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J Brune

Publications and source records attributed to J Brune.

At least 73 records · Page 4Linked to original sources
PubMed1986

[Pulmonary metastases in medullary cancers of the thyroid. Study of 4 cases. Originality of the lymphangitic form with amyloid stroma].

We studied the clinical and radiological features of pulmonary metastases present in 4 out of 22 patients with medullary carcinoma of thyroid. Two patients presented with common metastases: macronodules in one, and micronodules in the other one. The other two patients presented initially with reticulonodular perihilar lesions on chest X-ray, leading to the diagnosis of sarcoidosis in both of them. The observation of such pulmonary metastases is original: initially latent, they progress very slowly, and they correspond to a lymphangitic spread of the tumour with amyloid deposition in peribronchovascular structures without alveolar involvement, as shown in one of our cases with pathologic study.

Adult↗
PubMed1986

[Chronic cryptogenic pneumonia].

We report a case of a 72 year old man with the appropriate criteria for the recently identified chronic cryptogenic pneumonia: dyspnoea, cough, low general state, fever, raised sedimentation rate, localised opacities on the chest x-ray; no cause has been identified; the patient will improve on steroid therapy even though antibiotics are without effect, but relapses on stopping the steroids. A lung biopsy shows a predominant intra-alveolar fibrosis. A definitive cure can be obtained by 12 weeks of steroid therapy.

Aged↗
PubMed1985

[Diagnostic value of the assay of carbohydrate antigen 19-9 in patients with primary bronchial cancer].

We studied the levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) in 90 patients with primary lung cancer. One or both markers were increased in 45 patients (50%): CEA only was increased in 13, CA 19-9 only was increased in 19, and both CEA and CA 19-9 were increased in 13. Increase of markers did not differ according to histologic subtype of cancer. Increase or decrease of the markers (mainly CA 19-9) usually parallelled evolution of the disease in our patients. Thus, measurement of both CEA and CA 19-9 levels are of diagnostic value in half the patients with primary lung cancer.

Adenocarcinoma↗
PubMed1985

[Respiratory function and alveolar biological changes under the effect of CDP-choline in pulmonary interstitial pathology: pulmonary fibrosis and sarcoidosis].

Various anomalies of pulmonary surfactant have been described in relation to acute respiratory distress syndromes, hypersensitivity lung disease and pulmonary sarcoidosis. Phosphatidylcholine (PC) is the essential phospholipid component of pulmonary surfactant. Cytidine diphosphocholine (CDP-choline) is an essential intermediary in the biosynthesis of PC. The authors studied two groups of patients: one group consisted of diffuse interstitial pulmonary fibrosis and the other consisted of pulmonary sarcoidosis with parenchymal involvement. They observed quantitative and qualitative abnormalities of the phospholipid fractions of surfactant and more particularly of PC. The finding of a marked decrease in this phospholipid, especially in the cases of pulmonary fibrosis, justified the study of the therapeutic effects of CDP-choline. After one month of treatment with this substance, at a dose of 1 g I.M. per day, the PC fraction had returned to normal and, at the same time, there was an improvement in the PaO2 at rest and after exercise. Long term administration of CDP-choline appears to be valuable in the maintenance of the phospholipid equilibrium of pulmonary surfactant and in the improvement of the quality of alveolar gas exchange.

Adult↗
PubMed1985

Pulmonary sarcoidosis: flow cytometry measurement of lung T cell activation.

Lung T cell activation is considered a major factor in the pathogenesis of pulmonary sarcoidosis. Our study was designed to investigate several parameters of T cell activation among blood and alveolar cell populations, including expression of HLA-DR or MLR antigens, increased cell size, and presence of dividing cells. Blood sampling and bronchoalveolar lavages were performed in 20 patients with pulmonary sarcoidosis. Cell populations were analyzed by flow cytometry using immunofluorescence labeling with monoclonal antibodies to lymphocyte differentiation or activation antigens. Cell types were identified by their light-scattering properties. Cell cycle analysis was done after staining with acridine orange. Bronchoalveolar lavage contained a higher proportion of small T4-positive lymphocytes, and large cells of the same phenotype were detected in three patients. T cells bearing HLA-DR antigens were detected in six of 14 bronchoalveolar lavage samples. A marked increased of MLR-positive cells was found in the peripheral blood of eight of eight patients and in the bronchoalveolar lavage of five of seven patients. Increased percentages of cells in the S + G2 + M phases were found in blood lymphocytes from three patients and in half the bronchoalveolar lavage samples. Therefore, a variety of activation markers may be expressed by alveolar T cells. Their qualitative and quantitative assessment may provide additional criteria for staging the intensity of the alveolitis, and the possible relationship between these markers and disease progression or activity deserves long-term clinical investigation.

