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Biomedical subjects

A Buge

Publications and source records attributed to A Buge.

At least 37 records · Page 2Linked to original sources
PubMed1985

[Early manifestations of neuromeningeal syphilis. Review of the literature apropos of 3 severe forms].

We report 3 cases of severe syphilitic neuro-meningitis during the secondary stage: acute transverse dorsal myelitis with permanent paraplegia in a 17 year old teenager (case no. 1), uveo-meningitis with intracranial hypertension and diminished vision in a 52 year old woman (case no. 2), lower medulla lesion in a 46 year old man (case no. 3). The diagnosis was based upon highly positive serological tests for syphilis, associated with a compatible clinical context and meningitis in CSF specimens. Treatment was successful in cases nos. 2 and 3, unsuccessful in case no. 1 due to the irreversible character of the medullar lesions. Based on these 3 cases, the following points are discussed: the relatively atypical clinical character in the current context, the difficulties of the diagnosis, and the treatment regimens recommended for neurological syphilis. Despite the rarity of such cases, their extreme severity early in the secondary stage strongly implies the necessity for prevention by detecting and treating early syphilis. Attention is drawn upon the importance of doing serological tests for syphilis when presented with any atypical neurological situation.

Adolescent↗
PubMed1985

[Hemichorea and oral contraceptives].

A 26 year-old woman presented with a left hemichorea while taking oral contraceptives (a combination of ethinyl-estradiol and norethisterone). There was marked improvement of the choreic movements after discontinuation of the oral contraceptive and complete resolution by 6 weeks. Induction of chorea is a rare complication of oral contraceptives. The possible mechanisms are briefly reviewed.

Adult↗
PubMed1985

[Nerve and muscle microvasculitis: 50 cases].

Fifty consecutive cases of nerve and muscle microvasculitis (MV) seen on nerve and muscle biopsies were studied. These were observed in a 5 years period, among 1076 nerve and/or muscle biopsies performed in adult patients in the Laboratoire de Neuropathologie Charles Foix. The systemic necrotizing vasculitides, in which the arteries of diameter greater than 70 microns are involved, acute polymyositis, sarcoidosis and acute polyneuritis were not considered in this study. Mononuclear cell infiltration was the rule. It was associated to leukocytoclasis in 2 cases. No fibrinoid necrosis was seen. These changes were highly diagnostic when seen in the nerve or the connective tissue of the epi or perimysium. The etiology of these microvasculitides was mainly connective tissue diseases (42 p. 100) and, overall, panarteritis nodosa (16 p. 100), or malignancies (28 p. 100) which comprise 7 solid tumors and 4 lymphomas. Other cases were related either to systemic diseases (thromboangiitis obliterans, monoclonal dysglobulinemia, cholesterol embolus) or to local trauma. The relationship between MV and peripheral neuropathy was less obvious in 3 cases of mononeuritis multiplex associated with diabetes mellitus and in 3 cases of acute idiopathic and regressive mononeuritis multiplex. In 5 cases, no cause was found.

Adult↗
PubMed1985

[Clinical analysis of 70 neuropathologic cases of multiple sclerosis].

A retrospective study of clinical files of 70 pathologically confirmed cases of Multiple Sclerosis (MS) (53 women and 17 men), selected from the records of the Laboratoire de Neuropathologie Charles Foix (Hôpital de la Salpêtrière) was performed. The following data were recorded and analysed by a computer program (HP 85): sex, age of onset of disease, clinical course (classified into Remittent, Remittent-Progressive, Progressive and Acute) and the date of each new neurological symptom or sign. The mean age of onset was 36.8 +/- 12. In women, the disease began earlier (34.6 +/- 12) and the duration was longer (17.4 +/- 12). In men the age onset was 40.6 +/- 11 and the duration was 12.5 +/- 6. In remittent courses, the mean age of onset was 30.8 +/- 13 and the duration was 21 +/- 10. In progressive courses, the age at onset was 45 +/- 10 and the duration was 2. In women, progressive courses began significantly later (42.3 +/- 9.2) and were shorter (15 +/- 8) than remittent courses which began at 26.8 +/- 8.2 and lasted 23 +/- 10. The histogram of the duration of clinical courses showed three groups: acute courses (8 cases less than 5 years long), intermediate courses (41 cases, between 5 and 20 years long), and long courses (21 cases longer than 20 years). Women were more often affected with acute (7/8 cases) or long courses (20/21 cases). The mean duration of the disease was the same when the symptoms and signs at onset were motor weakness, sensory disturbances, optic neuritis or diplopia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Retinal, muscular and cutaneous cholesterol emboli. Progressive encephalopathy].

