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J F Cordier

Publications and source records attributed to J F Cordier.

At least 19 recordsLinked to original sources
PubMed1992

[Pseudo-asthma and asthma with hypereosinophilia].

Despite of its high prevalence, asthma is not the sole cause of wheezing dyspnea: the obstruction of the principal airways, some diffuse bronchial diseases may present as pseudoasthma. The diagnosis of some behavioral dyspneas as well as functional laryngeal obstruction is sometimes highly difficult. The finding of a marked hypereosinophilia prompts the clinician to research a parasitic infection as a cause of pseudo-asthma, allergic bronchopulmonary aspergillosis complicating asthma, or an idiopathic hypereosinophilic disorder of which asthma is a component (as in Churg and Strauss syndrome).

Asthma↗
PubMed1992

Pulmonary hemorrhage and glomerulonephritis in primary biliary cirrhosis.

We observed life-threatening intrapulmonary hemorrhages and focal proliferative glomerulonephritis in a 41-yr-old woman with primary biliary cirrhosis. The severity of the symptoms necessitated blood transfusions and mechanical ventilation; the patient improved with the help of corticosteroid therapy. No formal evidence of either Goodpasture's syndrome or any other well-defined systemic vasculitis could be found. Neutrophil cytoplasmic antibodies were initially positive and became undetectable after 3 mo of immunosuppressive treatment without relapse. This association has not been described previously and may be added to the list of extrahepatic immune-mediated conditions associated with primary biliary cirrhosis.

Adult↗
PubMed1992

Characterization of the smooth muscle cell infiltrate and associated connective matrix of lymphangiomyomatosis. Immunohistochemical and ultrastructural study of two cases.

Lymphangiomyomatosis (LAM) consists of smooth muscle (SM) cell proliferation of unknown origin involving the lymph nodes and the lung interstitium. From morphological studies showing both SM differentiation of the proliferating cells and lymphatic hyperplasia, hypotheses were suggested concerning the origin of the proliferation. Two cases of LAM were investigated by electron microscopy and immunohistochemistry; tissues were obtained by lymph node and open lung biopsies. Cytoplasmic and matrix protein markers were used in order to clarify the pattern of differentiation of the proliferating cells and to characterize their connective tissue environment. The proliferating cells present ultrastructural characteristics of SM cells; they contain vimentin, desmin, and alpha-SM actin and are devoid of Factor VIII, favouring a parieto-arterial origin. The connective tissue matrix inside the infiltrate is composed of interstitial collagens and basement membrane components. At the late stage of the disease, remodelling of the interstitial matrix accompanies the infiltrate and remains perilesional.

Adult↗
PubMed1992

Pretreatment staging evaluation in small cell lung carcinoma. A new approach to medical decision making.

The real need for extensive staging at the time of diagnosis is discussed in regard to small cell lung carcinoma. We performed a decisional retrospective analysis on a series of 182 patients, based on three staging steps: the first step included physical examination and routine biologic tests. The second step consisted of liver ultrasonography and needle aspiration of any clinically detectable tumor mass, and the third step included bone marrow examination, radionuclide bone scan, thoracic, abdominal, and brain CT scan. A stepwise multivariate logistic regression performed on 11 variables considered in the first step shows that a four-parameter model can predict the spread of the disease (limited or extensive): weight loss, performance status, and elevated LDH or alkaline phosphatase levels. Limited disease can be predicted in two ways: (1) elevated LDH with normal alkaline phosphatases, no weight loss, and good performance status, or (2) normal LDH and alkaline phosphatases. In this series, 28 percent of patients can be predicted as having extensive disease and can be treated with chemotherapy alone without chest irradiation. After the second step, the probability of disease being extensive is only 25 percent, and only 84 (46.15 percent) patients would need to undergo the third step of staging procedures (brain CT scan, bone marrow aspiration and biopsy, radionuclide bone scan) with this method. We conclude that a multistep approach represents a simple staging method and offers the advantage of harmlessness and lower costs for patients not to be evaluated in prospective clinical trials.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Thoracic splenosis presenting with hemoptysis.

Thoracic splenosis (post-traumatic autotransplantation of splenic tissue) is rare and generally asymptomatic. We report a patient with thoracic splenosis presenting with repeated hemoptysis. The blood supply of the hypervascular splenic transplants originated from a bronchial and an intercostal artery. Hemoptysis improved after surgical exeresis of splenosis. Recognizing splenosis presenting with hemoptysis is important, since percutaneous embolotherapy could be hazardous because of the risk of ectopic splenic tissue infarction.

