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Biomedical subjects

J Brune

Publications and source records attributed to J Brune.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Pulmonary hamartoma. Apropos of 49 surgically treated cases].

A series of 49 patients with pulmonary hamartoma subjected to operation is described. 28 patients were male and 21 female, with a mean age of 49.8 years. Most cases were discovered on routine chest films. Six patients had radiologic changes produced by obstruction, while 43 had a rounded peripheral opacity. Fine calcifications were present in four cases. In no case was diagnosis achieved by bronchoscopy, whereas one of the more recent cases was diagnosed by percutaneous fine needle biopsy. Sinner has shown that this last technique can establish diagnosis in most cases. As such tumors are invariably benign and grow slowly, diagnosis by percutaneous biopsy renders operation unnecessary: periodic follow up only is required.

Adolescent↗
PubMed1984

[Radiology of spontaneous pneumothorax in young patients. Apropos of 200 cases].

In 200 young patients with apparently idiopathic spontaneous pneumothorax, the following radiologic features were analyzed: degree of collapse on the initial chest film, areas of atelectasis, and presence of blebs, apical opacities, fibrous adhesions, pleural effusions, and controlateral shift of mediastinal structures. Confrontation of apical changes with pathologic findings in operative specimens suggests that mesothelial rupture with reactive hyperplasia results in a "pneumatization chamber" visible as a bullous image. Following drainage, homolateral shifts of mediastinum and four cases of pulmonary edema were recorded. Risk factors for pulmonary edema include severe pulmonary collapse with areas of atelectasis, persisting for more than 48 hours and an aspiration which either exceeded 1.5 l. of air or was performed with a depression of more than 30 cm of water.

Adolescent↗
PubMed1984

Activated lung lymphocytes in hypersensitivity pneumonitis.

T-lymphocyte activation was investigated in peripheral blood and bronchoalveolar lavage (BAL) of four patients with hypersensitivity pneumonitis. The study was performed by flow cytometry with the use of immunofluorescence labeling with monoclonal antibodies to lymphocyte differentiation or activation antigens. Simultaneous measurement of DNA and RNA content by acridine orange staining was used for cell-cycle analysis. The various cell types were identified by their light-scattering properties. T cell activation was demonstrated in the BAL of all patients by the presence of T cells (OKT3 positive) bearing class II histocompatibility antigen (HLA-DR) and activated T cell markers (MLR 1-3). Lymphocyte proliferation was evidenced in BAL but not in blood of patients by an increased percentage of cells in S + (G2 + M) phases. In addition, T-lymphocyte subsets analysis revealed no abnormalities in the blood and no major imbalance in the BAL despite a slightly increased OKT4/OKT8 ratio. The finding of T cell activation and lymphocyte proliferation in hypersensitivity pneumonitis alveolitis is consistent with the contribution of a local type IV immune reaction to the pathogenesis of this disease.

Alveolar Process↗
PubMed1984

[Exclusive demonstration of creatine phosphokinase BB isoenzyme in serum, pleural fluid and neoplastic tissue in a case of small-cell pulmonary neoplasm].

The presence of circulating CPK BB isoenzyme is not as rare as was originally supposed. Theoretically damage of organes containing CPK activity should release soluble enzyme into the general circulation. So CPK BB has been reported in sera of patients with brain injury, prostate resection or with gastrointestinal malignant diseases. We present one case of small-cell lung carcinoma associated with 100% of CPK activity type BB in serum. This enzyme pattern was found also in malignant pleural effusion and in the biopsy of the malignant tumour tissue. In this tissue total CPK activity was found markedly more than in normal lung tissues or in epidermoid lung cancers. Brain type CPK is the fetal form of the enzyme and it is possible that our findings is yet another example of tumour expression of a fetal marker in the case of this very undifferentiated tumour.

Carcinoma, Small Cell↗
PubMed1984

[Primary pulmonary pseudolymphomas and lymphomas. 4 cases].

