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Biomedical subjects

J C Guerin

Publications and source records attributed to J C Guerin.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Isolated pleuropulmonary metastases of uterine sarcoma].

We report the case of a 52-year old post-menopausal woman in whom the finding of a right paravertebral mediastinal and pulmonary mass and a homolateral pleural effusion revealed the presence of a large uterine tumour. Pleural fluid cytology was in favour of an undifferentiated tumour, and biopsy of the endometrium pointed to a connective tissue tumour. Following immunohistochemical staining, hysterectomy combined with adnexectomy confirmed the diagnosis of uterine sarcoma. Later on, the patient underwent thoracoscopy which showed multiple pleural metastases. In view of concordant histological results and of the appearance of multiple spherical images at radiology, chemotherapy with adriamycin, ifosfamide and vincristine was instituted but proved to be ineffective: the patient died after two cycles of this therapeutic regimen.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[A familial case of metabisulfite intolerance. Clinical and pharmacological study].

Within a context of a familial case of severe respiratory signs, with intolerance of sulfites and aspirin, we decided to study the clinical reliability of "in vitro" activation of human basophils in the presence of sulfites. Positivity of these tests for the three patients in the study (60, 73, and 66%) is confirmed by passive sensitization of donor basophils, which was destroyed when the serum was heated. This argument in favour of IgE dependence was strengthened by observation of an "in vitro" desensitization by an anti-IgE and not by an anti-IgG. These "in vitro" data are in agreement with the clinical history, daily routine of the patient, skin tests and where done, oral provocation tests.

Adult↗
PubMed1992

[Mediastinal-pulmonary sarcoidosis with unilateral pseudotumorous presentation. Apropos of a case].

We report a case of a patient of forty two years who was admitted with a chronic cough and had a left hilar "tumour". Scanning showed a hilar opacity with an air bronchogram. Fibreoptic bronchoscopy did not succeed in achieving a precise diagnosis, the biopsies showed no sign of malignancy. An open lung biopsy was necessary to establish the diagnosis of pulmonary mediastinal sarcoidosis with a pseudo-tumoral presentation and localised unilateral disease involving a segmental bronchus and the left upper lobe. There was a rapidly favourable outcome after treatment with steroids.

Adrenal Cortex Hormones↗
PubMed1992

[Diseases of the pleura. Materials used and study technics].

Pleural diseases frequently pose problems to the pulmonary physician. The clinical and radiological approaches are often insufficient and it is necessary to resort to techniques which enable a precise morphological diagnosis of the pleural lesion. Starting with a needle puncture and biopsy, the medical investigation of the pleura has been enriched by thoracoscopy which enables visualisation of not only the parietal and visceral pleura and the lung but also the mediastinum and the pericardium. Using this technique the diagnostic yield and the harmless nature of the technique are of the first importance. After recording traditional techniques of investigation of lung disease (puncture, needle biopsy) the equipment, the technique, the indications and the risks and the diagnostic results from thoracoscopy are discussed.

Biopsy, Needle↗
PubMed1991

Activity of intrapleural recombinant gamma-interferon in malignant mesothelioma.

Twenty-two consecutive patients with malignant diffuse pleural mesothelioma were treated with recombinant gamma-interferon by the intrapleural route. Diagnosis was made by thoracoscopic examination and all cases were confirmed by the French Mesothelioma Panel of Pathologist. Patients were staged based on thoracoscopic examination and computed tomography (CT) scan: 12 patients were classified as Stage I and 10 were Stage II. A solution of gamma-interferon (40 X 106 U) was infused twice a week over 2 months. Every patient experienced fever. One patient had a Grade 2 leukopenia and one patient suffered from pleural empyema. Response evaluation was based on the following: (1) CT scan performed 2 weeks after treatment ended, and (2) repeat thoracoscopic examination with histopathologic verification in nine patients who had demonstrated a stabilization or a regression of the disease on CT scan. From the original group, 19 patients could be evaluated. Four complete thoracoscopic histopathologic responses and one partial response were observed in Stage I patients (56%). One partial response was observed in Stage II patients.

Alkaline Phosphatase↗
PubMed1991

Acute silicosis due to inhalation of a domestic product.

A 20-yr-old woman with no history of pulmonary disease presented with acute dyspnea and fever. After various investigations and treatments the symptoms persisted and a lung biopsy was performed. Pathologic analysis disclosed the presence of silicotic crystals within lung tissue and mediastinal lymph nodes. The patient admitted having repeatedly inhaled a domestic scouring powder rich in silica during the preceding 6 months. This is the first report of acute pulmonary silicosis developing after exposure to a common household product.

Acute Disease↗
PubMed1991

[Cystic lymphangioma of the mediastinum. 2 personal cases and a review of the literature].

Two mediastinal lymphangiomas (KLM) are described, in 36 and 41 year-old women. They presented as an incidental finding on chest radiograph. The mediastinal mass was anterior or posterior, compressing the adjacent vital structures, and cystic on computed tomography. The complete surgical removal was possible, but complicated by the size (12 x 7 x 4 cm and 10 x 7 x 5 cm), the hypervascularization and the infiltrative tendency of the lesions. The patients are well 36 and 30 months after removal. We compare these cases with 109 previously reported. They account for 1 p. 100 of the whole lymphangiomas and for 0.5 to 4.5% of all mediastinal tumours. The congenital or infantile cervico-mediastinal lymphangiomas are more frequent (10%). The general signs, symptoms, pathological findings, treatment and pathogenetic theories are discussed.

