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Biomedical subjects

J M Orgogozo

Publications and source records attributed to J M Orgogozo.

At least 109 records · Page 6Linked to original sources
PubMed1978

Cerebral blood flow in migraine and cluster headache. Compartmental analysis and reactivity to anaesthetic depression.

CBF was studied in 15 cases of vascular headache by the 135Xe intra-arterial injection method. The mean CBF was found to be increased during the headache phase of the migraine attacks in half the cases, mainly due to an increase in the rapid component (CBFg). After the attack there could be an increase or a decrease of the slow component (CBFw). Reactivity to anaesthetic depression was studied in 8 migraine cases and on the whole it was found not to be much altered in most cases. Finally, no modifications of CBF were found in any of 3 cases of cluster headache who were studied during attacks of severe pain.

Alfaxalone Alfadolone Mixture↗
PubMed1977

Clinical consequences of corticectomies involving the supplementary motor area in man.

Three patients with well-mapped, circumscribed ablations of the medial part of the frontal lobe are reported. A specific clinical evolution in 3 stages was observed: (1) post-operatively there was global akinesia, more prominent contralaterally, with an arrest of speech; (2) recovery occurred suddenly but even then there was severe reduction of spontaneous motor activity contralaterally, an emotional type facial palsy and a reduction of spontaneous speech; (3) long after the operation the only sequela was disturbance of the alternating movements of the hands. The anatomical basis of these disorders appears to be a lesion of the supplementary motor area (SMA). Three main points have been discussed, namely: (1) the nature of the motor disorder which may be a disturbance of the function of the SMA in initiating and sustaining spontaneous and automatic motor activity; (2) the nature of the arrest of speech which appears not to be aphasic; the studies reported in the present paper do not support a left cerebral dominance for the SMA as suggested by previous studies; (3) the method of clinical examination appears to be important in distinguishing between spontaneous and voluntary motor and speech performance. Differences in method may account for differences between our findings and those reported in previous studies.

Adolescent↗
PubMed1976

[Gerstmann's syndrome (critical review of the literature)].

Serious doubts have been casted upon the validity of the Gerstmann's syndrome since the paper of Benton in 1961. On the other hand, the results of several recent works suggest that it could not be a mere artifact. The analysis of this results, and mostly the theoretical works of Luria on the physiology of higher cortical functions, make it possible to imagine a functional unity behind the heterogenous signs of this syndrom, and the other manifestations of left parieto-occipital lesions. The data collected in the litterature are discussed, with special reference to the theoretical implications of Gerstmann's syndrome.

Agnosia↗
PubMed1976

[Effects of Alfatesine (ct 1341) on cerebral blood flow and metabolism in man. Global and regional changes].

The effects of Alfatesine on local cerebral blood flow and on cerebral oxygen consumption were studied in 5 normal subjects and in 6 patients suffering from diffuse vascular repercussion of cerebral distress. There is a 75 p. 100 fall in cerebral blood flow in the gray substance and a parallel fall in oxygen consumption. At rest, the caracteristic anaesthetic action modifies the caracteristical distribution of blood flows in the cortex. A relative hyperemia appears in the area of the central sulcus. Those focal changes could not be found in the group of pathogical patients.

Adult↗
PubMed1976

[Facial paralysis with inverse autonomic-voluntary dissociation from a frontal lesion. Cortical origin. Relation to supplementary motor area].

As a result of 6 cases of frontal tumour presenting central facial paralysis with inverse dissociation this symptom was investigated in patients subjected to cortical excisions for intractable epielpsy. A study of 8 cases of frontal cortical excision, 6 of them affecting the internal and posterior portion, and two the prefrontal region, has provided evidence of a link between inverse automatic-voluntary dissociation facial paralysis and lesions affecting the Penfield supplementary motor area. In such cases, facial palsy is usually associated with motor disorders in the limbs, the most characteristic of which is unilateral motor under-utilisation. The possibility of inverse dissociated facial paralysis occurring as a result of a rostral premotor lesion cannot be ruled out in our present state of knowledge.

