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T Etienne

Publications and source records attributed to T Etienne.

At least 19 recordsLinked to original sources
PubMed1992

[Asymptomatic mediastinal masses: prognosis, attitude and impact of thoracic radiography].

Mediastinal masses remain an interesting diagnostic and therapeutic problem for the clinician. Recent advances in imaging techniques and the increased use of chest roentgenograms in medical practice contribute to early screening of asymptomatic mediastinal masses. From 1965 to 1990, 290 patients with a primary mediastinal cyst or neoplasm were operated and treated in our institution. Among those, 80 patients presented with asymptomatic mediastinal masses. The prognosis of these asymptomatic lesions was evaluated and compared to that of symptomatic ones. Overall, two third of patients who were asymptomatic at diagnosis had a neoplasm, which proved to be malignant in half of the cases. A significantly greater number of patients with malignant neoplasms were asymptomatic at the time of diagnosis during the recent period. The prognosis of these asymptomatic lesions appeared to be better in selected tumoral types (e.g. thymomas, lymphomas) although it was difficult to completely avoid statistical bias. Early radiological detection of mediastinal tumors could improve their prognosis in selected cases. Incidental diagnosis of mediastinal masses by radiological examination should lead to early aggressive diagnostic procedure and treatment.

Adolescent↗
PubMed1992

[Impact of organ shortage on the transplantation program].

The purpose of the study was to evaluate the consequences of a recent progressive shortage of donor organs on our different transplant programs. Although the waiting time before transplantation remained in general relatively short (4.6 [mean], 0-3, 0-10 months for renal, liver and heart transplantation, respectively), patients started to accumulate on our waiting list during the last year (1990) of the study (kidney transplantation). Furthermore some patients clearly deteriorated, other died awaiting transplantation (18% and 15% of the patients listed for liver and heart transplantation, respectively). In emergency, organs were provided most often by neighbouring foreign centers. Given these facts adhesion to supranational donor networks should be considered.

Humans↗
PubMed1992

[Kidney retransplantation: results and prognostic factors].

48 non primary renal transplants were performed in 40 recipients during the 1973-1990 period in our institution (40 second grafts, 6 third grafts and 1 four and fifth grafts). Despite poor HLA matching our second graft survival rates compare favorably with others (80% and 70%, 1 and 5 year graft survival rates). The type of immunosuppression (including ciclosporine A or not) and the duration of the first graft had an influence on the outcome of second grafts. Our experience with repeated retransplantation is limited, but graft survival appears to be poor: most of the grafts were rejected within 2 years (or less). However patient survival was not affected by overimmunosuppression following multiple grafts.

Adolescent↗
PubMed1991

[Incidence of primary mediastinal lesions: change in the profile and therapeutic implications].

The pattern of occurrence of mediastinal masses has to be taken into account when treating and approaching these lesions. In most reported series tumors of neural or germinal origin and thymomas are predominant. We reviewed the records of 277 patients operated for primary mediastinal lesions over the last 25 years (1965-1989) in our center. Surprisingly (Hodgkin's and non-Hodgkin's) lymphomas (24-25%) were found to emerge as the most common tumors in our series, whereas tumor of neural (11%) and germinal (65%) origins were relatively rare and decreasing in incidence. Thymomas (17%) and mediastinal cysts (14%) occurred as predicted in the literature. Consequently the malignancy rate was high (53%) even in asymptomatic patients (18%). Similar findings have been described recently by others. Factors responsible for this new distribution are difficult to identify. The therapeutic implications of the changes are discussed.

Adolescent↗
PubMed1990

[Pulmonary aspergilloma].

Pulmonary aspergillomas usually arise from colonization of Aspergillus in preexisting lung cavities. Between 1972 and 1988, 18 patients underwent thoracotomy for treatment of pulmonary aspergilloma in our institution. Eight patients had simple aspergilloma and ten had complex aspergilloma. Hemoptysis was the most frequent complication. Tuberculosis was the most common underlying lung disease. Patients presenting with complex aspergilloma usually had associated factors potentially reducing their immune competence. Patients with simple aspergilloma tolerated surgery quite well and the outcome was satisfactory. By contrast operative mortality was 30% (3 deaths) in patients with complex aspergilloma and complications occurred in 8 patients (80%). Treatment of pulmonary aspergilloma must be individualized to take into account the patient's overall health and the risks attendant with each treatment modality.

Adult↗
PubMed1990

[Elaboration of an ethogram for the diagnosis of Pattern "A"].

In order to develop a technique which allows the detection of Pattern A (P.A.) we present in this paper a series of steps for constructing an observation grill (ethogram) which allows for the quantification of behavior in situation of structured interview. The behavioral units making up the final ethogram are derived from inter-item correlations taken from a population of 48 subjects who had suffered heart attacks. The observations on this population permit an inclusion score in the P.A. These observations also confirm that the P.A. present a risk factor which is independent of classical risk factors. A significative positive correlation with work stress has been found showing, in accordance with the view of Friedman and Rosenman that the P.A. corresponds to a particular behavioral pattern which is dependent on the work environment.

Adult↗
PubMed1990

[Elaboration of an ethogram for the diagnosis of the A Pattern in coronary pathology].

In order to develop a technique which allows the detection of Pattern A (PA) we present in this paper a series of steps for constructing an observation gril (ethogram) which allows for the quantification of behavior in situation of structured interview. The behavioral units making up the final ethogram are derived from inter-item correlations taken from a population of 48 subjects who had suffered heart attacks. The observations on this population permit an inclusion score in the PA. These observations also confirm that the PA present a risk factor which is independent of classical risk factors. A significative positive correlation with work stress has been found showing, in accordance with the view of Friedman and Rosenman that the PA corresponds to a particular behavioral pattern which is dependent on the work environment.

