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Biomedical subjects

P Leclerc

Publications and source records attributed to P Leclerc.

At least 91 records · Page 5Linked to original sources

[Erasmus syndrome in a dental technician. Importance of the prevention of occupational hazards].

A case of generalised scleroderma is reported in a dental technician exposed to the risk of silicosis. A study of the occupational toxic risks in this patient showed pulmonary overload with silica and metallic particles composed of chromium, cobalt and tungsten. The job also involved the handling of vinyl chloride and its stable polymer. This chemical is known to give rise to scleroderma-type skin disease. The relationship between these occupational factors leads to a difficult physio-pathological problem and justifies preventative measures, even though they may be costly and demanding.

Dental Technicians↗

[Is annual X-ray examination of the chest still justified in industrial medicine?].

Between 1975 and 1979, 137.526 annual X-ray examinations of the chest were performed among the employees of a large Paris administration. Fifty-four cases of tuberculosis, 28 cases of sarcoidosis, 10 cases of bronchial carcinoma and 26 miscellaneous chest diseases were detected. This study confirms the inadequacy of radiological examination for detecting chronic obstructive bronchopulmonary conditions. The small proportion of tuberculosis (0.39 p.1000) and bronchial carcinoma (0.07 p.1000) revealed by this method suggests that it should be reserved to high risk patients.

Carcinoma, Bronchogenic↗

[Serum angiotensin converting enzyme activity in sarcoidosis. A review of seventy cases].

The serum angiotensin converting enzyme (ACE) activity was assayed in seventy untreated patients with sarcoïdosis. Results were considered abnormal if they exceeded 34,5 U/ml. (SEM + 250). Increased ACE activity was found in 55,7% of the patients. Most of these patients had either Stage II or disseminated disease. Significant decreases in ACE activity always occurred during remission, whether spontaneous or induced by corticosteroids. In most patients with persistant roentgenologic features ACE activity was still high six months after onset. No correlations were found between serum ACE activities and lymphocytosis in bronchial washing samples. We conclude that, while serum ACE activity assays are not of significant diagnostic utility in patients with sarcoidosis, they are helpful for monitoring the course of the disease.

Adult↗

[Transbronchial biopsy of the lung : value for diagnosis of sarcoïdosis. A study in 53 patients (author's transl)].

Data yielded by bronchial and transbronchial biopsy specimens removed during fiberoptic bronchoscopy in 53 patients with sarcoïdosis (24 stage I, 27 stage II, and 2 stage III) was analyzed. Bronchial biopsies (3 to 5 specimens) were positive in 49% of patients (41,6% stage I, 55,5% stage II, 1/2 stage III). Transbronchial biopsies removing bronchiolar and alveolar specimens yielded 88,6% positive results (91.6% stage I, 85,1% stage II, 2/2 stage III). Lymphocyte counts bronchioalveolar washings exceeded normal values by 15% in all 42 patients studied. We conclude : 1) that transbronchial lung biopsies yield significantly more information than proximal bronchial biopsies ; 2) that results of bronchioloalveolar washings reflect granulomatous immunologic changes in the lung and do not allow unequivocal diagnosis.

Adolescent↗

Electrophoretic determination of isoamylases in serum with commercially available reagents.

We describe and evaluate a method for determining isoamylases in serum. With this method, which involves conventional electrophoretic apparatus and commercially available reagents, seven isoenzymes can be resolved. The electrophoresis is performed in agarose gel, and isoenzymes are detected with a water-insoluble cross-linked starch polymer linked to a blue dye. The isoenzymes are quantified by densitometry. Within-assay imprecision (CV) was less than 7%, between-assay CV less than 11%. This method has the sensitivity to detect the major isoamylases (P2 and S2) in the serum, even at low total amylase activity. Reference intervals for P-type isoenzymes were 2-52 U/L and for S-type 2-85 U/L. P2S2 is the most common pattern found in normal individuals, then (in decreasing order) P1P2S2, P2S2S3, and P2 patterns. Patterns found in serum from cases of acute pancreatitis, mumps, macroamylasemia, and pelvic inflammatory disease are illustrated.