Adult↗
PubMed1985

[Chronic idiopathic eosinophilic pneumopathies. A study of 16 cases].

We report 16 cases of chronic idiopathic interstitial pneumonia (P.C.I.E.). P.C.I.E. has well defined clinical, radiological and biological characteristics which enable the eosinophilic pulmonary infiltrates to be recognised and the diagnosis to be confirmed without histological proof. The data from broncho-alveolar lavage (L.B.A.) show that besides the radiological infiltrates, there is a diffuse alveolar eosinophilia; sometimes confirming the pulmonary function results, which show a similar pattern to diffuse interstitial pneumonia (P.I.D.). The frequent association of asthma (50%) and extra-pulmonary signs (30%) may suggest a vasculitis or more particularly the Churg-Strauss syndrome, all the more so without a lung biopsy; however the evolution of the disease and the response to low dose steroid therapy is against the latter two being considered in the differential diagnosis. The prognosis for P.C.I.E. is good in the short and medium term; nevertheless during the period under observation (mean 6.3 years) steroid therapy could only be stopped in 3 out of 16 patients. The other patients were stable with a low dose of Cortisone. No patient with P.C.I.E. associated with asthma or hypergammaglobulinaemia or extra-pulmonary signs could be weaned from steroids. The authors advocate that the dose of steroids should be adjusted as low as possible to maintain an eosinophilia below 500/mm3.

Adult↗
PubMed1985

[Pneumopathy caused by hypersensitivity to isocyanates. Value and dangers of a realistic provocation test].

Organic isocyanates are responsible for bronchial pathology and in rare cases of hypersensitivity pneumonia. We present a new observation supported by a complete lung function assessment, histology of a transbronchial biopsy and a positive bronchial challenge test. The progress of the disorder was followed by repeated lung function measurements and bronchoalveolar lavage. The alveolar response at first showed an alveolar leukocytosis, then a mixed picture, finally becoming a pure lymphocytosis. The activity of the alveolar cells was assessed for T lymphocytes by cytofluorimetry, the presence of DRa like and LMR antigens and lastly for macrophages with Gallium scans. The inflammatory response was followed by analysing the proteins in the lavage liquid. The value of studying alveolar cell-activity and equally alveolar protein content is underlined in this study and reminds one of the character, sometimes unpredicted and dangerous, of challenge tests using isocyanates.

Bronchi↗
PubMed1985

[Apparently primary thoracic hemangiopericytoma. Apropos of 12 cases].

Twelve cases of apparently primary thoracic hemangiopericytoma are reported: 7 intrapulmonary and 5 extrapulmonary. These cases, taken together with 75 others already published, serve as a basis to describe the characteristics of thoracic hemangiopericytomas. Intrapulmonary forms raise the problem of a single peripheral X-ray lesion, often detected in a routine film, with no accompanying endoscopic abnormality. Extrapulmonary forms also take the form of a well defined tumor with diaphragmatic or mediastinal parietal connections. Up to the present, the diagnosis has always been made at thoracotomy. It is probable that a preoperative diagnosis will be possible in the future by transbronchial biopsy. Silver stains and the use of the electron microscope form the basis of histological diagnosis. However it is not possible to distinguish by histology between benign and malignant forms, nor between primary or metastatic hemangiopericytomas. It is for this reason that doubt will long persist as to the primary nature of the tumor and only prolonged survival of patients after excision confirms that the lesion was indeed primary. Treatment is essentially surgical. New high energy radiotherapy techniques and new possibilities in chemotherapy (using adriamycin) should improve the prognosis in those forms which run a malignant course. However the standard therapeutic strategy for these rare tumors has yet to be defined.

Adult↗
PubMed1985

[Comparative clinical trial of cefoperazone versus ampicillin + tobramycin in severe bronchopulmonary and pleural infectious pathology].

