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Biomedical subjects

B F Pertuiset

Publications and source records attributed to B F Pertuiset.

33 records · Page 2Linked to original sources
PubMed1980

[Paralysis of digestive tract with lesions of myenteric plexuses. A new paraneoplastic syndrome (author's transl)].

A 67 years old man was admitted on July 1979 for nausea, dysphagia and rectal pain. At age 64 he had undergone radiotherapy on the lower lip for an epidermoid carcinoma. He remained then healthy. His medical history was negative with the exception of chronic bronchitis. He had never been exposed to toxic agents or drugs and had never left Europe. A few days after admission he suffered acute intestinal obstruction but at laparostomy no etiology was found. At the same time the patient complained of pain in all four limbs and he was found to have diffuse wasting of muscles, areflexia and distal sensory loss. No sign of dysautonomia was present. Physical examination was negative with the exception of a cervical lymphadenopathy. The lymph node biopsy showed an undifferentiated metastatic carcinoma. Negative investigations included: blood cells count; serum ionogram and immunoelectrophoresis; thyroid function tests; serological test for Chagas' disease. The following abnormalities were found: ESR: 55-105; CSF protein: 145 mg/100 ml and 1 cell mm3; whole blood folic acid: 1,7 mg/ml; Hbs antigen was present in blood; EMG showed evidence of denervation but motor conduction velocities were normal. By September the patient's weakness had increased and complete intestinal obstruction persisted. At oesophageal, gastric and duodenal fibroscopy no contraction was visible, and biopsies were negative. The patient died of peritonitis on October 5th, 1979. At necropsy peritonitis secondary to multiple perforation of the large bowel was found. No recurrence of the lip carcinoma or metastase or evidence of a primary carcinoma was found. Light microscopy showed no evidence of amyloidosis or scleroderma. Examination of the alimentary tract showed abnormalities restricted to the myenteric plexuses which varied from one level to another. In the small bowel there was hyperplasia of the smooth muscle and the myenteric plexuses were enlarged by marked proliferation of Schwann cells. Severe neuronal loss and nodules of Nageotte were also noted. Schwann cells proliferation was less marked in the stomach and large bowel. Lympho-histiocytic infiltration strictly confined to the region of the myenteric plexuses was present in oesophagus, stomach, large bowel and rectum. Mild chronic inflammatory lesions were also found in anterior and posterior spinal roots and semi-lunar ganglia. The striking feature of this case is the association of an undifferentiated carcinoma and a polyradiculoneuritis with a complete alimentary tract palsy of rapid onset, secondary to lesions restricted to the myenteric plexuses. The low folate level was insufficient to explain the neuropathy. Investigations showed no evidence of the usual causes of intestinal pseudo-obstruction: muscular, dysautonomic, toxic, plexic (idiopathic, familial, inflammatory), Chagas' disease). The clinical course, the pathological pictures of the alimentary tract and spinal roots and the association with a carcinoma suggest that our case may represent a paraneoplastic syndrome...

Aged↗
PubMed1979

Malignant gliomas treated after surgery by combination chemotherapy and delayed irradiation. Part I: Analysis of results.

Forty-six patients with gliomas were introduced after surgery into a therapeutic programme of six cycles of combination chemotherapy with VM26 and CCNU, followed by delayed irradiation six months after surgery with an average dose of 5,800 rads. After irradiation the same preradiation chemotherapy was readministered for an average of four cycles. The results were compared to those from another group of 28 patients treated only by the same chemotherapy (CRC and C groups sucessively). Twelve patients (26%) died before irradiation in the CRC group, six patients (13%) had recurrences at the time of irradiation, and 28 patients (61%) had no clinical or radiological signs of recurrence at the time of irradiation. For the total of treated patients the median survival after surgery was 17 months, and 46% of the patients were surviving at 18 months. The percentage of survivors at 18 months was significantly more elevated in the group treated by combination chemotherapy and delayed irradiation than in a control group treated by the same combination chemotherapy alone. This result suggests that in approximately 50% of cases combination chemotherapy after surgery, and delayed irradiation six months after surgery, cumulated their effects on survival time.

Adolescent↗
PubMed1979

Malignant gliomas treated after surgery by combination chemotherapy and delayed radiation therapy. Part II. Tolerance to irradiation after chemotherapy.

34 patients operated on for malignant gliomas were successively treated by combination chemotherapy with VM26 and CCNU and conventional radiation therapy with an average dosage of 5,800 Rads, six months after surgery. The general and haematological tolerance of delayed irradiation after chemotherapy was satisfactory. Twelve patients developed neurological complications during or after irradiation. The complications were early in 10 cases, and delayed in 2. They were probably due to tumour growth in five cases, and secondary to irradiation in seven. In four of the seven cases the preradiation chemotherapy seemed to potentiate the radiation effect on the central nervous system.

Brain↗
PubMed1979

[C.T. scan appearances of acute necrotizing herpes encephalitis (7 cases). Preliminary therapeutic results after isoprinosine (author's transl)].

