[Evaluation of pulmonary arterial hypertension by Doppler echocardiography in chronic respiratory insufficiency]. / Evaluation de l'hypertension artérielle pulmonaire par échocardiographie doppler dans l'insuffisance respiratoire chronique.

The usefulness of doppler-echocardiography for the assessment of pulmonary arterial hypertension in patients with chronic respiratory failure was evaluated in 24 consecutive patients with chronic obstructive lung disease. Seventeen of these 24 patients (71 p. 100) who had tricuspid valve regurgitation analysable by the continuous wave doppler technique were selected as study group; they included 15 men and 2 women aged from 33 to 78 years (mean 63 years). The highest maximum velocity value (method A) or the maximum velocity value averaged on several cycles (method B) of the tricuspid regurgitation jet was used to calculate the right ventriculo-atrial pressure gradient, using Bernouilli's equation. Right atrial pressure was determined by three methods: haemodynamic measurement, clinical evaluation or attribution of an arbitrary 10 mmHg value. The pulsed doppler study of the pulmonary ejection flow included measurement of the acceleration time and calculation of the acceleration time/ejection time ratio. The usual echocardiographic parameters were measured. Catheterization was performed 2.5 days on average after the doppler study. Correlations between doppler examination and catheterization to evaluate the right ventricular systolic pressure were significant (p less than 0.001) and better with method B than with method A. Depending on the method employed to evaluate the right atrial pressure, the correlation coefficients obtained with method B were: 0.93 (haemodynamic measurement), 0.91 (clinical evaluation) and 0.88 (arbitrary value of 10 mmHg). The right ventricular systolic pressure evaluated by doppler ultrasound using method B and by clinical evaluation of the right atrial pressure was 47 +/- 12 mmHg (22 to 70 mmHg), as against 51 +/- 13 mmHg (28 to 74 mmHg) measured by catheterization.(ABSTRACT TRUNCATED AT 250 WORDS)

[Brushings and bronchial biopsies in small-cell cancer. Comparison of results]. / Brossages et biopsies bronchiques dans les cancers à petites cellules. Confrontation des résultats.

The typing of bronchial carcinoma is important for therapeutic decisions and may be made on bronchial brushings. Sixty six small cell and poorly differentiated squamous cancers were studied. Our personal method of preparing brushing is suggested. The cytological criteria which characterise the two tumour types were analysed. The results from the biopsies and particularly the brushings were related to the quality of the technique and the experience of the Pathologist. There is a good correlation between biopsy and brushing such that brushings may be considered reliable. In cases where the biopsy was not feasible or uninterpretable, brushings confirmed a cancer in all the cases and the type of cancer in eleven. The examination is inexpensive and avoids the need for ultrastructural studies in the majority of cases.

[Legionnaires' disease with late pulmonary sequelae. Apropos of a case]. / Maladie des légionnaires avec séquelles pulmonaires tardives. A propos d'un cas.

The authors report a case of legionnaires' disease with retractile late sequelae affecting the lingula and the dorsal segment of the culmen. They stress the need for appropriate and prolonged treatment because of the possible presence of intracellular Legionella pneumophila. The existence of an associated staphylococcal infection is also one of the hypotheses raised in explaining such sequelae.

Automatic cytopathologic diagnosis of bronchial carcinoma. I. Cytocentrifugation of bronchial brushings for image analysis.

A cytocentrifugation technique for the preparation of monodispersed preparations of bronchial cells collected by brushing is described. First developed with the aim of obtaining slides suitable for automated analysis, it was found to be useful for routine morphologic examinations. This technique requires careful preparation as well as "education" of the pathologist/screener in the appearance of the cellular elements in its samples. However, it is reliable and reproducible and, above all, eliminates a certain number of artifacts found in conventional preparations.

[Morphological aspects of non-tumoral bronchial cells recovered by brushing (author's transl)]. / Aspects morphologiques des cellules bronchiques non tumorales recueillies par brossage.

A series of 132 bronchial brushings studied according to a strict protocol, both in obtaining the specimens and their subsequent laboratory preparation, has allowed us to study the cells of the bronchial mucosa in greater detail. Until now the greater part of the work in this field has been on the characteristics of tumour cells and the variability in detecting cancer, slightly neglecting the analysis of normal, inflammatory or dystrophic cells. The brushings were compared to the cytology requests on sputum and/or corresponding aspirations by conventional methods. This work has shown that the different types of normal epithelial cells so recovered, as well as dystrophic cells, have a very different appearance than those same cells when observed using classical cytological methods (on sputa and aspirations). The cyto-pathologist ought to adjust the technique before interpreting the specimens. The differences are due to a better state of conservation of the recovered cells, thanks to improvement in current endoscopic technique. We infer that certain cytological appearances considered pathological until now, using classical expectoration or aspiration, may in reality only be artefacts.

[Superior vena cava syndrome of rare aetiology (author's transl)]. / Syndrome cave supérieur d'étiologie exceptionnelle.

The case of malformation of the subclavian artery (arteria lusoria) reported here is of interest not only because of its rarity but also the diagnostic problems which it posed and its unusual clinical presentation -- haemoptysis. This case report is completed by a review of the literature, which is restricted concerning this subject.

[Scintigraphic discordances between technetium 99m and iodine 131 in the study of thyroid nodules]. / Discordances scintigraphiques entre le techneétium 99 m et l'iode 131 dans l'étude des nodules thyroïdiens

Eighty thyroid nodules found to be hyperfixating, isofixating or heterogeneous after an initial scintigraphy with Technetium 99m were studied comparatively using iodine 131. Differences in the apparent activity of the nodule and the extra-nodular parenchyma were found in one third of cases. A "cold nodule" appearance, not seen with techneitum was found in 8 cases at the time of the examination using iodine. Five of these patients underwent operation, the diagnosis being a carcinoma in one.