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J J Lafitte

Publications and source records attributed to J J Lafitte.

At least 73 records · Page 4Linked to original sources
PubMed1995

[Myeloma with intrathoracic tumor expression].

We report a case of a patient of 58 years old who suffered from a left apical opacity occurring in a context of deterioration in general health. Subsequent clinical developments were dominated by the ophthalmic disease and a frontal syndrome. The radiological work-up showed tumoral lesions which had developed from the first rib, from the structures at the base of the cranium and the frontal area and were associated with multiple lacunae of the cranial vault. There was evidence of hyperproteinaemia, and an IgG gamma monoclonal gammopathy, a significant medullary plasmocytosis with morphological anomalies of the plasmocytes leading to a diagnosis of myeloma with a plasmocytoma of the rib and the retro-orbital area. Thoracic disease associated with this pathology is common but mainly present as osteolytic lesions. The occurrence of intrathoracic plasma cell tumours is rarer as are orbital manifestations. In spite of treatment which can frequently lead to an objective response, the prognosis of this disorder remains gloomy.

Bone Neoplasms↗
PubMed1994

Determinants of response to immunosuppressive therapy in idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) response to corticosteroids and cytotoxic medications appears to be the most important determinant of survival. The purpose of this retrospective study was to analyse the determinants of response to immunosuppressive therapy with prednisone alone, or prednisone and cyclophosphamide, in IPF. Twenty five consecutive patients were studied. Initial evaluation in untreated patients included clinical, biological and functional parameters. Sequential evaluation by pulmonary function tests (forced vital capacity (FVC) and transfer factor of the lungs for carbon monoxide (TLCO)) was performed at a 3 month interval. Response to therapy was defined as an improvement in FVC and/or TLCO of more than 10% after 12 months, with maintenance of this improvement for at least another 12 months. Twelve of the 25 patients were classified as responders. A symptomatic disease of less than 12 months duration before onset of therapy related to response. FVC was more impaired in the group of responders when the comparison was limited to patients with an FVC of less than 90%. Bronchoalveolar lavage cell counts were not significantly different between responders and non-responders. Assessment of pulmonary function after 3 months of treatment was predictive of maintenance of the response or of even further improvement. Patients with improved FVC after 3 months of therapy had a significantly shorter symptomatic disease before onset of treatment (7.6 +/- 7.1 vs 20.2 +/- 18.6 months). A beneficial effect of addition of cyclophosphamide was observed only in patients who demonstrated an early but short-lived improvement to steroids. Adverse reactions of immunosuppressive therapy were noticed in 10 patients, and required discontinuation of treatment in six of them.(ABSTRACT TRUNCATED AT 250 WORDS)

Bronchoalveolar Lavage Fluid↗
PubMed1992

The binding of amikacin to macromolecules from the sputum of patients suffering from respiratory diseases.

Antibiotics bind to whole cystic fibrosis sputum, however, the composition of sputum varies from one patient to another, making the interpretation of binding studies difficult. This problem has been examined by standardizing the macromolecule concentration of sputum from 13 patients suffering from cystic fibrosis, chronic bronchitis or bronchiectasis and adding amikacin to the sputum components. Also binding to fractions of sputum was studied before and after treatment with DNase or chondroitinase. These studies indicated that the degree of amikacin binding is dependent on the DNA concentration and the presence of acidic mucins.

Amikacin↗
PubMed1992

[Adenocarcinomatous pleural lesion associated with hypoglycemia].

We report the case of a patient suffering from a glandular pleural lesion. The evolution of the disease was punctuated by periods of hypoglycaemia, which caused a coma. There was no clinically evident explanation for these hypoglycaemic episodes. Investigations revealed adrenal failure, but this adrenal failure was unrelated to the neoplastic process in the patient. This case is a reminder that the cause of hypoglycaemia associated with tumours can really have a paraneoplastic origin and justifies an in depth study to achieve an aetiological diagnosis.

Adenocarcinoma↗
PubMed1991

Chondroitin sulfate in sputum from patients with cystic fibrosis and chronic bronchitis.

In order to ascertain whether or not the presence of glycosaminoglycans in sputa of patients suffering from chronic bronchial disorders was related to tracheobronchial infection, an electrophoretic procedure was set up. The different acidic macromolecular components of sputum, namely nucleic acids, glycosaminoglycans, and bronchial glycopeptides could be identified in proteolyzed sputum using agarose electrophoresis before and after the action of different enzymes: nucleases, chondroitinases, hyaluronidase and heparinase. This procedure was used to analyze 13 sputum samples from patients suffering from cystic fibrosis (CF) and 12 sputum samples from patients suffering from chronic bronchitis. Chondroitin sulfate was identified in 11 infected sputum samples from patients with CF and also in the noninfected sputum from a patient with chronic bronchitis. These data suggest a relationship between the presence of chondroitin sulfate proteoglycans in sputum and severe tracheobronchial infection in CF.

