Biomedical subjects
Publications and source records attributed to C Alexandre.
The two sterile brothers were found to have the same sperm abnormalities. The flagella were short or absent. The constituent elements of the flagellum were disorganized, and the axone structure was disturbed. These abnormalities give rise to a problem of explaining the genetic origin of certain sperm defects similar to those found particularly in mice.
Splenectomies were performed on 142 patients (86 men and 56 women). The majority of them (117) were stages III or IV. The purpose of the laparotomy was therapeutic and not exploratory. Surgery was indicated, either due to evolution of the disease suggesting splenic involvement or to symptoms of hypersplenism. Splenic involvement was confirmed in 71% and hepatic involvement in 40%. Despite the risk of mortality during the first month after surgery, proportional to the extent of the disease, the overall results are encouraging provided that surgical intervention is followed by aggressive polychemotherapy. Serious infections were observed, however, in 9 patients; they did not occur for several months or even several years after splenectomy.
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Dobrin et al described in 1975 the first case report with acute renal failure due to tubulo-interstitial nephritis accompanied by uveitis and an inflammatory syndrome. The young adults are frequently involved and the complete resolution is usually obtained after corticosteroid treatment; this contrasts with the tendency towards relapse of the uveitis. The etiology and the pathogenesis of this syndrome remain unknown. We report the case of a woman which the renal function was incompletely reversible with corticosteroids.
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Two cases of total marital sexual impotence which occurred after the diagnosis of pregnancy following AID are reported by way of illustration. This impotence was accompanied by reoganisation of the economic situation in the marriage with a declaration that there was a very strong attachment for the wife and the child and a desire to have a second child and apparently for the wife to accept the whole situation. The influence of AID on the dynamics of a couple where the husband is sterile has been presented (it is the theme of a preliminary psychological enquiry which has been undertaken following the creation of CECOS IN 1973). A psychological study is a catch if we try to understand the interpretation. It is necessary to carry out a long-term psychoanalytical study of both partners in the marriage.
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In order to evaluate the relationship between apparently idiopathic osteoporosis and parathyroid hormone secretion, plasma immunoreactive parathyroid hormone (iPTH) was measured in 57 untreated osteoporotic patients using a carboxyl-terminal specific antiserum, and sections of undecalcified iliac bone biopsies from these subjects, who had been previously doubly labelled with tetracycline, were quantitatively analysed. Twenty-one patients (36%) exhibited histological signs of a high remodeling similar to that which is present in primary hyperparathyroidism, but their osteoplastic appositional rate values were lower. Among these 21 cases 8 had an increase of their iPTH levels. These data and those of the literature indicate that in a few cases high remodeling osteoporosis may be associated with parathyroid hypersecretion, but do not bring out the evidence that the increased circulating iPTH is the cause of osteoporosis. The authors draw from their results some practical consequences for the treatment of high remodeling osteoporosis.
Two cases of familial hypocalciuric hypercalcaemia (FHH) in the same family are presented. This congenital disease is characterized by biochemical evidence of parathyroid toxicity but differs from primary hyperparathyroidism by the presence of normal parathyroid hormone levels. However, histomorphometric studies of transiliac bone biopsy specimens after double-labeling with tetracycline shows intensive remodelling of bone tissue with increase in osteoclastic resorption and osteoblastic apposition areas, all features identical with those observed primary hyperparathyroidism. The authors suggest hypersensitivity of target-organs (bones and kidneys) to parathyroid hormone as a probable physiopathological mechanism for FHH.
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Study of 1303 cases of male sub-fertility led to a certain number of practical conclusions: - From a diagnostic viewpoint, the "fertility" of an individual, which is difficult to assess, depends more on the motility than the number of spermatozoa. This is most faithfully reflected in the crossed penetration test which defines the quality of penetration of a control mucus. The value of electron microscopic cytological study in the case of total asthenospermia or major monomorphous teratospermia, reflecting an irreversible constitutional abnormality of the ultrastructure of the spermatozoon, is emphasised. - From a therapeutic viewpoint, recent progress has involved the technique of surgical treatment for varicocoele as well as hormone therapy. It is essential not to neglect empirical "minor aids" indicated in the case of unexplained abnormalities (homologous artifical insemination in the case of abnormalities in the volume of the ejaculate, retard androgen therapy in the case of polyzoospermia). - From a prognostic viewpoint. The distinction must be drawn between aetiologies of good prognosis (80% of our success) responsible for transient abnormalities in spermatogenesis (infections, metabolic disturbances, varicocoele) and aetiologies with an unfavourable prognosis since they cause tubulopathies of greater or lesser severity with a lesional impairment of spermatogenesis.
BACKGROUND: Mycobacterium xenopi is a potential pathogen for man and can cause bone and joint infections, particularly spondylodiscitis. Most cases of infection occur in fragilized patients and are found more and more often in AIDS patients. CASE REPORT: A 41-year-old HIV+ woman developed cervical spondylodiscitis due to Mycobacterium xenopi infection. The strain was isolated from a discovertebral biopsy and was resistant to several antibiotics. Outcome was unfavorable. DISCUSSION: Most of the cases reported to date have involved spondylodiscitis of the thoracic or lumbar spine. To our knowledge, this is the first report of cervical spondylodiscitis dut to Mycobacterium xenopi in an HIV+ patient. Antibiotic combinations using fluoroquinolones and new macrolides are usually prescribed. Such protocols may provide cure of these opportunistic infections in immunodeficient patients.