Biomedical subjects
Publications and source records attributed to A Destee.
Chronic subdural haematomas are frequently seen in neurosurgical practice, but because of the multitude of their clinical presentations, appropriate diagnosis is often not made in the early stages. The cases reported concern a 62-year-old male and a 54-year-old woman, both presenting in an unusual manner, namely a progressive quadriparesis.
The methionine-enkephalin analog FK 33-824 was administered intravenously to 12 patients with Huntington's disease in a crossover double-blind study. The abnormal involuntary movements (AIM) were not improved after administration of 0.5 mg of FK 33-824. A significant decrease in the AIM score was observed only 150 and 180 min after injection of high doses (2 mg); however, the difference between the active drug and the placebo was never statistically significant. These results are discussed in terms of experimental data suggesting a relationship between methionine-enkephalin and dopamine neurons in the brain and of methionine-enkephalin deficiency in the brain of patients with Huntington's disease.
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Three adults presented convulsive fits for the first time in their lives, and examination with a CT scan showed no anomalies. Repetition of the CT scans a few weeks later revealed the presence of evolving lesions. Based on these 3 cases and 11 previously published cases, the problem of "normal" CT scans and rapidly developing glioblastomas is discussed.
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Data of brain scans with 201Th and 99mTc - D.T.P.A. are studied in 43 patients. Some of the results sustained earlier data from Ancri (1978): lack of interest through vascular diseases, good sensitivity for the focalized brain lesions (24/25). But new features are underlined: occurrence of false - positive, intermediary patterns laying between normal scan and focal pathologic distributions but without etiologic correspondence. The quantified contrast is usually better with 99mTc - D.T.P.A. than with 201Th; these data challenge Ancri's ones. Actual indications of Thallium brain scan are discussed.
The course of acute leukaemias, particularly of the lymphoblastic type, is very frequently complicated by the development of neuromeningeal localisations of the disease. They may, more rarely, be presenting initial lesions, their origin being confirmed clinically and/or biologically, but it is exceptional that they remain a strictly isolated expression of the affection. A case is reported of a 16-year-old adolescent with leukaemic meningitis, in whom haematological tests (blood counts, bone marrow smear, iliac medullary biopsy, lymph node biopsy) gave negative results over a period of at least two months. Based on the findings in this case, the significance of early neuromeningeal localisations of acute leukaemias is discussed.
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