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Biomedical subjects

R Loire

Publications and source records attributed to R Loire.

At least 163 records · Page 9Linked to original sources
PubMed1987

[Lipid pneumonia and superinfection by Mycobacterium fortuitum. Apropos of a case].

We report a case of lipoid pneumonia complicated by supra-infection with Mycobacterium fortuitum. The diagnosis of a lipoid pneumonia was suggested by the CT Scanner which showed a negative density in the pneumonic tissue. The supra-infection by the mycobacterium dit not change the radiological opacities which stayed the same following a cure of the mycobacterial infection. A histo-pathological study showed evidence of macrophages with voluminous lipid inclusions but equally the atypical mycobacteria were associated with a giant cell-epithelioid reaction. In patients with a lipoid pneumonia the possibility of an infection should be considered and a supra-infection with an atypical mycobacterium should be looked for. At the same time, when a bacteriological study of sputum or fibreoptic aspiration of a rapidly growing mycobacterium is obtained this should raise the possibility of oil inhalations. Alveolar lavage seems to be a technique which seems to be entirely appropriate to obtain the diagnosis of the two concomitant disorders.

Amikacin↗
PubMed1986

Amyloidosis of the lower respiratory tract. Clinical and pathologic features in a series of 21 patients.

Twenty one cases of amyloidosis of the lower respiratory tract were seen at a single center. In three patients, multifocal bronchial amyloid plaques led to stenosis and atelectasis, and in two, small pseudotumor masses were an incidental bronchoscopic finding. Two patients had nodular parenchymal amyloidosis, in one of whom the lesions were progressive and in the other static. Fifteen patients had diffuse parenchymal amyloidosis. Two of these had severe interstitial involvement and died in respiratory failure; eight had congestive cardiac failure, and parenchymal amyloidosis was a post-mortem finding; two had senile cardiorespiratory amyloidosis, also found at autopsy; and in three, the amyloidosis was associated with malignancy. The degree of respiratory embarrassment seemed to be related to the amount of amyloid in the gas diffusion zones, irrespective of the etiology of amyloidosis.

Adult↗
PubMed1986

[2 cases of coronary embolism. Angiographic diagnosis and anatomopathological confirmation].

The authors report two cases selected from a series of 61 cases of coronary embolism observed over an 18 year period at the Cardiovascular Hospital (Lyon) out of 4,860 autopsies of adult patients who died of cardiovascular causes. These two cases underwent coronary angiography, the results of which correlated with the autopsy findings. The authors review the causes and clinical manifestations of coronary embolism and compare their results with previously reported data, to establish the radiological features of coronary embolism. They notice the regular appearance of obstruction due to embolism and underline the importance of the associated negative signs (normality of the rest of the coronary circulation, absence of collateral vessels...) which makes the angiographic diagnosis one of elimination.

Adult↗
PubMed1986

[Pulmonary metastases in medullary cancers of the thyroid. Study of 4 cases. Originality of the lymphangitic form with amyloid stroma].

We studied the clinical and radiological features of pulmonary metastases present in 4 out of 22 patients with medullary carcinoma of thyroid. Two patients presented with common metastases: macronodules in one, and micronodules in the other one. The other two patients presented initially with reticulonodular perihilar lesions on chest X-ray, leading to the diagnosis of sarcoidosis in both of them. The observation of such pulmonary metastases is original: initially latent, they progress very slowly, and they correspond to a lymphangitic spread of the tumour with amyloid deposition in peribronchovascular structures without alveolar involvement, as shown in one of our cases with pathologic study.

Adult↗
PubMed1986

[Chronic cryptogenic pneumonia].

We report a case of a 72 year old man with the appropriate criteria for the recently identified chronic cryptogenic pneumonia: dyspnoea, cough, low general state, fever, raised sedimentation rate, localised opacities on the chest x-ray; no cause has been identified; the patient will improve on steroid therapy even though antibiotics are without effect, but relapses on stopping the steroids. A lung biopsy shows a predominant intra-alveolar fibrosis. A definitive cure can be obtained by 12 weeks of steroid therapy.

Aged↗
PubMed1985

Lesions of digital arteries in Dupuytren's disease. A study of twelve cases.

Twelve cases of histologically examined digital collateral arteries severed accidentally during surgery for Dupuytren's disease are presented. All arteries were repaired immediately after specimen retrieval for histological examination. Only one artery had a normal structure; 11 cases showed subendothelial fibrosis while two arteries thrombosed. These changes might account for the confusion of these arteries with adhesions and might explain their severance. Typically the zone involved was the distal part of the palm, in which the neurovascular bundle twists around the spiral cord. We believe that the lesions are a consequence rather than a cause of Dupuytren's disease.

Aged↗
PubMed1985

[Lambl's excrescences].

First described in 1856 as small, filiform, pale outgrowths from the free border of the cardiac valves, larger specimens can now be detected by echocardiography. We analysed 30 consecutive cases to define the anatomic of LE were determined macroscopically and histological examination was then carried out with six different stains. LE was found on 18 aortic, 10 mitral, 2 tricuspid and 2 pulmonary valves in the 30 patients examined. Their size ranged from 2 to 12 mm with 7 examples being over 5 mm long. Histologically there appeared to be two forms: mobile, pediculated lesions (20 cases) either with the usual changes of an acellular fibrous axis containing rings of granulous orcenophilic material or with more complex associations of these changes resulting in pseudo-papillomata of the valves; the second form of LE is incorporated in the valve itself. It thickens the valve and becomes covered by a layer of flattened endothelium. The histological study suggested several pathogenic mechanisms, all related to local conditions rather than to general circulatory changes: folding of the valvular endothelium onto itself followed by organisation into tubular structures filled with oedema and hyaklin, deposits of fibrin layers on zones of endothelial ulceration caused by trauma on the line of apposition of the cusps with partial detachment of fibrinous material which then endothelialises; finally, subendocardial incorporation of oedema, fibrin, and red blood cells. Although LE may occur in association with non-bacterial thrombolic endocarditis, these two conditions do not seem to be related.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1985

[Coronary embolism. Apropos of 61 anatomo-clinical cases].

