[Acute renal insufficiency and ischemic neuromyopathy during toxic coma: apropos of 2 cases].
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Biomedical subjects
Publications and source records attributed to N Telerman-Toppet.
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The involvement of the central nervous system (CNS) by a vasculitic process is an infrequent but serious manifestation of several systemic diseases. The neurological disturbances are most often due to cerebral ischemia; however, vascular inflammation is not the only pathogenetic factor of CNS disease in systemic vasculitis. Most often, the specific diagnosis of CNS vasculitis depends on identifying clinical or histologic evidence of target organ involvement outside the CNS. The primary angiitis of the central nervous system (PACNS) is a rare form of vasculitis limited to the central nervous system. The diagnosis of this disorder is difficult owing to its various clinical manifestations and to the poor specificity of the neurological investigations. The demonstration by cerebral angiography and/or tissue examination of an arteritic process is mandatory for establishing this diagnosis.
A young patient had an auriculo-ventricular block and a distal myopathy with muscle biopsy findings suggestive of inclusion body myositis. What was most unusual was the presence of numerous sarcoplasmic bodies identified as desmin by electron microscopy and immunocytochemistry. The nosological situation of this condition is discussed.
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The age factor is analysed for the operative indication in old patients. For the authors, operative indications are depended of mental and general status, clinical grade (I or II), localization and anatomical conformation of the aneurysm. The operation is performed only if the patient is asymptomatic or three weeks after the onset of the subarachnoid hemorrage. The peroperative hypotension is prohibited.
The motor innervation in muscle biopsies from 45 myasthenic patients was studied by intravital staining with methylene blue. The enzymatic pattern and fibre type distribution was analysed in 12 cases. Quantitative data including the proportion of elongated motor endings and the terminal innervation ratio (TIR) of motor axons, were compared to histochemical data and to clinical data including age of patients. The incidence of elongated motor endings tends to be greater in younger patients, whereas an increased collateral ramification of motor axons occurs only after the age of 50. Small type III fibers suggesting denervation are also found in elderly patients only. The significance of these morphological differences in relation to age is discussed.