Biomedical subjects
Publications and source records attributed to G Forzy.
Bisalbuminemias are characterized on serum electrophoresis with a double band of albumin. They could be hereditary or acquired. This double band is composed of a protein with a normal mobility and with a protein with an other mobility which migrates in a more anodic or more cathodic position.
Both methods enable the clinical laboratory to identify monoclonal gammapathies with a good sensitivity. The immunofixation method, more quickly used than the immunoelectrophoresis, is easier to obtain the best resolution. It is well adjust for the characterization of low concentration gammapathies like immunoglobulin light chains. Immunofixation appears to take a more and more important place in the clinical laboratory.
Oral anticoagulants (OC) prevent the activation by carboxylation of coagulation proteins. However this action also affects osteocalcin, or bone Gla-protein, a parameter of bone remodelling. Phosphorus and calcium metabolism, osteocalcin levels and bone mineral content were studied in twelve men aged under 60, and who had been taking OC for more than a year, in comparison with a paired group of nine controls with the same cardiovascular pathology but not taking anticoagulants. Osteocalcin levels were lower in the OC group (3.44 ng/ml) than in the control group (5.88 ng/ml) (p = 0.01). There was no significant difference in other phosphorus/calcium balance parameters nor in bone density between the two groups. No evidence was found of any osteopathy in the OC group, but the decrease in serum osteocalcin could result either from inhibition of its secretion or of its carboxylation, or from an action on the osteoblast.
Amniotic fluid infection and its principal sequel bacterial infection of the newborn are major problems in obstetric pathology. The authors hav analysed prospectively 346 obstetrical casenotes over a period of 18 months in order to try to describe and specify the clinical features and to try and work out using bacteriological tests the risk of infecting the neonate by materno-fetal transmission. They compared a control group (27 case histories) and the group at risk (235 cases). 4% of the control group and 18.7% of the "at risk" group were biologically infected (p less than 10(-2)). The following are among the classical clinical criteria to correlate this risk: maternal pyrexia, premature delivery, urinary tract infections and fetal distress; an apparent lessening in active fetal movements is also well correlated to the risk of infection. The bacteriological criteria are: the presence of quantities of altered polymorphonuclear cells in the amniotic fluid--this seems to be more important than others (sensitivity = 70%, specificity = 89%, but positive predictive value = 60% and negative predictive value = 93%). From this study it should be possible to work out antenatally whether the newborn baby will be at high risk of developing an infection in order to consider giving antibiotics to prevent materno-fetal transmission.
Late auditory evoked potentials (AEPs) were recorded by the odd-ball method in 55 non-deteriorated parkinsonians (NP) and in 27 parkinsonians with cognitive deterioration (CDP), compared with 20 controls (C) and 24 patients with Alzheimer-type senile dementia (ATSD). The latency of P 300 was prolonged in the CDP and ATSD groups (410.72 +/- 24.45 and 433.62 +/- 38.30 respectively; P less than 0.001. The latency of N 100 was prolonged only in the CDP group (106.6 +/- 4.82; P less than 0.001). Late AEPs were also studied in 63 subjects with possible or confirmed disseminated sclerosis (DS) compared with 33 controls of similar mean age. The ERFC test divided these patients into 38 with non-deteriorated DS (NDS) and 25 with deteriorated DS (DDS). The latency of P 300 was prolonged in both groups: NDS 331.14 +/- 25.89; DDS 376.64 +/- 29.51 (P less than 0.001). The latency of N 100 was prolonged in the NDS group (100.25 +/- 9.20) and the DDS group (104.43 +/- 9.01). Following a study of correlations between the degree of mental deterioration and the electrophysiological parameters in these populations, the significance of the N 100 latency as electrophysiological marker of subcortical dementia is discussed.
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The Hellp syndrome defined as the association of micro-angiopathic haemolytic anemia, hepatic cytolysis and thrombocytopenia, correspond to a severe form of gravidic toxemia, combined to manifestations of classic-pre-eclampsia. This retrospective study, conducted over 6 years, concerns 9 cases of Hellp syndrome, including 2 occurring during the immediate post-partum. Only cases where this biological triad was obvious and not associated with manifestations of disseminated intravascular coagulation, were considered in this study. In addition to the usual criteria of gravidic toxemia, the early clinical manifestation occur, in this study, between 28 and 38 weeks of amenorrhea and gastrointestinal manifestations are predominant. The physiopathogenic hypotheses of this syndrome remain variable and management varies depending on the authors. Treatment is that of pre-eclampsia. Medical treatments (steroids, heparin, immunosuppressants,...) are discussed, but severe feto-maternal complications require, most of the time, a surgical approach, depending on the number of pregnancies, the obstetrical conditions, the stage of the pregnancy and the severity of the syndrome.
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Now it is not possible to choose an efficacious dosage of trimipramine when measuring serum drug concentrations. At once those measurement are useful to assure the long term surveillance of the treatment. That's why we propose to define a personal therapeutic interval that allows to limit the area in which the drug concentrations must be found.
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Systematic investigation of hyperphenylalaninaemic infants for tetrahydrobiopterin deficiency has recently led to the description of new variants of cofactor deficiency. In the present case, the initial observation was of hyperphenylalaninaemia with a significant increase in the neopterin to biopterin ratio in the urine. A tetrahydrobiopterin loading test resulted in a significant decrease of blood phenylalanine levels. Cerebrospinal fluid (CSF) biopterin and neurotransmitter metabolite levels were within the normal range. The in vivo clearance of phenylalanine remained altered despite a high dietary tolerance. At 9 months of age, the patient was clinically well, but minor neurological signs appeared when blood phenylalanine levels increased. These data were similar to those found in the so-called "peripheral form" of tetrahydrobiopterin deficiency. However, an unidentified pteridine-like compound had been found in the urine and CSF since the birth, suggesting the existence of an unknown block in the biosynthetic pathway of biopterin.
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Electrochemical detection is more and more frequently used in clinical chemistry. The performances of eleven detectors (sensitivity stability, limit of detection, figure of merit) have been compared. There is a large variation in results for sensitivity and figure of merit, but all of these detectors seem stable and reproducible.
The authors report two new cases of endocarditis secondary to exceptionnally encountered germs: one to Pasteurella pneumotropica, the other ascribed to Leptospira ictero-haemorragiae, on serologic criteria. Concerning these two cases, they propose to take a census of rare germs, from a detailed study of the literature. Among more than 5,000 cases of endocarditis published after 1944, are considered as rare germs those causing a disease in less than one p. cent of the cases. This purely "mathematical" definition enable to include 45 germs. A synthesis of all the cases reported attempts to demonstrate a few particular traits of these endocardites secondary to rare germs.
Neopterin and biopterin concentrations were measured in amniotic fluid in 226 pregnancies from the 12th week of gestation to term. At mid-gestation, neopterin and biopterin levels were low and remained relatively constant between 12 and 26 weeks of gestation, whereas during the third trimester, a progressive increase was observed. Near term the values were greater than those in maternal serum and the higher neopterin to biopterin ratio suggested that pteridine concentration in amniotic fluid may reflect the maturation of pteridine metabolism in the fetus.
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