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Biomedical subjects

R Loire

Publications and source records attributed to R Loire.

At least 199 records · Page 11Linked to original sources
PubMed1983

[Apparently primary pulmonary hemangiopericytoma. Apropos of 7 cases].

Seven cases of pulmonary hemangiopericytoma (presumed to be primary v.i.) are reported. Personal observations on these cases combined with 43 already described in the literature allow certain characteristics of the disorder to be accurately defined. Clinically, primary pulmonary hemangiopericytoma raises the aetiological problem of a peripheral solitary tumour beyond endoscopic vision. Until the present time the diagnosis has always been made by thoracotomy. Transpleural pulmonary biopsies may allow a preoperative diagnosis. Silver stains and electron microscopy enable an anatomo-pathological diagnosis. Histological studies can neither distinguish between benign and malignant forms nor differentiate between primary or metastatic hemangiopericytoma. For this reason there is always a long period of doubt whether the tumour is primary; only prolonged survival of the patients after excision will confirm whether the tumour was a primary or not. Treatment is essentially surgical. It seems that new techniques in radiotherapy (high energy) and new possibilities of chemotherapy (with Adriamycin) are capable of improving the prognosis of the malign form. However, such a therapeutic strategy remains to be defined as these tumours are so rare.

Adult↗
PubMed1982

[The anatomical forms of mitral incompetency (author's transl)].

A change in any of the parts of the mitral valve apparatus may cause systolic leakage: the mitral ring, the large and small valve, the papillary muscles and the chordae tendinae, hence the possibility of a large number of anatomical and physiological mechanisms and many possible etiologies in the onset of mitral incompetency. For each of the four anatomical constituents of the mitral valve these mechanisms are successively reviewed and their etiologies considered, as various as the sequelae of rheumatic or infective endocarditis, metamorphic calcifications, mucoid degeneration, ischemic or other myocardial changes, constitutional abnormalities. Each type of mitral incompetency has a variable effect on the heart cavities and the pulmonary circulation.

Humans↗
PubMed1982

Post-traumatic-shock lung: postmortem microangiographic and pathologic correlation.

In post-traumatic-shock lung, increased pulmonary vascular resistance and pulmonary hypertension are prominent features. The explanation for them was sought by postmortem microangiography of the lungs of 17 patients dying of respiratory failure after trauma. The 10 patients with thoracic injury died earlier (1-8 days). Extravasation of contrast material due to alveolar capillary rupture was present in all but one specimen and occupied 20% of the sampled area. Pulmonary artery thrombi lay proximal to these extravasations. Hypovascular areas due to infection and hemorrhagic alveolitis were found in all patients and involved 40% of the surface area. The small pulmonary arteries were poorly filled and contained many microthrombi. Some patients had hematomas, cavities, and areas of interstitial edema occupying about 5% of the lung area and associated with compressed or occluded vessels. Several mechanisms including pulmonary trauma may be responsible for the antemortem rupture and obstruction of small blood vessels. In the post-traumatic-shock lung, small artery occlusion and compression are associated with pulmonary hemorrhage, infarction, and infection and are important contributors to perfusion abnormalities and respiratory failure.

Adolescent↗
PubMed1982

[Broncholithiasis].

Eight cases of broncholithiasis requiring surgical treatment are reported, and diagnostic and therapeutic difficulties of this affection discussed. Clinical symptomatology is not very specific and associates slight or moderate hemoptyses with signs of a febrile pulmonary disorder. Expectoration of a broncholith was not observed in these cases. Radiological images were suggestive by demonstrating hilar and/or peripheral calcifications, often with a parenchymatous opacity in the same region. Fibroscopy is not always conclusive and may even suggest the presence of a tumor. A tuberculous etiology is admitted in France in spite of the absence of bacilli in the sputum. Differential diagnosis from cancer is a real problem, this explaining why two pneumonectomies were performed, in addition to the six lobectomies.

Adult↗
PubMed1981

Diagnosis and treatment of intracordal cysts.

Seventy-one cases of intracordal cysts are reported. They were all diagnosed between 1970 and 1980: 53 were epidermoid and 18 retention cysts. They caused longstanding dysphonia characterized by lowered tonality, huskiness, desonorization, and vocal strain. Clinical signs were often discrete and stroboscopy revealed a lack of vibrations on the cystic cord. Surgery was followed by vocal re-education and there was a high percentage of good vocal results.

Adolescent↗
PubMed1980

[Oral contraceptive and coronary thrombosis. Two clinicopathological cases].

