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Biomedical subjects

F Congy

Publications and source records attributed to F Congy.

At least 19 recordsLinked to original sources

Brain tuberculomas.

Although brain tuberculomas have become rare in developed countries, diagnosis should be kept in mind when confronted with brain space-occupying lesion(s), particularly in immigrants from endemic countries. Surprisingly, Human Immunodeficiency Virus (HIV) infection does not seem to have affected the incidence of this tuberculous lesion. Clinical, biological and radiological signs are only suggestive. Thus, when no other active extracranial tuberculous process is found, the diagnosis should be confirmed by a biopsy before beginning antituberculous treatment which is rapidly effective. Adjunction of steroids may be warranted owing to the common paradoxical enlargement of lesions during the first weeks of therapy, as is now well described in lymph node tuberculosis. Cure can be obtained in more than 85% of the cases, but neurological sequelae are not rare.

AIDS-Related Opportunistic Infections↗

Antioxidant status of elderly chronic renal patients treated by continuous ambulatory peritoneal dialysis.

BACKGROUND: An oxidative stress has been reported in patients with chronic renal failure (CRF) treated by haemodialysis. To our knowledge, only scant information is available concerning CRF patients treated by continuous ambulatory peritoneal dialysis (CAPD) with regard to their redox and nutritional status. METHODS: The oxidative stress and the biological nutritional status were evaluated in 20 elderly CRF patients treated by CAPD, compared with a control group of 30 elderly non-CRF patients. Plasma peroxidation products were assayed as thiobarbituric acid-reactive substances (TBARS), and two enzymatic antioxidant systems were determined: erythrocyte superoxide dismutase (SOD), glutathione peroxidase activity in plasma (P-GSH-Px) and in erythrocytes (E-GSH-Px). Selenium, vitamin E, beta-carotene and vitamin A were evaluated as plasma non-enzymatic antioxidants. Nutritional status and iron status were assessed by determining serum albumin, prealbumin, iron, ferritin and transferrin concentrations. RESULTS: Plasma TBARS concentration was high in both groups (CAPD: 1.37 +/- 0.06 mumol/l versus non-CRF: 1.41 +/- 0.06 mumol/l; P = NS), compared with usual values (0.60 to 1.20 mumol/l), on account of the patients' ages. SOD and E-GSH-Px activities were normal in both groups. A significant lowering in P-GSH-Px activity was observed only in CAPD patients (211 +/- 14 U/l, usual values: 480 to 650 U/l). Plasma selenium concentration, decreased in both groups, was significantly lower in CAPD than in non-CRF patients (P < 0.01). Plasma vitamin E, beta-carotene and vitamin A concentrations were significantly enhanced only in CAPD patients (P < 0.0001, P < 0.005 and P < 0.0001, respectively. Biological nutritional markers were similar in both groups and within usual values. CONCLUSIONS: This study demonstrated the existence of an oxidative stress in CAPD-treated elderly CRF patients, evidenced by a decrease in plasma selenium levels and in P-GSH-Px activity. However, plasma TBARS were not higher in CAPD patients than in age-matched non-CRF control subjects, probably on account on the patients' ages.

Aged↗

[Pancreatic endocrine tumor with metastases and increase of alpha-fetoprotein. A case report].

The authors report the case of a 48 years old man presenting a pancreatic islet cell carcinoma (gastrinoma) with liver, nodes and peritoneal metastases, associated with an elevated alpha-fetoprotein (AFP) concentration. Incomplete remission was first obtained with a chemotherapy using Streptozotocin combined with 5-Fluorouracil, in association with a Somatostatin analogue (SMS 201-995). But when relapses occur, another chemotherapy was not so effective. Serum gastrin and AFP levels had the same evolution and appear to have the same interest to follow the course of the disease.

Antineoplastic Combined Chemotherapy Protocols↗

[Free radicals and lipid peroxidation in cell biology: physiopathologic prospects].