Aged↗
PubMedDate not supplied

[Sneddon's syndrome: review of the literature apropos of a case].

The authors report the case of a young woman with Sneddon's syndrome and expose literature review. This rare entity is characterized by idiopathic livedo reticularis, ischemic stroke, and occasionally, mild arterial hypertension. Skin biopsy shows endarteritis obliterans of deep dermal arteries. The pathogenesis of this disorder is still unknown and the treatment is not clearly established.

Adult↗
PubMedDate not supplied

[Changes in regional blood flow of the brain during althesin anaesthesia (author's transl)].

The effect of Althesin on local blood flow in the brain was studied using intra-carotid Xenon 133 in 18 subjects: 6 apparently normal, 6 with diffuse cerebro-vascular pathology, and 6 cases of ischaemic cerebral accidents identified by scintigraphy, tomodensitometry and angiography. Blood flow decreased under Althesin in the first 2 groups, although to a lesser extent in the second group, with a concomitant decrease in oxygen metabolism. In the third group a "paradoxical" increase in blood flow was observed in infarcts, and a decrease proportional to the rest of the brain in limited ischaemia which had subsequently regressed. The "Althesin test" proposed by Rasmussen (1975) thus reveals the existence of a disconnection between blood flow and metabolism within cerebral infarcts, and provides a possible means of differentiating the latter from reversible ischaemias.

Alfaxalone Alfadolone Mixture↗
PubMedDate not supplied

[Cerebral blood flow and metabolism under "diazanalgesia" (author's transl)].

"Diazanalgesia" employs the combination diazepam + fentanyl. Its effects were studied on regional cerebral blood flow and oxygen metabolism in 8 normal subjects, who were examined angiographically. During diazanalgesia, cortical blood flow falls by 56 p. 100. The mean hemispheric flow calculated over 10 min falls by 34 p. 100. Cerebral O2 consumption (VcO2) falls by 34 p. 100. However, large individual variations are found which suggests that the fall in blood flow is not due solely to the decrease in O2 metabolism. The decreases in flow are not proportional to the amount fentanyl, and there is no direct relation between falls in VcO2 and amount of fentanyl. Cerebral vaso-reactivity to CO2 persists but is reduced under diazanalgesia compared with the waking state.

Anesthesia↗
PubMedDate not supplied

Chronic inflammatory demyelinating polyneuropathy: immunopathological and ultrastructural study of peripheral nerve biopsy in 42 cases.

The authors recently reexamined the peripheral nerve biopsies from 42 patients with chronic inflammatory demyelinating polyneuropathy (CIDP). There were 27 males and 15 females, aged from 9 to 84 years, and 13 had relapses. No patient had vasculitis, monoclonal gammopathy, tumor, diabetes mellitus, Lyme disease, familial neuropathy, HIV, or any other immune deficiency. In the endoneurium, perivascular inflammatory cell infiltrates were present in only one case, but scattered histiocytes marked by KP1 on paraffin-embedded fragments were present in every case and there were no T-lymphocytes. At ultrastructural examination macrophage-associated demyelination was observed in 17 cases, of which 6 had relapses separated by intervals of several months or years. Axonal lesions without associated primary demyelination were observed in 4 cases and 3 of these had relapses. Thirty-two patients had mixed lesions of demyelination and axonal involvement. This study confirms other recent data indicating that in all cases of CIDP, macrophages are present in the endoneurium. Macrophage-associated demyelination is the characteristic feature of demyelinating forms. On the other hand, isolated primary axonal forms, which have been known since 1989, are relatively frequent and prone to relapses.

Adolescent↗
PubMedDate not supplied

Vascular dementia: European perspectives.

