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Biomedical subjects

M Lemay

Publications and source records attributed to M Lemay.

16 recordsLinked to original sources
PubMed1992

Incidence of liver toxicity associated with the use of flutamide in prostate cancer patients.

PURPOSE: The incidence of flutamide-related liver toxicity was studied in 1,091 consecutive patients treated for stage C or D prostate cancer with the antiandrogen flutamide and the luteinizing hormone-releasing factor (LHRH) agonist [D-Trp6, des-Gly-NH2(10)] LHRH ethylamide. PATIENTS AND METHODS: Liver function tests, namely measurement of serum aspartate amino-transferase (AST) and alanine aminotransferase (ALT), total bilirubin, alkaline phosphatase, gamma-glutamyl transpeptidase (gamma-GT), and prothrombin and thromboplastin times, were performed at 4, 8, and 12 weeks and every 3 months thereafter. Clinical signs and symptoms of liver dysfunction were also sought. The causal link between the antiandrogen used and liver injury was assessed on the basis of the temporal relationship with the use of the drug in the absence of other possible causes and, in two patients, through rechallenge of the putative causative drug after a period of normalization of liver function. RESULTS: An increase in AST and ALT at fourfold or more above upper normal limits was observed in only four patients (0.36%). Total serum bilirubin and alkaline phosphatase were elevated in only one patient at 126 mmol/L and 640 IU/L, respectively. Among the four patients, only two developed clinical manifestations of liver disease (0.18%). Biopsy was performed in one patient, and the histopathologic findings showed a mixed pattern of cytotoxic and cholestatic changes. All clinical and biologic manifestations of liver toxicity rapidly disappeared upon discontinuation of flutamide alone. No sequelae were observed in the long-term follow-up at 18, 22, 31, and 62 months. The 1,087 remaining patients experienced no or mild (less than fourfold upper normal limit) and transient elevation in aminotransferase serum levels during the first 6 months of treatment, with normalization at later time intervals. CONCLUSION: Despite the fact that the cases reported so far, along with our large series, indicate that the incidence of flutamide-induced liver toxicity is very low, we recommend serial blood aminotransferase measurements at 2 and 4 weeks of treatment in order to detect early signs of possible flutamide-induced hepatic injury, thus avoiding the low potential risk of clinically significant liver toxicity.

Adenocarcinoma↗
PubMed1992

The pressure-dependent nature of the rash in Henoch Schönlein purpura.

A 10 month old girl with Henoch-Schönlein purpura (HSP) developed a rash predominantly on the anterior aspect of the knees. The authors speculate that this distribution of the rash was due to the pressure effects consequent to crawling and propose that the distribution of the rash in HSP should be described as pressure-dependent rather than merely gravity-dependent. The therapeutic implications of pressure-dependency in HSP are discussed.

Female↗
PubMed1991

[Pathologic study of Morton's neuroma].

The clinical syndrome of Morton's neuroma [correction of nephroma] was described over a century ago, but its etiopathology remains unknown. Recent studies suggest that it may be induced by compression neuropathy. Histologic changes in digital nerves resected for therapeutic purposes were compared with histologic findings of digital nerves sampled at autopsy of asymptomatic subjects. Results show that approximately one-third of resected "diseased" digital nerves were histologically normal. The authors question the therapeutic approach, which consists of resecting the nerves.

Adolescent↗
PubMed1990

Intact "biological motion" and "structure from motion" perception in a patient with impaired motion mechanisms: a case study.

A series of psychophysical tests examining early and later aspects of image-motion processing were conducted in a patient with bilateral lesions involving the posterior visual pathways, affecting the lateral parietal-temporal-occipital cortex and the underlying white matter (as shown by magnetic resonance imaging studies and confirmed by neuro-ophthalmological and neuropsychological examinations). Visual acuity, form discrimination, color, and contrast-sensitivity discrimination were normal whereas spatial localization, line bisection, depth, and binocular stereopsis were severely impaired. Performance on early motion tasks was very poor. These include seeing coherent motion in random noise (Newsome & Paré, 1988), speed discrimination, and seeing two-dimensional form from relative speed of motion. However, on higher-order motion tasks the patient was able to identify actions from the evolving pattern of dots placed at the joints of a human actor (Johansson, 1973) as well as discriminating three-dimensional structure of a cylinder from motion in a dynamic random-dot field. The pattern of these results is at odds with the hypothesis that precise metrical comparison of early motion measurements is necessary for higher-order "structure from motion" tasks.

Cerebral Cortex↗
PubMed1978

Real-time B-scan-directed amniocentesis.

Utilizing real-time B scan, 150 amniocenteses, 14 in the second trimester and 136 in the third trimester, were carried out in 143 patients. In 146 procedures, amniotic fluid was obtained with a single attempt. In four other procedures, two attempts were required, and oligohydramnios was present in two. In one, both taps were dry, while in the other a second tap yielded a slight amount of meconium fluid. One patient was tapped in a site other than that suggested by real-time scanning, and a bloody tap (Apt negative) was obtained. Clear fluid was obtained when the real-time-indicated site was used. The remaining patient had premature rupture of membranes, and two attempts yielded bloody fluid (Apt negative) and the procedure was abandoned. Amniocenteses in eight patients had failed previously (one to three attempts). With the subsequent aid of real-time B scan, fluid was obtained in a single attempt. These data suggest that real-time B scanning prior to and/or during amniocentesis is as reliable as the static B scan method and, in some cases, may have a clear advantage.

Amniocentesis↗
PubMed1977

[Obstructive parietal hemodissection of the intracranial vessels, a particular form of dissecting aneurysm].

A six year old girl complained of sudden severe headache, became hemiplegic and unconscious. A right carotid arteriogram revealed an obstruction of the right anterior cerebral artery and many sulvian branches. Death occurred four days later. At autopsy, a recent softening of nearly all the right middle cerebral arterial territory was found. Thrombus filled the sylvian artery and its main branches. Histologic examination of the vessel walls showed a dissecting infiltration of blood between the internal elastic lamina and the media. This particular form of dissecting aneurysm, occurring in young subjects, in the absence of atherosclerosis, high blood pressure and idiopathic medial necrosis, represents a distinct medial necrosis, represents a distinct nosologic entity that has been called "Obstructive parietal hemodissection of intracranial vessels." The pathogenesis of the disease is unknown: trauma has been mentioned, also congenital defects in the elastic lamina or other morphologic abnormalities of that lamina.

Aortic Dissection↗