We reviewed 61 autopsy cases of coronary embolism observed over an 18 year period (up to the end of 1983) out of a total of 4 860 post-mortems performed on adults dying of cardiovascular causes in order to determine the nature and site of embolisation, the site of origin and establish the clinical features and evolution. A total of 75 emboli were found in the 61 cases (47 single, 11 double and 3 triple emboli). The emboli were recent fibrinothrombi in 43 cases; there were 9 associated calcific emboli, 2 embolized fragments of myocardium, 1 of Teflon and 1 of malignant tissue; the diagnosis was made "retrospectively" in 5 cases on a number of criteria. The main site of embolisation was the left anterior descending artery (34 cases) followed by the right coronary (20 cases), left circumflex (14 cases) and left main coronary artery (7 cases); obstruction was observed at the coronary ostium (7 left, 2 right) in 9 patients. The origins of the emboli were varied: 19 intracardiac thromboses (left atrial 10, left ventricule 6, suture of left atriotomy 3) 12 bacterial vegetations in cases of infective endocarditis, 10 thrombosis of prosthetic valves, 9 calcific emboli (8 aortic stenosis, 1 calcification of the ascending aorta) and 10 others.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomyopathies↗
PubMed1985

[Cardiac abscess in infectious endocarditis. Apropos of 25 anatomo-clinical cases].

Although rarely suspected clinically, cardiac abscesses are a serious and not uncommon complication of infective endocarditis (IE). Twenty-five cardiac abscesses were found at autopsy in 125 cases of IE on native valves. The anatomoclinical features of these cases are described. Cardiac abscesses usually occur in patients with previous valvular heart disease (21/25) and more commonly in aortic valve endocarditis (15/25) especially when complicating calcific aortic stenosis (9/25). The predominant infecting organism was staphylococcus aureus (9 cases). An iatrogenic portal on entry was confirmed in 9/25 cases. Conduction defects (14/25) commonly led on to sudden death (9 cases) despite attempts at temporary pacing (14/25) commonly led on to sudden death (9 cases) despite attempts at temporary pacing (2 cases%. The clinical history was shorter than 2 months in 4/5 cases. The average age of the patients was 53.3 years. The commonest site of infection was the aortic valve (16/25), affecting the posterior cusp in all cases. It is difficult to summarise the localisation of the abscesses as collection of pus extended in all directions. Involvement of the valve rings (aortic 10 cases--mitral 5 cas), of the interventricular septum (15 cases), of the LV free wall (17 cases), was common, sometimes in association, and fistula formation between two different cavities was observed in 4 cases. The abscess may communicate with a cardiac chamber or remain enclosed in the parietal structures (17 cas) reaching an average size of 2 cm diameter. Histological examination distinguished collected forms with an identifiable pyogenic membrane from the extensive, gangrenous, necrotic form with detectable microbial colonies in 9 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Abscess↗
PubMed1985

Epidermoid cysts, sulci, and mucosal bridges of the true vocal cord: a report of 157 cases.

Presented is a summary of our experience with 157 patients having a diagnosis of epidermoid cyst, glottic sulcus, or mucosal bridge of the true vocal cord. Each patient in this group was diagnosed and treated jointly by a phoniatrist and microlaryngoscopist and then evaluated for results of surgical and phoniatric therapy. Included in the discussion are methods of examination and diagnosis, microanatomy and histopathology of the lesions, methods of treatment, and results of treatment. An argument for a common etiology for these lesions is advanced.

Adolescent↗
PubMed1985

[Apparently primary thoracic hemangiopericytoma. Apropos of 12 cases].

Twelve cases of apparently primary thoracic hemangiopericytoma are reported: 7 intrapulmonary and 5 extrapulmonary. These cases, taken together with 75 others already published, serve as a basis to describe the characteristics of thoracic hemangiopericytomas. Intrapulmonary forms raise the problem of a single peripheral X-ray lesion, often detected in a routine film, with no accompanying endoscopic abnormality. Extrapulmonary forms also take the form of a well defined tumor with diaphragmatic or mediastinal parietal connections. Up to the present, the diagnosis has always been made at thoracotomy. It is probable that a preoperative diagnosis will be possible in the future by transbronchial biopsy. Silver stains and the use of the electron microscope form the basis of histological diagnosis. However it is not possible to distinguish by histology between benign and malignant forms, nor between primary or metastatic hemangiopericytomas. It is for this reason that doubt will long persist as to the primary nature of the tumor and only prolonged survival of patients after excision confirms that the lesion was indeed primary. Treatment is essentially surgical. New high energy radiotherapy techniques and new possibilities in chemotherapy (using adriamycin) should improve the prognosis in those forms which run a malignant course. However the standard therapeutic strategy for these rare tumors has yet to be defined.

Adult↗