Vascular dementia (VaD) is the second most frequent cause of organic acquired cognitive dysfunction in the Western world and is probably the first cause in some Asian countries. Therefore, it represents an important target for drug trials in dementia. This report puts in perspective methodological issues in VaD trials, as opposed to Alzheimer disease (AD), and reproduces in extenso the European Medicinal Products Evaluation Agency (EMEA) guidelines for trials of symptomatic treatments of dementia, particularly in AD. There are no explicit guidelines for VaD trials, but many of the recommendations for AD are already applicable to VaD for drugs aiming at alleviating symptoms of dementia. However, VaD can be viewed as being one of the many possible consequences of cerebrovascular diseases, so that there is more to expect from secondary prevention strategies for VaD than for AD (in which both the etiology and the pathophysiological mechanisms are largely unknown). So it seems logical to put more emphasis on the stabilization of the symptoms of VaD, by preventing progression or recurrence insofar as the vascular risk factors for VaD can often be identified and controlled, than in attempting to improve the existing clinical manifestations of established vascular brain damage. Even if purely symptomatic drugs are developed to improve the symptoms of VaD, they will have to be studied in the context of a tight control of existing vascular risk factors. For secondary prevention, trials of at least 1 year seem advisable.

Alzheimer Disease↗
PubMedDate not supplied

Adult dementia due to intraneuronal accumulation of ceroidlipofuscinosis (Kufs' disease): ultrastructural study of two cases.

Two cases, a man and a woman, presented the initial signs of progressive dementia at about age 40 years. Aphasia, facial dyskinesias, and ataxia were associated with behavioral disturbances in the first patient. Aphasia, oculomotor disturbances, and ataxia coexisted with dementia in the second patient. In both cases, ultrastructural examination of a cerebral biopsy showed intraneuronal granular osmiophilic deposits mixed with lamellar structures and fingerprint profiles. Such deposits are characteristic of Kufs' disease. In the first patient, brain autopsy was performed 3 years after cerebral biopsy. Our two cases presenting dementia with motor disturbances correspond to type B Kufs' disease.

Adult↗
PubMedDate not supplied

Outcome measures for the study of activities of daily living in vascular dementia.

Decline in functional abilities is a major component of the dementia syndrome. The definition of dementia in the International Classification of Diseases (10th rev.) requires a cognitive impairment sufficient to impair personal activities of daily living (ADL). The Diagnostic and Statistical Manual of Mental Disorders (4th ed.) also requires cognitive deficits sufficiently severe to cause impairment in occupational or social functioning and must represent a decline from a higher level of functioning. However, the term disability is more appropriate than impairment to describe a loss in activities, as opposed to a loss of elementary functions, and is consistent with World Health Organization definitions of impairment, disability, and handicap. There is no doubt that ADL outcomes are required in therapeutic drug studies on vascular dementia, and there is a good rationale and some evidence for the use of ADL scales developed for therapeutic research in Alzheimer disease, favoring scales devoid of items sensitive to physical disabilities. Similarly, ADL-related clinical milestones could be used for longer-term studies aiming predominantly at slowing progression of disease in both early and later stages of dementia. Slower decline in ADL and delay in reaching ADL-related clinical milestones should be considered as valid outcomes by regulatory bodies in the process of dementia drug approval.

Activities of Daily Living↗
PubMedDate not supplied

[Memory, aging and risk factors. Lessons from clinical trials and epidemiologic studies].

Memory troubles associated with age justify treatment and medical attention because they lead to real disabilities in daily living even without dementia, and also because they are early predictors of dementia in Alzheimer's Disease (AD). However, the treatment of these troubles remains uncertain, badly codified and extremely variable depending on the health systems concerned. Moreover, the dominant idea of many physicians, in the general population and even in health authorities, is that it is normal to have memory troubles in the elderly. This fact explains the common attitude of therapeutic nihilism. However, recent progress in the treatment of AD demonstrates that this disease should not be considered as an irremediable phenomenon. Moreover, on the basis of the follow up of an elderly cohort, it is possible to determine subjects at high risk of dementia where preventive interventions could be undertaken.

Aging↗