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Biomedical subjects

A Delaloye-Bischof

Publications and source records attributed to A Delaloye-Bischof.

8 recordsLinked to original sources
PubMed1991

Loss of psychic self-activation with bithalamic infarction. Neurobehavioural, CT, MRI and SPECT correlates.

Two patients with bilateral thalamo-mesencephalic infarct in the paramedian territory developed vertical gaze dysfunction and marked behavioural changes, in the absence of significant motor inability and formal neuropsychological impairment. While they were physically and emotionally active before stroke, they became apathetic, aspontaneous, indifferent, and seemed to have lost motor and affectic drive, as well as the need itself for any psychic activity. However, this mental and motor inertia was reversible when the patients were repeatedly stimulated by another person. This need for constant external programming, together with a lack of emotional reactivity, made the patients resemble robots. CT and MRI suggested involvement of the dorsomedial and midline nuclei of the thalamus, and SPECT showed remote frontomesial hypoperfusion. A disturbance of the striatal-ventral pallidal-thalamic-frontomesial limbic loop is suggested by previous reports of a similar "loss of psychic self-activation", "pure psychic akinesia", or "athymhormia" with bipallidal, bistriatal, or subcortical bifrontal lesions.

Arousal↗
PubMed1990

Prolonged hypoperfusion and early stroke after transient ischemic attack.

Many patients suffer a stroke early after a transient ischemic attack, but the reason why is often unclear. We studied 12 patients with less than 75% stenosis of the internal carotid artery and a single hemispheric transient ischemic attack lasting less than 1 hour who had a normal neurologic examination 3-13 hours later and a normal computed tomogram 24-36 hours later. Single-photon emission computed tomography using technetium-99m HM-PAO less than or equal to 50 hours after the attack showed no abnormality in eight patients, but in the other four there was an area with 30-50% reduction in perfusion ipsilateral to the transient ischemic attack. Three of these four patients developed an ipsilateral infarct 3-7 days later, but none of the eight patients with normal single-photon emission computed tomograms had a stroke during the following weeks. No difference in therapy, risk factors, severity of internal carotid artery disease, or timing of the technetium-99m study could explain these findings. We suggest that some transient ischemic attacks, though clinically identical to others, may be associated with persisting focal hypoperfusion, which predisposes to early stroke.

Aged↗
PubMed1988

Manic delirium and frontal-like syndrome with paramedian infarction of the right thalamus.

A disinhibition syndrome affecting speech (with logorrhoea, delirium, jokes, laughs, inappropriate comments, extraordinary confabulations), was the main manifestation of a right-sided thalamic infarct involving the dorsomedian nucleus, intralaminar nuclei and medial part of the ventral lateral nucleus. Resolution of conflicting tasks was severely impaired, suggesting frontal lobe dysfunction. These abnormalities correlated with the finding on SPECT of a marked hypoperfusion in the overlying hemisphere predominating in the frontal region. We suggest that this behavioural syndrome was produced by disconnecting the dorsomedian nucleus from the frontal lobe and limbic system.

Afferent Pathways↗
PubMed1987

Myocardial injury after electrical burns: short and long term study.

Miscellaneous cardiac abnormalities can occur after electrical burns. The long term outcomes are still unknown. We studied 10 patients, 9 of whom suffered high-voltage electrocution, and one of whom was struck by lightning. Serial electrocardiograms (ECG) and serum MB creatine phosphokinase isoenzyme (MB-CPK) activities were obtained during their stay in hospital. ECG and thallium 201 cardiac scintigraphy at rest, as well as echocardiograms were obtained in all patients 4 to 48 months after discharge. In hospital, 9 patients showed one or more abnormal findings at physical examination (4 cases), ECG (8 cases), MB-CPK (1 case). At long term follow-up, 5 patients had one or more myocardial functions or conduction abnormalities, with or without symptoms. One patient had compensated heart failure. Nine patients were asymptomatic. Abnormal ECG findings persisted in 3 patients. Three cardiac scans showed evidence of regional myocardial hypoperfusion. Decreases in left ventricular indices measured by echocardiogram were found in 3 patients. We conclude that high-voltage electrocution is associated with a high incidence of cardiac abnormalities, which may persist. Long term evaluation, requiring cardiac T1 201 scintigraphy and echocardiogram, may be justified.

Adult↗
PubMed1985

[Myocardial involvement in nontraumatic rhabdomyolysis following an opiate overdose].

Eight young addicts developed rhabdomyolysis as a complication of heroin overdose. ECG, plasma enzyme time activity curves and thallium myocardial scintigraphy were highly suggestive of a myocardial lesion associated with rhabdomyolysis. Such changes were particularly striking in 3 patients with acute left ventricular failure, as shown by a hemodynamic investigation (3 patients) and by echocardiography (1 patient). All patients recovered but myocardial scintigraphy and ECG remained abnormal for a period ranging from 8 months to 3 years following the acute episode. Although associated metabolic changes may play a role in myocardial dysfunction, the most likely mechanism appears to be a direct toxic effect of heroin on cardiac muscle.

Adult↗
PubMed1985

Clinical comparison of 99mTc-HMDP and 99mTc-MDP. A multicenter study.

99mTc-Hydroxymethylene diphosphonate (HMDP) was compared to 99mTc-methylene diphosphonate (MDP) with respect to image quality, lesion detectability, and the uptake ratios of normal bone to soft tissue (B/S), metastatic bone to soft tissue (M/S) and bone metastases to normal bone (M/B) at 2 and 3 h after injection in the same subjects. Thirty-three patients with bone metastases were examined in six nuclear-medicine departments, with each center using its usual bone-scanning protocol which was identical for both compounds in the same patient. The uptake of 99mTc-HMDP in normal bone (B/S) was significantly higher than that of MDP at 2 and 3 h, but there were no significant differences between the two compounds with regard to the M/S or M/B ratios. The M/B of HMDP at 2 h was not significantly different from that of MDP at 3 h, the latter showing a significantly higher B/S and M/S ratio. All lesions were detected with both compounds, even at 2 h. The image quality was rated as follows (in decreasing order): HMDP (3 h), MDP (3 h), HMDP (2 h), and MDP (2 h). HMDP was shown to be a useful bone-imaging agent, especially when shorter intervals between injection and recording are required.

Adult↗
PubMed1980

[Factors aggravating the anemia in chronic hemodialysis: destruction or loss?].

Sixteen out of 78 patients (20.5%) on chronic hemodialysis had a mean hematocrit below 0.20 L x L-1 during a six months follow-up period. Three of the 16 had been previously binephrectomized. Eleven of the remaining patients were investigated by 51Cr labelling of red cells. Blood loss in the dialyzer and blood lines was measured at 2.72 +/- 1.90 ml of red blood cells (0.97-7.31). Occult intestinal blood loss was detected in 2 patients. Clinically latent hypersplenism was evidenced in all patients, as demonstrated by an increased splenic-cardiac ratio (99.5 +/- 38% and a decreased red blood cell half-life (16.3 +/- 2.3 days). Hypersplenism and blood loss during dialysis are two underestimated but major contributory factors in the increased anemia observed in chronically hemodialyzed patients.

Anemia↗