Oxygen derived free radicals (OFR) arise in the course of normal cellular life, especially during cellular respiration. They are formed when molecular oxygen is reduced to water. These highly reactive species are controlled by a protective system both enzymatic and non enzymatic which helps to prevent the accumulation of peroxidative damage to the cell. Lipid peroxides result from the reaction of oxygen derived free radicals with polyinsatured fatty acids of membranes phospholipids and can be formed both non enzymatically and enzymatically (eicosanoids). Oxygen derived free radicals attack over-running beyond the protective system leads to oxidative stress. The cells involved in inflammation (polymorphonuclear, leucocytes, monocytes, platelets, endothelial cells) release oxygen derived free radicals and lipid peroxides and inflammatory diseases of infectious or non infectious origin can be considered as oxidative stress. Intracellular oxidative stress can lead to cellular death or trigger a strong inflammatory reaction. This occurs during ischemia reperfusion injury and hyperoxia. Exposure to ionizing radiation results in overproduction of oxygen derived free radicals both extra and intracellular. Oxidative stress may be involved in atheroma (where oxidised LDL are described), ageing and cancer.

Animals↗

[Nailfold capillaroscopy. Comparison of 100 subjects over 65 years of age and of 100 young adults].

Nailfold capillary microscopy patterns in 100 patients aged more than 65 years and free from inflammatory diseases were compared to those of 100 young healthy adults. A higher prevalence of arteriovenous sludge (36% vs 7%, p less than 10(-6)), increase in capillary loop length (12% vs. 0%, p less than 10(-3)) and especially prominent subpapillary plexus (63% vs 12%, p less than 10(-9)) was found in the geriatric group. Such capillary patterns cannot be considered as abnormal in patients aged more than 65 years. Enlargement of capillary loops and loss of capillaries were never encountered. Bushy capillary formations and hemorrhages were very uncommon in both groups.

Adult↗

[AIDS in elderly patients. Apropos of 22 cases observed in the Paris region].

If geriatric AIDS is defined as the occurrence of this disease in individuals over 60 years old, it represents about 5% of the cases reported to the Direction Générale de la Santé by the end of 1988. We retrospectively analyzed 22 clinical cases of geriatric AIDS observed between 1985 and 1987, i.e. 21% of the cases reported at that time. In 55% of them, infection resulted from contaminated blood transfusions. Initially, hospitalization was indicated due to a significant deterioration of the patient's general condition, however, neuropsychiatric disorders and intellectual degeneration were present in 18% of the cases. Biological anomalies at the time of admission were classical with the exception of a high frequency of leukopenia often associated with anemia or thrombopenia. During the evolution of the disease, opportunistic infections were very common (90% of the cases). However, the major characteristic of this clinical form of AIDS is the high percentage (55%) of patients suffering from major neurological and psychiatric disorders, including subacute encephalitis in more than half of these patients. The prognosis is very bad, with an average survival time of 4.3 months from the time of diagnosis (median 2.5 months). The cumulative effect of the delay in diagnosing AIDS during the first hospitalization and the classical seriousness of encephalitis suffice to explain the very poor prognosis in patients whose age can play a role in altering the immune response.

AIDS Dementia Complex↗

In vitro and in vivo effects produced by the immunomodulating agent RU 41740 on human polymorphonuclear leukocytes in the elderly.

The activity of RU 41740, a glycoprotein extract from Klebsiella pneumoniae has been investigated on some polymorphonuclear (PMN) functions. Chemotaxis, random migration and oxidative metabolism (assessed by chemiluminescence, O2 consumption and O2- generation) were studied in parallel. PMN were collected from adult and aged human volunteers. Experiments were performed either in vitro or in vivo in a double blind placebo assay. In both PMN populations RU 41740 enhanced oxidative metabolism either in in vivo or in vitro experiments. However, a higher and dose-related activity was observed on PMN collected from the younger subjects whereas maximal effective concentration was reached earlier with PMN collected from aged subjects. RU 41740 did not modify random migration but inhibited chemotaxis of PMN collected from the younger population in a dose-related manner. These data corroborated previous results observed on PMN collected from various animal species and suggested an interaction of RU 41740 on PMN membrane. Moreover drug-induced macrophage and lymphocyte stimulation might also explain, at least in part, the in vivo effects described in this study. Thus RU 41740 could partly account for the protective effects exerted against bacterial and fungal infections through its activity on PMN functions.

