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Biomedical subjects

J M Orgogozo

Publications and source records attributed to J M Orgogozo.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Development of a neurological score for the clinical evaluation of sylvian infarctions].

Among the main methodological problems raised by clinical trials in cerebral vascular accidents, one of the most serious is the lack of well-established and widely accepted criteria to evaluate the course of the disease. On the basis of published scores and of several trials carried on by us in three different centres during the last few years, we have developed a neurological score devised to reflect, as accurately as possible, deficits due to infarctions in the Sylvian territory, yet rapid and simple enough to provide an objective and reproducible rating. We report here the results of a prospective study concerning the inter-rater variations of the score from one centre to the other (inter-centre study) and within each centre (intra-centre study). These results have led us to withdraw three items with insufficient response rate and poor agreement, viz, "mental confusion", "visual field" and "sensory disorders". With the remaining 10 items the mean agreement between individual items varied from 85% to 90% and the global score agreement exceeded 90%. A study comparing our score with the Barthel index showed close correlation up to the autonomy threshold (Barthel index = 60) and divergent results beyond that point. The good agreement observed between inter-rater variations suggests that the score is reliable but does not inform on its sensitivity. In view of their relative independence, the neurological and the functional score should be regarded as complementary and should be used together as criteria of clinical assessment.

Aged↗
PubMed1983

Nuclear inclusions in oculopharyngeal dystrophy. An ultrastructural study of six cases.

Nuclear inclusions in striated muscle from patients with oculopharyngeal dystrophy have been detected recently. We carried out ultrastructural examinations of biopsy specimens on 5 patients with oculopharyngeal dystrophy and we also reexamined a former case. In these 6 cases we found filamentous inclusions in a few nuclei. These inclusions seem to be characteristic of this disease as they have never been seen elsewhere.

Aged↗
PubMed1982

[Analysis and quantitative study of language disorders in lesions of the left thalamus: thalamic aphasia].

We have studied 5 patients having a language disturbance associated with a left thalamic lesion documented by computerized tomography. These patients were submitted to a french adaptation of the Boston Diagnostic Aphasia Examination, originally designed by Goodglass and Kaplan. A quantitative analysis of these language disturbances has shown that they are characterized by reduction of fluency, resembling that of dynamic aphasia, with impaired volume, tone and articulation of speech. There is also a difficulty at finding word categories. Perseverations are frequent while paraphasias are scarce, being then mostly incoherences. Comprehension is impaired, but only at a complex level. Reading and writing are inconsistently affected. This symptom-complex is coherent enough from case to case to be considered as a recognizable type of aphasia, and specially since it is invariably associated with a left thalamic lesion.

Adult↗
PubMed1981

[Cerebral emboli due to subclinical heart disease. Value of thorough investigations (author's transl)].

In a series of 250 cases of cerebral vascular accident, the authors have selected 12 patients whose embolus appeared to have originated in the heart, although this could not be confirmed by clinical examination, ECG, Holter system monitoring and echocardiographic studies. Angiocardiography, complemented or not by His bundle exploration and/or coronary arteriography, revealed the presence of a heart disease likely to produce emboli in 11 cases, and in 8 cases, this was prolapsed mitral valve. These 11 cases represent 4.5% of the whole series and 22% of cases with emboli of suspected cardiac origin. Thorough cardiological studies, therefore, seem to be justified in young adults presenting with stroke. The high incidence of prolapsed mitral valve is in keeping with recently published data.

Adolescent↗
PubMed1981

[Contribution of continuous emission Doppler examination to the assessment of internal carotid artery permeability (author's transl)].

Results of continuous emission directional Doppler examinations of 325 internal carotid arteries in 210 patients were compared with angiographic data. The sensitivity and specificity of the method were considered, and more particularly the predictive value of the Doppler examination for the diagnosis of obstruction and for assessing the permeability of the internal carotid arteries. The present work confirms that the Doppler examination is not valid for the diagnosis of non-obstructive emboligenic lesions of the artery, but is of definite value for determining the presence or absence of obstruction in nearly 100 p. cent of the cases. This excellent reliability suggests that Doppler examination should take place in planned investigations allowing to perform carotid angiography with less risks and a maximum therapeutic efficiency.

Arterial Occlusive Diseases↗
PubMed1980

[Multiple affections of the cranial nerves as a pathognomonic sign of periarteritis nodosa. Relationship with Cogna's syndrome (author's transl)].

A 43-year-old woman was found to have multiple cranial neuritis affections, present as an isolated disorder over a long period, and characterized by bilateral deafness and associated lesions of the VII and V cranial nerves. On investigation, visual disturbances were discovered which were of a transitory nature and made up a total clinical picture suggesting Cogan's syndrome. Neuropathological examination revealed the presence of typical periarteritis nodosa lesions in the cranial nerves. The authors suggest, therefore, that certain cases described as Cogan's syndrome are in fact particular forms of periarteritis nodosa.

Adult↗
PubMed1979

Activation of the supplementary motor area during voluntary movement in man suggests it works as a supramotor area.

Measurements of cerebral blood flow in man revealed that complex voluntary movements are associated with a blood flow increase in the supplementary motor area of the brain. This increase is additional to and similar in magnitude to the Rolandic sensorimotor area activation that occurs during all kinds of movement. When subjects counted silently there was no activation of any focal cortical area in the brain; when they counted aloud there was a marked increase in activity in the supplementary motor area. These results are consistent with the hypothesis that the supplementary motor area plays a major role in the initiation and control of at least some kinds of voluntary movement in man and is, therefore, a motor center of a higher order than the primary Rolandic areas.