A 73 year-old man experienced left monocular blindness and transient right hand clumsiness. A left carotid arteriogram was performed 4 days after admission. Immediately following arteriography, there was a right hemiparesia and dysphasia. After 24 hours, the abnormalities resolved. The patient was treated with heparin. During the following weeks, he became gradually drowsy and confused. Pseudo-bulbar palsy and astasia appeared after a fluctuating but progressive neurological course. The combination of systemic symptoms, high sedimentation rate, renal failure, livedo reticularis and purple toes suggested necrotizing angiitis. With corticosteroid treatment, there was a slight improvement of systemic symptoms. Cholesterol emboli were seen in both fundi. Cholesterol embolization was proved by identifying the biconcave cholesterol crystal clefts in muscle and skin biopsies. The subsequent course was marqued by continuous neurological deterioration. The patient became stuporous and died 7 months after admission. Despite the lack of central nervous system pathological study, the clinical picture was highly suggestive of cerebral cholesterol embolism. A few cases have been reported, with only eight well-documented clinical descriptions. Clinical signs and symptoms were closely similar to those of the present case. Anticoagulant therapy of cholesterol emboli has been unsuccessful. In the present case, the onset of embolization was temporally related to anticoagulation.

Aged↗
PubMed1984

[Progesterone receptors in normal human leptomeninges in adults].

Cytosolic and/or nuclear 3H-R 5020 binding sites were detected in 6/6 samples of normal leptomeninges obtained at the time of operation in human adults. The levels of binding sites were higher in leptomeninges samples (range of values: 140-1780 fmol/gT) than in the corresponding intracranial tumors (one meningioma, two neurinomas, one metastasis) in 3 out of the 4 cases that were simultaneously studied. The 3H-R 5020 binding systems were characterized in 2 groups, A and B, of pooled samples representing respectively 4 and 17 samples of normal leptomeninges. The study of A (cytosolic and nuclear binding sites) and B (cytosolic binding sites) groups showed that binding systems had a limited capacity and a high affinity (Kd were respectively 2 X 10(-9) and 5.3 10(-10) M) as previously noted for the progestin receptor in human meningioma. Biochemical data and ultrastructural pictures obtained in the present study as well as in previous works, allow to consider the presence of the progestin receptor in normal leptomeninges.

Adult↗
PubMed1983

[Kinetics of multicellular spheroids developed from a human glioblastoma, and effect of 1,3-bis (2-chloroethyl)-1-nitrosourea].

Multicellular spheroids (MCS) were yielded in vitro by early stages of human glioblastoma cell cultures. The spheroids were grown in suspension in the culture medium in agarose-coated (0.65%) dishes. The volume doubling time during the exponential growth phase was longer (13 days) than the population doubling time of monolayer cultures (2-3 days). Pathological examination of MCS showed a thin proliferative outer layer and areas of necrosis in the center. In two experiments BCNU caused a growth delay of MCS which was dose-related. The cells were sensitive to BCNU in monolayer cultures (CFE's assay), whereas the tumor was resistant in vivo. The usefulness and pitfalls of studies using MCS cultured from early passages of human malignant gliomas are discussed.

Brain Neoplasms↗
PubMed1983

Steroid hormone receptors in human meningiomas, gliomas and brain metastases.

