[Computerized tomography of pleuropulmonary pathology due to asbestos]. / Tomodensitométrie de la pathologie pleuro-pulmonaire de l'amiante.

28 patients presenting with proven pleuro-pulmonary pathology due to asbestos underwent conventional radiography and also computed tomography (TDM). It is evident that TDM was more sensitive in detecting the presence of pleural plaques which were either hidden or invisible on standard radiographs. False parietal images were often eliminated. With a mesothelioma it can guide the biopsy approach and by visualising contra-lateral plaques that the origin is asbestos. It should enable irregular plaques to be monitored more easily.

[X-ray computed tomography in pleuropulmonary asbestos pathology]. / Apport de la tomodensitométrie dans la pathologie pleuro-pulmonaire de l'amiante.

Results of computed tomography and conventional radiology were compared during investigation of 17 patients with pleuropulmonary lesions from confirmed asbestosis. Computed tomography images appeared to provide improved data for detection and analysis of pleural plaques, particularly in the costovertebral grooves; false pleural images (associated shadows, fatty tissue) can be eliminated. The CT scan should occupy a place of choice for surveillance of subjects in contact with asbestos and presenting pleural anomalies.

[The Yellow-nails syndrome. Apropos of 2 cases. Review of the literature]. / Syndrome des ongles jaunes. A propos de 2 cas. Revue de la littérature.

The authors report 2 cases of yellow nails. These cases have evolved these last years, producing clinical aspects that reflect a typical association between the pulmonary and/or sinus reactions and the yellow nails. The authors discuss the scarce typical to the yellow nails syndrome and the different associations reported in the literature. The physiopathology is not known but many hypothesis have been discussed.

[Industrial factors in the etiology of obstructive respiratory diseases. Implications for prevention]. / Facteurs industriels dans l'étiologie des maladies respiratoires obstructives. Conséquences pour la prévention.

The statistics of occupational diseases in industrial medicine, as well as the markedly elevated incidence of chronic bronchitis amongst workers, show that there is an additional respiratory risk linked to industrial environment and the conditions of work. Epidemiological studies in industry and in particular certain occupations, such as mining and the construction industry have led to a better understanding of this industrial risk as a generator of the additional obstructive respiratory disease occurring in exposed workers. Among the unrecognised risks is the prolonged exposure to the oxides of nitrogen which are capable of affecting gas exchange, as has been shown in one of our investigations in the production of nitrogenous fertilizers, which explains the mechanism. In industrial medicine, a preventative strategy should be planned, on the one hand considering individual risks and taking account of personal and genetic factors, on the other hand monitoring of respiratory risks by the identification of new irritants and finally the organisation of respiratory function screening for the early detection of lung dysfunction, by more sensitive tests than the FEV1 (VEMS), whose validity should be studied. The priority is primary prevention by the suppression of toxic irritants and by the improvement of working conditions.

[Clinical approach of asthma (author's transl)]. / Approche clinique de la maladie asthmatique.

The identification of asthma is based on the analysis of clinical data. The integration of such individual and subtle information into the field of epidemiology requires that these data be comparable, collective, and suitable for statistical use. With this in mind, only a broad conception of the asthmatic condition, with a specific definition, would eliminate the possibility of not recognizing an asthmatic subject in a given group. A fundamental basis is given in a general questionnaire which enables a qualitative and quantitative evaluation, the establishment of a scale of severity, and a nosologic classification of asthma. This questionnaire should eventually include specific questions adapted to the objectives of the investigation to be carried out.

[Medico-social consequences of asthma in adults (author's transl)]. / Conséquences médico-sociales de la maladie asthmatique chez l'adulte.