Chronic Disease↗
PubMed1992

[Purulent pleurisy revealing an esophageal diverticulum].

We report a very rare case of a purulent pleurisy which was revealed to be caused by an oesophageal diverticulum. The pleuro-pulmonary infection probably followed the inhalation of septic material which refluxed from an oesophageal diverticulum into the trachea. This was suggested by a barium swallow which showed the transit of the barium into the trachea during swallowing movements.

Anti-Bacterial Agents↗
PubMed1992

[Infectious agents associated with exacerbations of chronic obstructive bronchopneumopathies and asthma attacks].

Infections of the respiratory airways are frequently responsible for exacerbations of chronic obstructive pulmonary disease (COPD) and attacks of asthma. However, the causal infectious agents in practice are rarely precisely identified. We have undertaken a prospective study with the aim of researching into the bacteria and viruses associated with these exacerbations. Forty-seven patients who were in hospital between 1987 and 1989 for attacks of asthma (13 episodes) or exacerbations of COPD (35 episodes) were included in this study. The microbiological analysis consisted of: 1) the bacteriology of expectorated material or the products aspirated by fibroscopy with direct examination, quantitative cytology and culture; 2) samples taken from the nasal airways to identify and isolate pneumotropic viruses and mycoplasma; 3) serial serology looking for antibodies against pneumotropic bacteria and viruses. One of more infectious agents were shown in 47% of the episode studies of which 57% were exacerbations of COPD and treated 23% attacks of asthma. In the cases COPD bacteria were identified in 13 cases including Haemophilus influenzae [3], Streptococcus pneumoniae [3], Pseudomonas aeruginosa [3]. Amongst the 14 viruses recovered, the influenza virus [8] and the respiratory syncytial virus (VRS) [4] predominated. In 14 cases of acute asthma only 4 infectious agents were shown; Mycoplasma pneumoniae, influenza A, VRS and parainfluenza virus. The influenza virus was the agent most frequently discovered (26%) during the course of exacerbation of COPD and of asthma.

Bacteria↗
PubMed1992

[Localized pleural fibrous mesothelioma (submesothelial pleural fibroma). Anatomo-clinical study of 25 cases].

We studied a retrospective series of 25 sub-pleural fibromas (benign localized pleural mesotheliomas) of which 23 where excised, collected over a period of 20 years. The current series confirms the excellent prognostic of these rare tumors. They are sometimes bulky, but not infiltrating and discovered by systematic chest X-ray. Modern imaging using CT-Scan and nuclear magnetic resonance can suggest their diagnostic which is confirmed by histopathologic analysis of the usually pediculate and easily removed tumor. Transthoracic needle aspiration is generally of little help for diagnosis. The histopathologic diversity of the tumor is rather confusing but characteristic features can be found with fusiform cells ans collagen stroma. Immuno-histochemistry is more helpful for diagnosis and histogenesis recognition than electron microscopy.

Adult↗
PubMed1991

[Etiology and physiopathology of pulmonary artery hypertensions (PAHT)].

Pulmonary hypertension results from many causes: left cardiac failure, increased pulmonary blood flow, proximal vascular obstruction, decrease of the distal vascular bed (by loss of vessels, narrowing of their luminal diameter, or endoluminal obstruction). A part from passive hemodynamic responses, active processes contribute to pulmonary hypertension by vasomotricity and remodeling of the vascular wall. The biopathology of vasomotor mediators, as well as of endothelial and smooth muscle cell interactions just begins to be understood.

Humans↗
PubMed1991

[Diffuse infiltrative lung diseases and fibrosis].

The clinician confronted to the diagnosis of infiltrative lung disease has to consider a wide spectrum of aetiologies. Among them, diffuse fibrosing interstitial lung disease is characterized by the deposition of collagen within alveolar structures. Either acute alveolar injury or chronic inflammatory alveolitis can induce pulmonary fibrosis. Basic research investigates the cells, the cytokines, and the extracellular matrix involved in the perpetuation of the fibropoliferative process.

Humans↗
PubMed1991

[Bilateral diaphragmatic paralysis, the cause of acute insufficiency in chronic obstructive bronchopathy. The value of nasal mechanical ventilation].

