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Biomedical subjects

M Demedts

Publications and source records attributed to M Demedts.

At least 145 records · Page 8Linked to original sources
PubMed1990

Pulmonary metastases of a tibia adamantinoma. Case report and review of the literature.

An adamantinoma is a rare primary tumour of bone. It is usually seen by stomatologists as a tumour of the jaws, although several cases of the long bones, especially the tibia, have been described. The tumour is considered as a low grade malignancy with unknown histogenesis. It has a high rate of local recurrence after resection and metastasizes in part of the cases. This report describes a 41-year-old woman with multiple pulmonary metastases occurring 27 years after the diagnosis of a tibia adamantinoma. The clinical, radiographic and fiber-bronchoscopic findings are presented. The literature of adamantinoma metastasis is reviewed. The need for an early locally aggressive treatment is stressed as the treatment of metastatic disease seems very disappointing.

Adult↗
PubMed1990

Tracheobronchial tuberculous ulceration. Report of 2 cases.

We describe two cases of tracheobronchial tuberculous ulcerations, without radiological signs of active pulmonary tuberculosis, and with cough as main complaint. Diagnosis was obtained by fiberoptic bronchial endoscopy and subsequent demonstration of Acid Fast Bacilli in biopsy specimen, bronchial aspiration fluid and sputum. A diagnostic fiberoptic bronchoscopy should be performed in persisting cough, even with normal chest X-ray.

Aged↗
PubMed1990

Bronchoalveolar lavage findings in a patient with the organic dust toxic syndrome.

A previously healthy student developed the organic dust toxic syndrome after unloading a grain silo for one day. Bronchoalveolar lavage seven days later showed a total cell count six times normal with 70% lymphocytes. This suggests that the previously described acute neutrophil influx into the alveolar spaces in this syndrome is rapidly replaced by a lymphocyte dominated infiltration.

Acute Disease↗
PubMed1990

Intermittent dobutamine infusion in severe chronic heart failure in elderly patients.

We describe the short- and long-term haemodynamic evolution of an elderly patient with severe intractable heart failure, who was treated with intermitted dobutamine infusion. This therapeutic regimen improved haemodynamic parameters and clinical status (New York Heart Association Functional Class) and prevented the hazardous cardiac, pulmonary and psychiatric disturbances the patient had suffered from with the previous therapeutic approach. No major side-effects were noted, except for a transient drop in arterial blood pressure. Subsequently, 9 other elderly patients were treated successfully with the same protocol. We propose the intermittent use of dobutamine in elderly patients with intractable heart failure, as a useful therapy for the improvement of their cardiac condition and general well-being.

Aged↗
PubMed1990

Rapidly fatal progression of cobalt lung in a diamond polisher.

Interstitial lung disease was diagnosed in a 52-yr-old male diamond polisher, who worked with polishing disks containing cobalt. After a further 7 months of probably high occupational exposure without any specific treatment, he had to quit work because of dyspnea. Despite treatment with systemic corticosteroids and continuous oxygen administration, he died 3 months later in respiratory distress. Postmortem examination of the lung tissue showed a typical giant-cell interstitial fibrosis, with active inflammatory cell infiltration superimposed on an established centrilobular fibrosis. The lung tissue contained 2.1 micrograms cobalt/g wet weight (more than 100-fold the normal concentration); cobalt particles, mainly localized in macrophages, were identified by transmission electron microscopy and energy-dispersive X-ray analysis. We speculate that the rapid deterioration and fatal outcome resulted from the continued exposure to cobalt, leading to a high pulmonary concentration of cobalt, and from the oxygen treatment because cobalt promotes the formation of hydroxyl free radicals.

Air Pollutants, Occupational↗
PubMed1990

Comparison of dynamic lung function indices during forced and quiet breathing in upper airway obstruction, asthma, and emphysema.