Progestin, estrogen, androgen, glucocorticoid as well as mineralocorticoid receptors (PR, ER, AR, GR and MR, respectively) were all evaluated with specific synthetic radioligands (biochemical assays) in 25 meningiomas, 9 gliomas and 4 brain metastases. In meningiomas the main steroid hormone receptors appeared to be the progestin receptor, present in 24/25 cases (mean level: 7 105 fmol/gT) and the androgen receptor, present in 23/25 cases (mean level: 2 265 fmol/gT). Progestin receptor levels were found to be significantly lower in meningiomas of the fibroblastic subtype whereas none of the steroid hormone receptors were detected in the anaplastic case. On the other hand, glucocorticoid receptor levels were related to the preoperative glucocorticoid therapy. In gliomas only estrogen receptors (2/9 cases) and especially androgen receptors (8/9 cases) were noticeable: the latter seemed to be related to the histological types and to the sex of patients. No receptors were found in any of the four studied metastases, including one from breast cancer. The biochemical characterization of the receptors as well as their relevance to tumor biology and to the physiology of the normal tissues where tumors arise, were discussed, and biochemical data were compared with those previously reported.

Adult↗
PubMed1983

[Hypothalamic form of Whipple's disease. Favorable effect of rifampicin].

An unusual case of Whipple's disease is reported. The diagnosis was difficult as the characteristic digestive sign and symptoms (malabsorption, diarrhea, mucosal infiltration by PAS-positive macrophages) were absent. After a ten-year history of seronegative arthritis, myocardiopathy, with aortic insufficiency, basilar pulmonary infiltrates, enlarged lymph nodes, the patient, a 56 years old man, was referred to us for a severe vegetative and neurological dysfunction: stupor, dysarthria, akinesia, hypertonia, hypothermia and abnormal thirst. A CT-scan showed a low-density area of the right hypothalamus, and PAS-positive macrophages were found in a lymph node, in the CSF and in a cerebral biopsy. The patient then received a classical antibiotic treatment, yet the neurologic dysfunction remained severe. Finally, a trial with rifampicin brought a striking improvement of the patient's condition, which has now lasted for three years.

Humans↗
PubMed1983

[Acquired cerebral toxoplasmosis in adults. Clinical and neuropathologic study].

Two cases of acquired cerebral toxoplasmosis in adults are reported. In the first case no subjacent disease was found, and the neurological signs were of a meningo-encephalitic type with disorders of consciousness and a C.S.F. cellular reaction. A second case was observed in the course of the treatment of Waldenström disease by chloraminophene. The neurological signs were bifocal, and the C.S.F. showed a moderate increase of protein. In both cases C.T. scan showed contrast enhanced and hypodense areas. In the first case the enhancement was heterogenous and the hypodense area occupied the whole right hemisphere. The second case showed two ring enhancements in the left frontal and the right occipital regions. A cerebral biopsy was performed in both cases but no parasite was found. The diagnosis was presumed to be malignant lymphoma or encephalitis in the first case, glioblastoma in the second. No specific treatment was administered and the patients died within a few weeks. The complete pathological study by light and electron microscopy showed free and cystic forms of Toxoplasma Gondii. The results of the neuropathological examination and the thorough study of the biopsy specimens were compared to the pathological findings in the literature. The particular character of the necrosis and the inflammatory encephalitic reaction in the absence of the parasite may suggest the diagnosis when the clinical, biological and radiological data are compared.

Aged↗
PubMed1982

Progestin and oestrogen receptors in meningiomas. Biochemical characterization, clinical and pathological correlations in 42 cases.

Progestin receptors (PR) were evaluated in 40 intracranial and 2 spinal meningiomas. PR measured with radiolabelled R 5020 were found in 93% of cases (39/42). PR levels were significantly higher (p = 0.05) in females (mean: 5,720 fmol/gmT) than in males (mean: 3,120 fmol/gmT). Biochemical characterization of the R 5020 saturable binding sites showed that they were mainly cytosolic, had a high affinity constant (Kd approximately equal to 1 nM) and were progestin specific. Correlation with sex suggested some biological activity of PR in meningiomas. Oestrogen receptors (OR) were evaluated in 36 intracranial and 2 spinal meningiomas. OR measured with radiolabelled R 2858 were present in 79% of cases (30/38). OR mean levels were equal in females (mean: 285 fmol/gmT) and in males (mean: 330 fmol/gmT). The relevance of PR and possibly OR in the biology of meningiomas and of leptomeninges was suggested by the presence of receptors in a sample of normal leptomeninges.