Adult↗
PubMed1990

[Bronchospasm disclosing pulmonary embolism].

We report the case of an 82-year old male patient without history of chronic obstructive lung disease in whom a sudden respiratory distress syndrome with sibilant rales in both lungs revealed a moderately severe pulmonary embolism, later confirmed by angiography. Bronchospasm occurring in the acute phase of pulmonary embolism may be expressed as acute asthma refractory to bronchodilators. This bronchoconstriction, seldom detectable clinically, seems to be related to regional alveolar hypocapnia in the territories embolized and to platelet-produced mediators, through a vagus nerve-mediated reflex. It must not hide pulmonary embolism, particularly in a suggestive context and when bronchodilators are ineffective.

Aged↗
PubMed1990

[Chemotherapy with high-dose cisplatin in brain metastasis of lung cancers].

CDDP is one of the most active single drugs in non small cell lung carcinoma. High doses of 200 mg/m2 are well tolerated when fractionated doses are used over a period of 5 d. Twenty-four consecutive patients (male, age range 38-70 y) with brain metastasis of lung carcinoma were included in this study. The total dose of CDDP - 200 mg/m2 - was divided into 5 equal daily fractions, infused over 6 h. Parenteral hydratation commenced the night before therapy. Efficiency was assessed by means of CT scan 15-30 d after the last course of chemotherapy. Complete response was achieved if no lesion was found on the CT scan; partial deafness 2 cases, renal toxicity 1 case, severe myelotoxicity 2 cases. Efficiency: failure was observed in 17 cases, objective responses in 7 cases (2 cases without injection contrast in the tumor, 3 partial regressions, 2 complete regressions). Thirty per cent of patients in this study exhibited an objective response with low toxicity. CDDP seems to be very useful in cerebral metastasis of lung carcinoma.

Adenocarcinoma↗
PubMed1990

[Amoxicillin as a 1st choice: 275 acute focal pneumopathies treated on an outpatient basis].

From December 1986 to January 1988, 100 General Practitioners and Pneumologists working outside hospital included in open unmatched series 275 patients who were diagnosed as having pneumonia at home. The study consisted of 53.2% men with an average age of 49.3 plus or minus 19.3. Their temperature on the first day (J1) was in 72.7% of cases greater than 38.5 degrees Centigrade. The doctors felt that the general state was good in 66.5% of the cases. Cough was present in 83.5% of cases but was dry in one out of every two. The patients received Amoxycillin in a dose of 2 grams per day orally (66.9%), or by injection (33.1%). On the third day (J3) 90% of the patients had a temperature below 38.5 degrees Centigrade. Their general state was improved in 94.6% of cases. The diagnosis of pneumonia at home was confirmed radiologically on 219 of the films available, confirming the good specificity of the clinical diagnosis of pneumonia at home. Ten patients were hospitalised. The apparent treatment of Amoxycillin was given in 247 cases (89.8% of cases). In 28 cases (10.2%) the treatment was changed by the addition or substitution of a Macrolide (15), or another antibiotic (5), and in 80 cases a change of treatment was not specified. 25 of these 28 cases were reviewed on the 14th day (J14) and no failures were observed after the change of treatment. In 247 patients in whom the treatment with Amoxycillin was followed 336 were reviewed on the 15th day and there had been four failures. Three were intolerant to the drug and there was one relapse.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulatory Care↗
PubMed1989

High doses of inhaled corticosteroids in unstable chronic asthma. A multicenter, double-blind, placebo-controlled study.

In a multicenter, randomized, double-blind study, inhaled beclomethasone dipropionate (BDP) 1,500 micrograms/day was compared to placebo in 43 chronic asthmatic patients uncontrolled by inhaled salbutamol and oral theophylline. During the prestudy period, a test of maximal steroid reversibility with oral prednisolone 0.5 mg/kg/day for 14 days was performed. The therapeutic response was measured over an 8-wk period as the ability to maintain the clinical improvement and the optimal pulmonary function induced by prednisolone. During the study, severe asthma exacerbation occurred in one (5%) of the 21 patients who received BDP and in 15 (78%) of the 22 patients who received placebo (p less than 0.001). In patients who received BDP, FEV1 and peak expiratory flow (PEF) remained above the optimal postprednisolone value, with a trend to improvement during the 8-wk study period. In patients who received placebo, FEV1 and PEF decreased and remained below the optimal value. We conclude that, in chronic asthma, inhaled BDP 1,500 micrograms/day maintains the optimal pulmonary function in addition to the clinical benefit induced by a short course of oral corticosteroids.

Administration, Inhalation↗
PubMed1988

Treatment of brain metastases of lung cancer with high doses of etoposide (VP16-213). Cooperative study from the Groupe Franais Pneumo-Cancérologie.

To study the efficacy of etoposide in brain metastases of lung carcinoma, etoposide was given during 3 consecutive days. The total dose of 1500 mg/m2 was divided into six 1 h perfusions delivered over 3 days to 19 patients having squamous (7), large cell (3), small cell (5) or adenocarcinoma (4). Response to chemotherapy was assessed by means of computerized tomography (CT) before and 15-30 days after the last course of chemotherapy (course interval = 28 days, maximum of four courses). Severe myelotoxicity was observed in nine patients with seven patient deaths resulting from infection. Efficacy could be evaluated in 13 patients. Failure was observed in seven cases. An objective response was observed in six patients (4/14 NSCLC and 2/5 SCLC), two patients having a complete regression. Average survival time was 10 weeks.

Adenocarcinoma↗