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Biomedical subjects

O Guard

Publications and source records attributed to O Guard.

At least 19 recordsLinked to original sources

[Changes in erythrocyte deformability in Alzheimer's disease].

In a previous work we showed an alteration of erythrocyte filtration ability in patients with Alzheimer's disease according to their age and illness duration. This study has for aim to find a criteria of deformability that would be constant in all Alzheimer patients and would show a modification of red cell membranes. The erythrocyte filterability was studied in this present paper, in accord to Reid and Dormandy method using two values of depression (5 and 0 cm of water). These depressions correspond to the physiological values of blood pressure at the level of precapillary and capillary systems. The ratio between the result obtained at 5 cm and the result at 0 cm is constant in normal patient without organic disease and it is independent of age. At the opposite, this ratio increase very significantly in all Alzheimer patients, and this is not correlated to the initial value of filtrability. This ratio could be an index of the alteration of red cell membranes.

Adult↗

[Cardio-respiratory anomalies in disseminated sclerosis].

A case of acute pulmonary edema without cardiac failure, infectious or toxic cause, revealing a Multiple Sclerosis (M.S.), one case of bradycardia during a bout in a known M.S. and one case of orthostatic hypotension without change of cardiac frequency, during a bout of a known M.S. are reported. The common point of these 3 cases is that during their autonomic failure, there were disorders pointing to the medulla oblongata: swallowing difficulties, rotatory nystagmus, vestibulo-cerebellar syndrome, sensory and motor defect of upper limbs. A plaque of M.S. in the medulla oblongata, particularly near the tractus solitarius could explain these cardio-pulmonary abnormalities unusual in M.S.

Adult↗

[Crossed alexia-agraphia in a right-handed patient].

A right-handed man, born of a right-handed family, presented an infarct in the territory of the right middle cerebral artery, with a left hemiplegia, a left lateral homonymous hemianopsia and an expression aphasia. The oral trouble disappeared in some weeks, but later a permanent linguistic deficit persisted, affecting mainly the written language and realizing a clinical picture of alexia-agraphia with Gerstmann's syndrome. The neurolinguistic study showed a preferential alteration of the phonologic system in the written language, and at a lesser degree in the oral modality. The extent of the lesion and the relative integrity of oral expression and comprehension, suggested that these functions were localized in the left hemisphere, whereas lecture, writing, calculation, body-parts notion, laterality notion, had been simultaneously implanted during the ontogenesis in the right hemisphere. The latter was probably also responsible for phonological aspects of written and spoken language, according to a scheme opposite to that of usual right-handers.

Agraphia↗

[Elevation of gamma-glutamyltransferase levels in treated epileptic patients].

Plasma levels of gamma-glutamyl transpeptidase were measured prospectively in 75 epileptic patients treated with one of the following drugs: phenobarbitone (n = 20), phenytoin (n = 23), carbamazepine (n = 18) or sodium valproate (n = 14). A significant increase in gamma-glutamyl transpeptidase levels was observed from the 7th day of treatment onward. The increase was particularly pronounced in the phenytoin group, with mean and maximum values of 104.10 and 215 mU/ml respectively, followed by the phenobarbitone group (mean 68.15, max. 124 mU/ml), the carbamazepine group (mean 49.83, max. 100 mU/ml) and the sodium valproate group (mean 35.42, max. 70 mU/ml). This was due to enzyme induction being highest with phenytoin and phenobarbitone which are strongly liposoluble and have prolonged half-life. Any epileptic patient with plasma gamma-glutamyl transpeptidase levels higher than those found in this study may be suspected of having viral or alcoholic hepatitis.

Adult↗

Effects of vasopressin and desmopressin on memory. A double-blind study in 40 healthy volunteers.

In a study involving 40 healthy student volunteers, 10 subjects were given lysine vasopressin at a dose of 0.4 ml (23 IU) per day in 3 divided doses for 15 days by the nasal route. Ten subjects were given desmopressin at a dose of 0.2 ml (20 micrograms) per day in a single dose for 15 days by the nasal route. Twenty subjects were given placebo by the nasal route. Memory tests were conducted under the same conditions before and after treatment (verbal span, verbal retention, visual retention, visual learning, verbal learning). Only the contents of the tests were varied, so as to avoid familiarity. Statistical analysis did not show any significant change in the scores between the first and the second series of tests, between the two treated groups, or between them studied separately and the control subjects.

Adult↗

[Migraine and somnambulism. A survey of 122 migraine patients].

A retrospective study looking for an history of somnambulism in childhood, in a population of 122 patients with migraine, and 110 patients with non-migraine headache has been performed. A very high frequency of somnambulism in patients with migraine was found whereas frequency of somnambulism in patients with non-migraine headache was similar to that of the general population. The probability that a sleepwalking child acquires a migraine is greater when she is a girl. Migraine is then often of the ophthalmic type. Somnambulism and migraine appear at different ages, the former in the late infancy, the latter in childhood and both could be due to a disorder of serotonin metabolism. The authors suggest that somnambulism be considered as an accessory criterion for the diagnosis of migrainous disease.

Adolescent↗

[Non-traumatic rhinorrhea from a latero-sellar fistula of the temporal fossa adjacent to an empty sella turcica. Computed tomography aspects; surgical treatment].