We report four cases of primary pulmonary pseudolymphoma and lymphoma with the usual features of these disorders: lack of symptoms, radiological opacities sometimes multiple with soft wooly contours and air bronchograms, and slowly evolving pattern. The distinction between pseudolymphoma and lymphoma, prior to histological diagnosis is currently controversial. Immunological studies aim at defining whether the lymphoid proliferation is polyclonal or monoclonal (the benign process being considered polyclonal and the malign monoclonal). This distinction works in some cases, as in one of our cases of lymphoplasmacytic lymphoma with a monoclonal IgM gammopathy, a predominance of cells containing IgM on immunofluorescence, and an illness evolving over 9 years. Other cases raise discussion points such as one of our patients with classical histological characteristics of pseudolymphoma, an absence of monoclonal markers on immunofluorescence, but having a monoclonal gammopathy in the serum. This example raises the question as to the possible coexistence of, or a switch over from, a polyclonal to a monoclonal process. In this way the primary pulmonary lymphoproliferative process ought to be considered as one element in a large spectrum ranging from benign to malign disorders and not as distinct illnesses with definitive patterns.

Adult↗
PubMed1984

[Amiodarone: a new etiology of diffuse interstitial pneumopathy? Apropos of 2 personal cases and 10 cases from the literature].

Diffuse Interstitial Pneumonia (PID) is probably, although rarely, a complication of Amiodarone therapy. We describe two new cases and review 19 from the recent literature. The first patient was a man treated solely with Amiodarone for three years (total dose 185 g). He presented clinically with a picture of PID with slight dyspnoea, weight loss of 4 kilos and a dry cough. There were pulmonary crackles on auscultation, diffuse reticulo-nodular shadows radiographically and compatible pulmonary function tests. Broncho-alveolar lavage (LBA) was lymphocytic (30%). Stopping Amiodarone without resorting to steroids led to the disappearance of the clinical signs within 15 days and the return to normal of the LBA and pulmonary radiograph within six months though the pulmonary function was unchanged. The second case was a 78 year old man treatment with Amiodarone for six months (total dose 20 g). He presents acutely with grade IV dyspnoea and low grade fever. There were pulmonary crackles on auscultation and a bilateral pulmonary infiltrate on the chest radiograph. The pulmonary function tests were compatible with PID showing a restrictive ventilatory defect, a reduced Carbon Monoxide transfer (single breath) and hypoxia. The diagnosis was confirmed by a transbronchial biopsy showing a parieto-alveolar infiltration with increased cellularity and collagen formation. The LBA was predominantly polymorphonuclear. Stopping the Amiodarone associated with steroid treatment produced a normal chest radiograph within six weeks, whilst moderate dyspnoea and less severe restrictive ventilatory defects persisted. The clinical, radiological, functional and histological features of our patients were comparable to those 19 cases reported in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

[Pulmonary mucormycosis. Apropos of a case with serologic confirmation].

We report a new case of primary pulmonary mucormycosis. The radiographic evidence and anatomopathological facts demonstrate an intra-cavitary mycetoma of Fowler associated with a chronic pneumonia in the left basal segment. The patient was not immunosuppressed but had undergone a left upper lobectomy 25 years before. This appears to be the first case in which a serological study has confirmed the diagnosis.

Humans↗
PubMed1984

[Alveolar cancer and localized parieto-alveolar fibrosis].

We report a case, cytologically diagnosed, of broncho-alveolar cancer associated with localised interstitial pulmonary fibrosis. This association of fibrosis with bronchiolo-alveolar cancer is classical and a pathogenic affiliation has been deduced by the majority of authors. We review the pathogenesis in relation to recent datas concerning the activation of successive oncogenes: the first stage of carcinogenesis may correspond to the activation of an oncogene coding for a fibroblastic growth factor leading to fibrosis.

Adenocarcinoma↗
PubMed1984

[Diffuse pulmonary carcinomatous lymphangitis. Study of respiratory function in 18 cases].

Respiratory function studies were carried out in 18 patients with diffuse and isolated pulmonary lymphangitis (LCP) diagnosed on radiological and cyto-histological grounds. Restrictive ventilatory defects were found in 17 out 18 cases CPT: 75,3% (DS = 5), CV: 56.7% (DS = 14,5). The Tiffeneau coefficient was less than 65% in 50% of cases but the DEM/CV was reduced in 77% of cases, evidence of the great frequency of airflow obstruction. The measure of the (formula; see text) was normal in 5 out of 17 cases, implying the absence of an alveolar neoplastic lesion or obliteration by arteritis or capillaritis in LCP. The alveolar-arterial oxygen gradient on hyperoxia was normal (less than 27 kPa) 14 times out of 18 and slightly increased in 4. Important hypoxaemia at rest was present 17 times out of 18; PaO2: 8 kPa (DS = 1). There was no patient with alveolar hyperventilation: PaCO2: 4.3 kPa (DS = 0.5). On exercise, hypoxaemia remained stable 4 times, improved 5 times and worsened 9 times. A pathophysiological interpretation was given for each disturbance of respiratory function. In conclusion, a characteristic respiratory function profile of LCP is proposed, with a restrictive ventilatory disturbance or moderate mixed picture, a DLCO/VA ratio generally normal, almost constant hypoxaemia at rest and improvement or worsening on exercise. CPT = Mean total lung capacity. CV = Mean vital capacity. DS = Standard deviation.