Seven cases of confirmed or probable acute necrotizing herpes encephalitis (ANE) were studied using computer tomography during the various acute or chronic stages of the disease. They were bilateral, or in some rare patients, asymmetrical pseudofocal cases of ANE. Computer tomography appearances are described from the morphological and topographical point of view, before and after intravenous injection of a contrast medium. Analogous data reported in the published literature is used to describe the findings and to emphasize the problem of differential diagnosis. Computer tomography appears to be an essential examination for establishing the diagnosis and prognosis in herpes encephalitis, but it must be correlated with the results of an electro-encephalogram, and biological and immunological tests of the cerebrospinal fluid. It can also be of value for choosing the optimal site for urgent cerebral biopsy with immunofluorescence. Treatment must be given very early, whether Ara A antiviral DNA or Isoprinosine (Inosiplex) which stimulates cellular immunity, as soon after diagnosis has been established as possible. The authors chose the latter medication for 6 of the 7 cases reported, as well as in 12 other cases of acute primary viral encephalitis, and 3 cases of subacute sclerozing panencephalitis, and obtained very positive results.

Adolescent↗
PubMed1975

[Von Eulenburg's congenital paramyotonia and aptitude for military service. Cases taken from a family with 25 cases since 1789].

The authors present four cases of von Eulenberg's paramyotonia. From the family history it was possible to follow the condition through seven generations since 1780; it confirms the autosomal dominant nature of genetic transmission, with almost complete penetrance. From the clinical standpoint, the condition observed is particularly pure, occurring exclusively in the cold. At no time were paralyses or adynamia independent of the myotonic phenomena and of temperature variations observed. The laboratory investigations carried out, ionic and enzyme, showed no abnormalities. Electromyographic study showed the presence of numerous true myotonic out-bursts, variable in shape and in amplitude, independant of the myotonic phenomenon, and present in the absence of exposure to cold. The effects of the condition on aptitude for military service are examined and in this respects the author recalls that the history of myotonia is intimately bound up with medico-military problems.

Adult↗
PubMedDate not supplied

[Delayed radionecrosis of the cerebral hemispheres following betatron electron beam irradiation for scalp cancer. Pathological and clinical findings in one case (author's transl)].

Three years following an irradiation by the Betatron's electron beam of an epithelioma in left parieto occipital area of the scalp in a female patient aged 77, early suffering from high blood pressure, a fatal pseudo-tumoral brain necrosis occurs presenting as a rapidly increasing from of Wernicke's aphasia. The necropsy shows intense radionecrosis lesions of the brain and the bone, free of any parenchymatous malignant proliferation note-worthy for the striking density of microvascular changes as previously described in radiation therapy. The case observed some years ago, allows to definite again the limits doses of the extracranial irradiations now estimated at 1760 rets. That is the "Nominal Standard Dose" (NSD) measured by rets and taking into account the number of seances (N) and the duration of irradiation (T) which would be to take the place of "the total dose" (D) (rads). These dosimetric criteria themselves must be adjusted to the age and the vascular features of each patient.

Age Factors↗
PubMedDate not supplied

[Strümpell Lorrain's familial spasmodic paraplegia. An anatomical and clinical review and report on a new case (author's transl)].

The authors describe the anatomical and clinical findings in a case of the pure form of Strümpell Lorrain's familial spasmodic paraplegia. This hereditary condition of the dominant autosomic type has very monomorphic pathognomonic features which are found in all patients affected. The slowly progressive isolated spastic hypertonia appears exclusively in the upright position and the extent of the disease can be ascertained by clinical observation during walking. The myelino-axial degeneration which is strictly limited to the spinal cord has an elective localization in the crossed pyramidal tracts, is less evident in the direct tracts and is mainly predominant in the lumbosacral and low dorsal regions of the cord. The extension of the process beyond the limits of the extrapyramidal tracts confirms the generally accepted unity of spinocerebellar degenerations. In this case the spinocerebellar tracts were less involved than the lumbar spinal ganglia, as well as their distant axial continuation to Goll's tracts only at the cervical level and until the bulber nucleus gracilis.

Brain↗
PubMedDate not supplied

[Malignant gliomas treated by combination chemotherapy and delayed radiation therapy (author's transl)].

The authors present the therapeutical results of two clinical and histological homogeneous series of malignant gliomas. The first group includes 46 patients operated upon and treated successively by chemotherapy associating VM26 and CCNU, a conventional delayed radiotherapy 6 months after surgery and again chemotherapy. In this group, the mean survival is 17 months and 46% of patients were surviving at 18 months. The second group includes 28 patients operated upon and treated with the same associated chemotherapy without radiation therapy. The mean survival was 11 months and 24% of patients were surviving at 18 months. The comparison of results shows that after surgery, the association of a chemotherapy and delayed radiotherapy is more efficient than chemotherapy alone. However, the systematic study of nervous system tolerance to irradiation post-chemotherapy suggests that, in some cases, the chemotherapy is able of increasing the pathogenic effect of irradiation on the brain.

Adult↗
PubMedDate not supplied

[Interest of glioma 26 in the selected chemotherapy of intracranial tumors (author's transl)].

Glioma 26 (G26) is a chemically induced ependymoblastoma of mouse. It was used through sub-cutaneous and/or intracranial injection in 7 experiences which showed that this experimental model was able to select drugs acting on intracranial tumors : nitrosourea (CCNU), VM 26, procarbazine (PCB). Combination chemotherapy (VM 26-CCNU ; VM 26 CCNU-PCB) was more active than monochemotherapy in 2 out of 3 experiences. It seems that the variability of the results is at least partly due to the important tumoral necrosis in tumors treated by combination chemotherapy and to technical problems. The latters can be avoided by the mechanical dispersion of tumor cells and by their injection through a stereotaxic frame. Selection of drugs is easier and cheaper to perform with G 26 than with other in vivo and in vitro experimental models. The main problem for all models remains their lack of specificity.

Animals↗