[Voluminous angio-histo-cyto-fibroma of the right pulmonary hilum. Pneumonectomy under extracorporeal circulation].
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Biomedical subjects
Publications and source records attributed to L Toty.
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The authors present an unusual case of asbestosis. The latter had very diffuse macrophagic and giant cell granulomatous lesions. The morphological findings and the history enabled one to relate the appearance observed to the conjoined handling of asbestos and talc. A primary adenocarcinoma developed on these lesions.
The penetration of minocycline into lung tissue was evaluated in 14 patients about to undergo excision of the lung for cancer. The patients received minocycline orally in doses of 100 mg twice a day for 3 days, the 100 mg in the morning of the operation day. Minocycline concentrations were measured in plasma samples taken before surgery and in the lung tissue resected. The mean tissue/plasma concentration ration was 3.17 +/- 0.41 (range: 1.5 to 7.48). The same ratios were obtained in peritumoral and tumoral tissues. These results indicate that minocycline penetrates well into tissues.
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Different problems involved in the surgery of 220 cases of pulmonary aspergilloma are analyzed. The operatory blood loss, which was more abundant than usual, did not bring about any complication. The authors believe that pleural cavities were observed for only 6% of the partial excisions, probably because of the complementary thoracoplasties they performed. The true problem is raised by the patients suffering from respiratory failure for whom techniques of direct approach are the only solution.
After the use for several years of an endoscope which enables electro-coagulation in the treatment of some tracheo-bronchial lesions, the limitations and accidents of this method were compared with clinical results and experimental research. Results seem to indicate that the flexible laser beam can considerably improve therapeutic possibilities. This beam, conducted by a flexible fiber, could easily be used by medico-surgical teams who already possess the suitable endoscopic material, or material that could readily be adapted to this method.
Pleural aspergillosis is an uncommon localization; only about 60 observations have been previously reported and two-thirds of them in France. A new case characterized by the presence of a giant mycetoma (450 g) is reported. It should be kept in mind that this lesion develops in the residual cavity, resulting from a therapeutic pneumothorax. Conservative surgery is therefore required and enables (as shown in this case) a satisfactory recovery of the underlying parenchyma.
Different problems involved in the surgery of 220 cases of pulmonary aspergilloma are analyzed. The operatory blood loss, which was more abundant than usual, did not bring about any complication. The authors believe that pleural cavities were observed for only 6% of the partial excisions, probably because of the complementary thoracoplasties they performed. The true problem is raised by the patients suffering from respiratory failure for whom techniques of direct approach are the only solution.
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For several years we employed an endoscope permitting electro-coagulation in the treatment of some broncho-tracheal lesions and were able to observe the limits and accidents involved in this method. When compared with clinical results (work of Freche in ORL, laser CO2) and after experimental research, the use of a flexible laser beam (YAG) seems to bring about a noteworthy increase in therapeutic possibilities. This flexible fiber beam could easily be used by some medico-surgical teams who already possess appropriate of easily adaptable endoscopic equipment. Clinical studies are in progress.
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