Effects of air pollution and climatic conditions on the frequency of ophthalmological emergency examinations.
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Air Pollutants↗
Biomedical subjects
T Bury
Publications and source records attributed to T Bury.
[Combining artificial tears---are they always synergistic?].
We report one case of thick, sticky, palpebral and conjunctival deposits following administration of artificial tears in a patient treated for dry eye syndrome. Experimental data confirmed clinical observation. The association of Refresh artificial tears and Dacudoses or Dacryoserum used as a washing solution should be avoided.
Borates↗
Increased TGFbeta1 plasma level in patients with lung cancer: potential mechanisms.
BACKGROUND: Plasma transforming growth factor beta1 (TGFbeta1) levels are elevated in patients with lung cancer. As TGFbeta1 is mainly found in platelets and as nonmalignant pulmonary diseases (NMPD) are frequently associated with lung cancer, we investigated the potential contribution of platelet degranulation and/or of a concomitant NMPD to the increased plasma levels of TGFbeta1 reported in patients with lung cancer. MATERIALS AND METHODS: Blood samples were collected in duplicate from 30 healthy subjects, 14 patients suffering from NMPD and 37 patients with lung cancer. The platelet count was determined and the samples were processed to obtain plasma. One sample was collected in EDTA (EDTA plasma) and the other in a mixture inhibiting platelet degranulation (PIM plasma). TGFbeta1 concentrations and beta-thromboglobulin (betaTG) levels, an index of platelet degranulation, were measured in both plasma samples. RESULTS: TGFbeta1 and betaTG plasma levels measured in PIM plasma were lower than those obtained in EDTA plasma. With respect to PIM plasma, both TGFbeta1 and betaTG levels were higher in patients with lung cancer than those with NMPD and in healthy individuals. In patients with NMPD, only TGFbeta1 levels were increased as compared to healthy controls, betaTG levels being similar. CONCLUSION: Methods for collecting and processing blood samples are critical in determining reliable circulating TGFbeta1 levels. Increased TGFbeta1 plasma levels observed in patients with lung cancer are related, at least partly, to concomitant NMPD and also to platelet degranulation as proved by increased betaTG levels.
Adult↗
[Exercise spirometry in medical practice].
Cardiopulmonary exercise testing is a unique tool to assess the limits and mechanisms of exercise tolerance. It is also useful for establishing the profiles and adequacy of the responses of the systems at submaximal and maximal exercises. The measure of VO2 max (maximal oxygen uptake) has become the "benchmark" to quantify cardiovascular functional capacity and aerobic fitness.
Cardiac Output↗
[Physiologic evaluation of explosive force in sports].
Although we all possess the capability for anaerobic and aerobic energy metabolism, the capacity for each form of energy transfer varies considerably among individuals. Sports such as football or weightlifting, rely almost exclusively on energy derived from the muscles's pool of high-energy phosphates. Researchers have proposed different tests to estimate the power-generating capacity of high energy phosphates: stair-sprinting power tests, jumping-power tests or sprint cycling. In reality, however, it is difficult to obtain precise physiological or biochemical data during all-out exercise of brief duration.
Adenosine Triphosphate↗
[Exercise training in COPD].
Rehabilitation for patients with chronic obstructive pulmonary disease (COPD) is well established and widely accepted as a means of enhancing standard therapy in order to alleviate symptoms and optimize function. The primary goal of rehabilitation is to restore the patient to the highest possible level of independent function. There is, however, no consensus on the optimal training modalities. Both walking and cycling improve exercise performance; there is substantial evidence that lower extremity exercise training should be included in rehabilitation programs for patients with COPD.
Exercise Therapy↗
[18FDG-PET applications in thoracic oncology].