We compared the dynamic lung function indices in patients with asthma (n = 27), emphysema (n = 20), and UAO (n = 18), with the purpose being to examine whether different patterns of abnormalities could be found and which tests were most discriminative among the three groups. Forced expiratory indices were measured (FEV1; PEF; MEF50%), as well as indices obtained during quiet breathing (Raw; Gaw; Gaw/VL). The three groups were comparable as far as PEF was concerned (about 60 +/- 20 percent of predicted, yet the group with UAO showed significantly larger FEV1 (84 percent of predicted vs 55 percent and 57 percent of predicted in asthma and emphysema respectively), and larger MEF50% (71 percent of predicted vs 25 percent and 23 percent of predicted in the other groups), and the group with asthma had the largest Raw (0.37 +/- 0.18 kPa.s.L-1 vs 0.24 +/- 0.13 in UAO and 0.22 +/- 0.10 in emphysema). From these functional tests, several ratios were derived which were discriminative among the three groups. Upper airway obstruction could be recognized by a significantly lower PEF/MEF50% ratio and higher FEV1/PEF ratio than in the other conditions. Furthermore, a distinction between asthma and emphysema could be made by comparing airway patency during forced and quiet breathing, ie, the MEF50%/Gaw ratio. This ratio was, in fact, significantly different for all three groups, having the lowest value in emphysema (0.19 +/- 0.08 kPa vs 0.44 +/- 0.23 kPa and 0.63 +/- 0.34 kPa in asthma and UAO, respectively). Within the group with UAO, those with variable intrathoracic obstruction showed the least difference from asthma and emphysema for the measured indices.

Adult↗
PubMed1990

Predictive value of bronchoalveolar lavage in pulmonary sarcoidosis.

We investigated whether analysis of cellular composition (including lymphocyte subsets) in bronchoalveolar lavage (BAL) fluid at the start of follow-up in patients with untreated sarcoidosis has any predictive value for further evolution of the disease. The outcome was evaluated by the chest roentgenograms, the lung volumes, and the single breath diffusing capacity for CO (DCO) after 22 to 36 months. In contrast to the general belief, patients who improved radiologically had a significantly higher T4 cell count (as percentage of BAL lymphocytes) (p less than 0.02) and a higher T4-T8 ratio in the initial BAL sample (9.3 vs 3.2; p less than 0.05) than those whose chest roentgenogram showed deterioration or remained unchanged. Total cell count and the percentage of lymphocytes in BAL fluid were not different between both groups. The change in DCO at the end of the follow-up period correlated positively with the baseline BAL T4 cells (Rs = 0.44; p less than 0.05) and with the BAL T4-T8 ratio (Rs = 0.51; p less than 0.03) and negatively with the baseline BAL T8 cells (Rs = -0.48; p less than 0.04). In only three patients progression of the disease necessitated steroid therapy, and they all had a low to normal T4-T8 ratio in the initial BAL sample. Bronchoalveolar lavage was repeated at least once in ten patients. Improvement of the chest roentgenograms in these patients was accompanied by a decrease of the BAL T4 cell count (as percentage of lymphocytes) and of the T4-T8 ratio. We conclude that a high lymphocyte count, a high T4 cell count (as percentage of lymphocytes), and a high T4-T8 ratio in BAL fluid reflect an intense alveolitis at the time of the procedure, but they are not indicators of poor prognosis on which therapeutic decisions can be based.

Bronchoalveolar Lavage Fluid↗
PubMed1990

[Regional distribution mechanisms of lung volumes and transpulmonary pressures. Effect of body posture during deep semi-static respiratory maneuvers].

This study is a critical evaluation of the concept of Milic-Emili et al. (J. Appl. Physiol 1966, 21: 749-759) that lung density has an overwhelming influence on the regional distribution of alveolar expansions and transpulmonary pressures, at least in healthy subjects in quasi-static conditions. Our measurements showed, indeed, that these distributions have a vertical, gravitational gradient, and that almost mirror images of these were obtained after 180 degrees body inversion. These inversions of distributions were not accompanied by interfering changes in shape of chest or lung. This implies that the lung, although being a structured network and thus essentially subjected to stress-strain interactions, behaves mechanically as a liquid in a gravitational field, at least within the conditions of our investigations.

Adult↗
PubMed1990

Bronchial stump recurrence after surgery for bronchial carcinoma.

In 10 out of 295 patients (3.4%), followed-up after radical resection for non-small cell bronchial carcinoma in the period from 1980 until 1986, bronchial stump recurrence developed. A good relationship was found between relapse time (4-52 months) and distance between the primary tumour and bronchial resection line (1-7 cm) (i.e. 5-8 months.cm-1) in 8 of the patients (p less than 0.01). The mean survival time after detection of the recurrence was 10 months (range 1-15 months), and was not clearly influenced by the therapy applied (resurgery, chemotherapy, radiation), nor by the TNM stage of the bronchial stump recurrence.

Aged↗
PubMed1990

Evaluation of the safety and efficacy of amrinone in chronic obstructive lung disease with cor pulmonale.

In a pilot study the effect of a bolus dose of amrinone intravenously (IV), 0.5 or 1 mg/kg body weight, in 10 patients with chronic obstructive lung disease and cor pulmonale was evaluated. We found that the higher dose of 1.0 mg/kg IV significantly (P less than 0.05) decreased the mean pulmonary artery pressure and pulmonary wedge pressure without significant changes in cardiac output, in systemic blood pressure or in arterial blood gas values. No adverse effects were recorded in any of the patients.

