Trousseau's syndrome with nonbacterial thrombotic endocarditis: pathogenic role of antiphospholipid syndrome.
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Biomedical subjects
Publications and source records attributed to M Bérard.
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Micellar electrokinetic capillary chromatography with sodium dodecylsulfate as anionic surfactant was used to separate simultaneously fifteen non-steroidal anti-inflammatory drugs. UV detection was performed at 254 nm. The electroosmotic flow was carefully adjusted for optimal separation. Resolution of the drugs was obtained using a buffer containing 40 mmol l-1 NaH2PO4, 0.104 mol l-1 sodium dodecylsulfate and 3% (v/v) methanol, adjusted to pH 8 with sodium hydroxide. Lack of interference was checked with a number of drugs and metabolites. Between-day coefficients of variation ranged between 2 to 10%.
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A major impediment to the use of the objective structured clinical examination (OSCE) is that it is a labor-intensive and costly form of assessment. The cost of an OSCE is highly dependent on the particular model used, the extent to which hidden costs are reported, and the purpose of the examination. The authors detail hypothetical costs of running a four-hour OSCE for 120 medical students at one medical school. Costs are reported for four phases of this process: development, production, administration, and post-examination reporting and analysis. Costs are reported at two ends of the spectrum: the high end, where it is assumed that little is paid for by the institution and that faculty receive honoraria for work put into the examination; and the low end, where it is assumed that the sponsoring institution defrays basic costs and that faculty do not receive honoraria for their participation. The total costs reported for a first-time examination were $104,400 and $59,460 (Canadian dollars) at the high and low ends, respectively. These translate to per-student costs of $870 and $496. The cost of running an OSCE is high. However, the OSCE is uniquely capable of assessing many fundamental clinical skills that are presently not being assessed in a rigorous way in most medical schools.
A soluble form of thrombomodulin (TM), an anticoagulant proteoglycan of the endothelial cell membrane, exists in plasma. We recently developed an ELISA assay to measure it. Plasma TM level depends both on endothelium integrity and on the clearance of the molecule. It increases with endothelium damage as seen in different pathological situations.
Serum was examined for a cytotoxic effect on cultured human fibroblasts, using 8 normal controls and 4 patients. Three of the patients had secondary lipidoses associated with monoclonal gammapathies of IgA kappa, IgG kappa and IgG lambda types. The fourth had systemic lupus erythematosus (SLE) with hyperlipidemia. Only serum containing the monoclonal IgG lambda was found to be cytotoxic. This circulating IgG lambda was strongly bound to HDL and behaved like an antilipoprotein antibody. The circulating immune complexes may be the serum factor responsible for the cytotoxicity and the cutaneous plane xanthomas, thus giving another example of 'antibody-dependent' cellular cytotoxicity previously described for endothelial cells in other diseases.
In Golden Hamster the Greene malignant lymphoma is a subcutaneous and homotransplantable tumor whose development is associated with a constant hypertriglyceridemia and a large-decreased plasma post-heparin lipase activity. The tumoral cell line is well maintained on a human fibroblast monolayer culture and is demonstrated to secrete two IgG immunoglobulins.
A study on hexachlorophene encephalopathy in mice and baboons is reported. By light microscopy, a severe spongiform lesion of the central nervous system (CNS) was localized in the white matter, without myelin breakdown or cellular reaction. By electron microscopy, the myelin alteration was characterized by wide intralamellar spaces or "splitting" developed in the intraperiod line of compact sheaths. The acute changes described were induced by administration of the drug by the digestive or cutaneous routes at various dosage levels in an aqueous solution or in talcum powder. The toxic effects depended on the age of the animals, the survival times and the concentrations of hexachlorophene, i.e., 6%, 3%, and 0.5%. The findings are compared with previous reports on the neurotoxicity of hexachlorophene and other chemicals in human and experimental animals. Hexachlorophene cannot be recommended for use in young infants because of its neurotoxicity in very low doses as demonstrated in the present report.
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One case of malignant tumour of the left nasal cavity is reported in a woman 56 year old, affected by the disease 24 years. Numerous recurrences appeared and various histological diagnoses were performed. At the last surgery, the tumour invaded the ethmoid and was a typical olfactory esthesioneurocytoma. By electron microscopy, mature ganglion cells with dense cored vesicles (neurosecretory granules) were densely packed. Neuritic processes with microtubules were rarely normal in size and their content was most often abnormal; furthermore dystrophic axons were noted in great number.
Subcutaneous transplantation of Greene lymphoma in golden hamsters is followed by a type IV-V hyperlipoproteinemia with major hupertriglyceridemia and impairment of labelled triglyceride clearance. Postheparin lipase activity studies show that this hyperlipidemia is correlated with the decrease in the lipolytic enzyme, which plays an important role in triglyceride clearance. The role of the tumor is considered.
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