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H Regis

Publications and source records attributed to H Regis.

12 recordsLinked to original sources

Sleep electroencephalogram at the early stage of Creutzfeldt-Jakob disease.

We describe sleep EEG studies in three patients at the early stage of Creutzfeldt-Jakob disease. Little work has been devoted to the study of the sleep EEG in the course of the CJ disease: disorganized sleep architecture was noted, associated with a decrease in stage 4 and an almost complete disappearance of the REM stage. Our patients were considered to have normal stage 2; yet spindles and K complexes were rare at this stage. No evolution towards stage 4 was noted. The percentage of rapid eye movement sleep was significantly low in two cases and normal in one case. Sleep disturbances in the other dementing disorders are reported.

Aged

Sensory evoked potentials in Creutzfeldt-Jakob disease.

Eight patients presenting with intermediate or terminal evolution of Creutzfeldt-Jakob disease (CJD) were investigated by means of evoked potentials. Fifteen age-matched healthy subjects served as controls. The 8 patients had well-recognizable but simplified flash evoked potentials (FEPs) consisting of P1 and N2 waves followed by a single late positive (P2) deflection. Enlarged FEPs were found in 2 of the 8 patients. The somatosensory central conduction time was normal in 3 of 5 patients, and it resulted in upper normal limits or was moderately slowed in 2 patients. No enlarged somatosensory scalp potentials were recorded. Cortical somatosensory responses were characterized by an unrecognizable (4 patients) or delayed (2 patients) N33 wave. Brainstem auditory evoked responses, recorded in 6 patients, were normal. In CJD very important functional impairment of the sensory cortical areas is associated with absent or mild dysfunction of the subcortical sensory pathways.

Acoustic Stimulation

[Detection of respiratory allergies using the Phadiatop test in children 1 to 6 years of age].

Phadiatop, a new test for detecting hypersensitivity to airborne allergens, was used in 83 children aged 9 months to 6 years with recurrent respiratory manifestations, i.e. recurrent expiratory obstruction and/or recurrent respiratory infections. A good correlation was found between this test and both the prick tests (95%) and the specific IgE assays (91% for RASTS of classes greater than or equal to 1, and 95% for RASTS of classes greater than or equal to 2). However, the correlation was less strong with the total IgE level (68%). The overall correlation with the specialist's prediction based on history and physical evaluation was excellent (94%). In this study, Phadiatop was found to have a 90% sensitivity and a 98% specificity. Furthermore, this test costs 40% less than the often used strategy combining skin tests and determinations of total and specific IgE levels. In the age group studied, Phadiatop is most useful above the age of two, since in younger patients true respiratory allergies are fairly infrequent in recurrent ENT and lower respiratory tract infections, whereas infections are far more common.

Child

[The brain in the aged].

Under the very broad term of brain in the elderly, we cannot consider exhaustively all the anatomical, physiopathological and pathological aspect and, still less, the therapeutic possibilities in diseases of the anesthetist should know concerning the special characteristics of this aging organ. First are recalled the anatomical, macro and microscopic data of the senile brain. The metabolic characteristics are then considered. Investigations which may give the clinician information concerning the organic state and metabolic capacities of the brain of the elderly subject, e.g. cerebral blood flow, fundus oculi, E.E.G. brain arteriography, tacography or tomodensitometry by scanner, are consideres. But in practice, they are difficult to use and their data are only relatively reliable, i.e. clinical examination is of great imporatnce and the overall impression prevails. The therapeutic possibilities are limited and in these elderly subjects with cerebral metabolism in unstable equilibrium, one should be circumspect and careful in treatment.

Aged

[Effect of ablation of the motor cortex or the cerebellum on postural-kinetic coordination in the cat].

1. A cat, restrained in a hammock, stands with its feet on supporting trays each furnished with strain gauges to measure the isometric upthrust. Placing reactions are elicited by contact of the left or right forelimb with a moving tray. The placing movement is preceded and accompanied by a postural adjustment characterized by an increase of the upthrust exerted by the opposite forelimb. 2. After ablation of the motor cortex on one side, the placing movement of the contralateral forelimb is abolished for the first few days after the operation and thereafter is delayed. However, the postural adjustment of the ipsilateral forelimb persists, with the same range of latencies as before the operation. 3. After unilateral motor cortical ablation, the contralateral forelimb still takes part in the postural adjustment associated with the placing movement of the other forelimb. 4. In two cats which had 2 years earlier undergone a total cerebellectomy, the placing movement was lacking or appeared with a long delay, whereas a postural adjustment of the other forelimb could be observed, although reduced. 5. The results indicate that the nervous structures responsible for the movement and for the associated postural adjustment are separate but partially linked.

Animals

[Influence of inaccuracy of certain parameters on dose distribution in telecobalt therapy (author's transl)].