The authors report a case of non traumatic rhinorrhea due to an osteo-dural fistula communicating between the latero-sellar part of the left middle cranial fossa and the sphenoidal sinus. This fistula, probably congenital, was adjacent to an intrasellar arachnoidocele ("empty" sella turcica), but was not responsible for it. This lesion was demonstrated by CT scan associated with the injection of Metrizamide. The surgical treatment (trans-sphenoidal approach) allowed complete cure of the fistula and its associated symptoms.

Cerebrospinal Fluid Rhinorrhea↗

[Thalamic dementia after a unilateral hemorrhagic lesion of the right pulvinar].

A 68 year-old man with a history of right thalamic hemorrhage demonstrated radiologically in the pulvinar and posterior portion of the dorsomedian nucleus developed a clinical picture of severe physical sequelae associated with major affective, behavioral and psychic disorders. Affective manifestations were a permanent anxiety-depression state contrasting with indifference to his surroundings. Behavioral changes included marked apathy, inertness and hypersomnia, together with occasional clastic agitated episodes and verbal and gestural stereotypies and soliloquies. Psychic sequelae were psychotic in nature: depersonalization crises, delusions of persecution, multisensorial hallucinations and absurd acts.

Aged↗

[Orthostatic arterial hypotension and giant aneurysm of the basilar trunk].

The authors report two observations of giant aneurysm of basilar artery, where the first neurological signs were preceded or escorted by a postural hypotension. They emphasize the place of rhombencephon in the control of blood pressure and they bring together their cases with those reporting a postural hypotension revealing a lesion of medulla. They insist upon the necessity to look a peripheric and central neurological lesion in front of a postural hypotension.

Adult↗

[Evaluation of changes in gamma-glutamyltransferase in chronic treatment with antiepileptic agents].

To know the intensity of liver enzyme induction during a treatment with anticonvulsant, the authors have measured gamma GT before and at the 7th, 30th, 60th days after a treatment by one of the 4 major anticonvulsant as phenobarbital, diphenylhydantoin, carbamazepine and sodium valproate. All alcoholic patients, and all the patients having a liver disease have been eliminated. The results show that diphenylhydantoin is the most important inductor of gamma GT with an elevation that can reach 312% of basal level, followed by phenobarbital, when sodium valproate and carbamazepine are the weakest inductors. More, induction by carbamazepine in women is more weak than in man. Age takes a place in intensity of induction with a major induction observed between 30 and 50 years old for phenobarbital, and above 50 years old for sodium valproate. These effects are not dependent of an hepatitis. The knowledge of the upper levels of gamma GT induction by anticonvulsant appear to us usefull for several reasons: carbamazepine and sodium valproate being the weakest inductors, they must be chosen in priority in women under contraceptive treatment. Any abnormal elevation of gamma GT need to look of an alcoholic intoxication, an hepatitis or a liver cancer.

Adult↗

[A unusual manifestation of multiple sclerosis: sciatica].

The authors recall the possibility of a typical sciatica in multiple sclerosis and describe seven new cases. Their main clinical features are: early onset before any other signs of the disease, hyperalgic, paroxysmal, short, repetitive episodes, absence of mechanical or effort triggers, absence of improvement with rest or anti-inflammatory drugs, well defined course. The intra-medullar origin of these attacks is suggested by the clinical criteria and the aspect of evoked potentials of the lower limbs recorded in 2 of the 7 patients.

Adult↗

[Value of a neurologic assessment when faced with the discovery of a cervical lesion using the Doppler method].

Four situations are envisaged for which a Doppler "unravelling" examination in a patient with arteritis, conducted on a routine basis, led to the detection of stenotic or occlusive lesions of neck vessels. The first case concerns a patient with a recent or long-standing permanent neurological disorder related to an established cerebral lesion. Once the latter has been confirmed as being due to the cervical lesion then angiography is not always essential, since treatment of an established vascular accident is usually ineffective. The second case involves asymptomatic patients with a history indicative of one or more transient episodes suggestive of carotid or vertebro-basilar insufficiency. This situation is the one where most benefit can be obtained from future investigations. The case of a patient with "cerebral circulatory insufficiency" is discussed ant the different clinical pictures produced outlined, while emphasizing that this term should not be used too easily for all presenile intellectual deterioration states. Finally, the last situation is that of an asymptomatic patient (rarely referred to the neurologist for an opinion): various topoghraphic, clinical and paraclinical factors must then be assessed before deciding to continue or not with investigations.

Arteritis↗

[Bilateral parietal syndrome approximating a Balint syndrome].

A patient presented with disorders of saccadic and pursuit movements a wandering gaze, the impossibility to maintain fixation, a concentric shortening of visual attention mainly of the right side, an incomplete right homonymous hemianopia (respecting 10 to 20 degrees), and optical and auditory ataxia predominantly affecting the right hand. Pathology showed a large left parietal glioma in the white matter in the superior and inferior parietal lobes, with microscopic evidence of parietal cortex invasion. A hematoma on the right side was situated entirely parasagitally in the precuneus, approaching the cortex at this level. The two lesions were independent and the splenium was intact. The frontal lobes were normal. A review of nearly 30 cases of bilateral syndrome of the parieto-occipital junction showed that anomalies of visually guided ocular movements were always present. These cases require differentiation from those, such as the present case, which involve mainly a visuomotor coordination disorder and from those with predominant visual disorientation.

Ataxia↗