33.2 +/- 25.3%) than at 23 g (27.7 +/- 22.1%). We conclude that bronchoalveolar cell counts vary with changes in processing lung lavage fluid and that this variability should be considered when using BAL cell counts.

Bronchi↗
PubMed1983

[Why, when and how to treat sarcoidosis?].

The natural history of sarcoidosis is favourable in 90% of cases; in 10% deterioration occurs with the appearance of respiratory failure, aspergillous or tuberculous infections which cause death in 5% of patients. Thus the problem for the clinician is the early detection and treatment of those patients whose outcome will be unfavourable. Certain clinical pointers exist measuring the activity and the dissemination of the sarcoidosis as well as its consequences. Among these are radiology, biological tests (such as the serum angiotensin converting enzyme of differential cell counts on bronchoalveolar lavage), scintigraphy and respiratory function; despite the above it is more difficult to determine the prognosis early as in practice this is decided by repetitive screening tests. Steroid therapy seems more effective than other treatments. But drugs cannot be held responsible for those cures which occur apparently unrelated to the treatment received; the occurrence of relapses after interruptions of treatment demand prolonged treatment if an unfavourable outcome is suspected.

Adult↗
PubMed1983

[Test of human basophil degranulation. The interpretation and analysis of variability factors in the absence of antigen].

The human basophil degranulation test (TDBH) is performed using a concentrated cell suspension enriched for polymorphonuclear basophils. This preparation is placed in wells on a glass slide with an allergen solution of decreasing concentration. After incubation the cells are fixed in the wells and stained with toluidine blue. Preparations containing fewer metachromatic basophils than in control preparation of the same cell suspension without antigen contain degranulated basophils and in this way a degranulation index can be calculated. By considering the variability in the number of basophils between duplicate control wells from the same cell suspension, it can be shown that the test can be considered to be positive only if the number of degranulated basophils equals or exceeds 50% of the total number of basophils. This variance can be attributed to the subjectivity of the reader, and to differences in the differential cell counts from well to well. On the other hand, the presence of atopic allergy had no effect on the basophil counts.

Adolescent↗
PubMed1983

Role of bacterial vaccines in prevention of respiratory infections with special reference to pneumococcal vaccines.

There are significant differences between polymicrobial and monomicrobial vaccines. Polymicrobial vaccines clearly cannot prevent all bacterial diseases and their indications are ill-defined, but might be better established by controlled clinical trials in which these preparations are tested against placebos. The pneumococcal vaccine represents real progress in reducing the incidence and mortality of pneumococcal infection in patients with either a high risk of contracting such an infection or a high risk of a fatal outcome if infection occurs.

Bacterial Vaccines↗
PubMed1982

Broncho-alveolar lavage in sarcoidosis. Correlation between alveolar lymphocytosis and clinical data.

Bronchoalveolar lavages (BAL) were performed in patients with pulmonary sarcoidosis and in normal subjects. In both smoking and nonsmoking sarcoid patients, the proportion and number of lymphocytes were significantly increased compared to corresponding controls (p less than 0.001 in each cases). BAL lymphocytes were identified as T lymphocytes (88 +/- 9% formed E rosettes). Neither the radiological stage, nor the duration of disease are related to the lymphocyte number. However, alveolar lymphocytosis is significantly correlated with clinical pattern (p less than 0.02) and with clinical extrathoracic dissemination (p less than 0.001). Black patients have significantly more disseminated disease than Whites (p less than 0.001). The lymphocytosis of the bronchoalveolar space is associated with the presence of granulomas in bronchial biopsies (p less than 0.005). For clinical purposes, the results of BAL were helpful in determining the evolutivity of the disease, particularly progression to stage III. Together with a high lymphocyte count, a significant increase of all the polymorphonuclear leukocytes (PMNL) was found in stage III (4.0 +/- 4.6 X 10(4) PMNL/ml, p less than 0.001) compared to earlier stages (respectively 0.6 +/- 0.5 X 10(4), 0.7 +/- 0.9 X 10(4) and 0.7 +/- 0.9 X 10(4) PMNL/ml for stages I, IIA and IIB). BAL may also be used to follow up sarcoid patients. Repeated BAL were performed in 23 patients. No modification in alveolar lymphocytosis is found in patients with steady state disease, but, in healed patients the lymphocyte number returns to normal.

Adult↗
PubMed1982

[Pulmonary immunology].

Knowledge of pulmonary immunology is essential to the understanding of certain respiratory diseases. The airways and alveolar zones may be seen separately and in contrast on the basis of the immune system of the lung. Broadly speaking, within the airways there are mast cells, polynuclear eosinophil and lymphocytes. By contrast in the alveolar zones there are macrophages and lymphocytes which are either free in the alveolar lumen or present in the pulmonary interstitial tissue, as well as lymphocytes. In most instances inhaled antigens are not at the origin of an immune response, whether deposited on the mucociliary surface or phagocytosed by the alveolar macrophage. The BALT play a probably primordial role in immune information within the tracheobronchial epithelium. The immune response occurs in the airways in the form of the secretion of secretory A immunoglobulins, whilst in the alveolus phagocytosis by the alveolar macrophage represents the principal means of defence. Such phagocytosis only rarely gives rise to inflammatory phenomena which would impair alveolar function. Finally, the collection of bronchoalveolar washings is a technique which may be used to collect immunocompetent cells of principally alveolar origin for the purpose of their study.

Antibody Formation↗