Adult↗
PubMed1981

[Clinical symptoms and anatomical locations in primary haemorrhages of the basal ganglia. A neuropathological study of 64 cases (author's transl)].

The signs, symptoms and courses of 64 cases of "primary" haematoma of the basal ganglia have been retrospectively studied, and the main clinical data have been analyzed in relation to the location and extent of the bleeding. Onset with hemiplegia, accompanied or not by impaired consciousness, was more frequent with intermediate and lateral haematomas than with medial haematomas (p less than 0.001). Among patients with initial hemiplegia, impaired consciousness was more frequent with intermediate and medial haematomas than with lateral haematomas (p less than 0.005). At a later stage, patients with intermediate and lateral haematomas more often went into deep coma than those with medial haematomas (p less than 0.01). There were no statistically significant differences between the three anatomical groups with regard to frequency of other signs and symptoms or duration of the disease before death occurred.

Basal Ganglia↗
PubMed1981

Paramedian thalamic and midbrain infarct: clinical and neuropathological study.

The clinical and neuropathological findings in 28 cases of paramedian thalamic and midbrain infarcts are reported. The 4 instances of unilateral paramedian thalamic infarct were characterized by mood and behavioral changes, limitation of the infarct to the center of the anatomical paramedian territory, and symmetrical configuration of the paramedian thalamic arteries. Basilar artery occlusion was found in 1 patient. The 5 cases of bilateral paramedian thalamic infarcts were characterized by disturbances of consciousness and behavior, extension of the infarct (to the mammillothalamic tracts in 4 cases, the red nuclei in 3, and the hypothalamus in 2), and a variable paramedian thalamic arterial pattern. The arterial pattern was symmetrical in 2 cases, asymmetrical in 1, and unilateral in 1. The basilar artery was occluded in 1 case, the basilar communicating and posterior cerebral arteries in 1, and a third patient had occlusion involving an aneurysm of the basilar artery. The 19 patients with paramedian thalamopeduncular infarcts had marked disturbances of consciousness (hypersomnia, deep coma, akinetic mutism) associated with ocular motility changes. Later, abnormal movements--always delayed--and memory disturbances were observed in some. Thalamic changes were restricted to beh paramedian territory in only 3 cases. The arterial pattern was symmetrical in 5. The basilar and posterior cerebral arteries were occluded in 4 patients each. Paramedian infarcts were rarely found as isolated lesions and were always bilateral when there was only one arterial pedicle. The paramedian thalamic pedicle can supply the polar thalamic territory.

Aged↗
PubMed1981

Epileptic phenomena in bismuth toxic encephalopathy.

Seventy patients admitted to hospital with bismuth encephalopathy had repeated clinical and EEG examinations. All the patients exhibited myoclonic jerks, but no paroxysmal features ever appeared on EEG. Computed tomography showed cortical hyperdensities. Seizures were observed in 22 patients, but epileptic EEG patterns appeared only when the bismuth blood level was below 1500 microgram/1. It is suggested that a high cortical intracellular bismuth concentration induces a "cortical inhibition" which causes suppression of physiological electrical brain activity, the absence of EEG paroxysmal phenomena during myoclonic jerks, and explains the rarity of epileptic seizures.

Adult↗
PubMed1980

[The treatment of peripheral neuropathies in a case of IgA myeloma and one of mixed cryoglobulinaemia. Repeated plasmapheresis (author's transl)].

Peripheral neuropathies were the presenting feature of an IgA lambda myeloma in a 61-year-old man and a mixed cryoglobulinaemia in a 46-year-old woman. A spectacular improvement in these symptoms followed treatment including large volume plasma exchanges with appropriate chemotherapy. This efficacy of repeated plasmapheresis leads to a discussion of the possible mechanisms of these neuropathies.

Cryoglobulins↗