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Biomedical subjects

M Riquet

Publications and source records attributed to M Riquet.

At least 109 records · Page 6Linked to original sources

Acquired factor VII deficiency associated with pleural liposarcoma.

Isolated acquired factor VII (FVII) deficiency (0.15 U/ml) was identified in a 30-year-old man with pleural liposarcoma. The patient underwent surgery with continuous FVII concentrate infusion. No anti-FVII antibody or FVII/anti-FVII complex was detected. However, the short half-life and low recovery of FVII after concentrate infusion suggested the presence of an antibody. Whatever the mechanism, this FVII deficiency was related to the presence of the liposarcoma. FVII level normalized during tumour regression and fell again when the liposarcoma relapsed.

Adult↗

Expression of heat shock proteins in human lung and lung cancers.

Heat shock proteins (HSP) are highly conserved molecules whose expression is induced in eukaryotic cells following a broad spectrum of environmental stresses. These proteins can also be expressed by virally transformed cells and cancer cells and are important targets for T lymphocytes. Little is known about the abundance and distribution of HSP in the normal lung, the effect of cigarette smoking on their expression, or their expression in human lung carcinomas. We have used monoclonal antibodies coupled with immunohistochemical and immunoelectrophoretic techniques to evaluate the distribution of four different HSP (HSP 90 kD, HSP 73 kD/constitutive, HSP 72 kD/inducible, and HSP 63 kD) in normal lung (n = 14) and lung cancers (n = 15). In lung tissue from nonsmokers (n = 7), bronchiolar epithelial cells were intensely positive for HSP 90 kD and HSP 72 kD/inducible and weakly reactive for HSP 63 kD. Most macrophages also expressed these HSP at low levels, but no other parenchymal or immune/inflammatory cells were positive. Cigarette smoking did not modify the distribution or the intensity of HSP in bronchiolar epithelial cells, and macrophages from smokers expressed similar or lower levels of these HSP. Tumor cells from 14 of 15 lung carcinomas expressed one or more of the HSP. Considerable heterogeneity in the expression of HSP by cells in a given tumor was observed, explained in part by differences in the differentiation of the cells. Detection of HSP by immunohistochemical and immunoelectrophoretic techniques gave similar results for HSP 72 kD/inducible and HSP 90 kD.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

[Surgery of bronchial cancer in patients aged 75 and over].

From April 1984 to December 1990, 66 patients 75 years of age or older underwent curative mediastinal lymph node dissection. There were 37 pneumonectomies. Post-operative mortality was 12% and was not affected by the type of dissection. Five-year survival was 16.2 +/- 6.29% (median 23 months) and was more than 45% in less elderly patients. Survival rate was highly affected by presence of metastasis in the mediastinal nodes and was zero in N2 cases. More than half of the patients died from cancer-related causes. Generally, we operate all the N2 cases which appear technically dissectable. Retrospectively, we think that N2 stage detected, and confirmed histologically in patients over 75, would be the only contra-indication for this attitude.

Age Factors↗

[A rare tumor of the thoracic wall: synovial sarcoma].

The synovial sarcoma is a tumour of the soft tissues. Its thoracic localisation is unusual. The authors report a case of a recurrent tumour of the scapula, whose excision required major plastic surgery to the dorsal chest wall. The diagnosis was revealed by the biphasic histological nature which was confirmed on immunological studies. Such tumours give rise to discussions on their histogenesis; their subsequent progress is slow and recurrences are common. Healing depends on the radical nature of their excision.

Adult↗

[Prognostic factors of survival in resected N2 bronchial cancer].

This study was based on 206 patients with non small cell lung cancer and N2 nodal disease submitted to curative surgery: pneumonectomy 163, lobectomy 39 and segmentectomy 4. All accessible mediastinal lymph nodes were removed and classified according to their anatomical location in lymph node chains; "skip" metastases were present in 24.8% of cases. N2 disease would have been missed in 20% of cases if routine removal of mediastinal nodes had not been performed. There was solitary nodal chain involvement by metastasis in 126 cases (61.2%). Overall 5-year survival was 18.3% +/- 3. Survival was not influenced by site, size or extension (T) of tumor, adjuvant radiotherapy, tumor histology or presence of vascular invasion. The prognosis was significantly worsened by the presence of microscopic residual disease (22 cases) and of satellite nodules (18 cases). Survival was significantly improved when metastases involved a single node chain (25% versus 8.5%). The location and number of involved nodes in the chain, "skip" metastasis and presence of extracapsular spread of carcinoma did not influence prognosis. Routine mediastinal lymph node dissection is necessary to improve survival and for classification of lung cancer. Anatomical description allows better understanding of N2 disease which is not a contraindication to surgery when a complete gross resection can be achieved.

Adult↗

Anatomic basis of lymphatic spread from carcinoma of the lung to the mediastinum: surgical and prognostic implications.

