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Biomedical subjects

Y Cormier

Publications and source records attributed to Y Cormier.

At least 145 records · Page 8Linked to original sources
PubMed1983

The yellow nail syndrome. Light and electron microscopic aspects of the pleura.

The yellow nail syndrome is a rare cause of recurrent pleural effusions. We studied a case of this entity, placing special emphasis on the microscopic and ultrastructural aspects of the pleural lymphatics. The patient had the classic symptoms of recurrent bilateral pleural effusions, yellow, dystrophic fingernails and toenails, and lower-limb edema. To control the pleural effusions, a left parietal pleurectomy was performed. Histologic study showed both pleura to be thickened with fibrosis and chronic inflammatory infiltration. The lymphatic capillaries in the visceral pleura were dilated. Electron microscopy confirmed the lymphatic nature of these capillaries. We believe that these ectatic lymphatic capillaries suggest a downstream obstruction to the lymph drainage.

Humans↗
PubMed1982

Benefits of polychemotherapy in advanced non-small-cell bronchogenic carcinoma.

The benefits of polychemotherapy in advanced (Stage III) non-small-cell bronchogenic carcinoma remain uncertain. In attempt to answer the important question whether treatment improves well-being and survival in these patients, we did a prospective, randomized, single-blind study to compare polychemotherapy to a placebo. Thirty-nine consecutive patients were enrolled. Twenty received a drug combination consisting of: methotrexate, doxorubicine hydrochloride (Adriamycin), cyclophosphamide, and lomustine (CCNU) (MACC). The other group (19 subjects) received a placebo physically comparable to MACC. The two groups were initially comparable in terms of age, sex, clinical status, and tumor burden. In the treated group, seven patients had a radiologic response (more than 50% reduction in the tumor size), and the tumor stabilized in an additional five subjects. There were no responders in the placebo group. Median survival was 30.5 weeks for the MACC group compared to 8.5 weeks in the placebo group (P less than 0.0005, Gehan-Wilcoxon). We conclude that polychemotherapy (in this case MACC) significantly benefits patients with advanced non-small-cell lung cancer.

Aged↗
PubMed1982

Metabolic gas effect on phase III slopes of single-breath nitrogen tests.

This study was designed to estimate the relative contribution of gas exchange to the slope of phase III and the mean respiratory quotient (R) during this maneuver. With eight normal volunteers, we studied single-breath nitrogen tests and single-breath reversed tests (SB-N2, SB-R) without and with CO2 added to the test inspiration (SB-N2CO2, SB-RCO2). With an inspired CO2 of about 6% the slope of phase III in SB-N2 and SB-N2CO2 increased from 0.87 +/- 0.24 (mean +/- SD) to 1.03 +/- 0.21% N2.l-1 (P less than 0.01); however, in SB-R an SB-RCO2 the steepness of the slope of phase III decreased from 0.65 +/- 0.13% to 0.50 +/- 0.14% N2.l-1 (P less than 0.01). From these data we can calculate that gas exchange accounted for 13% of the slope of phase III in SB-N2 and SB-R. The mean R value during the slope of phase III for this effect was between 0.6 and 0.7. R was further decreased when CO2 was added, and its influence was increased to 26% of the slope of phase III.

Adult↗
PubMed1982

Contribution of residual volume to the increased alveolar plateau with bronchoconstriction.

We studied 10 normal volunteers with single-breath nitrogen tests before and after methacholine-induced bronchoconstriction. On the first day we challenged each subject with increasing methacholine concentrations to obtain a 20% drop in the partial forced expired volume in 1 s/partial forced vital capacity ratio. This resulted in an increased residual volume (RV) from 1,536 +/- 138 to 2,371 +/- 216 ml (mean +/- SEM, p less than 0.01). On the following day we did single-breath nitrogen tests from RV, RV + delta V (delta V is the individual's RV increase after bronchoprovocation) and after a similar methacholine rechallenge. Baseline slope of phase III was 0.88 +/- 0.11% N2/1 (mean +/- SEM), 1.36 +/- 0.22% N2/1 with the RV + delta V test (p less than 0.01), and 2.84 +/- 0.68% N2/1 with bronchoconstriction (p less than 0.05). The results show that the changes in RV per se accounted for 24% of the increase in the slope of phase III seen with bronchoprovocation.

Adult↗
PubMed1982

The role of gas exchange in phase IV of the single-breath nitrogen test.