Aged↗
PubMed1984

[Interlobar pneumothorax].

The features of interlobar (intrafissural) pneumothorax are little known. Of the 4 cases reported here, 1 was associated with spontaneous pneumomediastinum and 3 were consecutive to pleurodesis for spontaneous pneumothorax. Interlobar pneumothorax does not occur unless pleural adhesion is present. The diagnosis is confirmed by radiography of the chest which shows an oblong air-clear area prolonged by a fissural line and corresponding, on lateral projection, to the normal fissure. This image should not be confused with that of pneumatocele, which also resolves spontaneously.

Adult↗
PubMed1983

[Embryonal carcinoma and vitelline tumor of the mediastinum. Diagnostic and prognostic value of alpha-fetoprotein levels. A propos of 5 cases].

Five cases are reported of embryonal carcinoma with a vitelline structure more or less predominating. The presentation was of an anterior mediastinal tumour occurring in young men and in three cases there was mediastinal obstruction. The clinical examination, in particular testicular examination, was negative. In each case the level of the alpha-fetoprotein was greater than 1,000 micrograms/l, even post-operatively. The alpha-fetoprotein and HCG-beta should be measured systematically in all cases of anterior mediastinal tumour occurring in young subjects, and would enable a more frequent identification of tumours with difficult histology. The serum levels reflected the changes noted clinically and radiologically. Polychemotherapy bases around cis platinum led to a significant but transitory regression of the tumours. Radiotherapy was ineffective. Surgery was never totally curative.

Adult↗
PubMed1983

[Apparently primary pulmonary hemangiopericytoma. Apropos of 7 cases].

Seven cases of pulmonary hemangiopericytoma (presumed to be primary v.i.) are reported. Personal observations on these cases combined with 43 already described in the literature allow certain characteristics of the disorder to be accurately defined. Clinically, primary pulmonary hemangiopericytoma raises the aetiological problem of a peripheral solitary tumour beyond endoscopic vision. Until the present time the diagnosis has always been made by thoracotomy. Transpleural pulmonary biopsies may allow a preoperative diagnosis. Silver stains and electron microscopy enable an anatomo-pathological diagnosis. Histological studies can neither distinguish between benign and malignant forms nor differentiate between primary or metastatic hemangiopericytoma. For this reason there is always a long period of doubt whether the tumour is primary; only prolonged survival of the patients after excision will confirm whether the tumour was a primary or not. Treatment is essentially surgical. It seems that new techniques in radiotherapy (high energy) and new possibilities of chemotherapy (with Adriamycin) are capable of improving the prognosis of the malign form. However, such a therapeutic strategy remains to be defined as these tumours are so rare.

Adult↗
PubMed1983

[An unusual cause of hypoxia: anastomosis of the right superior vena cava into the left auricle. Surgical correction].

Anomalies of drainage of the superior vena cava (S.V.C.) usually consists of a persistent left S.V.C. draining into the left auricle. Until now there has only been one published case of S.V.C. anastomosis with the left auricle. We describe a second case of a four year old boy who had undergone two operations for a recurrent cerebral abscess. This child presented with cyanosis, polycythaemia and arterial hypoxaemia. This abnormality is associated with a partially anomalous pulmonary venous drainage. Surgical correction using prosthetic and pericardial grafts enabled closure of the right to left shunt.

Adolescent↗
PubMed1982

[4 cases of Mycoplasma pneumoniae pneumonia].

The authors report four cases of Mycoplasma pneumoniae pneumonia which occurred towards the end of 1981, concurrently with an intensification of this infection. Three patients had severe respiratory distress and one required ventilatory assistance. The features shown on chest roentgenograms are discussed. All four patients had been treated initially with penicillin or cephalosporin. This report is evidence that patients with pneumonia should be given a macrolid as the first treatment.

Adult↗