The cases reported are interesting from two points of view: they confirm the thrombotic mechanism of the arteria lesions (coronary amongst others) and the oral contraception pill was the only cardiovascular risk factor, smoking, hyperlipidaemia, hypertension and coronary atherosclerosis having been eliminated. The two young women (31 and 34 years old) presented with severe myocardial infarction and shock, leading to death within hours in one case and within weeks in the other (despite an attempt to resect the infarct and prolonged intraaortic balloon pumping). In both cases multiple thromboses were discovered: coronary, intra cardiac and in the collateral aortic circulation.

Adult↗
PubMed1980

[Comparative study of myocardial protection by coronary perfusion in deep hypothermia (10 degrees C) with or without potassium cardioplegia. Clinical, electrocardiographic, enzymatic results; biochemical and histological controls].

A technique of coronary perfusion with diluted blood, giving homogenous myocardial cooling (10-12 degrees C) under lignocaine perfusion, with or without potassium (K) cardioplegia is presented. The first 75 operated cases were used to adjust the optimal lignocaine (5 mg/min) and K (2 meq/min in continuous coronary perfusion, 5 meq/min in discontinuous coronary perfusion) dosage in the myocardial protection circuit. Then, 123 operated patients (78 aortic valve replacement, 30 mitro-aortic double valve replacement, 15 other operations on the ascending aorta) were classified into four groups prospectively: 1. Continuous coronary perfusion 10 degrees C, 2. Continuous coronary perfusion 10 degrees C with associated K cardioplegia, 3. Discontinuous coronary perfusion 10 degrees C, 4. Discontinuous coronary perfusion 10 degrees C with K cardioplegia. The best return of cardiac activity was observed in Group 1 and this was statistically significant with a high percentage of spontaneous heart beating after declamping the aorta (average 10 minutes), immediate efficacity of left ventricular contraction, and absence of arrhythmias, especially the transient conduction defects observed with K cardioplegia. In Group 1, during mitro-aortic valve replacement, after over 60 minutes aortic clamping, no significant reduction of ATP or myocardial phosphocreatinine or changes of hexosemonophosphates were observed, contrary to the findings after 15 minutes aortic clamping at 28 degrees C in a control group of mitral valve replacements (n = 10). Myocardial changes on electron microscopy in the subendocardial region of the left ventricle were minimal or absent, especially with respect to the mitochondria. The early post-operative course was the same in all four groups: of the 123 patients operated, early mortality was 2.4 p. 100 (1.6 p. 100 from intercurrent causes), severe arrhythmias were observed in 1.6 p. 100, supraventricular arrhythmias in 4.9 p. 100, myocardial infarction in 0.8 p. 100, electrocardiographic ischaemia in 0.8 p. 100, and atrioventricular block in 0.8 p. 100. The average enzyme level (CPK, SGOT, LDH) in the early postoperative period were low, with no correlation with the duration of aortic clamping.

Chemical Phenomena↗
PubMed1980

[Intrathoracic splenosis. Apropos of a case].

The authors report an exceptional case of intrathoracic splenosis in a 34 year old woman suffering from a circulation injury with rupture of the spleen and left diaphragm and hemothorax. She had been splenectomized. Eleven years later, a systematic thoracic X-ray examination revealed a rounded opacity of the left extremity. Exeresis of a lump the size of a nut located in the pleural space without individualized vascular pedicle was performed. The lesion showed macroscopic and microscopic characteristics of splenic tissue. If peritoneal splenosis is more frequent, intrathoracic splenosis is exceptional (only 7 observations known). Every time, a traumatic splenic antecedent has been noted. The etiopathogeny consists of an autograft of splenic tissue most often in the pleural cavity, when a diaphragmatic lesion has been associated to the injury. The lesion is asymptomatic and does not provoke complication in that area. Histologically, the splenic parenchyma can be normal or limited to the red pulp with a more or less important degree of white pulp. The histological differences with the normal or accessory spleen are the non contractile collagenous texture of the capsular and the septa and the absence of hila. One should consider this etiology when antecedents of splenic and diaphragmatic traumatism are noted. Hepato-splenic scintigraphy can be useful in the diagnosis and help to avoid thoracotomy.

Adult↗
PubMed1980

[Pulmonary amyloidosis. Report of a case with 14 year follow-up (author's transl)].

A patient, 37 years old in 1966, presented hemoptysis and an excavated lesion of left upper lobe; there were no acid-fast bacilli in the sputum, but he was considered as having tuberculosis. After one year of treatment, the lesion had progressed and was removed surgically; pathologic diagnosis was silicosis. During the following years, three excavated lesions developed in the controlateral lung. When seen in 1979, the patient had consolidation of the whole right upper lobe and an excavated mass of right lower lobe. Amyloidosis was suggested; the pathologic sections of 1967 were reviewed and confirmed amyloidosis.

Adult↗