Herpes simplex type 2 pericarditis and bilateral facial palsy in a patient with AIDS.
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Biomedical subjects
Publications and source records attributed to M Poisson.
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Forty-six cases of non-surgical malignant glioma were treated by several repeated infusion of non-superselective intra-arterial chemotherapy using HECNU, followed by conventional radiotherapy. Chemotherapy was well tolerated immediately. Good responses rate was 46% for the whole group, but was higher in anaplastic astrocytomas (71%) than in glioblastomas (43%). The median survival for responders was 17 months, and clinical improvement was observed in a large majority of them. Later, neurological or ophthalmological ipsilateral complications of varying severity were observed in 8.7% and 15% of the cases respectively. Despite these complications the treatment was generally well tolerated and gave in responders a longer survival with better comfort.
EGF receptors were assayed by immunohistochemistry using a monoclonal antibody against EGF-R in 32 surgical samples of meningioma. EGF-R were found in all samples (32/32). Only tumor cells were stained and staining was homogenous in tumor tissue. EGF-R was simultaneously assayed by 125I-EGF binding on membrane preparation and immunohistochemistry on frozen sections in 10 meningiomas. Results were qualitatively equivalent in 9 cases. Staining intensity was not correlated with the histological type, the proliferative status of the tumor or the age and hormonal status of the patients. The immunohistochemical data are in agreement with previous biochemical assays on tissue homogenates.
A case-referent study was undertaken to look for occupational risk factors among patients with glioma treated in a neurological hospital in Paris between 1975 and 1984. In the study group were 125 men with gliomas (aged less than or equal to 65) and 238 patients (also less than or equal to 65) admitted for non-neoplastic, non-malformative vascular diseases in the same department during the same period constituting the reference group. All diagnoses were confirmed by tomodensitometry. Information on occupational history was obtained from a postal questionnaire and from medical records. Comparison of cases and referents showed a significant excess risk among teachers (OR = 4.1) and a raised risk among wood workers (OR = 1.6). Four of nine cases of glioma who had been employed as wood workers reported that a colleague had suffered from glioma (those reports were confirmed by hospital records). None were reported among 11 referent wood workers. Using a complementary questionnaire on wood work, exposure assessment to wood preservatives and solvents showed that frequent exposure to organochlorine wood preservatives and to organic solvents occurred more often among cases than referent wood workers (p less than 0.10).
We report two cases of heparin-induced thrombocytopenia (H.T.) associated with a disseminated intravascular coagulopathy (DIC). Heparin was prescribed after a cerebral infarct in the first case and after an orthopedic surgical procedure in the second case. The DIC induced neurological complications and the death of both patients. Heparin-induced thrombocytopenia is common but is exceptionally associated with neurological symptoms. Heparin-induced DIC is quite uncommon, since only 20 cases have been reported but neurological complications (focal deficits or disturbances of consciousness) are noted in about one third of the cases and the outcome is fatal in 60 percent of the cases. The treatment of heparin-induced DIC and thrombocytopenia is disappointing. Monitoring of the platelets count is warranted during heparin treatment to prevent this severe complication.
Two cases of cerebral amyloid angiopathy with transient ischemic attacks are reported. Both patients died of cerebral hemorrhage. Transient ischemic attacks seem to having been due to the cerebral angiopathy a disease in which small infarcts are frequently mentioned at post-mortem examination. However only 6 other cases of transient ischemic attacks with cerebral amyloid angiopathy have yet been reported.
Epidermal growth factor receptor (EGF-R) were assayed by 125I-EGF binding in 28 surgical samples of human meningiomas. High affinity EGF-R were found in 26/28 tumors (92 p. 100) at concentrations ranging from 20 to 410 femtomoles per mg of membrane protein (fmol/mg prot. mb.). In 18/26 cases (64 p. 100), the EGF-R concentration was between 95 and 230 fmol/mg prot. mb. No relationship was found between the EGF-R level and the site or histopathology of the tumor. The only noticeable observations were the low levels of EGF-R in the 3 anaplasic meningiomas as compared to the whole population and the undetectable level of EGF-R in the angiomatous tumors. In addition, no correlation was found between EGF-R levels and the hormonal status of the patients, nor between EGF-R levels and the intratumoral concentration of progesterone receptors assayed simultaneously. The biological relevance of EGF-R in meningioma is discussed in this context.
Clinic-initiated topical treatment of recurrent genital herpes with foscarnet cream (concentration, 0.3% in men and 1% in women) was compared with a placebo in a Canadian multicenter trial involving 309 patients. Culture-positive episodes of herpes took significantly longer to heal than did the others. Lesions in men were larger and lasted longer but were less symptomatic than those in women. Foscarnet did not statistically improve the times to healing or the loss of symptoms overall but did result in a higher proportion of symptom-free individuals after one day of treatment. Foscarnet-treated patients had a reduced duration of shedding of virus, and this was significant for men. These clinical benefits do not, however, warrant general use of this agent for established lesions. Earlier, prodromal treatment might have been more effective, but patient-initiated studies include a greater proportion of culture-negative (shorter) episodes that often make results difficult to interpret.
The association of Waldenström disease and glioblastoma was observed in two patients. Both diseases were diagnosed almost simultaneously. In the first patient the diagnosis of glioblastoma was made on cerebral biopsy. In the second case, the diagnosis was confirmed at autopsy. The association of Waldenström's disease and glioblastoma is rare but it does not seem to be coincidental. The physiopathological problems related to this coexistence are discussed.
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Atypical mycobacteria are responsible for an increasing number of skin and soft-tissue infections. We present a case of Mycobacterium chelonei keratitis that developed 3 months after penetrating keratoplasty. Our case illustrates how early diagnosis of M. chelonei keratitis and aggressive therapy with appropriate antibiotics can lead to a complete cure, with excellent functional results.
The authors report one case of pituitary abscess; the diagnosis of which was particularly difficult due to its association to a multiple sclerosis that began twelve years before. A review of thirty-one pituitary abscess reported in the literature from 1970 to 1985 is made. Opto-chiasmatic compression is observed in fifty-five per cent of the cases, pituitary insufficiency in fifty-five per cent, and meningitis in sixty per cent of the cases. Although the characteristic association of meningitis and pituitary tumor symptoms occur in thirty per cent of the cases, the diagnosis is made at surgery. Pituitary adenoma and craniopharyngioma were the most frequent preoperative misdiagnosis for pituitary abscess. The extended use of cerebral C.T. Scan will allow an easier recognition of this rare entity. The discussion includes life and visual prognosis. The etiology remains unexplained in nearly half of the cases.
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The authors report a case of multiple recurrent intracranial meningioma associated with breast cancer in a menopausal woman. High affinity estrogen (ER) and progestin receptors (PR) were assayed independently in the meningioma and the tumor. ER were found to be very low in the meningioma and high in the breast tumor. On the contrary PR were found to be high in the meningioma and could be not detected in the breast tumor. This unique case suggests that meningioma and breast cancer are not under the same type of hormonal influence.
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