Because at the end of a prolonged expiration the respiratory quotient is less than 1, ongoing gas exchange could add to the rising N2 concentration in phase IV of the single-breath nitrogen (SB-N2) test. To verify this, 7 normal subjects performed SB-N2 and reversed gradients (SB-R) tests with and without a 20-s apnea at the onset of closing volume. In the SB-R test, the residual gas is 100% O2 and the final VC inspiration is room air. This gives a downward slope of phase IV (delta N2IV). Apnea, by prolonging total expiratory time, should increase the contribution of gas exchange and therefore increase the delta N2IV in the SB-N2 test and decrease it in the SB-R test. In the SB-N2 test, the delta N2IV increased, with the apnea, from 5.58 +/- 1.35 to 8.12 +/- 1.52 (mean +/- SD, p less than 0.01). In the SB-R test, the delta N2IV decreased from 4.31 +/- 1.65 to 1.43 +/- 1.45 (p less than 0.01). These results suggest that 10% of the N2 changes in the delta N2IV in the normal SB-N2 test may be related to gas exchange.

Adult↗
PubMed1982

Immune reactions in the lungs of asymptomatic dairy farmers.

To test the hypothesis that asymptomatic farmers with serum precipitins to farmers' lung disease antigens also have an immune reaction involving the lungs, we did bronchoalveolar lavage (BAL) in 3 groups of dairy farmers. Group 1: 7 patients with acute farmers' lung disease. Group 2: 10 asymptomatic farmers with serum precipitins to Micropolyspora faeni. Group 3: 9 normal farmers without serum precipitins. Group 1 patients had a large number of cells (90.4 +/- 20 X 10(6)) (mean +/- SEM) with 72 +/- 5.8% lymphocytes in their lavage fluid. Their lavage also had high immunoglobulins A and G/albumin ratios. Six subjects in Group 2 had an increased number of cells (54.1 +/- 14.1 X 10(6)) and a high percentage of lymphocytes (52.5 +/- 6.6%) in their BAL. Two subjects in Group 3 had similar alterations in their lavage fluid: 60.0 and 69.6 X 10(6) cells with 20 and 37.5% lymphocytes, respectively. The other subjects in Groups 2 and 3 had normal lavages. Proliferative responses of BAL lymphocytes to phytohemagglutinin was similar in each group. Circulating immune complexes were increased only in subject with acute farmers' lung disease (Group 1). These results show that some normal farmers have signs of an alveolitis.

Adult↗
PubMed1981

Contribution of gas exchange to slope of phase III of the single-breath nitrogen test.

To study the influence of gas exchanges on the slope of phase III, single-breath nitrogen tests (SB-N2) and reversed tests (SB-R) were performed with 10 normal volunteers at expiratory flows of 100 ml.s-1, 500 ml.s-1,11.s-1, and 21.s-1. During the prolonged expiration required for the SB-N2 test, more O2 is consumed that CO2 eliminated. This factor could contribute to the rising slope of phase III. However, if one obtains a reversed slope of phase III (by having O2 as the residual gas and room air as the inspired gas), factors increasing N2 concentration with time of expiration should decrease the steepness of this reversed slope. Our data show that, at an expiratory flow of 100 ml.s-1, the slope of phase III was steeper in SB-N2 than in SB-R by 0.92 +/- 0.31% N2 1-1 (mean +/- SD, p less than 0.01). As the expiratory flow was increased to 500 ml.s-1, this difference decreased to 0.33 +/- 0.19% N2 1-1, and both slopes became similar in magnitude but opposite in direction at an expiratory flow of 1 1.s-1. These data suggest that active gas exchange has a significant influence on the slope of phase III of the SB-N2 test.

Adult↗
PubMed1980

Subclinical reduction in airflows after Teflon injection of vocal cord.

Results of intracordal Teflon injection for symptoms of unilateral vocal cord paralysis have been excellent. There seems to be no significant long-term foreign body reaction or limitation to maximum airflows. However, acute inflammatory reactions and airflow obstruction have been reported. The objective of the present study was to evaluate the frequency, extent, and duration of airway obstruction following Teflon injection. Forced inspiratory and expiratory airflows were measured in seven consecutive patients before, 24 hours, and 10 days after Teflon injection. Significant variable upper airway obstruction, as demonstrated by an increase in the ratio of forced expiratory airflows at 50% Vital Capacity to the forced inspiratory airflows at the same lung volume (VE50/VI50), was found in each subject. At 24 hours after the injection this ratio increased from a baseline of .098 +/- 0.50 (mean +/- S.D.) to 1.41 +/- 0.67 (P less than 0.01), and returned to baseline values in 10 days (0.95 +/- 0.14). We conclude that Teflon injection into a paralyzed vocal cord creates a significant inspiratory airway obstruction that is reversible in 10 days.

