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Biomedical subjects

M David

Publications and source records attributed to M David.

At least 55 records · Page 3Linked to original sources
PubMed1991

Buschke-Ollendorff syndrome of the scalp: histologic and ultrastructural findings.

Buschke-Ollendorff syndrome is an association of connective tissue nevi and osteopoikilosis that usually appears in the first decades of life. The nevi occur on the trunk and extremities. In a 48-year-old man with this rare syndrome the connective tissue nevus was located on the scalp and was pruritic. Histologically, involvement of the epidermis with cystic dilatation of the hair follicles and an abnormality of mucopolysaccharides were present. The nevi in this syndrome may involve an alteration in the three components of connective tissue to a variable degree.

Collagen↗
PubMed1991

Papillon-Lefèvre syndrome with acroosteolysis.

The Papillon-Lefèvre syndrome is characterized by palmoplantar hyperkeratosis and juvenile periodontitis that results in the precocious loss of both the deciduous and permanent teeth. We report a patient with Papillon-Lefèvre syndrome associated with acroosteolysis, an association that has not been previously described.

Adult↗
PubMed1991

Acne fulminans with hepatosplenomegaly and erythema nodosum migrans.

Acne fulminans is a rare form of acne characterized by ulcerative nodules and associated with systemic complications. We report the case of a 17-year-old boy with cystic acne who experienced sudden onset of acne fulminans associated with fever, weight loss, hepatosplenomegaly, and erythema nodosum migrans. To the best of our knowledge, this is the first reported case of acne fulminans manifested by hepatomegaly and erythema nodosum migrans.

Acne Vulgaris↗
PubMed1991

Primary anetoderma associated with a wide spectrum of autoimmune abnormalities.

Although the underlying pathologic mechanisms of primary anetoderma have not yet been identified, data suggest the participation of an immunologic mechanism in some cases. In a woman with clinical and histopathologic features of primary anetoderma (Jadassohn-Pellizzari type) of 30 years' duration, laboratory investigation disclosed positive antinuclear factor, hypocomplementemia, hypergammaglobulinemia, granular deposits of immunoreactants along the dermoepidermal junction, and fibrillar deposits in the papillary dermis. In addition, she was found to have autoimmune hemolysis and circulating lupus anticoagulant associated with recurrent deep-vein thrombosis and a history of Graves' disease (starting 5 years after onset of primary anetoderma). To our knowledge, none of the latter three autoimmune conditions has been previously associated with primary anetoderma.

Antibodies, Antinuclear↗
PubMed1991

Melanocytes and Langerhans cells in aged versus young skin before and after transplantation onto nude mice.

Previous studies have demonstrated decreased numbers of melanocytes and Langerhans cells (LC) in aged skin. In the present study, we employed dopa and indirect immunoperoxidase techniques in epidermal sheets to determine the fate of melanocytes and LC of aged versus young donors after skin transplantations onto nude mice. The detection of positive homologous leucocytic antibody reaction of degeneration (HLA-DR) of LC indicates an age-associated reduction in sun-protected thigh skin in aged versus young subjects (263 +/- 63 versus 589.25 +/- 142.643, p less than 0.001). The mean number of LC four weeks after transplantation remained almost constant. Prior to skin engraftment, a decreased number of melanocytes was found in aged versus young epidermis (160.77 +/- 51.7 versus 255.83 +/- 81.2, respectively, p less than 0.05). A significantly increased number of melanocytes was noted four weeks following engraftment in epidermis from aged (307.44 +/- 174, p less than 0.05) and young human donors (402.16 +/- 139, p less than 0.02). The marked increase in density of dopa-positive melanocytes following engraftment onto nude mice may indicate the existence of circulating factors in nude mice that perhaps both stimulates and enhances proliferation and activity of these cells.

Adult↗
PubMed1991

Aged versus young skin before and after transplantation onto nude mice.

The behaviour of aged skin transplanted onto nude mice was investigated to determine whether the skin maintains its histological features. Split-thickness skin grafts obtained from the unexposed skin on the thighs of healthy aged and young volunteers were grafted onto nude mice. A significant difference between the mean thickness of young versus aged epidermis was noted before transplantation (P less than 0.001). The epidermis of aged and young skin showed an increase in thickness following engraftment with a mean increase in epidermal thickness of 18.8% in the young (P less than 0.01) and 142.5% in aged skin (P less than 0.001). The number of blood vessels in the aged skin was significantly lower than in the young skin, but a remarkable increase was found post-transplantation. These findings indicate that part of the typical histological changes of unexposed aged skin are reversible.