This study involved an open trial with parallel randomised series receiving either cefoperazone (2 g/d) or a combination of ampicillin (6 g/d) and tobramycin (3 to 4 mg/kg/d). The 30 patients included were of both sexes (male predominance), hospitalised, aged 62 +/- 11,5 years and suffering from a severe bronchopulmonary or pleural infection. Underlying pathology was serious (neoplasm, C.O.D.L., bronchiectasis, cardiac pathology). No significant difference was seen in the sampling of the two populations. Cefoperazone was prescribed in 2 infusions per 24 hours. Ampicillin was given as 3 infusions, followed by tobramycin administered by a similar number of injections. The duration of treatment was 16.8 +/- 9 days (cefoperazone) and 11,8 +/- 6,5 days (ampicillin + tobramycin). Overall evaluation (clinical, radiological and laboratory criteria) showed 88% (cefoperazone group) and 71% (ampicillin + tobramycin group) recovery and improvement rates. There were two failures in the cefoperazone group and 6 failures in the other group. These results were not statistically different. Three of the 6 failures could be attributed to resistance of the initial bacteria or selected by one or other type of treatment. None of the antibiotics prescribed raised any acceptability problems.

Aged↗
PubMed1984

Cryptogenic fibrosing alveolitis and Epstein-Barr virus: an association?

13 patients with cryptogenic fibrosing alveolitis (CFA) and 12 with interstitial lung disease (ILD) of known cause were studied for their humoral response to herpes simplex virus (HSV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV). Serum antibodies to HSV and CMV were within the normal range in all patients. 10 patients with CFA had raised serum antibodies to EBV, and IgA against viral-capsid antigen (VCA) was detectable in all 13. In the other 12 patients EBV serological profiles were normal and IgA against VCA was detectable in only 1 patient. The EBV antibody levels did not correlate with the level of circulating immune complexes, the presence of rheumatoid factors, or the cytological findings of the alveolitis. The presence of IgG against VCA in 5 CFA patients suggests local production of EBV-specific immunoglobulins. Elevated IgG and IgA against EBV in CFA may indicate non-specific depression of cell-mediated immunity or that EBV plays a part in the aetiology of CFA.

Adult↗
PubMed1984

Lactic dehydrogenase isoenzyme electrophoretic patterns in the diagnosis of pleural effusion.

The relative value of each lactic dehydrogenase isoenzyme (iso LDH) was measured by electrophoretic separation in the serum and the pleural fluid of 100 patients. In each case, the cause of the pleural effusion was known. Two types of LDH isoenzyme pattern were found in the serum: a normal type with a low value of LDH 5 and an abnormal type with a high value of LDH 5. This high LDH-5 level is due to an impaired liver function. In the pleural fluid, the electrophoretic patterns of five LDH isoenzymes were found by computerized processing. During congestive heart failure (28 cases) the electrophoretic pattern of the LDH isoenzymes was always similar in the serum and in the pleural fluid (transudative pleural effusion). During thoracic empyema, the relative values of the isoenzymes in the pleural fluid were regularly increasing from LDH 1 to LDH 5. In this situation, the evaluation of LDH 5 appeared to emanate from the increased granulocytes in the pleural fluid. In 22 inflammatory pleural effusions, the relative values of the five isoenzymes were equal. During malignant effusions (35 cases) a high level of LDH 5 was found in 21 patients. LDH 5 is known to be secreted by malignant tissue, and the authors confirmed it by finding a high level of LDH 5 in biopsy specimens of patients with mesothelioma or epidermoid lung cancer (7 cases). Conversely, the level of LDH 5 was low in biopsy specimens from normal lung tissue or benign inflammatory pleuritis (6 cases). Among the 14 patients with low levels of LDH 5 in the pleural fluid during malignant pleural effusion, the authors found the malignant lymphomas (three cases) and the small cell lung carcinoma (five cases). In these cases, the low level of LDH 5 was in agreement with the result of a low level of LDH 5 found in the biopsy of a metastatic liver localization of a small cell lung carcinoma. So the electrophoretic determination of LDH isoenzymes pattern in pleural fluid is a sensitive tool for the management of pleural effusion.

Carcinoma, Squamous Cell↗