Progress in dosimetry and in radiobiology together with the evolution of radiation generators led to adopt very elaborated radiotherapy protocols. However, the therapist should have confidence in these protocols on condition that irradiation parameters are strictly respected. For obvious reasons, this is impossible despite the meticulous rules. In this, paper, we therefore intend to study the role of the angle of incidence on the actual distribution of doses; we also study the inaccuracy of certain parameters recorded during preparation for the therapy or shown during successive irradiation courses. In this paper we retain only errors which can be easily quantified. These are errors concerning the irradiation apparatus (source to skin distance, angle of the rays, field dimension) and those due to factors related to the patient treated: contour measurement, entrance point of rays and positional changes of the patient. The different errors can be associated in various ways for a given therapy protocol. For the same reason, an isodose of a given nominal value will have several curves. All these tracings are lined by two curves which we call "superior and inferior envelops": these border the "incertitude area". It can be said that at the end of the treatment, the given isodose lies in this area; it is however impossible to define its form or exact position. A few examples in the text illustrate these results and show the possible practical angles of incidence. If we assume that errors during successive irradiations are distributed at random, a certain compensation is noted and the "areas of incertitude" decrease. But if the errors are constantly on the same side, as is sometimes the case, the dose distribution can be very different from that predicted in the dosimetric protocol.

Breast Neoplasms

[Value of computerized axial tomography in cranio-cerebral injuries].

Since May 1975 was have been working in the field of C.A.T. and its application to study head injuries. We are presenting differents groups of patients studied by C.A.T. I. -- DATA OF C.A.T. IN THE CASES OF EMERGENCY AND IMMEDIATE POST-OPERATIVE FOLLOW-UP OF HEAD INJURIES A) EMERGENCY STATE As soon as the clinical state of an head injured patient was supposed to need an operation, C.A.T. was realized; so differents abnormal scanners may be observed: 1. epidural hematoma, 2. subdural hematoma, 3. intra-cerebral hematoma, 4. acute subdural hematoma or contusion. We must do some comments: -- The Emi-scanner is pre-eminent in showing the exact topography of the lesion : so, the flap is easier to realise. -- In most cases the Emi-scanner is easier to interpret than angiogram for example contusion and hematoma. We know the goods results in hematomas and the poors results in surgery of contusions. -- But the senior advantage of C.A.T. is to provide all the informations in the totality of skull content. Emi-scanner shows bilateral lesions, ipsilateral lesion. C.A.T. is pre-eminent in showing the presence of this two lesions, more accurately than senior methods of investigations, so C.A.T. permits emergency neurosurgical treatment. B) C.A.T. AND FOLLOW-UP Repeated studies at post-intervals can be accomplished without risk to the patient, thus making follow-up simpler and more effective to the neurosurgical attitude. C) POST-OPERATIVE CONTROL AND C.A.T. Post-operative complications are always hard to diagnosis. C.A.T. is painless, quick and safe, and easier to interpret than an angiogram. II -- SEQUELLAE STADE AND C.A.T. In this field certains advantages of C.A.T. are immediatly apparents. In most cases the C.A.T. is the best screening method. Patients carried out are: -- psychiatric troubles, -- post-traumatic epilepsy. The results are not reliable. There is no anatomical-clinical relation in most cases. Differents pictures are observed: -- asymetrical ventricle enlargment, -- global ventricule enlargment, -- partial cerebral atrophy. III -- DISCUSSION 1. We are at the beginning of our study. 2. This not always possible to obtain a C.A.T. in emergency for a head injury, especialy at night. 3. Patients investigated following head trauma are among the most difficult to study with C.A.T. These invididuals send to be restless and uncooperative. Numerous artefacts produced by patient motion may lead to erroneous negative or positive diagnosis, so general anesthesia is often helpful. It is hoped that as a more rapid scanners become available this problem will be obviated. The C.A.T. alone is not capable, to provide all the necessary date concerning head injury. The C.A.T. is, however, re-adjusting our total investigation (E.E.G., angiograms) philosophy and practice rather than replacing the standard neuroradiological technique, except, may be, with epidural hematoma.

Brain Injuries

[Diagnostic criteria of depressive pseudodementia].

Ten patients fulfilling the DSM III (A, B, C, D) criteria for both dementia and major depression and presenting the diagnostic dilemma of depressive pseudodementia were included in a prospective study in search of indices for the differential diagnosis of depressive pseudodementia (DPSD) and organic dementia (OD). Patients were assessed with the Hamilton Depression Rating Scale (HDRS), the Blessed Dementia Rating Scale (BDRS), the Wells's criteria, the Mini Mental State (MMS), computerized tomography (CT scan) of the brain, the dexamethasone suppression test (DST), total plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) and sleep electroencephalograms (EEG). Patients suffering from DPSD were defined as showing an improvement higher than 50% in both the HDRS et BDRS scores following adequate antidepressant treatment. Wells's criteria, MMS scores, CT scan and DST do not contribute to the separation of DPSD (n = 6) and OD (n = 4). On the contrary, plasma MHPG levels higher than 35 ng/ml and EEG measures of sleep structure and REM sleep significantly differentiate the two groups.

Aged