Adult↗

[Free radicals derived from oxygen and lipid peroxidation. Role in cellular biology and physiopathology].

Lipid peroxidation results from the attack of membrane phospholipids by free radicals derived from oxygen. It plays a major role in normal cell life processes. Under physiological conditions, this attack is modulated by an enzymatic system (superoxide dismutase, catalase, glutathione peroxidase) and by a non-enzymatic system (vitamin E and others). Many pathological processes might be explained by a deficient protection system or by an imbalance between attack and protection. Lipid peroxidation is difficult to detect and measure, and the methods available still have low sensitivity.

Animals↗

[Plasma zinc levels in elderly hospitalized subjects. Correlation with other nutritional and immunological markers and survival].

Plasma zinc levels were measured in 95 elderly patients hospitalized in a long stay unit and in 100 healthy controls under 65 years of age. Plasma zinc concentrations were significantly lower in the elderly patients, as compared to the younger subjects (p 0.001). The correlations with serum prealbumin (p 0.05) and serum albumin (p 0.05) concentrations and the frequent association with protein-calorie malnutrition suggest that the low serum zinc levels mirror a low dietary zinc intake. Immunological tests in the elderly show moderate lymphopenia, high serum IgA and frequent depression of delayed cutaneous hypersensitivity to DNCB and PHA. We find a significant correlation between plasma zinc concentration and peripheral blood lymphocyte counts, but not the other immunological parameters. Linear discriminant analysis shows that the association of low plasma zinc values, low serum protein concentration and high serum IgG concentration implies poor prognosis.

Age Factors↗

[Retrospective study of 290 cases of hyperthyroidism after 55 years of age without previously documented thyroid disorders].

Previous studies having shown differences in the clinical presentation of hyperthyroidism in the young and in the over sixty-years old patients, we studied the presentation of hyperthyroidism of late onset without previous thyroid disorder to determine if it continued to change with age after 55 years. Two hundred and ninety cases of hyperthyroidism presenting after the age of 55 years without a previous history of goitre, collected in the Department of Nuclear Medicine of the Pitié Hospital between January 1976 and May 1980, were analysed retrospectively. There was no significant correlation between age and heart rate or total circulating thyroxine (T4) and triiodothyronine (T3) concentration. A positive correlation with weight loss and a negative correlation with I 131 fixation were observed. It was higher in cases of atrial fibrillation and hyperthyroidism with normal thyroid scintigraphy. Graves' disease with goitre was associated with the most overt signs of thyrotoxicosis and the highest hormonal concentrations, contrarily to toxic adenoma. The T3 but not T4 concentration correlated positively with heart rate. T3 and T4 were positively correlated with weight loss, and this correlation remained significant at constant T4 and T3 concentrations.

Age Factors↗

[Recent data on the epidemiology and etiology of Crohn's disease].

The disease described by Crohn and co-workers fifty years ago escapes precise definition as it involves not only the ileum but the whole digestive tract. When restricted to the colon, it cannot easily be differentiated from that other inflammatory disease of the large bowel: ulcerative colitis. Meanwhile, Crohn's disease seems to be increasingly frequent, spreading from north to south, with a higher incidence among Jews and relatives of patients presenting with the condition. This would suggest interaction between a specific genetic factor and an as yet undetermined environmental agent which becomes pathogenic in the digestive tract. The lesions of Crohn's disease point to an immune conflict but so far, no definite disorder of the immunoregulation system has been demonstrated.

Crohn Disease↗