Adolescent↗
PubMed1991

An attempt to evaluate lung aggression in monkey silicosis: hydrolases, peroxidase and antiproteases activities in serial bronchoalveolar lavages.

Exposure to silica can induce fibrosis and/or emphysema. Various factors such as proteases, other hydrolases and oxidants may be involved in the destruction of lung parenchyma. On the other hand, antiproteases play an important role in the protection of lung parenchyma against the action of proteases. We have developed an animal model of silicosis in monkey Macacus cynomolgus and followed these factors by bronchoalveolar lavage (BAL). We have studied glycosidases activities, elastase-like activity, immunoreactive alpha 1-protease inhibitor (alpha 1PI), neutrophil elastase inhibitory capacity (NEIC) and myeloperoxidase. Bronchoalveolar cells in serial BAL were also studied. Six monkeys were exposed to quartz aerosols (100 mg.m-3) for 18 wks. They were followed until they developed X-ray changes, which occurred between 21-64 wks after the end of the dust exposure. Cellular "silicotic nodules" were observed in lung biopsies. A control animal underwent serial BAL. Changes were seen in the differential cell count. The release of superoxide anion by bronchoalveolar cells obtained during the experiment was increased. Separation on a gradient of Percoll showed the presence of young macrophages, which exhibited enhanced release of superoxide anion as compared to the totality of bronchoalveolar cells. The biochemical analysis of BAL fluids obtained during and after the period of dust exposure showed an increase in glycosidases, alpha 1PI and NEIC. Some free elastase-like activity was simultaneously detected in BAL fluids from exposed animals but not from the control. This elastase-like activity was very low compared to NEIC. The increase in enzymatic and antiprotease activities occurred at different points in time for each animal, suggesting large differences in individual responses to dust, but occurred before the chest X-ray abnormalities.

Acetylglucosaminidase↗
PubMed1990

Abnormal secretion of interleukin-1 and tumor necrosis factor alpha by alveolar macrophages in coal worker's pneumoconiosis: comparison between simple pneumoconiosis and progressive massive fibrosis.

The aim of this study was to compare the secretion of tumor necrosis factor alpha (TNF alpha) and interleukin-1 (IL-1) by alveolar macrophages (AMs) harvested from patients with coal worker's pneumoconiosis (CWP) and control subjects. We observed higher levels of spontaneous TNF alpha and IL-1 secretion by AMs from patients with CWP than in those from healthy controls. We did not find any significant difference between the two groups in the incidence of simple pneumoconiosis and progressive massive fibrosis. In the group of coal miners without radiologic signs of pneumoconiosis, we found high levels of both cytokines in a subgroup of subjects still exposed to the mineral dust but not in the subgroup of subjects removed from exposure. These results indicate that AMs are involved in chronic lung inflammatory reactions to mineral dusts, partly by way of cytokine secretion. Moreover, cytokine secretion by AMs appears to be an early event that is detectable at the moment of mineral dust exposure. The results open new perspectives in the study of the mechanisms leading to CWP.

Bronchoalveolar Lavage Fluid↗
PubMed1990

Cisplatin and vindesine for disseminated non-small cell lung cancer. Results of a prospective trial with 81 patients.

Eighty-one patients with disseminated non-small cell lung cancer (stage IV) were treated with 2 monthly cycles of initial chemotherapy combining cisplatin with vindesine. The initial chemotherapy-responding patients (CR, PR, MR) were randomized to 2 cycles or 4 cycles of maintenance chemotherapy. After initial chemotherapy, the response rate was 33% (CR, PR, MR) with 18.5% objective responses. The overall 1-year survival rate was 15% with 37% for responders as opposed to 2% for non-responders. Maintenance chemotherapy did not improve the response rate obtained after initial cycles. The small number of patients does not allow us to reach a definite conclusion on the optimum duration of maintenance chemotherapy. In the absence of large placebo versus chemotherapy randomized trials, no definite conclusion can be made on the benefit of chemotherapy in disseminated non-small cell lung cancer. This study suggests, however, that chemotherapy is associated with a significantly longer survival in responding patients.

Adult↗
PubMed1989

Identification of plasma proteins contained in bronchoalveolar fluid from Macacus cynomolgus.

1. Serial bronchoalveolar lavages (BAL) were performed on a subhuman primate (Macacus cynomolgus) in order to give an experimental model for silicosis. 2. We have identified and quantified some plasma proteins of monkey BAL fluid. 3. The results were compared to those previously obtained in humans. 4. Two proteins previously detected in human BAL fluid (alpha 1 acid glycoprotein, alpha 1 antichymotrypsin) were not detected in monkey control BAL fluid. 5. Two kinds of transferrins were detected in monkey BAL fluids while only one is described in human. 6. The present results will now permit sequential follow up studies during the course of experimental silicosis.

Animals↗