[The hepatopulmonary syndrome].

Definition: The hepatopulmonary syndrome (HPS) associates a chronic hepatic affection, hypoxemia < 70 mm Hg and pulmonary vasodilatation.

Physiopathology: The mechanisms leading to pulmonary vasodilatation are complex and unclear. There appears to be an imbalance between the vasodilatating and vasoconstricting mediators.

[Lemierre syndrome: clinical and radiological characteristics of a rare disease].

A benign oropharyngial infection without appropriate treatment can be complicated by a jugular vein thrombosis and disseminated septic embolies with deleterious pulmonary effects. This septic clinical picture most commonly known as Lemierre syndrome is attributed to Fusobacterium necrophorum, a Gram negative anaerobic bacilli. We describe a case of a young patient who has presented this syndrome accompanied by typical pulmonary manifestations.

Reduced cardiac sympathetic autonomic tone after long-term nasal continuous positive airway pressure in obstructive sleep apnoea syndrome.

The increased sympathetic activation that occurs in obstructive sleep apnoea (OSA) may play an important role in associated morbidity. We investigated the effect of long-term (3 month) nasal continuous positive airway pressure (CPAP) on the autonomic nervous system assessed by heart rate variability (HRV). Fourteen patients (12 men), mean age 61.

[An unusual cause of aorto-bronchial fistula: tuberculosis aortitis].

The aortic rupture in the pulmonary parenchyma or the bronchi rarely results in an haemoptysis. It means in most of the cases the rupture of an aortica aneurysm. We relate the observation of a aorto-bronchial fistula from a tuberculosa origin in an old woman case.

Bronchial carcinoids. A review of 22 cases.

This study investigated 22 patients with histologically proven primary bronchial carcinoids and in particular the relationship between assessment parameters and survival. In each patient, age, sex, smoking habits, mode of presentation, results of diagnostic investigations, methods of treatment and pathological examination of resected specimens were recorded. Follow-up was possible in all patients for at least 5 years.

[Mediastinal adenopathies metastatic from a basocellular skin carcinoma].

Skin basocellular carcinoma is very frequent, and does not usually cause distant metastasis. However, a few cases of distal lymph node, pulmonary, bone metastasis have been described in the literature. In the present case, we report a basocellular mediastinal lymph node metastasis.

Efficacy of tracheal and bronchial stent placement on respiratory functional tests.

Stent placement is the only available treatment in patients presenting either a localized external compression or a malacia of the tracheobronchial tree. To assess the functional benefit of prosthesis insertion in these indications, we compared functional respiratory values before, immediately after (48 h), and at sometime after (mean, 10.1 months) operation in 24 patients presenting with a bronchial lesion (B group, n = 5) or a lesion of the intrathoracic part (ITT group, n = 9) or of the extrathoracic part of the trachea (ETT group, n = 10).

[Study of chemosensitivity in patients believed to have sleep apnea syndrome].

We performed polysomnography and measured hypoxic ventilatory (HVR), hypercapnic ventilatory responses (HCVR) in 42 patients (60 +/- 11 years) with obesity and a clinical suspicion of sleep apnea syndrome (SAS) in order to determine whether an altered chemosensitivity was associated with SAS. The apnea/hypopnea index was 38 +/- 20 events per hour of sleep in 28 patients (SAS+ group) and less than 10 in the 14 others (SAS- group). The 2 groups differed only by a lower waking PaO2 in SAS+ as compared to SAS- (71.

[Acquired hypogammaglobulinemia and multifocal granulomatosis].

In adult acquired hypogammaglobulinaemia multi focal granulomas have often been described and have regularly led to the hypothesis of an association with sarcoidosis. We present a case of this type in a man aged 29 who was a smoker with a hypoglobulinaemia involving IgG, IgA and IgM and which was discovered following pneumococcal pneumonias. He presented with a significant hepatosplenomegaly and absent cutaneous reactions to T dependent antigens with an elevated ACE activity.

Initial combined cryotherapy and irradiation for unresectable non-small cell lung cancer. Preliminary results.

In unresectable non-small cell lung cancer (NSCLC) with a patent mainstem bronchus, some studies of obstructive tumors, showed (1) a poor role for irradiation in obtaining efficient debulking and (2) an interest in preliminary laser treatment in these patients. Cryotherapy is another method to obtain debulking. Moreover, several studies showed that cryotherapy would increase the radiosensitivity of a tumor.

Raynaud's phenomenon of the lung. A reality both in primary and secondary Raynaud syndrome.

Vasospasm of RP is thought to occur in the lungs. To assess pulmonary vasospasm, we analyzed the early and late Dsb variations after a digital CPT. Sixteen normal volunteers and 20 patients (7 with primary, 13 with secondary RP) were included.

[A case of congenital pulmonary varices].

Pulmonary varices are rare disorders (only 72 published cases), and are most often congenital in origin, asymptomatic and have a benign outcome. In some cases the appearance of varices is favoured by pulmonary venous hypertension which is most often related to mitral valve disease, or it is associated with other vascular or bronchial malformations. We present a new case of isolated pulmonary varices occurring in an asymptomatic young woman aged 20.

[Small cell lung carcinoma. Value of the evaluation of extension for the therapeutic strategy].

Small-cell lung carcinoma can be distinguished from other histological types of lung cancer because of its high metastatic potential. Initial staging procedures divide the patients into two main prognostic groups: the so-called "limited" (to the thorax) and the extensive disease patients. Based on the results of a prospective pilot study involving 182 patients and on a review of the literature, the authors discuss the usefulness of initial staging in increasing the number of detectable metastases, assessing tumour burden, evaluating treatment results and identifying prognostic factors.

[Interstitial pneumopathies caused by busulfan. Histologic, developmental and bronchoalveolar lavage analysis of 3 cases].

Busulfan-induced diffuse interstitial pneumonia is a rare but serious disease attributed to a direct toxic effect of busulfan (an alkylating antimitotic drug) on alveolar cells. We report three new cases explored by repeated bronchoalveolar lavages and lung biopsies. All patients had circulating immune complexes, abnormalities at capillaroscopy and above all lymphocytic or mixed alveolitis at bronchoalveolar lavage.

[The bone in non-corticoid-treated sarcoidosis. A histomorphometric study].

The sarcoidosis granuloma secretes 1-25 dihydroxyvitamin D (1-25(OH)2 D) at the origin of the hypercalcemia found in about 20 p. cent of sarcoidoses. Its mechanism was considered exclusively of a digestive nature, but the activity of osteoclastic stimulation of 1-25(OH)2 D must consider an associated bony origin.

[Thymoma and lupus: apropos of a case with recurrences and histological dedifferentiation].

A case of thymoma associated with chronic lupus erythematosus is reported. The course of the lupus was parallel to that of the thymoma, with several successive relapses. Histologically, the thymoma became increasingly undifferentiated.

[Intratracheal destruction of tumor lesions: laser or cryotherapy? A preliminary analysis].

Intrabronchial laser has become the reference method for palliative destruction of intrabronchial tumours. Cryotherapy, which destroys tumours by cold-induced lesion at -89.5 degrees C, has recently been introduced.