Le Poumon et le coeur最新文献

Larva migrans syndromes are rare affections that occur mainly in young children. The usual parasite involved is Toxocara canis, its presence in humans leading to encystment of the larvae and an eosinophilic granulomatous reaction. A case of an adult with this affection is reported, and clinical aspects and diagnostic and therapeutic problems discussed.

Five cases of eosinophil lung are reported in which the fungus responsible for the affection was not Aspergillus. Documented data include reports on 19 similar cases with a clinical picture suggestive of allergic bronchopulmonary aspergillosis but with negative tests for Aspergillus. The various fungal species isolated included Candida albicans, Penicillium, Geotrichum candidum, Stemphylium lanuginosum, Culvularia lunata, and Drechsleria hawaïensis. Diagnostic criteria are discussed, with particular emphasis on the importance of the inhalation provocation test, as well as possible efficacy of antifungal treatment.

Cockett's syndrome is due to compression of the left common iliac vein by the left iliac artery. Anatomical factors and venous anomalies contribute to the venous obstruction. Clinical symptoms only develop in cases with marked compression; they consist of functional disorders predominant in the left lower limb and, frequently, recurrent oedema. The compression may be revealed by complications such as deep thrombosis of the iliac vein or veins of the calf, or pulmonary embolism. The diagnosis is made by phlebo-ilio-cavography.

A new case of carcinoid tumour of the thymus is reported. Such tumours are extremely rare and of somber prognosis when accompanied by local or regional metastases or metastases in other organs.

Five new cases of solitary fibrous mesothelioma of the visceral pleura support this review of the literature. Well encapsulated, mostly pedunculated, the implantation on the visceral pleura remains asymptomatic for a very long time and is more likely to be an incidental finding on a chest radiograph. Two extrathoracic signs are associated with certain huge tumors : hypoglycemia and osteoarthropathy. Histologic examination discloses whorls of collagen with scattered spindle-shaped cells. Electron microscope reveals characteristic features of both fibroblasts and mesothelial cells. Complete surgical removal is the best treatment for localized fibrous mesotheliomas of the visceral pleura. Recurrences after resection are rare and late recurrence, as long as 16 years after initial excision, usually behaves in a benign fashion.

Drug-addicts frequently suffer from pulmonary diseases, particularly those who practice self-injection of the drugs intravenously. Emphasis is at present laid on the various excipients which are thought to induce acute alveolitis with subsequent acute pulmonary oedema in heroin-addicts. It has also been suggested that the deep ventilatory depression that precedes pulmonary oedema may play a part and this is interesting since the depression can now be prevented with naloxone. Infectious lesions, such as septic pulmonary embolism or endocarditis, are easier to explain. The ever increasing use of tablets crushed for injection is responsible for peri-arteriolar granulomas of the lung with possibly severe sequelae. Finally, the almost generalized consumption of marihuana in the United-States has led to the discovery of new properties of this drug, including ventilatory stimulation and broncho-dilatation. However, this is mostly of theoretical interest. The psychotropic effects of marihuana and its irritant effect on the bronchi when inhaled make it unlikely that it will be ever be used for therapeutic purposes.

A systematic recording of primary cancer of the bronchi, pleura or lung would be of descriptive, etiological and operational interest if the collected data were exhaustive, if it were possible to resolve the problems set by epidemiological surveys (the only kind of study to be considered) and finally if an effective means to fight against these cancers were available.

The effector function of eosinophils is studied in experimental models, emphasizing the prominent role played by antibodies among which IgE, and also the activation of the cytotoxic activity by mast cell-derived ECF. A tetrapeptides. The demonstration of the cytolytic effect of basic proteins present in eosinophil granules allows to clarify this mechanism on a molecular basis. Eosinophil effector function is then envisaged in various clinical situations. In pulmonary eosinophilias, a relation appears between the detection of proteins released by eosinophils and the tissue damage. Eosinophils seem also to be implied in the inflammatory process characteristic of endomyocardial disease or in Crohn's disease. Whereas they were first considered as beneficial cells for the host, the eosinophil granulocytes may therefore express according to the targets, a dual either beneficial or nocious function.

Mycosis fungoides is today classified amongst the cutaneous T lymphomas. The course of the disease is slow, first strictly dermatological, then with polyvisceral spread most often presenting as lymphadenopathy. Pulmonary involvement, with a poor prognosis, is often recognised only at autopsy. The differential diagnosis between pulmonary involvement by the disease and isolated or associated opportunistic infectious pathology is virtually impossible during the patient's lifetime except by surgical lung biopsy. The case reported here illustrates these data and has the particular feature of the onset of pulmonary involvement during cutaneous remission of the disease, contrasting with the visceral spread found at autopsy.

Over recent years, several cases have been reported of bronchiolitis obliterans, of very rapid onset and serious clinical course in patients with rheumatoid arthritis being treated with D-Penicillamine. After reporting a new case, the authors stress the unusual features of this bronchiolar condition which is probably of iatrogenic origin and irreversible, with death occurring within a few years. The pathogenesis is poorly understood and many questions still remain concerning the relationships between rheumatoid arthritis, the bronchiolar lesions and D-Penicillamine in this disease of pulmonary collagen. The ultrastructural examination and the morphometric examination of this new case suggest the presence of predominantly type III collagen, which is normally present in the lungs in only small quantities.