The evaluation of the medico-social consequences of asthma in adults encounters difficulties that are inherent to a chronic disease with varying clinical pictures. Overall statistical analyses, particularly concerning mortality, provide little information in a socio-economical perspective, especially in France. However, based on the results of fragmentary but varied analyses, the study of this disease in relation to the working careers of asthmatic subjects underlines the importance of the repercussions at the very start of professional life (choice of profession, recruitement in a company). The study of absenteeism and inaptitude reveals to what degree these consequences are related to the seriousness of the disease and to the asthmatic person's social sphere. The same is true for family and social life which is more difficult to evaluate. Systematic analyses alone will be useful in determining whether asthma is considered a "social disease" with its eventual implications on a public health program.

[Medico-social consequences of asthma in children (author's transl)]. / Répercussions médico-sociales de la maladie asthmatique chez l'enfant.

The author proposes a study of the medico-social consequences of asthma. Having shown the impossibility of a monolithic conception of asthma, he shows how much it is conditioned in the child by his social and family surroundings. Different levels of consequences are considered: restraints linked to the therapeutics of a chronic disease, effect on physical activity and leisure, importance of the repercussions on school life (absenteeism and slowness). In conclusion, the author stresses both the importance of these consequences on the personal and professional future of the child and the need to define high risk groups corresponding to criteria based on seriousness and social environment for whom the prevention of these repercussions must have priority.

[Broncho-pulmonary amylosis (about two cases) (author's transl)]. / Amylose broncho-pulmonaire. A propos de deux observations.

The authors reported two recent cases of broncho-pulmonary amylosis with monoclonal gammapathy. The first observation concerned a diffuse amylosis characterized by a bilateral pulmonary infiltration with pleural effusions and secretion of IgGlambda with a Bence Jones proteinuria. Pleural and pulmonary biopsies will provide the proof of amylosis. Evolution will rapidly be fatal in case of renal insufficiency. Post-mortem sampling will confirm the amyloid involvement (muscle, liver, kidney). The second observation described a localized amylosis developed in contact with a mediastino-pulmonary lymphoplasmocytic lymphoma with tumoral secretion of IgMlambda. Although pneumonectomy brought out the disappearance of the abnormal paraportein, death occurred within a few months, linked either to the spreading of the lymphomatous process or to the onset of a bacillary surinfection. The authors then recalled the main clinical and diagnostic data of the broncho-pulmonary amylosis. They underlined the importance of GLENNER'S work who, by proving the immunoglobulinic nature of amyloid, explained that in both cases, amylosis appeared as the consequences of an abnormal immunoglobulins synthesis.

[Complex pneumoconiosis in dental laboratory technicians]. / Pneumoconioses complexes chez les prothésistes dentaires.

Five cases of complex pneumoconiosis are described in dental prosthesis makers. The histo-spectrographic analysis with Castaing's microprobe of the lung fragment obtained by surgical biopsy revealed a complex disease associating silicosis of cobalt pneumoconiosis.

[Contribution to the scintigraphic diagnosis of malignant endothoracic tumors by 57Co labeled Bleomycin (author's transl)]. / Apport de la bléomycine marquée par le cobalt 57 dans le diagnostic scintigraphique des tumeurs malignes endothoraciques

The authors report the results of the exploration by 57Co Bleomycin scinitigraphy in 97 thoracic tumors. The Bleo-57Co scintigraphy detects primary and secondary malignant tumors underevaluated by classical tests. In the thorax, the radioactive focus are easily detected on account of the light physiological fixation of the Bleo-57Co. It is particularly interesting in the mediastinal tumors where the picture is not covered by cardiovascular interference. Mediastinal, pleural and costal tumors have been explored. Pulmonary tumors give the best results, they fixe in 93% of the case. All the mediastinal tumors have capted the bleomycin but the authors insist on the fact that the fixation was very light even when the tumor was a large one. The exploration of pleural and costal tumors was less interesting. In conclusion, the Bleo-57Co scintigraphy, gives indications about the volume of the tumor and its spread in the organism. By this method, we can diagnose malignancy in tumor. It can be used to survey cancer patients which have been treated. Nevertheless the long half-life (270 days) and the lack of specificity of the Bleo-57Co for the malignant tumors, justify discussion about indications and the results of such an exploration.