New concept using Passive Infrared (PIR) technology for a contactless detection of breathing movement: a pilot study involving a cohort of 169 adult patients.

A pilot study has been conducted to validate the Breath Motion Detecting System (BMDS), a new concept using Passive Infrared (PIR) technology for a contactless detection of respiratory movements. The primary objective of the study was to show if movements detected during sleep by the BMDS were indeed related to breathing. This medical device is not intended to measure the respiratory rate, but in a second step, it will be able to detect pathological central apnea in adults. One hundred and sixty-nine adult patients underwent a full polysomnography in which each respiratory movement was recorded concomitantly through the BMDS. Curves obtained by the BMDS were compared to those of thoracic movements recorded by classical piezoelectric belts and of pressure obtained with nasal cannula. The correlations between the PIR sensors were highly indicative of respiratory movement detection. Since PIR sensors are sensitive only to the exemplification of the rib cage, they did not detect obstructive apnea. Unfortunately, only a few patients in the studied population had a central apnea. Moreover as our sleep laboratory was equipped only with piezoelectric bands, the central apnea respiratory effort data are not a validated signal to be used during sleep recordings. The data recorded by the BMDS demonstrate the ability of the PIR technology to detect respiratory movements in adults. The concept is practical, inexpensive and safe for the patient. Further studies with respiratory inductive plethysmography are needed to investigate the potential of BMDS to detect central apneas.

[Pulmonary hamartoma with lipomatous form]. / Hamartome pulmonaire à forme lipomateuse.

We report of the case of a 41-year-old patient, who had previously undergone thoracic surgery at the age of 16 for a single giant emphysematous bulla. The CT scan showed an abnormal middle mediastinal lesion containing an aerated cystic areas and areas of fat density. The patient underwent surgery and a well-defined mass was found between the mediastinum and the pulmonary hilum, which was able to be completely resected. Microscopic examination disclosed a composite tumour containing a bronchogenic cyst, a benign lipoma and two hamartochondromas. As no similar case had been reported previously, it was difficult to assert the nature of the lesion, which has been labelled as a "hamartoma". The main diagnoses which should be considered when an intra pulmonary fat density mass is disclosed, are discussed.

Lex2B, a phase-variable glycosyltransferase, adds either a glucose or a galactose to Haemophilus influenzae lipopolysaccharide.

Nontypeable Haemophilus influenzae is a commensal that frequently causes otitis media and respiratory tract infections. The lex2 locus encodes a glycosyltransferase that is phase variably expressed and contributes to the significant intrastrain heterogeneity of lipopolysaccharide (LPS) composition in H. influenzae. In serotype b strains, Lex2B adds the second beta-glucose in the oligosaccharide extension from the proximal heptose of the triheptose inner core backbone; this extension includes a digalactoside that plays a role in resistance of the bacteria to the killing effect of serum. As part of our studies of the structure and genetics of LPS in nontypeable H. influenzae, we show here that there are allelic polymorphisms in the lex2B sequence that correlate with addition of either a glucose or a galactose to the same position in the LPS molecule across strains. Through exchange of lex2 alleles between strains we show that alteration of a single amino acid at position 157 in Lex2B appears to be sufficient to direct the alternative glucosyl- or galactosyltransferase activities. Allelic exchange strains express LPS with altered structure and biological properties compared to the wild-type LPS. Thus, Lex2B contributes to both inter- and intrastrain LPS heterogeneity through its polymorphic sequences and phase-variable expression.

[Evaluation of advanced non-small-cell lung cancer (ANSCLC) chemotherapy in routine practice]. / Chimiothérapie en pratique de routine des cancers bronchiques non à petites cellules (CBNPC) localement avancés ou métastasés. Evaluation des pratiques et analyse médico-économique.

BACKGROUND: Patients in ANCCLC chemotherapy-trials are not representative of the general lung cancer population. The purpose of this study was to describe the ANCCLC population routinely treated by chemotherapy in a general hospital, and to assess the results of chemotherapy in this population. METHODS: All newly diagnosed IIIB/IV ANCCLC chemotherapy-treated patients over a three-year period were prospectively assessed for response rate, toxicity and survival. RESULTS: Seventy seven patients (70% stage IV, 69% PS 1/0, 30% with cerebral metastases, 60% ineligible for major lung trials) received first-line chemotherapy (cisplatine or paraplatine with vinorelbine) with tumor control in 31 (40%) and symptom improvement in 20 (26%) patients. 17 (22%) patients experienced febrile neutropenia. 33 (43%) patients received second line chemotherapy (gemcitabine) with tumor control in 12 (36%) and symptom improvement in 9 (27%) patients. Overall median survival was 7 months and 30% patients were alive at 1 year. CONCLUSIONS: Routinely ANCCLC chemotherapy-treated patients in our center have poor prognostic factors and many comorbidities. Chemotherapy results in tumor control in 43% patients, - of whom two thirds have symptom improvement -, with a high rate of febrile neutropenia.

[An unusual case in Belgium of intestinal myiasis due to Eristalis tenax]. / Un cas exceptionnel en Belgique de myiase intestinale due à Eristalis tenax.

We report an unusual case in Belgium of indigenous intestinal myiasis caused by Eristalis tenax during canicular summer 2003 in a 36 year old man living in Belgium. This patient complain near its general practitioner about diarrhea and intestinal rumbles. Larvae emitted on several occasions were identified as Eristalis tenax larvae. Socio-economical status of the patient and atmospheric conditions seems to be related to this observation. Clinical evolution has been spontaneously and quickly positive. An empirical treatment with an association of metronidazole and nifuroxazide was however prescribed.

[Primary pulmonary choriocarcinoma]. / Choriocarcinome pulmonaire primitif.

The authors report a case of a young woman who had been found to have a chorio-carcinoma in the apex of the left lower lobe, following a major and recurrent haemothorax. A study of her past history and a gynaecological examination had not revealed any evidence of a primary tumour. Following this observation the possibility of a primary pulmonary carcinoma was considered and also the usual aetiological hypothesis, namely the migration of trophoblastic cells during an abortion even followed by a normal pregnancy and a degeneration after several years of these cells blocked in the pulmonary capillaries.