A 57 year old man with chronic bronchitis sought a consultation for dyspnoea at rest associated with an absolute inability to lie flat. Examination revealed paradoxical respiration and respiratory function testing revealed a mixed ventilation disturbance, which was predominantly obstructive and was aggravated in the dorsal decubitus position. Radiology revealed bilateral diaphragmatic paralysis, which was confirmed on measurement of transdiaphragmatic pressure. The patient benefited from assisted ventilation by the nasal route with an excellent result in both the short and the medium term. Investigation into the cause was negative, in particular there was no evidence of any neuromuscular abnormality. This case recalls the role of the diaphragm in acute respiratory failure and shows the value of mechanical ventilation by the nasal route in the treatment of certain types of diaphragmatic paralysis.

Bronchitis↗
PubMed1991

[Bronchiolitis obliterans with severe obstructive ventilation disorder after a bone marrow transplant. Study of 7 cases].

In 40 to 60% of bone marrow grafts there are pulmonary complications of which the most frequent is the occurrence of an interstitial pneumonia. We report 7 cases here of a more rare complication, that of bronchiolitis obliterans (BO). Between December 1979 and November 1989, 7 patients (3.4% of our cases of GMO) have developed over several months a chronic obstructive respiratory failure (a mean VEMS of 43% of the theoretical value) in the year following the transplantation (mean delay 190 days). 6 patients presented with cutaneous, digestive or hepatic signs of chronic graft v host illness (GVH) whereas the prevalence of this complication in the population studied was 17%. Treatment combining bronchodilators and immunosuppressants was only successful in 2 cases and the outcome was fatal in the 5 other cases as a result of respiratory failure (mean delay 208 days between the appearance of respiratory symptoms and death). The pathogenesis of BO after GMO remains poorly understood. It may rest on an immune process during the course of which the BO would be the result of a chronic pulmonary GVH. Another hypothesis is that the state of the immunosuppression in these patients would favour the appearance of a bronchiolitis of an infectious origin, particularly viral. The prognosis of BO after GMO is very poor and in the absence of specific effective treatment the therapeutic strategy remains essentially that of prevention by the early detection of respiratory anomalies.

Adolescent↗
PubMed1991

[Bronchiolitis obliterans organizing pneumonia (BOOP). Characteristics and boundaries of an anatomo-clinical entity].

Bronchiolitis obliterans organizing pneumonia (BOOP) is defined by endoluminal obstruction of distal airspaces by a fibrous granulation tissue consisting of inflammatory cells, fibroblasts, and connective tissue. The morphogenesis of the process is the following: diffuse alveolar injury leading to basement membrane denudation and intra-alveolar exudate of fibrinogen, immunoglobulins, coagulation factors, fibronectin; intra-alveolar migration of interstitial fibroblasts through gaps of the epithelial basement membrane; intra-alveolar secretion of loose connective tissue (codistribution of collagens I, III, V, and fibronectin) by the fibroblasts-myofibroblasts. The main characteristic of this peculiar fibrosis is its possible reversibility. BOOP is not specific for any aetiology, and it is found in various conditions as infectious diseases, drug induced pulmonary diseases, connective tissue diseases. It is also present in other conditions where it is not the most contributive information to diagnosis (hypersensitivity pneumonitis, chronic eosinophilic pneumonia). But in some cases BOOP remains idiopathic and has to be individualized. Three clinical and imaging profiles are distinguished: the most characteristic consists of an inflammatory context with imaging patchy alveolar opacities, migrating and relapsing, and most steroid sensitive; the other two presentations are less remarkable: pseudo-neoplastic localized chronic pneumonia, and diffuse infiltrative lung disease. BOOP is a clinico-pathologic entity that the clinician must know because of the efficacy of corticosteroid treatment in most cases, and it further represents an unique model to understand the pathogenesis of fibrosing pulmonary diseases.

Bronchiolitis Obliterans↗
PubMed1990

[Small cell lung carcinoma. Value of the evaluation of extension for the therapeutic strategy].

Small-cell lung carcinoma can be distinguished from other histological types of lung cancer because of its high metastatic potential. Initial staging procedures divide the patients into two main prognostic groups: the so-called "limited" (to the thorax) and the extensive disease patients. Based on the results of a prospective pilot study involving 182 patients and on a review of the literature, the authors discuss the usefulness of initial staging in increasing the number of detectable metastases, assessing tumour burden, evaluating treatment results and identifying prognostic factors. Complete tumour staging at the time of diagnosis appears to be very helpful for a better knowledge of the disease and better therapeutic decisions.

Adrenal Gland Neoplasms↗