Acute Disease↗

[Bronchopulmonary aspergillosis (author's transl)].

Bronchopulmonary infections with Aspergillus give rise to three different pathological entities. Allergic bronchopulmonary aspergillosis, found in patients with an atopic predisposition, is marked by dyspnea of the asthmatic type associated with labile radiologically detectable infiltrates, blood hypereosinophilia, enhanced total IgE levels, specific IgG fractions, and positive immediate reactions to skin tests. The long-term risk is the development of proximal bronchiectasis. Dosage and duration of corticotherapy are function of eosinophilia and total IgE levels. Pathogenicity is similar to that of extrinsic allergic alveolitis, probably involving disturbances in immune complexes from a type I reaction. Intracavital pulmonary aspergillosis involves mycotic development within a cavity or a complicating parenchymatous lesion. Severe hemoptysis may occur. Medical treatment is ineffective, and radical surgery is necessary in patients able to support operative procedures, which vary as a function of the condition of the patient. Diffuse aspergillosis occurs in immunodeficient patients, usually during the acute phase of chemotherapy induction. Spread of the disease is either from the upper respiratory tract or through the blood as septicemia. A nosocomial origin is frequent. Diagnosis depends more on the presence of hyphae in tissue biopsy specimens than cultures or serological tests which are too unreliable. Treatment is with amphotericin B preferably associated with 5 fluorocytosin.

Adrenal Cortex Hormones↗

[Cytology of broncho-alveolar lavage samples in sarcoidosis (author's transl)].

The cytology of samples from broncho-alveolar lavage was studied in 18 patients with stage I or II sarcoidosis, three of whom were smokers (stage II). Cell content was 213 +/- 111.10(3)/ml with 30.8 +/- 15.7 p. cent of lymphocytes for stage I, and 338 +/- 98.10(3)/ml with 34.1 +/- 8.7 p. cent of lymphocytes for stage II patients who were non smokers. In the three patients in stage II who smoked, cell content was 206 +/- 107.10(3)/ml with 15.3 +/- 9.4 p. cent of lymphocytes. Measuring angiotensin conversion enzyme in 12 cases demonstrated elevated (7 cases) or normal (5 cases) levels unrelated to the radiological stage or the lymphocytosis. Diagnosis was confirmed by the presence of characteristic epithelioid granulomas in all cases, in 14 patients after trans-bronchial pulmonary biopsy. In comparison, cell content in 3 cases of extrinsic allergic alveolitis associated with histologically confirmed granulomas was 690 +/- 120.10(3)/ml with 50.3 +/- 10.7 p. cent of lymphocytes, and in 9 cases of different types of intestinal affections was 327 +/- 157.10(3)/ml with 6.33 +/- 7 p. cent of lymphocytes. Constantly elevated lymphocytosis in sarcoidosis constitutes a diagnostic aid; perhaps it can be used during follow-up examinations as a means of assessing progression of the disease. No correlation with the conversion enzyme was noted.

Adult↗

[Drug sensitivity of Haemophilus sp. and transfer of resistance into E. coli (author's transl)].

From June 1973 to July 1976, 742 strains of Haemophilus influenzae and parainfluenzae, isolated from clinical specimens, were routinely tested for in vitro sensitivity to twelve antibiotics: penicillin, ampicillin, cephalothin, streptomycin, kanamycin, gentamicin, chloramphenicol, tetracyclin, minocyclin, erythromycin, sulfamethoxazol, trimethoprim. 61 strains were found resistant to one or more of these antibiotics (ampicillin, kanamycin, chloramphenicol and tetracyclin). The MICs of 23 antibiotics were determined by the agar dilution method on most of the resistant strains and on 60 sensitive strains isolated during the same period and considered as control. 21 strains transferred their resistance determinants into E. coli K12; 23 plasmids were obtained isolated from these strains: 2 strains contained two different plasmids. 90% of the transconjugants were stable after repeated subcultures.

Anti-Bacterial Agents↗