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Biomedical subjects

P Delaval

Publications and source records attributed to P Delaval.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Thoracic actinomycosis. Two aspects of an infection with protean manifestations].

The authors report two cases of thoracic actinomycosis with contrasting presentations, just as the diagnosis was obtained by different tests underlying the varied aspects of this disease. Indeed this infectious pathology does infrequently mimic tuberculosis or lung cancer with similar clinical and radiological appearances. The particular characteristic of the bacteriological culture and the quasi specific character of the pale, yellow grains on histology are recalled, as well as the different treatments necessary to ensure a cure in 90% of cases.

Actinomycosis↗
PubMed1993

[Pneumoblastoma. Apropos of a case].

The authors report a case of pulmonary blastoma, a rare type of pulmonary malignant tumour. The patient was treated by pneumonectomy combined with chemotherapy and radiotherapy. The outcome was favourable, and during an 11-year follow-up there was no sign of recurrence.

Combined Modality Therapy↗
PubMed1991

Does peripheral blood T-lymphocyte population distribution in sarcoidosis provide a prognostic clue?

In its pulmonary form, sarcoidosis generally resolves spontaneously, but it may lead to fibrosis of the lung. The clinical, radiological and functional tests, as well as activity markers such as the serum angiotensin converting enzyme, intrathoracic uptake of 67Gallium and the cytological data provided by bronchoalveolar lavage are only the expressions at any given time of a disease which is constantly progressing and only partly express its evolutive potential. The authors studied the distribution of T-lymphocyte subsets in the peripheral blood and from bronchoalveolar lavage. 32 patients were included in the study. They were suffering from acute or chronic sarcoidosis of the mediastinum and lungs and were divided into 2 groups according to clinical, radiological and pulmonary function criteria; Group A (n = 19) included regressive forms (minimum follow up 2 years) and group B (n = 13) the progressive untreated forms. Lymphopenia with a decrease in the percentage of CD3 cells was found in both groups. The percentage of CD4 cells is significantly lower in group B (28 +/- 11%) than in group A (45 +/- 8%) (p < 0.01) or in the control population (46 +/- 8%) (p < 0.01). The percentage of CD8 cells is higher in group B (30 +/- 8%) than in group A (18 +/- 6%). This results in a CD4/CD8 ratio which is significantly reduced in group B (1 +/- 0.5) when compared with group A (2.72 +/- 0.8) (p < 0.01) and the control group (2.17 +/- 0.8) (p < 0.01), the difference between group A and the controls being minimal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Mycobacterium chelonei pulmonary infections. Apropos of a case].

Infections caused by Mycobacterium chelonei are rare. We report a case of pulmonary infection in a 57-year-old non-immunocompromised woman. Most of the abnormalities were observed at radiology which showed bilateral apical excavated opacities. The disease could only be diagnosed on surgical biopsies. Beside diagnostic problems, M. chelonei infections are a source of therapeutic problems.

Clarithromycin↗
PubMed1991

[The diagnostic value and therapeutic perspectives of monoclonal antibodies in bronchopulmonary cancer].

Monoclonal antibodies (AcM) have opened up new perspectives in the study of cancer. The production of murine AcM has been well described in the past. The characterisation of the antigen which they recognise and their in vitro and in vivo biological properties has led to their use in diagnosis and in due course to therapeutic possibilities. The specificity of AcM "vis a vis" certain molecules or tumour associated antigens enables their utilisation for diagnosis and their widespread use for the labelling of tumour markers. AcM may in difficult cases be more accurate in specifying the histological type of a bronchopulmonary or pleural tumour; by coupling the antibody to a radio isotope and injecting it into the circulation. This enables the detection of tumours in vivo by immunoscintigraphy. The numerous problems linked to the technique and above to biology of AcM limits its clinical value in assessing the degree of extension either locally or regionally of bronchopulmonary tumours. The therapeutic applications are at this stage experimental and above all studies have shown the limits of AcM used alone or coupled to a radio isotope, a toxin or a drug. The limits of the technique are linked to numerous factors, such as accessibility of the antigen site, the heterogeneity of tumour markers and non specific fixation and immunogenicity of the AcM. The experimental clinical stage should be continued in order to define the most effective utilisation of AcM in therapy which will doubtless be complementary to other forms of treatment.