Lymphatic spread of carcinoma of the lung to the mediastinum is an essential factor determining prognosis. An anatomic study of the mediastinal lymph nodes was made on 360 cadavers of adult subjects based on injection of the pulmonary segment. Eleven anatomic sites were involved. In 20 to 40% of cases the lymph reached these sites without any relay in the intrapulmonary lymph nodes. Within these sites the lymph flow continued towards the systemic circulation by traversing a variable number of lymph nodes, or sometimes none. The lymph flow reached the venous circulation in the neck, but in more than one case in ten the lymph had already entered the thoracic duct in the mediastinum, and in an intermediate number of cases the sites in the opposite mediastinum.

Adult↗

[Extrapulmonary intrathoracic pneumocystosis. Apropos of 4 cases in HIV positive patients].

The authors report 4 cases of intrathoracic extrapulmonary pneumocystosis; 3 of them involved the pleura and 1 the mediastinal lymph nodes. As in other rare but apparently increasingly frequent cases, everything seemed to incriminate the use of prophylactic Pentamidine aerosols, but only a prospective study of systemic versus aerosol prophylaxis can confirm this suspicion.

AIDS-Related Opportunistic Infections↗

[The lymphatic drainage of the esophagus].

The study was carried on 65 cadavers: 50 adults and 15 newborns. The esophagus was injected at the level to the neck 16 times, in the thorax at the superior level 18 times, middle level 30 times and inferior level 21 times. The lymphatic pathways were named short when joining the nodes at the same level, half long when joining the nodes of the neighbouring level, long when joining third level, and very long. At the level of the neck were injected 24 lymph nodes chains: in 12.5% of the cases the pathways were long, joining the nodes of the arch of the Azygos vein. At the superior thorax level were injected 27 chains: half of the pathways were half-long: 7.5% long (-joining the pharynx once and the cardia once). At the middle thorax level were injected 37 chains: 27% were long and very long. At the inferior thoracic level were injected 21 chains: The pathways were half long in half cases and very long in 15% of the cases joining the cervical nodes. These results compare with experience in oncology and justify the need for total esophagectomies and nodes resection of all levels in surgical treatment of carcinomas of the esophagus.

Adult↗

[Chylomediastinum after mediastinoscopy. Apropos of a case].

A mediastinal chylous effusion occurred in a young woman after a mediastinoscopy. This effusion healed rapidly with medical treatment. An understanding of the anatomy of these intra-thoracic/lymphatic channels explains that intra-thoracic chylous effusions may occur in case of incontinence of the lymphatic vessels which connect the tracheo-bronchial nodes to the thoracic duct in the mediastinum. This is very important following the surgical excision of a node because incontinent lymphatic vessels are directly sectioned. When the lymph nodes are biopsied in an enclosed cavity such as the mediastinum, the quantity of lymphoid tissue acts as an obstacle to reflux of the lymph which is thus less significant and more easily controlled.

Adolescent↗

Effect of 5-lipoxygenase inhibitors on the anti-IgE-induced contraction of passively sensitized human bronchus in vitro.

We assessed the effect of 5-lipoxygenase inhibitors on the contraction of human bronchial ring segments passively sensitized with IgE in vitro. Contraction was induced by increasing doses of anti-IgE (0.01-0.5 micrograms/ml) in the presence of the antihistamine mepyramine. Zileuton and MK-886 (10 microM) significantly inhibited the dose-related contraction to anti-IgE as compared with solvent (DMSO). At the highest dose of anti-IgE used, contraction reached 10.3 and 9.6% of the maximal carbachol contraction, respectively, as compared with 30.3% for solvent. Maximal carbachol contraction was unaffected. These results suggest a potential beneficial effect of 5-lipoxygenase inhibitors in anaphylactic reactions in man.

Antibodies, Anti-Idiotypic↗

[Isolated chylopericardium. Review of the literature apropos of a case].

Isolated chylopericardium is a rare entity with an obscure aetiology. "Cardiomegaly" was discovered incidentally in a 40 year old woman and was found to correspond to chylopericardium. The patient was referred to us after a failed attempt of left pericardio-pleural fenestration. Lymphography revealed injection of the left anterior mediastinal lymph node chain from the arch of the thoracic duct. At operation, the chylous leaks were sutured from this chain. Anatomical study of the lymphatic drainage of the heart revealed interconnections between the left anterior mediastinal, left recurrent, left suprabronchial lymph node chains and the thoracic duct. A review of the literature confirmed that chylous leak generally occurs from this lymphatic system when the cases reported have been investigated by lymphangiography or explored surgically.

Adult↗

[Excision of mediastinal nodes using video-thoracoscopy].

A man of seventy-one years with gross respiratory failure was suspected of having a cancer of the right upper lobe with metastases to the right pretracheal and intertracheobronchial nodes. A diagnostic mediastinoscopy did not achieve a diagnosis, and a right sub-bronchial node biopsy was performed, using videothoracoscopy and this revealed the presence of tuberculosis without any further delay.

Aged↗