Aged↗
PubMed1989

Cardiopulmonary function after lobectomy or pneumonectomy for pulmonary neoplasm.

Resection of pulmonary tissue for bronchial carcinoma causes a decrease in vital capacity of 15% after lobectomy and 35-40% following pneumonectomy. After operation the lung becomes stiffer and elastic recoil pressure and transdiaphragmatic pressure at TLC increase. Maximum effort tolerance decreases after pneumonectomy with a normal pulmonary artery pressure at rest and an increase in pulmonary artery pressure and in pulmonary vascular resistance on effort, compared to preoperative values. Cardiac output and stroke volume during effort show a decrease after operation with an increase in peripheral arterial blood pressure and in peripheral vascular resistance. Arterial oxygen saturation on effort decreases after pneumonectomy, possibly due to the absolute decrease in diffusing capacity. When comparing resting and exercise values at identical work loads, increases in systemic arterial blood pressure, pulmonary and systemic vascular resistance and arteriovenous oxygen difference were similar although generally less pronounced after lobectomy compared to pneumonectomy; cardiac output, stroke volume and oxygen consumption showed the same tendency to decrease after lobectomy and pneumonectomy.

Carcinoma, Bronchogenic↗
PubMed1989

Carcinosarcoma of the lung. Report of two cases and review of the literature.

Two cases of carcinosarcoma of the lung are presented. Until now, 76 cases have been recorded in the literature. The lesion contains an epithelial and a mesenchymal component, both with cytologic features of malignancy. A central endobronchial and a peripheral invasive type have been described. Fiberoptic biopsies usually show no tumour at all or contain only one of the two components. Treatment consists of lobectomy or pneumonectomy. Prognosis is not better for this tumour than for non-small cell bronchogenic carcinoma, and may even be worse.

Aged↗
PubMed1989

Scintigraphic regional lung dimensions in upright and head-down men.

Our purpose was to analyze regional intrapulmonary volumes and dimensions (especially heights) between total lung capacity and residual volume in upright and head-down healthy men. This analysis was based on the combination of previously obtained scintigraphic data of regional alveolar expansions and of lung shape. This analysis demonstrated that the changes in height were markedly smaller for the apical zones than for the diaphragmatic zones, especially in upright posture but to a smaller extent in head-down posture also. These changes in height in upright posture were attributable to the additive effects of changes in lung shape (which favored larger height changes in the more diaphragmatic zones) and the effects of the changes in regional alveolar expansion (which caused larger volume changes in the diaphragmatic zones). In head-down posture the effects of changes in lung shape (which again favored larger height changes in the diaphragmatic zones except at high volumes) were only partially counteracted by the now inverted changes in alveolar expansion. These height changes were qualitatively in agreement with the cephalad displacement of the minor fissure during lung inflation from residual volume to total lung capacity in both postures, measured previously on chest X-rays. In conclusion, this study shows that the gravitational distributions of alveolar expansion, as assessed by scintigraphy, go along with more complex shape-dependent distributions of regional dimensions and volumes as assessed, e.g., by radiological techniques.

Adult↗
PubMed1989

Diaphragmatic displacement measured by fluoroscopy and derived by Respitrace.

In eight healthy volunteers we simultaneously measured the axial diaphragmatic motion by fluoroscopy and the cross-sectional area changes of the rib cage (RC) and abdomen (ABD) by Respitrace (RIP) during semistatic vital capacities (VC). We found that, if the fluoroscopic axial displacement of the posterior part of the diaphragm between residual volume (RV) and total lung capacity (TLC) is considered equal to 100%, the movement of the middle part is 90%, whereas that of the anterior part is only approximately 60%; the ratio of the axial displacements to mouth volume, furthermore, decreases at high lung volumes, especially for the anterior part. The RIP signal is nearly linearly related to mouth volume, but the contribution of the RC (delta RC) progressively increases (and is approximately 80% RIP at TLC), whereas the volume contribution of the ABD (delta ABD) levels off (to 20% RIP at TLC). The diaphragmatic volume displacement calculated from the theoretical analysis described by Mead and Loring also levels off at high volumes similarly as the ABD but is approximately 50% RIP at TLC. Finally, the axial movements of the three parts of the diaphragm are linearly related to the RC and ABD cross-sectional-area changes (r 0.91-0.97) and are even significantly better correlated with the "calculated" diaphragmatic volume displacement.

Adult↗