Adult↗
PubMed1991

Activation of monocytes during inflammatory bowel disease.

Inflammatory bowel diseases lead to a systemic acute-phase response. Monocyte activation plays a central role during systemic acute-phase response via secretion of inflammatory cytokines. We determined the activation of peripheral-blood monocytes in patients with inflammatory bowel diseases by measuring their interleukin-6 (IL-6) secretion. Blood was obtained from patients with active Crohn's disease before treatment [mean Crohn's disease activity index (CDAI) = 332 +/- 34] and from patients after treatment with prednisolone (mean CDAI index = 139 +/- 20). The mean serum IL-6 levels measured by a hybridoma growth assay (B9) were 23 +/- 4 U/ml before therapy and fell to 16 +/- 3 U/ml after treatment with prednisolone. Healthy persons and patients with inactive Crohn's disease usually had serum IL-6 levels below the detection limit of 4 U/ml. An ex vivo whole-blood system was used to measure IL-6 secretion by peripheral-blood monocytes with and without stimulation. Spontaneous IL-6 secretion in this system was about 9 U/ml in patients with Crohn's disease and below the detection limit of 4 U/ml in healthy controls. Moderate stimulation of blood cells [100 pg/ml lipopolysaccharide (LPS)] from patients with active Crohn's disease before and after treatment led to mean IL-6 concentrations of 1,160 +/- 514 and 131 +/- 54 U/ml, respectively. Maximal stimulation of peripheral blood before and after therapy by LPS (100 ng/ml) led to mean IL-6 concentrations of 5,570 +/- 1,660 and 6,220 +/- 1,630 U/ml, respectively. Thus, administration of glucocorticoids led to a rapid down-regulation of IL-6 synthesis by peripheral-blood monocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute-Phase Proteins↗
PubMed1991

[Heparin-induced thrombocytopenia. Practical management of vascular complications].

The authors report 23 cases of heparin-induced thrombocytopenia with vascular complications. The clinical presentation consisted of arterial ischaemia in 16 cases, hemiplegia in 1 case, 4 cases of blue thrombophlebitis, 1 case of bilateral thrombophlebitis, 1 case of pulmonary embolism. The vascular surgeon faced with such emergency complications must be aware of the difficulties of clinical (atypical forms) and laboratory diagnosis (unreliability of platelet aggregability tests). Arterial occlusions are generally accessible to treatment with a Fogarty catheter during an operation performed without the use of heparin. The excessively frequent delay in diagnosis explains the severity of these complications and 2 deaths, 1 case of paraplegia, 4 cases of amputation secondary to arterial occlusion, 4 cases of severe postphlebitis disease, including 2 cases requiring transmetatarsal amputation and one case of pulmonary sequelae after pulmonary embolism were observed in our series of 23 patients. The diagnosis of heparin-induced thrombocytopenia requires immediate discontinuation of heparin therapy. Replacement by low molecular weight heparin is not devoid or risks and can only be considered with a negative platelet aggregability test (in the presence of low molecular weight heparin). As these test can be rarely performed as an emergency procedure, the use of rapid-acting oral anticoagulants appears to be the most reliable solution. The place of platelet antiaggregants and partial interruption of the inferior vena cava is discussed.

Adult↗
PubMed1991

[Conization and pregnancy--an analysis of various therapeutic measures for the prevention of premature labor].

In the period under review from 1/6/1980 to 31/3/1990 119 women with a state after conisation of the cervix have been delivered. For treatment of a resultant cervical incompetence there were used in 46% a cervical cerclage, in 7% a support pessary, in 20% the combination of cerclage: pessary and in 27% conservative measures. Retrospectively the final gestational week, the proportion prematured rupture of membranes, of prematurity and dates of the fetal outcome have been examined. The results demonstrate that a selection of patients has to be made with state after conisation according to the seriousness of the cervical incompetence giving the adequate indication for a conservative or active (cerclage and/or pessary) treatment referrend to pregnancy length and the uterine cervix findings. A general determination of only one treatment method for prophylaxis of therapy with state after cervix conisation is not advisable, be cause the results of all examined patient groups--after selection--were not significantly different.