PositIon emission tomography using 18-fluorodeoxyglucose (FDG-PET) is an imaging technique based on metabolic criteria rather than morphological criteria. We discuss the contribution of this technique in the field of pulmonary oncology and we summarize our work which has demonstrated the performance capacity of PET: to discriminate the malignant nature of a solitary pulmonary nodule; to improve sensitivity over CT for mediastinal assessment in non-small cell lung cancer; to seRach for distant metastasis in patients with non-small cell lung cancer; to complement CT imaging to better dissociate tumor residue or recurrence from post-therapeutic sequelae in non-small cell lung cancer. Finally, we present different expected progress for the future.
Carcinoma, Non-Small-Cell Lung↗
Typical appearance of mesothelioma on an F-18 FDG positron emission tomograph.
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Aged↗
[Contribution of positron emission tomography for the management of lung cancer].
18 FDG- PET is an imagining technique based on metabolic criteria rather than morphological criteria. (18) FDG- PET can demonstrate accelerated glycosis in cancer tissue related to increased transporter and glycolytic enzyme activity. Whole body PET is currently under validation in a growing number of indications during diagnostic and therapeutic assessment phases of cancer treatment. In the field of pulmonary oncology, (18) FDG- PET has already demonstrated its performance capacity to: 1) discriminate the malignant nature of a solitary pulmonary nodule, 2) improve sensitivity over CT for mediastinal assessment in small-cell lung cancer, 3) acquire whole body imaging to search for distant metastasis in patients with small-cell lung cancer; PET is particularly useful for evaluation of an adrenal mass, 4) complement CT imaging to better dissociate tumor residue or recurrence from post-therapeutic sequelae in small-cell lung cancer. Information provided by (18) FDG- PET is thus clinically relevant as it allows better dissociation of a benign process from a malignant process and better precision of small-cell lung cancer extension without necessitating systematic invasive exploration.
Bronchial Neoplasms↗
[How I investigate ... a broncho-pulmonary cancer by metabolic imaging (PET-18-FDG)].
Continuing advances in PET imaging have resulted in an improved ability to evaluate thoracic malignancies. Published reports demonstrate that PET provides accurate noninvasive detection of malignancy that is useful in the characterization of a pulmonary solitary nodule and in the mediastinal or extrathoracic staging of known lung cancer. Preliminary studies suggest that PET may also be able to assess the therapeutic response after surgery or radiation therapy.
Diagnosis, Differential↗
Value of FDG-PET in detecting residual or recurrent nonsmall cell lung cancer.
In order to evaluate the usefulness of 18-fluorodeoxyglucose (FDG) positron emission tomography (PET) in the assessment of therapeutic effects, a study was performed before and after therapy in 126 patients with non-small cell lung cancer (NSCLC) codified stage I to stage IIIB. Treatment with an early curative result was given in 58 patients, whereas in 68 cases it was limited to palliation. During the treatment follow-up period (8-40 months), each patient was evaluated every 3 months by clinical examination and < or =6 months by imaging techniques (PET and computed tomography (CT)). A diagnosis of persistent or recurrent tumour was established by means of pathological analysis in 31 patients and by clinical evolution and subsequent imaging progression in 29 other patients. PET showed increased FDG uptake in all cases (n = 60) of persistent or recurrent tumour, whereas CT was nonspecific in 17 cases. Conversely, there were five false positive cases via PET imaging and three via CT. In detecting residual or recurrent NSCLC, PET had a sensitivity of 100% and specificity of 92%, whereas CT had a sensitivity and specificity of 71% and 95% respectively. In conclusion, 18-fluorodeoxyglucose positron emission tomography correctly identified response to therapy in 96% (121 of 126) of patients. Positron emission tomography appears to be more accurate (p = 0.05) than conventional imaging in distinguishing persistent or recurrent tumour from fibrotic scar in patients undergoing treatment for non-small cell lung cancer.
Adult↗
[How to investigate ... diffuse interstitial lung disease].