Animals↗
PubMed1990

Immunoscintigraphy of human lung squamous cell carcinoma using an iodine-131 labelled monoclonal antibody (Po66).

Monoclonal antibody (McAb) Po66 has been obtained by immunisation of mice against a human lung squamous cell carcinoma. The in vitro reactivity of the antibody with cancer cells and its ability to localise in human lung cancer xenografts growing in nude mice have been reported earlier. Presented here is the first clinical evaluation of the antibody for scintigraphic detection of tumours. Thirty-three patients with histologically confirmed primary non-small cell lung carcinoma were investigated. Twenty-seven of them were explored at the preoperative stage and six at 6 months after surgery. Biodistribution results were obtained from seven operated patients by combining injections of 131I-radiolabelled Po66 and of 125I-labelled unrelated immunoglobulin. The localisation index was three times higher for this specific antibody. Immunoscintigraphy detected 78% of primary tumours and 100% of recurrences. In this short series of patients, immunoscintigraphy proved helpful in the assessment of tumour spread in four patients by visualising localisations in the mediastinum or the contralateral lung which the CT scan had failed to demonstrate. Immunoscintigraphy was also more efficient than plain chest X-ray for the detection of local tumour recurrences.

Adult↗
PubMed1990

The hyperimmunoglobulinaemia E and recurrent infections syndrome in an adult.

A 27 year old white woman with a history of chronic eczema and episodes of serious infection of the chest, skin, and bone presented with acute respiratory failure. She was found to have a spontaneous right pneumothorax and a pneumatocele in the left upper lobe. Despite a left upper lobectomy she was left with chronic respiratory failure, bullous lung disease, and bilateral bronchiectasis. The hyperimmunoglobulinaemia E and recurrent infections syndrome was diagnosed only in adult life.

Adult↗
PubMed1989

Distribution of radiolabelled monoclonal antibody Po66 after intravenous injection into nude mice bearing human lung cancer grafts.

Monoclonal antibody Po66, produced by immunization against a patient's lung squamous cell carcinoma was found suitable for the scintigraphic detection of human tumours. Surprisingly, the cellular antigen recognized by Po66 was abundant in the cytoplasm of tumour cells but could not be detected on the surface membrane. In the present work the biodistribution of radiolabelled Po66 and of an unrelated immunoglobulin were studied comparatively after intravenous injection into nude mice bearing lung squamous cell carcinoma grafts. Radioactivity distribution among mouse organs and tumour was analysed by gamma counting and autohistoradiography. After injection, radiolabelled Po66 decreased rapidly from the blood in tumour-bearing animals whereas, in controls, it remained at a level comparable to that of the unrelated immunoglobulin. The antibody seemed slowly trapped by the tumour and, 12 days after its injection, distribution ratios between tumour and mouse organs reached values of 20-30 as against 1 in animals injected with the non-specific immunoglobulin. Autohistoradiographic investigations in the tumour confirmed the slow diffusion rate of the antibody, which remained in the vascular spaces up to the 24th hour after injection and diffused afterwards throughout the clusters of tumor cells. Furthermore, radioactivity was detected in cells which, unexpectedly, seemed morphologically unaltered. These cells, the viability of which remains to be determined, were predominant in the central area of the tumours. The results presented constitute new evidence of the ability of an in vivo injected monoclonal antibody to reach a cytoplasmic target inside non-necrotic cells and suggest that the cells permeable to the antibody might be in defective nutritional conditions.

Animals↗
PubMed1989

[Post-intubation right paratracheal abscess. Apropos of a case].

We report the case of a young woman who had undergone a difficult emergency intubation and rapidly developed a mediastinal collection of pus. Mediastinoscopy, requested for diagnostic purposes, was also therapeutic as it drained the abscess. The patient received a course of antibiotics and was cured without sequelae. Accidents of tracheal intubation are severe, especially when unrecognized. They often include perforation of the oesophagus resulting in mediastinitis or abscess with an estimated 30 to 40% mortality rate, and they constitute a medico-surgical emergency. In the case reported here mediastinoscopy was crucial, but the theoretical value of computerized tomography must be stressed since this method not only detects the lesion but is also used to perform a guided drainage.

Abscess↗
PubMed1989

[Adult respiratory distress syndrome, a manifestation of severe pneumococcal infection].

