[Diffuse interstitial pneumopathy during treatment with gold salts]. / Pneumopathie interstitielle diffuse au cours d'un traitement par les sels d'or.

A case of severe diffuse interstitial pneumonia is reported in a 69 year old after 5 weeks treatment with gold salts. Regression of symptoms on withdrawal of gold salts and under steroid therapy, the similarity with previously published cases, the absence of another cause lead us to incriminate the gold salts. The case is documented with optical and electronic microscopic studies of transbronchial biopsy and repeated examination of bronchoalveolar lavage fluid. A general review of the literature is included with a critical discussion of the physiopathogenic mechanisms. The results of the examination of the bronchoalveolar lavage fluid are further evidence in favour of cell-mediated hypersensitivity reaction.

[Amyloidosis and its bronchopulmonary localizations. Apropos of 3 cases]. / L'amylose et ses localisations broncho-pulmonaires. A propos de trois observations.

Amyloidosis of the lower respiratory tract is a rare condition. We report three new cases and we review the literature. Tracheobronchial amyloidosis is the most frequent form. The diagnostic is made by fiberoscopy and biopsies with a risk of bleeding. Our patients were usually treated with intermittent bronchoscopic resections. In one of the three cases reported, desobstruction of the large airway was performed with laser. Nodular pulmonary amyloidosis is usually asymptomatic, and surgical resection results in cure in all cases. Diffuse pulmonary amyloidosis is very unusual and fatal.

[Angiofollicular lymphoid hyperplasia (Castelman's tumor) in the mediastinum. Apropos of 2 cases]. / Hyperplasie lymphoïde angiofolliculaire (tumeur de Castelman) de localisation médiastinale. A propos de 2 observations

The authors report two new cases of angiofollicular hyperplasia of the mediastinum (Castelman's tumour). The only clinical peculiarity was a rapid increase in volume. The authors then review about 200 published cases. Emphasising the existence of 3 different histological types (plasma cell form, vascular hyaline form and intermediate form) and on the association in certain cases of hematological disorders such as anemia and hypergamma globulinemia. The significance of this lesion is discussed. An inflammatory theory with reactional hyperplasia of the beta-lymphocytes is proposed. It was supported by a direct immunofluorescent study of two cases (first study of this type carried out on such lesions) which showed polyclonal plasma cell hyperplasia predominating on the IgG.

[Variations in gas exchange and hemodynamic effects of various means of oxygen administration (spontaneous ventilation, controlled ventilation and under I.P.P.B.) in 19 severely obstructed pulmonary hypertension patients]. / Variations de l'hématose et effets hémodynamiques de différents modes d'administration d'oxygène (en ventilation spontanée, en ventilation dirigée et sous I.P.P.B.) chez 19 obstructifs sévères, hypertendus pulmonaires

In 19 cases of severe chronic respiratory insufficiency by obstruction, the authors studied the haemogasometry and haemodynamic incidence of inhaling a mixture with FiO2 by various ways and in respiratory reeducation. Controled ventilation with or without manual abdominal pressure, instrumental kinesitherapy under pressure relaxor and simple oxygen inhalation. The pressure relaxor seems particularly suited to patients suffering above all from hypercapnia and obstruction because of its limited haemodynamic repercussions.

[Seeking an ideal protocol for the stability of blood gases during general anesthesia for bronchosopies]. / A la recherche d'un protocole idéal pour la stabilité des gaz du sang au cours des anesthésies générales pour bronchoscopies

During general anesthesia for bronchoscopy, hypoxemia is a major risk, especially in patients with a severe intrapulmonary shunt. With the technique of apnea in pure oxygen, after one hour denitrogentation, and with an intake of 50 liters of oxygen per minute through the bronchoscope, the PaO2 was greater than 400 mm of Hg, but hypercapnia and acidosis occurred. To compensate the latter, five minute sessions of apnea, alternating with two minutes of jet hyperventilation, nevertheless, have the disadvantage of producing a Ventrui phenomena at the proximal end of the bronchoscope, hence a fall in FiO2 which was dangerous in these high risk patients. The authors propose a method so that the Venturi phenomenon, which cannot be prevented, occurs in pure oxygen.