There are a large number of conditions of known or unknown causes that have a tendency to alveolar wall fibrosis. The patient usually presents with progressive dyspnoea and the chest radiograph shows bilateral shadows whereas physiological measurements show a restrictive defect. Because of implications with regard to treatment and prognosis, diagnosis and staging of the disease are important. Computed tomography ("high resolution") and bronchoalveolar lavage are very useful at all stages of management of interstitial lung disease.
Biopsy↗
Fluorine-18 deoxyglucose positron emission tomography for the detection of bone metastases in patients with non-small cell lung cancer.
Despite advances in morphological imaging, some patients with lung cancer are found to have non resectable disease at surgery or die of recurrence within a year of surgery. At present, metastatic bone involvement is usually assessed using bone scintigraphy, which has a high sensitivity but a poor specificity. We have attempted to evaluate the utility of the fluorine-18 deoxyglucose positron emission tomography (FDG PET) for the detection of bone metastasis. One hundred and ten consecutive patients with histological diagnosis of non-small cell lung cancer (NSCLC) who underwent both FDG PET and bone scintigraphy were selected for this review. In this group, there were 43 patients with metastatic disease (stage IV). Among these, 21 (19% of total group) had one or several bone metastases confirmed by biopsy (n = 8) or radiographic techniques (n = 13). Radionuclide bone scanning correctly identified 54 out of 89 cases without osseous involvement and 19 out of 21 osseous involvements. On the other hand, FDG PET correctly identified the absence of osseous involvement in 87 out of 89 patients and the presence of bone metastasis in 19 out of 21 patients. Thus using PET there were two false-negative and two false-positive cases. PET and bone scanning had, respectively, an accuracy of 96% and 66% in the evaluation of osseous involvement in patients with NSCLC. In conclusion, our data suggest that whole-body FDG PET may be useful in detecting bone metastases in patients with known NSCLC.
Aged↗
Clinical evaluation of whole-body 18F-fluorodeoxyglucose positron emission tomography in the detection of liver metastases.
BACKGROUND: Assessment of metastatic involvement of the liver remains a diagnostic challenge. The objective of this study was to evaluate the potential role of FDG PET in the detection of liver metastases. PATIENTS AND METHODS: Sixty-four patients with malignancy and possible liver involvement were included. Liver metastases were present in 31 cases, demonstrated by histopathological analysis in 15 cases and by follow-up in 16 cases. The negative cases were confirmed by pathology in four cases, peroperative ultrasonography in 12 cases, and follow-up in 17 cases. Whole-body FDG PET was compared to CT (n = 53) and US (n = 43). RESULTS: PET demonstrated a 97% sensitivity, an 88% specificity and a 92% accuracy, compared to 93%, 75% and 85%, respectively, for CT (P = NS). Concordant results were obtained in 44 of 64 patients (69%: 19 TP. 25 TN). PET provided new and accurate information in 15 of 64 patients (23.4%). PET demonstrated liver metastases in 11 patients in whom conventional methods yielded negative (two cases) or doubtful (nine cases) results. Four patients free of liver involvement were correctly staged with PET, while CT/US were equivocal. PET was erroneous in five of 64 cases (7.8%, four FP, one FN). CONCLUSIONS: FDG PET allows an accurate screening of liver involvement in patients with malignancy. Combined with CT, it provides additional diagnostic information that could directly affect the management of these patients.
Adult↗
Immunological status of competitive football players during the training season.
We investigated possible immunological changes in 15 professional football players before, during and after the sports season. We studied the leucocyte count as well as different functions such as T-lymphocyte proliferation, NK activity, chemotaxis and phagocytosis of neutrophils. Training and competitions did not produce any change in the total number of leucocytes but increased neutrophil counts and decreased T4 lymphocyte counts. We also observed a slight decrease of T-lymphocyte proliferation and a significant decrease of neutrophil functions. On the other hand, training and competitions did not induce significant changes in the number of NK cells nor in the total NK cytotoxic activity. The different change observed tended to normalize after the sports season. Our results suggest a predominant neutrophil function depression in football players during a training season which could partly explain the susceptibility of elite athletes to infections.