A retrospective study analyzing the case notes of 49 hospitalized adults, either in intensive care (n = 26) or in thoracic medicine units (n = 23), for acute bacteriologically proven pneumococcal pneumonia based on samples obtained other than by sputum examination. The mortality was 54% in intensive care and 17% in the thoracic medicine unit. This significant difference may be explained in part by a respiratory distress syndrome in whom there were adequate criteria on admission for 7 patients in the intensive care group. Among these latter only one patient had had a splenectomy. The others did not have underlying disorders (three were chronic alcoholics); 7 patients were shocked on admission, four with a leukopenia less than 5,000/mm3 and six had a thrombocytopenia less than 100,000/mm3; finally 6 had a temperature of less than 38 degrees C. 7 patients died in less than four days (mean 2 days) in a clinical context of refractory hypoxemia. The significance of the respiratory distress syndrome is probably very different from the usual pneumonia; it seems rather to be an integration of the toxins induced by the pneumococcus. Its presentation can be particularly misleading as regards the diagnosis; the prescription of antibiotics once a diagnosis is obtained would seem insufficient by itself in this context to obtain a cure.

Adult↗
PubMed1988

[Idiopathic pulmonary hemosiderosis and rheumatoid arthritis. Apropos of a case].

A 38-year-old woman was known to have had a histologically proven "idiopathic" pulmonary hemosiderosis for 7 years; the authors report the onset in this patient of polyarthralgias with articular swelling and positivity of rheumatoid factor, all features consistent with the diagnosis of rheumatoid arthritis, whose beginning was certainly hidden by steroid therapy. This case, as some others previously published, outlines the possibility of the association of pulmonary hemosiderosis and rheumatoid arthritis: is this a casual association, or may pulmonary hemosiderosis be a rare manifestation of rheumatoid arthritis?

Adult↗
PubMed1988

[Post-traumatic pneumatocele and hemato-pneumatocele of the lung. Apropos of 3 cases].

Pneumatocele and haemato-pneumatocele are air or air/fluid cavitary lesions which develop in the lung parenchyma after thoracic trauma. The formation of this lesion requires a direct violent impact on the pliable lung wall which explains its frequency in young adults. They are preferentially localised in the lung bases. The importance of associated lesions often marks the pneumatocele. Though rarely described, its frequency is certainly underestimated. If haemoptysis is the most frequent clinical sign it is the chest x-ray which demonstrates the early abnormality in the form of a rounded translucent image with a fine contour and variable diameter. The existence of a fluid level suggests the presence of blood (haemato-pneumatocele). The differential diagnosis with a localised pneumothorax, a diaphragmatic hernia and a pre-existing cystic lesion is easy as a rule but an evacuated pulmonary haematoma may lead to the discussion, especially as the mechanism of their formation may be the same. In isolation their clinical implications are minimal, their evolution favourable and after several weeks with a restitution of the integrity of the pulmonary parenchyma the absence of therapeutic intervention is justified.

Adolescent↗
PubMed1987

A monoclonal antibody (Po66) directed against human lung squamous cell carcinoma immunolocalization of tumour xenografts in nude mice.

Po66, a mouse IgG1 monoclonal antibody, was produced by immunization against a patient lung squamous cell carcinoma. The tissue reactivity of the antibody was measured by a radioimmunological assay with enzymatically dissociated cells, by an immunofluorescence test on frozen tissue sections and by peroxidase-staining of paraffin sections. The antibody bound to lung squamous cell carcinoma, oesophagus carcinoma and, inconsistently to lung adenocarcinoma but not to the other tumours tested. Some normal tissues also reacted positively, in particular bronchial serous glands, oesophagus epithelium and renal distal and collecting tubules. In normal and malignant tissues showing epithelioid differentiation, Po66 bound to the intermediate maturation area. The antigen immunoprecipitated by Po66 from lung squamous cell carcinoma appeared as a single band with a molecular weight 47,000 to 50,000 daltons. Purified monoclonal antibody Po66 and an unrelated IgG1 immunoglobulin were labelled with radioactive iodine and injected i.v. into nude mice bearing subcutaneous xenografts of human lung squamous cell carcinoma. The localization index in the tumour was 3.3. Antibody labelled with 131I allowed gamma-scintigraphic imaging of the xenografts which were clearly outlined by days 9 to 11.

Animals↗