PubMed Health⌕ Search

Biomedical subjects

J M Leger

Publications and source records attributed to J M Leger.

At least 37 records · Page 2Linked to original sources
PubMed1993

Hepatitis C virus and essential mixed cryoglobulinaemia.

Clinical and laboratory evidence of liver involvement are frequently found in essential mixed cryoglobulinaemia (EMC). We looked for evidence of hepatitis C virus (HCV) infection in 37 patients with EMC. Anti-HCV antibodies (Ab) were found in 16/37 (43%) patients with EMC using the ELISA 2 test and the RIBA 2 test. The 16 anti-HCV-Ab positive patients (group 1) were compared to the 21 anti-HCV-Ab negative patients (group 2). Group 1 patients had more frequent cutaneous involvement (P = 0.02), clinical, biological and histologic hepatic involvement (P < 0.01), higher serum cryoglobulin and lower CH50 levels (P < 0.001). Serum hepatitis B virus markers were infrequent in both groups and no patient from either group had detectable serum HBV DNA. These preliminary results suggest that HCV may be another cause of mixed cryoglobulinaemia.

Adult↗
PubMed1992

Characterization of cryoglobulins by immunoblotting.

We adapted an immunoblotting technique for the immunochemical characterization of cryoglobulins. We first compared the results from 157 samples with results obtained by immunofixation and immunoelectrophoresis and then with clinical observations in 125 cases. Full identification was possible in 98% of the cases by immunoblotting, in 54% by immunofixation, and in 28% by immunoelectrophoresis. Novel microheterogeneity aspects were observed by immunoblotting and immunofixation in 13% and 6% of the cases studied, respectively. Our results confirm the frequency of autoimmune and infectious diseases associated with mixed cryoglobulinemias, whereas a lymphoproliferative syndrome was observed only in cases of cryoglobulinemia with a monoclonal constituent or a microheterogeneity aspect, which was not always revealed by immunofixation or immunoelectrophoresis. The pathophysiological importance and classification of microheterogeneity aspects is not clear. These observations justify using a sensitive and specific method for identifying cryoglobulins, even when present at low concentrations, and call for long-term studies of these patients.

Autoimmune Diseases↗
PubMed1991

[Clinical and electrophysiologic study of the peripheral nerve in 28 cases of mitochondrial disease].

Twenty-eight patients with mitochondrial disease were systematically investigated on clinical and electrophysiological grounds for peripheral neuropathy (PN): 25 had predominant ophthalmoplegia (including 4 with Kearns-Sayre syndrome) and 3 had predominant central nervous system involvement. There were 11 men and 17 women, mean age 43 years. Nine of the 28 patients had signs of sensory polyneuropathy involving mainly the lower limbs. These 9 patients and another asymptomatic patient had electrophysiological abnormalities: in the lower limbs, sensory potentials were absent or decreased in amplitude in all cases. In peroneal nerves, motor conduction nerve velocities were decreased in 4/10 cases. These data were consistent with an axonopathy. No correlation was found between the presence of PN and the clinical features of the mitochondrial diseases or with the respiratory chain defect (studied in 14 cases).

Action Potentials↗
PubMed1991

[Current status of late onset delusion in the elderly].

In the field of chronic delusions, authors make synthesis of the delusion with late emergence in the elderly. This delusion is at once replaced in the history of its nosographic position, then defined in its presentation. The question of its refer with depression and its place in the limits of dementia are approached. Authors outline the importance of biological, psychological and sociological factors in induction of this particular delusion to clarify the means for its management.

Aged↗
PubMed1990

2-Amino-2-oxazolines, III: Synthesis, structure, and preliminary pharmacological evaluation of cycloaddition compounds with unsaturated carboxylic esters.

The reaction of 5-substituted 2-amino-2-oxazolines with unsaturated carboxylic esters yielded 2,3,5,6-tetrahydro- and 2,3-dihydro-7H-oxazolo[3,2-a]pyrimidin-7-ones. The structure of these compounds was established by IR- and NMR-spectra and by X-ray crystallography. They were tested for anti-arrhythmic and hypocholesterolemic activities.

Animals↗
PubMed1990

Three cases of spontaneous extracranial vertebral artery dissection.

We describe three cases of extracranial vertebral artery dissection that are unusual in both their modes of presentation and their associations with other pathologic conditions. The first patient had Marfan's syndrome and migraine; his dissection was asymptomatic and was diagnosed by chance at the time of repeat angiography following a previous internal carotid artery dissection. The second patient had systemic lupus erythematosus and presented with a subarachnoid hemorrhage attributed to an intracranial vertebral artery dissection by the demonstration of an extracranial dissection. The third patient had a minor basilar artery stroke in which dissection had occurred beside a congenital hemivertebra deformity.

Adult↗
PubMed1990

Polyneuropathy associated with IgM monoclonal gammopathy: a review. Clinical, electrophysiological and pathological features.

Polyneuropathy associated with IgM monoclonal gammopathy has been documented first for Waldenstrom's disease, then for IgM monoclonal gammopathy of undetermined significance (MGUS). The usual clinical aspect is a chronic symmetric predominantly sensory polyneuropathy, occurring insidiously in elderly patients. Tremor and ataxia are characteristic findings, but their mechanism is unclear. The electrophysiological and pathological features are consistent with a primary demyelination with secondary axonal loss. Monoclonal IgM level is frequently low in MGUS cases and the light chain is Kappa in most of the cases. The IgM M-protein is shown to bind to myelin-associated-glycoprotein (MAG) and/or other antigens of the peripheral nerve myelin in most of the cases. The course of the polyneuropathy is usually slowly progressive. Some other clinical aspects of peripheral neuropathy associated to IgM monoclonal gammopathy have been reported. Recently the attention has been directed towards motor neuron diseases (MND) associated to IgM MGUS, but the significance of this association remains unclear.