Analysis of Variance↗
Bronchial responsiveness in active steelworkers.
Coke-oven workers are exposed to dust and irritant gases. Therefore they are at risk of developing lung diseases including chronic bronchitis. Nonspecific bronchial hyperresponsiveness (BHR) has been advocated as a potential risk factor predisposing to the development of chronic bronchitis. In a previous study, we showed that prevalence of BHR was higher in retired coke-oven workers than in retired blast furnace workers. The present study was carried out to determine the prevalence of BHR in active steelworkers. Thus, 137 coke-oven workers and 150 blast furnace workers underwent clinical examination, a standardized questionnaire for the study of respiratory symptoms, pulmonary function testing and methacholine aerosol challenge. The study demonstrates a higher prevalence and degree of BHR [provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (PC20) < or = 8 mg x mL(-1)] in coke-oven workers than in blast furnace workers (31.4 versus 6.7%; p<0.001). Moreover, the frequency of respiratory symptoms and basal bronchial obstruction were greater among coke-oven workers with BHR in nonresponders. The basal maximum expiratory flow from 25-75% of forced vital capacity and the respiratory symptoms were correlated with bronchial responsiveness. The lack of correlation observed between BHR and the intensity of smoking or years spent in coke-oven environment may be explained by the high proportion of smokers, the worker turnover in the steel plant, and the "healthy worker effect". In conclusion, the higher prevalence and degree of bronchial hyperresponsiveness in coke-oven workers suggests that coke-oven pollutants are more intense irritants than those that escape from blast furnaces.
Adult↗
[Clinical case of the month. Multiple pulmonary nodules. Epithelioid hemangioendothelioma].
The epithelioid hemangioendothelioma of the lung is generally detected incidentally by a routine chest radiograph, usually in young asymptomatic woman. This tumor pursues a clinical course intermediate between that of hemangioma and angiosarcoma. Survival over 20 years have already been described in the literature. We report the case of a pulmonary epithelioid hemangioendothelioma diagnosed 16 years ago, with hepatic metastases and a radiologic follow-up that highlights the slow evolution of the pulmonary and hepatic lesions.
Adult↗
Soluble and cell-associated transferrin receptor in lung cancer.
The expression of transferrin receptor (TfR) has been identified in many malignant tumours. In lung cancer, lymphoma and breast cancer, it has been shown that the expression of TfR correlates with tumour differentiation, probably implying some prognostic value. A soluble form of TfR (sTfR) in human serum has been shown to be proportional to the number of cellular TfRs. Based on these data we examined the utility of measuring sTfR in the serum and bronchoalveolar lavage (BAL) fluid of patients with lung cancer (n = 32) and patients with chronic obstructive pulmonary disease (n = 22). BAL fluid was centrifuged to separate the supernatant from the cellular component. Cells were lysed in a detergent and cell-associated TfR was measured by enzyme-linked immunosorbent assay (ELISA) and expressed as ng 10(-6) cells in this cellular component. There was no difference in serum sTfR between the cancer and chronic obstructive pulmonary disease (COPD) groups. A higher level of cell-associated TfR was found in BAL of non-small-cell lung cancer patients than in COPD patients (P = 0.01). The calculated number of TfR molecules per cell in BAL correlated positively with the percentage of macrophages in BAL (P < 0.0001), suggesting that cell-associated TfR in BAL originates primarily from macrophages in this fluid. No correlation existed between BAL cell-associated TfR and tumour size, nodal status, the presence of metastases and serum sTfR. BAL cell-associated TfR was negatively correlated with BAL supernatant neuron-specific enolase (NSE) (P = 0.01). A combination of BAL supernatant NSE and cell-associated TfR detected lung cancer with a sensitivity of 91%, a specificity of 59% and positive and negative predictive values of 81% and 71% respectively. In conclusion, BAL cell-associated TfR may help in the differential diagnosis of lung cancer vs pneumonia.
Aged↗