[Value of thoracoscopy].

Formerly used in active tuberculosis to divide pleuro-pulmonary adhesions and to complete therapeutic pneumothorax, thoracoscopy has now become the object of renewed interest. By introducing, after pneumoserosa and usually through the axilla, a fine trocar into the chest, the whole thoracic cavity, including parietal pleura, diaphragm, lung and lung fissures, mediastinum and pericardium, can be explored. This technique, performed under local rather than general anaesthesia or under neuroleptanalgesia, is innocuous, fairly cheap and effective.

[Pleural pressure during thoracocentesis in patients with pleural neoplasms].

In 45 patients with cancerous pleural effusion, thoracocentesis was performed according to the following technique : after local anaesthesia (5 ml of 2% lidocaine) in the posterior part of the 6th intercostal space, thoracocentesis was carried out with a blunt trocar connected to a water manometer. The pleural pressure was measured before removal of the fluid (Po). Then three different techniques of drainage (active suction at -- 80 or -- 40 mmHg or underwater sealed drainage) were randomized.

[Diagnosis of localized pulmonary opacities by transbronchial biopsy].

In order to assess the value of transbronchial biopsy (BTB) in the diagnosis of local pulmonary opacities, we have carried out a prospective study from October 1981 to August 1982 on 180 patients with a localised pulmonary opacity radiographically. 73 presented with a tumour visible fibreoptically in whom the diagnosis was made by bronchial biopsy. In 56 patients the clinical and biological picture were not suggestive of a malignancy and the lesion disappeared in 15 days on antibiotic treatment.

Comparative reflex action of histamine, acetylcholine and serotonin on dog airways.

To dissociate airway stimulation from airway response, a segment of the cervical trachea was isolated from the rest of the bronchial tree in 15 anesthetized dogs; nerve and blood supplies of the segment were preserved. Patency of the intrathoracic airways was assessed with lung resistance (RL) measurements. When doses of aerosolized histamine (His), acetylcholine (ACh) and serotonin (Ser) causing comparable increases in RL were delivered into the intrathoracic airways, concomitant increases in pressure were recorded in the tracheal segment (indicating constriction) with His being the most effective.

[Clinical aspects and course of 38 cases of malignant pleural mesothelioma observed in the Marseilles region].

Epithelial or mixed mesotheliomas were detected in 38 patients in the region of Marseilles over a period of 9 years. Though an occupational element was involved in 80% of cases, no history of contact with asbestos could be obtained in certain of the patients. Confirmation of diagnosis requires wide pleural biopsies, because of the high level of false negatives and false positives from cytology and pleural needle biopsy.

[Respiratory function profile in scleroderma. 20 cases (author's transl)].

This study involved 20 patients, 13 female and 7 male, with a mean age of 49 years, suffering from localized (6 cases) scleroderma or generalized without Raynaud's syndrome (6 cas), with Raynaud's syndrome (6 cas) or acrosclerosis (2 cases). Respiratory function tests included study of volumes, flow rates, CO transfer (TLCO) and blood gases. There were 38% normal chest X-rays, 58% ventilatory disturbances (predominance of restrictive syndrome and decrease in (TLCO) was found in only 25% of cases.

Bronchodilator effects of antiasthmatic cigarette smoke (Datura stramonium).

In 12 asthmatic patients with mild airway obstruction we have measured the effect on specific airway resistance (sRaw) of inhaling the smoke of one Datura stramonium cigarette. In 11 patients sRaw decreased substantially after the cigarette, the mean maximal decrease being 40% at the 30th minute. In seven patients the subsequent inhalation of 200 micrograms salbutamol caused no further decrease in sRaw.