Adult↗
PubMed1980

Intra versus interregional nitrogen gradients in the single breath nitrogen test.

To investigate the genesis of cardiogenic oscillations (C.O.) and the slopes of the single-breath nitrogen test, we studied ten healthy volunteers with a modified test. This test utilized incremental volumes of air from 10% to 100% vital capacity (VC) after a nitrogen washout with oxygen. Subjects exhaled to residual volume, inspired the air volume and completed a full inspiration with oxygen. C.O. and both slopes were positive with low air volumes and negative with a VC of air. The slope of phase IV showed a linear decrease with the increasing inspired air volume, and reached zero with an air volume of 38% VC. AT higher volumes it became progressively more negative. The slope of phase III and C.O. were highly positive with 10% to 50% VC air volume then subsequently decreased. The values for C.O. and the slope of phase III were significantly different (P < 0.001) from those of the slop of phase IV and the apex-base gradients predicted by the model of Milic-Emili et al. These results suggest that intraregional gradients are significantly involved in the genesis of C.O. and the slop of phase III.

Adult↗
PubMed1979

Reverse nitrogen gradients in the study of phase III and cardiogenic oscillations of the single-breath nitrogen test.

The slope of phase III, phase IV, the slope of phase IV, and cardiac oscillations were measured on tracings obtained by both the regular single-breath N2 test (Tech I) and by a reverse technique (Tech II) in 9 healthy volunteers. Tech II consisted of 3 consecutive vital capacities (VC) of 100% O2 followed by one VC of room air. Theoretically, this should create a reversed apicobasal N2 gradient quantitatively similar to that of Tech I. From the total lung capacity following the VC2 of air, we monitored N2 concentration continuously at the mouth during a slow expiration in a manner similar to that of the single-breath N2 test. With Tech II, it is possible to preserve phase IV and its reversed slope in the presence of an almost flat slope of phase III and markedly blunted cardiac oscillations. When compared to Tech I, the slope of phase III with Tech II decreased from 0.66+/-0.20% N2/L (mean +/-SD) to 0.19+/-0.12 (p is less than 0.001), and cardiac oscillations decreased from a mean % N2 change with each heart beat of 0.87+/-0.37 to 0.24+/-0.21 (p is less than 0.005), whereas phase IV, although reversed in direction, remained quantitatively unchanged (0.35+/-0.15 L with Tech I and 0.37+/-0.14 L with Tech II), and the slope of phase IV tended to increase (2.7+/-1.9% N2 with Tech I and 3.4+/-2.1% N2 with Tech II, p=NS). We conclude that the N2 gradients within the lungs responsible for the slope of phase III and cardiac oscillations are largely independent of the gradients that give rise to phase IV and the slope of phase IV.

Adult↗
PubMed1979

Upper airways obstruction with bilateral vocal cord paralysis.

In ten patients with bilateral vocal cord paralysis, we demonstrated variable extrathoracic airway obstruction. The ratio of forced expiratory flow at 50 percent vital capacity to forced inspiratory flow at the same lung volume (VE50/VI50) was 1.65 +/- 0.77 (mean +/- 1 SD). There was marked variability of inspiratory flow obstruction with a mean VI50 of 1.63 +/- 0.75 liters/ sec and a range from 0.9 liters/sec to 3.2 liters/sec. Nine of the ten patients required tracheostomy for symptoms of dyspnea. Follow-up flow volume loops were obtained to document the effects of surgical intervention and tracheostomy.

Adult↗
PubMed1978

Airflow in unilateral vocal cord paralysis before and after Teflon injection.

The effect of unilateral vocal cord paralysis and intracordal Teflon injection on maximum expiratory and inspiratory flows was studied in 15 consecutive patients. Ten patients had a ratio of forced expiratory flow to forced inspiratory flow at 50% vital capacity (Ve50/Vi50) more than one. Of the remaining five, four had low Ve50 consistent with underlying bronchial disease. Repeat studies were obtained in 10 patients two or more weeks after Teflon injection into a vocal cord for voice therapy. Maximum expiratory flow rates did not change (means 6.64 +/- 0.881/sec before and 6.47 +/- 1.101/s after injection). Inspiratory flow at 50% vital capacity improved in all six patients with a forced expiratory volume in one second (FEV1) greater than 75% of the forced vital capacity (FVC). In patients with an FEV1 less than 75% FVC, no consistent changes could be seen. We conclude that a high Ve50/Vi50 suggestive of variable extrathoracic airways obstruction is a frequent finding in the presence of unilateral vocal cord paralysis. Teflon injection does not cause a significant reduction in forced expiratory flows and improves inspiratory flows in subjects without evidence of underlying bronchial disease.