Evoked Potentials, Somatosensory↗
PubMed1990

[Psychologic and human implications of intensive care and rehabilitation of severe head injuries patients].

Consequences which are involved in intensive care and rehabilitation of severely head injuries patients seem to be numerous, variable in different times and different situations. However, the authors, for more than ten years, have taken care of severely injured patients from coma to socio-professional reinsertion, and so, it allowed them to concentrate their interest to that main point: it is necessary to make a place to the patient as a desiring patient, and not only as brain injured patient who needs medical care, medical knowledge and who needs be repaired. So the Psycho-Rehabilitation Unit works this way, to allow a new intra and intersubjective homeostasis, in spite of injury and sequellae.

Amnesia↗
PubMed1989

Peripheral neuropathies during treatment with almitrine: report of 46 cases.

Almitrine bismesylate is thought to cause sensory peripheral neuropathy. Forty-six patients are reported who received almitrine bismesylate alone for chronic respiratory failure or in combination with raubasine for various cerebrovascular diseases. Polyneuropathy appeared between 9 and 25 months after the onset of treatment. Sensory signs and symptoms were confined to the distal parts of the lower limbs and involved large and small fibres. Histological and electrophysiological findings indicated axonal degeneration. Respiratory failure could have caused the polyneuropathy in some cases but many had no chest disease. Patients began to improve between 3 and 6 months after withdrawal of the drug. Recovery was usually complete after 12 months.

Aged↗
PubMed1989

The spectrum of polyneuropathies in patients infected with HIV.

Twenty five patients with peripheral neuropathy at different stages of human immunodeficiency virus (HIV) infection are reported. Cerebrospinal fluid (CSF) findings were available in 17 cases, electrophysiology in all and a neuromuscular biopsy in 11. Of six otherwise asymptomatic HIV+ patients, five had chronic inflammatory demyelinating polyneuropathy (CIDP) and one acute inflammatory demyelinating polyneuropathy (AIDP). CSF showed pleocytosis in all cases. Infiltration of the endoneurium and/or the epineurium by mononuclear cells was seen in biopsies from three cases. These six patients recovered either spontaneously, or with corticosteroids or plasmaphereses. Of five patients with AIDS related complex (ARC), three had distal predominantly sensory peripheral neuropathy (DSPN), one CIDP and one mixed neuropathy. Of 14 patients with AIDS, one had mononeuropathy multiplex and 13 painful DSPN. Electrophysiological studies were consistent with an axonopathy. Nerve biopsies in six cases showed axonal changes but surprisingly associated with marked segmental demyelination in two cases. Cell infiltration was present in nerve samples in two cases. Five patients died within six months after the onset of the neuropathy.

AIDS-Related Complex↗
PubMed1988

[Sleep abnormalities and evoked potentials (VEP-BAER-SEP) in progressive supranuclear palsy].

Few physiological studies have been performed in PSP. We studied: sleep abnormalities in 36 h polygraphic recordings; changes of PEV after pattern-reversal stimulation, of BAER and of short latency SEP after stimulation of the median nerve. The population was for the 1st group: 18 patients with full typical symptomatology, for the 2nd group: 7 patients with likely diagnose of PSP and for the 3rd group: 10 normal subjects as control sample. All patients of the 1st group had sleep abnormalities: decrease of total sleep time; decrease of the percentage of REM sleep; morphological abnormalities (specially horizontal ocular square wave jerks). Detail is given of the repartition of such abnormalities in the two groups of patients. There is no correlation between sleep abnormalities and the natural history of the disease. The PEV and BAER, abnormalities were present in 50% of the cases. The PES were always normal. The help that can be provided by electrophysiological studies in the diagnose of PSP is discussed (particularly in group 2).

Aged↗
PubMed1988

Postradiation segmental myoclonus selectively inhibited by REM sleep (sleep-wake myoclonus).

A 46-year-old male patient was irradiated following left orchiectomy for seminoma. Three months after radiation, segmental myoclonus appeared involving all skeletal muscle groups up to the level of D10, the area of radiation. Urodynamic testing showed the presence of segmental myoclonus in the urethral sphincter. An around-the-clock 'continuous segmental myoclonus' during sleep and wakefulness with a frequency of 1 c/s and an amplitude of 400 microV selectively inhibited by REM sleep was not found in the literature. This continuous segmental myoclonus caused by a radiation myelopathy at D10-D11 was followed up for 2 years. It was partially controlled by carbamazepine.

Carbamazepine↗
PubMed1988

[Study of antiglycolipid antibodies in IgM monoclonal dysglobulinemias associated with peripheral neuropathy].

An immunological mechanism may be responsible for the peripheral neuropathies related to IgM monoclonal gammopathies. Myelin-associated glycoprotein (MAG) has been found to be one the main target antigens for these paraproteinemias. Glycosphingolipids of peripheral nerve have been also found to be targets for these antibodies, especially a sulfated glycosphingolipid containing glucuronic acid (GLSG) specific for peripheral nerve. Crossed reactivity has been found between MAG and GLSG. Anti-glycolipid antibodies were determined in 14 patients with IgM gammopathy and polyneuropathy. Glycosphingolipids from human peripheral nerve were purified and chromatographed by thin-layer chromatography for immunodetection of the antibodies. The 12 patients who had GLSG antibody activity had a clinical status identical to the reported cases of dysglobulinemic neuropathies with anti-MAG antibodies.

Adult↗