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Biomedical subjects

R Loire

Publications and source records attributed to R Loire.

At least 181 records · Page 10Linked to original sources
PubMed1984

[Pulmonary hamartoma. Apropos of 49 surgically treated cases].

A series of 49 patients with pulmonary hamartoma subjected to operation is described. 28 patients were male and 21 female, with a mean age of 49.8 years. Most cases were discovered on routine chest films. Six patients had radiologic changes produced by obstruction, while 43 had a rounded peripheral opacity. Fine calcifications were present in four cases. In no case was diagnosis achieved by bronchoscopy, whereas one of the more recent cases was diagnosed by percutaneous fine needle biopsy. Sinner has shown that this last technique can establish diagnosis in most cases. As such tumors are invariably benign and grow slowly, diagnosis by percutaneous biopsy renders operation unnecessary: periodic follow up only is required.

Adolescent↗
PubMed1984

[Radiology of spontaneous pneumothorax in young patients. Apropos of 200 cases].

In 200 young patients with apparently idiopathic spontaneous pneumothorax, the following radiologic features were analyzed: degree of collapse on the initial chest film, areas of atelectasis, and presence of blebs, apical opacities, fibrous adhesions, pleural effusions, and controlateral shift of mediastinal structures. Confrontation of apical changes with pathologic findings in operative specimens suggests that mesothelial rupture with reactive hyperplasia results in a "pneumatization chamber" visible as a bullous image. Following drainage, homolateral shifts of mediastinum and four cases of pulmonary edema were recorded. Risk factors for pulmonary edema include severe pulmonary collapse with areas of atelectasis, persisting for more than 48 hours and an aspiration which either exceeded 1.5 l. of air or was performed with a depression of more than 30 cm of water.

Adolescent↗
PubMed1984

Prognostic factors and indications for surgical treatment of acute aortic dissections: a report based on 191 observations.

A total of 191 acute aortic dissections were examined to define prognostic factors for surgical intervention. Overall survival rate reached 40% in the 94 patients operated upon and 8% in the 97 patients not operated upon. Among the 122 patients with involved ascending aorta, survival rate was 2% in the 42 nonoperated patients versus 42% in 80 patients undergoing surgery. Since 1977, overall survival rate has reached 60% in the surgical group (21 of 35 patients) and 20% in the nonsurgical group (5 of 25 patients). Factors that showed a significant correlation with postoperative death include: persistent shock; persistent anuria; persistent neurologic deficit; diffuse intravascular coagulation; and involvement of either the celiac trunk, superior mesenteric artery, or both renal arteries at angiography. With the exception of those patients exhibiting any of these high-risk factors, emergency surgical treatment is recommended for all dissections that involve the ascending aorta.

Adult↗
PubMed1984

[Post-therapeutic development of small cell epitheliomas to malpighian epitheliomas, or initially composite forms? Apropos of 3 cases, review of the literature].

Three cases of transformation of small cell carcinomas into squamous cell cancer after chemotherapy are reported. A review of the literature shows that about 7% of small cell carcinomas are associated to different histological types of cancer before treatment. Such an association is found in about 25% of the cases after chemotherapy. Recent biochemical and ultrastructural approaches have led to new concepts concerning the histogenesis of lung cancer. The unicyst theory suggested by some authors could explain the therapy-induced maturation of undifferentiated small cell carcinoma.

Aged↗
PubMed1984

[Primary pulmonary pseudolymphomas and lymphomas. 4 cases].

We report four cases of primary pulmonary pseudolymphoma and lymphoma with the usual features of these disorders: lack of symptoms, radiological opacities sometimes multiple with soft wooly contours and air bronchograms, and slowly evolving pattern. The distinction between pseudolymphoma and lymphoma, prior to histological diagnosis is currently controversial. Immunological studies aim at defining whether the lymphoid proliferation is polyclonal or monoclonal (the benign process being considered polyclonal and the malign monoclonal). This distinction works in some cases, as in one of our cases of lymphoplasmacytic lymphoma with a monoclonal IgM gammopathy, a predominance of cells containing IgM on immunofluorescence, and an illness evolving over 9 years. Other cases raise discussion points such as one of our patients with classical histological characteristics of pseudolymphoma, an absence of monoclonal markers on immunofluorescence, but having a monoclonal gammopathy in the serum. This example raises the question as to the possible coexistence of, or a switch over from, a polyclonal to a monoclonal process. In this way the primary pulmonary lymphoproliferative process ought to be considered as one element in a large spectrum ranging from benign to malign disorders and not as distinct illnesses with definitive patterns.

Adult↗
PubMed1984

[Alveolar cancer and localized parieto-alveolar fibrosis].

We report a case, cytologically diagnosed, of broncho-alveolar cancer associated with localised interstitial pulmonary fibrosis. This association of fibrosis with bronchiolo-alveolar cancer is classical and a pathogenic affiliation has been deduced by the majority of authors. We review the pathogenesis in relation to recent datas concerning the activation of successive oncogenes: the first stage of carcinogenesis may correspond to the activation of an oncogene coding for a fibroblastic growth factor leading to fibrosis.

Adenocarcinoma↗
PubMed1984

[Diffuse pulmonary carcinomatous lymphangitis. Study of respiratory function in 18 cases].

Respiratory function studies were carried out in 18 patients with diffuse and isolated pulmonary lymphangitis (LCP) diagnosed on radiological and cyto-histological grounds. Restrictive ventilatory defects were found in 17 out 18 cases CPT: 75,3% (DS = 5), CV: 56.7% (DS = 14,5). The Tiffeneau coefficient was less than 65% in 50% of cases but the DEM/CV was reduced in 77% of cases, evidence of the great frequency of airflow obstruction. The measure of the (formula; see text) was normal in 5 out of 17 cases, implying the absence of an alveolar neoplastic lesion or obliteration by arteritis or capillaritis in LCP. The alveolar-arterial oxygen gradient on hyperoxia was normal (less than 27 kPa) 14 times out of 18 and slightly increased in 4. Important hypoxaemia at rest was present 17 times out of 18; PaO2: 8 kPa (DS = 1). There was no patient with alveolar hyperventilation: PaCO2: 4.3 kPa (DS = 0.5). On exercise, hypoxaemia remained stable 4 times, improved 5 times and worsened 9 times. A pathophysiological interpretation was given for each disturbance of respiratory function. In conclusion, a characteristic respiratory function profile of LCP is proposed, with a restrictive ventilatory disturbance or moderate mixed picture, a DLCO/VA ratio generally normal, almost constant hypoxaemia at rest and improvement or worsening on exercise. CPT = Mean total lung capacity. CV = Mean vital capacity. DS = Standard deviation.

Aged↗
PubMed1983

[Embryonal carcinoma and vitelline tumor of the mediastinum. Diagnostic and prognostic value of alpha-fetoprotein levels. A propos of 5 cases].

Five cases are reported of embryonal carcinoma with a vitelline structure more or less predominating. The presentation was of an anterior mediastinal tumour occurring in young men and in three cases there was mediastinal obstruction. The clinical examination, in particular testicular examination, was negative. In each case the level of the alpha-fetoprotein was greater than 1,000 micrograms/l, even post-operatively. The alpha-fetoprotein and HCG-beta should be measured systematically in all cases of anterior mediastinal tumour occurring in young subjects, and would enable a more frequent identification of tumours with difficult histology. The serum levels reflected the changes noted clinically and radiologically. Polychemotherapy bases around cis platinum led to a significant but transitory regression of the tumours. Radiotherapy was ineffective. Surgery was never totally curative.

Adult↗