Airway Obstruction↗
PubMed1976

Tracheobronchopathia osteochondroplastica.

Tracheobronchopathia osteochondroplastica is a rare disorder characterized by the projection of ossified formations into the trachea and bronchi. Unlike most cases, which are reported because of incidential postmortem findings, our patient presented with a slowly resolving pneumonia. The diagnosis was suspected by radiographic evaluation and bronchoscopic findings, then confirmed by histopathologic studis of a tracheal biopsy specimen. Pulmonary function studies were normal, except for flow-volume loops, which provided information for diagnosis and follow-up.

Aged↗
PubMedDate not supplied

Airborne microflora in Quebec dairy farms: lack of effect of bacterial hay preservatives.

Pediococcus pentosaceus is a lactic-acid producing bacterium inoculated in hay to prevent hay deterioration. This study sought to verify the effect of this treatment on the barn microenvironment. Air samples were obtained from 19 barns using bacterial hay treatment and from 18 control barns with six-stage Andersen samplers and all-glass impingers. Appropriate culture media were used for the recovery and identification of microorganisms. Endotoxins were measured with chromogenic Limulus amoebocyte lysate assay. Median values (respectively for treated and untreated hay barns) were: 5.28 x 10(5) and 3.84 x 10(5) colony-forming units (CFU)/m3 for total bacteria; 3.18 x 10(6) and 4.5 x 10(6) CFU/m3 for molds; 1.36 x 10(3) and 1.74 x 10(3) endotoxin units/m3 for endotoxin levels; and 1.03 x 10(3) and 3.00 x 10(3) CFU/m3 for Saccharopolyspora rectivirgula. No viable P. pentosaceus were recovered. The presence of S. rectivirgula, the causative agent for farmer's lung, was not influenced by the hay treatment. Since no significant difference was observed in any of the airborne contaminants, this type of hay treatment probably does not protect farmers from the respiratory effect of ambient microbial contaminants.

Agricultural Workers' Diseases↗
PubMedDate not supplied

Respiratory health impact of working in sawmills in eastern Canada.

Air contamination in sawmills can cause respiratory health problems. The authors measured respirable dust, bacteria, endotoxins, and molds collected from 17 sawmills in eastern Canada. A total of 1,205 sawmill workers answered a respiratory-health questionnaire, and they all participated in lung-function measurements, skin-prick tests, and venous blood sampling for specific immunoglobulins against molds found in the sawmills. Workers had normal lung functions, and most respiratory symptoms could be explained by smoking histories. Workers in pine sawmills had a greater prevalence of positive skin-prick test to pine than did workers in sawmills where other woods were used. High levels of specific antibodies were seen in some workers. The presence of a positive skin-prick test and/or specific antibodies had no impact on lung function(s). These Quebec sawmill workers did not experience significant respiratory illnesses; however, some of these workers may be at a higher risk of developing asthma and hypersensitivity pneumonitis than nonworkers.

Adolescent↗
PubMedDate not supplied

Effects of chronic organic dust exposure on respiratory function and airway responsiveness in peat moss factory workers.

Fifty-two males and 1 female, who were 19 to 62 y of age (median = 26), were employed at an eastern Quebec peat moss plant and were included in this study. Of these 53 workers, 29 were smokers, 5 were ex-smokers, and 19 had never smoked. The workers were divided by level of exposure into 4 groups: (1) group 1--minimal exposure (N = 7); (2) group 2--light exposure (N = 7); (3) group 3--moderate exposure (N = 17); and (4) group 4--heavy exposure (N = 22). Chest radiographs and physical examinations were normal for all subjects. Only 1 subject had precipitins to Penicillium and Monocillium species isolated from the peat moss plant. Pulmonary function tests were normal and similar in all groups. Thirty-three subjects (20 smokers, 4 ex-smokers, and 9 nonsmokers) had chronic bronchitis; these symptoms were related to work exposure for 28 subjects. Bronchial responsiveness to methacholine was measured in 14 subjects who had persistent cough and sputum. No subject had evidence of airway hyper-responsiveness, i.e., PC20 metacholine less than 8 mg/ml. We concluded that the peat moss workers in our study showed no evidence of extrinsic allergic alveolitis; however, chronic exposure to organic dust leads to chronic cough and sputum production, which is not associated with significant lung impairment nor increase in nonspecific airway responsiveness.

Adult↗