Adult↗
PubMed1991

[Risk factors for the development of diarrhea in children of 6-36 months carrying enteropathogenic microbes (apropos of 130 cases observed in Lomé-Togo)].

Diarrhoea, an important cause of infant morbidity and mortality is a priority problem in developing countries. The diarrhoea is most often of infectious origin. This is an evaluation of the parameters susceptible of influencing the carrying of enteropathogenic agents and the apparition of diarrhoea in children 6-36 months of age living in urban and peri-urban areas in the tropics. The study concerns 130 children divided between well nourished and malnourished. To the parameter "nutritional status" most often used in the different studies one finds in the literature, we chose to add a combination of others regrouped under the categories of "type of feeding" and "environmental factors". In our socio-cultural context, these last two parameters are intimately linked to the mother who lives in symbiosis with her child at least until 36 months of age. At the end of the study we were able to put together the results of research on carriage of a large gamut of enteropathogenic agents (parasites, bacteria, viruses) with our chosen parameters. This allowed us observe all the interactions between these two variables, particularly relating to onset of diarrhoea. We were thus able to conclude that the factors characterizing "Food hygiene and environmental hygiene play the most important role whatever the nutritional status of child".

Carrier State↗
PubMed1991

[The diagnosis of toxoplasmosis in the Lomé University Hospital Center].

819 sera and 3 cerebro spinal fluid have been tested for toxoplasmic antibodies. Serum positivity is higher in males than in females (64.86% against 58.70%). Global positivity is 59.26%. Children up to 10 years old have antibodies titre more than 300 UI/ml. These titres decrease as people are growing old.

Adolescent↗
PubMed1991

[Carl Wilhelm Mayer (1795-1868)--founder of the Berlin Society of Obstetrics].

115 years ago the society of gynaecology and obstetrics in Berlin was found. Already in 1844 the Berlin physician and obstetrician Carl Wilhelm Mayer (1795-1868) has initiated the foundation of a society of obstetrics. This was the first medical-scientific society of the world. We want to demonstrate the biography of C. W. Mayer and also his importance in the creation of a modern medical association. In the second part of present paper, the situation of foundation and the first years of the Berlin society of obstetrics were described.

Berlin↗
PubMed1991

[Colonic angiodysplasia with chronic digestive hemorrhage cured after valvular replacement for aortic valve stenosis].

Aortic stenosis is found in 15 to 25% of patients with gastrointestinal angiodysplasia. The usual treatment for haemorrhagic angiodysplasia associated with aortic stenosis is the same as for other types of gastrointestinal angiodysplasias: segmental intestinal resection, electrocoagulation and laser photocoagulation. The authors report the case of a 73 year old woman with a long history of gastro-intestinal bleeding and chronic anaemia requiring a number of hospital admissions for blood transfusions. The cause of this bleeding remained obscure for many years, as it was initially thought to be due to portal hypertension complicating cyrrhosis and a surgical porto-caval shunt was performed. Later, angiodysplasia of the colon was recognised and a segmental colonic resection was performed. These two surgical procedures had no effect on the chronic bleeding and finally the patient was referred for a gram negative endocarditis complicating aortic stenosis, previously considered to be non-surgical. After controlling the infection, the patient was sent for surgery of the aortic valve disease with mitral regurgitation in view of progressive degradation of left ventricular function. A double valve replacement with bioprostheses was undertaken with no complication. Finally, three years now after valve replacement, no further bleeding has occurred and control colonoscopy is normal. In the light of this case and a review of the literature of about 30 similar cases, the physiopathology and management of these patients is discussed with respect to the choice of valve prosthesis and the attitude to anticoagulant therapy. These observations suggest that in the presence of valvular heart disease at a surgical stage associated to an angiodysplasia, it is preferable to propose valve surgery to start with. Gastro-intestinal surgery is only indicated if haemorrhage persists after a period of observation.

Aged↗
PubMed1990

[A "non-narrowing" patch using the superior thyroid artery in surgery of carotid arteries].

It seems to be generally agreed that a closing patch is necessary after carotid endarterectomy. The materials utilized (prostheses or veins) having their own morbidity, we prefer to use a piece taken from the superior thyroid artery; Satisfactory results were obtained in the first 26 cases. This autologous biological material has the advantage of being an arterial structure (therefore compatible with the sutured artery) which is obtained in situ and spares the venous system.

Arteries↗