Cerebrovascular Circulation↗
PubMed1979

[Activation of supplementary motor areas during voluntary movements in man studied by measurement of focal cerebral blood flow (author's transl)].

Focal activation in the cerebral cortex during different motility and language tests in 52 patients examined by arteriography was studied by measuring focal cerebral blood flow (fCBF) by means of an apparatus of high resolution. A sterotactic or functional approach demonstrated that the upper premotor activation previously noted in certain types of movement, corresponds to supplementary motor area (SMA). A retrospective study of 157 maps of fCBF recorded during motor or verbal behaviour, compared to 90 recordings in subjects at rest, showed that SMA is involved in most voluntary movements, either verbal or non-verbal. An analysis of the results suggests that SMA acts during the establishment of new motor programs, and in the control of pre-established automatic activities, in response to internal and external stimuli.

Brain Mapping↗
PubMed1979

[Goodglass and Kaplan's test in patients with language difficulties due to thalamic lesions (author's transl)].

Two out of three patients with language difficulties from ischemic, tumoral, or hemorrhagic lesions of the left thalamus were studied by means of Goodglass and Kaplan's test. Results were compared to those obtained by using the same test in a patient with a hemorrhagic lesion in the posterior ramus of the left internal capsule, but no thalamic lesion. They demonstrate the autonomy of the clinical picture of "thalamic aphasia" as described in several cases reported in the published literature. The suggestion is made that the term, aphasia, can be applied to these cases as long as care is taken when defining them.

Aged↗
PubMed1978

An unrecognized syndrome of benign focal epileptic seizures in teenagers?

145 out of 1570 patients whose first fit occurred between the ages of 10 and 20 years and began as a focal seizure had no further fits for at least 5 years. This benign (non-recurring) form of focal seizures appears to be a distinct clinical entity. Its features, based on an analysis of the case-notes of 83 of the 145 cases, include: appearance of fit between the ages of 12--18 years in 84% cases; a higher incidence among males; an absence of family history of fits and of other factors predisposing to fits; normal electroencephalogram (E.E.G.) or non-specific, non-focal E.E.G. changes; and progression to generalised fits in 80.3%. The diagnosis can be suspected at presentation but confirmed only after a recurrence-free period without treatment.

Adolescent↗
PubMed1978

Effects of a diazepam-fentanyl mixture on cerebral blood flow and oxygen consumption in man.

The effects of a mixture of diazepam and fentanyl on cerebral blood flow (c.b.f.) and cerebral metabolism of oxygen (CMRo2) were studied in eight normal subjects and 13 patients with organic brain disease. The coupling of flow and metabolism and the carbon dioxide responsiveness of the c.b.f. were studied also. In the normal subjects the injection of the mixture resulted in a significant decrease in c.b.f. (34%), and a similar decrease in CMRo2 (34.5%). The vasoreactivity of the brain to carbon dioxide was maintained. C.b.f. decreased in all patients with intracranial pathology.

Brain↗
PubMed1978

[Cortical localizations seen by the dynamic gamma-camera : a new approach in neuropsychology].

We present here the results obtained in the study of normal brain functions, in normal awake man performing normal voluntary tasks, by mean of new approach developed in our laboratory. Its principle lies on the fact that focal changes in cortical blood flow during brain function are due to the coupling between local function aand metabolism, which has been demonstrated in man during hand movement by Olesen (1971) and by Raichle and associates (1976). So far as the changes are focal (uni- or multifocal) they can be assessed by external measurement of focal cerebral blood flow (rCBF) with the 133Xenon clearance technique, provided that the detection apparatus used yields a proper spatial and temporal resolution. A temporal resolution of 45 sec. is made possible by the initial slope calculation of Olesen and coll. (1971), using intracarotid injection of isotope. The spatial resolution has been improved by the design of a special system using 254 scintillation detectors with individual collimation, each 8 mm ø, connected to individual ratemeters (Sveinsdottir et al., 1975). This allows the simultaneous processing of the 254 clearance curves by a small on-line Varian computer. The results are displayed as functional colour pictures of the brain on a T.B. screen, less than 3 min. after isotope injection. The studies have been performed to date in more than 200 patients, usually in connection with carotid angiography. 84 subjects could be classified as "normals+ because of lack of detectable brain lesion and of permanent symptoms, and they constitute the reference material for exploring normal brain functions. In each case one or two "rest" studies have been made for comparison with the test situations. The following observations were made: Resting pattern: with the patients lying in a quiet dark room with minimal sensory input the normal pattern is much the same in both hemispheres and it is characterized by higher flows in the anterior upper parts of the frontal lobes (fig. 1 a). The percent variation in a given area during two different rest studies is about 5 percent (fig. 1 b). Primary sensory inputs. Auditory and visual inputs activate the corresponding parts of temporal and occipital regions (fig. 2 and 3). Simple cutaneous stimulation such as touch or vibrations do not change the rest pattern. Moderate pain gives a global increase of CBF, pre-dominantly in the frontal regions (Ingvar, 1976). Vestibular stimulation with cold or warm water in the ear gives an increase of rCBF in the parietal regions. Simple movements. Movements of mouth, eyes, hand or foot clearly activate the corresponding parts of the central region, with an increase of rCBF up to 50--100% (Sveinsdottir et al., 1975). When the movement is repetitive there is in all cases an additional clearcut increase in the upper premotor region, probably including the supplementary motor area. This last region is activated alone when the subject tries to imagine a movement without actually moving (fig. 5 a, b, c). Sensory discrimination...

Acoustic Stimulation↗