Coronary Disease↗
PubMed1989

Sequential determinations of urinary cytology and plasma and urinary lymphokines in the management of renal allograft recipients.

Urine cytology, plasma (P), and urinary (U) interleukin-2 (IL-2)* and IL-2 receptor (IL-2R) levels were evaluated as immunological monitoring techniques in 65 renal allograft recipients. Normal individuals showed normal urine cytology, IL-2(U) = 0, IL-2(P) = 0.4 +/- 0.1 ng/ml (mean +/- SEM) and IL-2R(P) = 318 +/- 26 U/ml. Stable transplants also showed normal urine cytology, no IL-2(U), IL-2(P) = 0.8 +/- 0.2 ng/ml, and IL-2R(P) = 326 +/- 29 U/ml. Rejection episodes (n = 21) were accompanied by cytologic changes, including lymphocyturia, exfoliation of immature tubular cells, platelet aggregates, and fibrin deposits. The corresponding lymphokine changes were IL-2(U) = 39.6 +/- 1.4 ng/ml, IL-2(P) = 79 +/- 21 ng/ml, and IL-2R = 1884 +/- 202 U/ml, all markedly increased. Successful treatment was associated with return of all parameters to normal; treatment failure was associated with continued abnormalities. Fourteen rejections unresponsive to Solumedrol (500 mg x 5 days) required OKT3 rescue (5 mg x 14 days). In the 11 that were reversed, onset of OKT3 therapy was characterized by markedly increased exfoliation of necrotic cellular debris, lymphocytes, and collecting duct cells. Interestingly, serum creatinine increases of 57.2 +/- 18.9% (range 25-90%) over pre-OKT3 levels were noted. Maximal changes occurred 48-72 hr after the first dose, followed by gradual return to normal. Rejections unresponsive to OKT3 (n = 3) showed no cytologic changes from the pretreatment mean creatinine increase of 13.2 +/- 2.7% (range 9-15%), and maximum change occurred 24 hr after the first dose. Rejections responsive to Solumedrol only (n = 4) showed gradual improvement of all parameters. Rejections treated with Solumedrol following failed OKT3 prophylaxis (n = 3) did not reverse and continued to show rejection associated cytologic changes and abnormal creatinines. Patients experiencing CsA toxicity (n = 12) showed mild creatinine elevations, normal or negative IL-2(P) and IL-2R(P) levels, and no IL-2(U). They showed distinctive cytologic changes consisting of swollen convoluted tubular cells with nuclear pyknosis and cytoplasmic vacuoles. Pretransplant IL-2(P) levels of patients who subsequently rejected were elevated, with 19/21 patients with preoperative IL-2 levels greater than 15 ng/ml having subsequent rejections. In contrast, pretransplant creatinine, urine cytology, and IL-2(U) levels showed no correlation to subsequent clinical course.(ABSTRACT TRUNCATED AT 400 WORDS)

Antibodies, Monoclonal↗
PubMed1989

[Surgical treatment of pulmonary metastases].

From 1973 to 1988, 58 patients underwent operation for pulmonary metastases in our institution. The operative mortality was low (1-2%). The primary tumor was a melanoma in 7 cases, a sarcoma in 7 cases and a carcinoma in the remaining 44 cases. The overall 5-year patients survival was 30% and compares favorably with other series. Radical surgical excision significantly affects survival. Repeated or bilateral surgical excisions are sometimes needed. With the increased effectiveness of chemotherapy the role of surgery is changing. Surgical treatment of pulmonary metastases is indicated in selected cases.

Adult↗
PubMed1985

Characterization of peptides cleaved by plasmin from the C-terminal polymerization domain of human fibrinogen.

The C-terminal region of the fibrinogen gamma chain is known to participate in several functional interactions including fibrin polymerization. This part of the molecule is retained on the gamma chain of fragment D (FgD) when fibrinogen is digested by plasmin in the presence of calcium to produce the fragment D-fragment E (FgD X FgE) complex but is lost if FgD is prepared in the absence of calcium. In an attempt to characterize the C-terminal polymerization domain we have used three techniques to examine this further degradation of FgD following the addition of EDTA and plasmin. Analysis of the digestion by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed a progressive cleavage of the gamma chain to two small remnants. The polymerization-inhibitory activity of the whole digest was studied using acid-solubilized fibrin. A progressive loss of inhibitory activity was associated with gamma chain shortening, reaching greater than a 120-fold reduction at the end of digestion. The cleavage of peptides was followed by reverse-phase high performance liquid chromatography and the release of a characteristic peptide triplet was associated with gamma chain cleavage. Manual sequencing, amino acid analysis, and fast atom bombardment mass spectrometry established the three peptides as gamma 303-356, 357-373, and 374-405. These peptides have sequences in common with those peptides recently reported by other investigators to be potent polymerization inhibitors. However, when a mixture of the three peptides was added in a 200-fold molar excess to polymerizing fibrin, no inhibitory activity could be demonstrated. It is concluded that the C-terminal polymerization domain of fibrinogen may be an extended region which includes the sequence gamma 303-405, when this is contiguous with the remainder of the gamma chain.

Amino Acid Sequence↗
PubMed1985

[Thymomas].

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Adolescent↗