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Biomedical subjects

A Rascol

Publications and source records attributed to A Rascol.

At least 109 records · Page 6Linked to original sources
PubMed1983

[Analgesic properties and plasma concentrations of clomipramine in chronic pain].

The analgesic effect of clomipramine and the possible relationships between the antalgic action, the doses and the plasma levels of this tricyclic drug have been studied in 15 patients with chronic pain induced by nervous lesions determining a deafferentiation. Eight of 15 patients treated with clomipramine (100 mg/IV during 10 days and then 150 me per os) reported a significant improvement (up to 50 per cent during 3 to 18 months). The study of the partial coefficients of correlation did not show a relationship between plasma levels and analgesia in the total population or in the subgroup of the 8 improved patients. These results confirm the analgesic properties of clomipramine and suggest that regular monitoring of plasma levels of clomipramine does not appear of practical interest in the treatment of chronic pain.

Adult↗
PubMed1982

Platelet arachidonic acid metabolism in severe cerebrovascular disease.

The ability of platelets to synthetise thromboxane B2 and hydroxylated fatty acids from arachidonic acid was studied simultaneously with arachidonic acid-induced aggregation in 42 patients suffering from severe cerebral atherosclerosis and also in 34 healthy controls. Additionally, phospholipase-A2-induced aggregation was performed as a probe for arachidonic acid located at the platelet surface. All the assays were performed with washed platelets, eliminating a possible influence of plasma. Platelets from patients were found responsive to significantly lower concentrations of arachidonic acid whereas thromboxane and hydroxylated fatty acid biosynthesis did not differ from controls. In the experimental conditions used, 75% of the control platelets underwent aggregation with phospholipase A2 plus sphingomyelinase C, in comparison to only 50% for the patients, indicating the necessity for further analysis of the platelet membrane lipids in atherosclerosis.

Adult↗
PubMed1982

[Crossed aphasia in right-handed patients. I. Review of the literature].

More than 70 cases of crossed dextral aphasia have been reported in the literature since the end of the XIXth century. If a genetic, environmental or even pathological factor--or lack of information about it--could be suspected to be responsible of a majority of these cases, 10 of them in which all these factors were eliminated still remain. A summary of the neurological, neuropsychological and neurolinguistic features of these 10 cases shows, among other things: 1. that nearly all of them present a (left) motor deficit associated with a quite large and deep right-hemispheric lesion; 2. that most of them also report the presence of one or the other of the neuropsychological signs usually seen in right hemisphere lesions in dextrals; 3. that if reduction and agrammatism are frequent aphasic signs, fluent jargon is also reported, more so in written than in oral expression. Some of the hypotheses put forward to explain crossed aphasia in dextrals are discussed in the light of these facts. It appears that none of these hypotheses can satisfactorily account for the occurrence of a right hemisphere aphasia in some dextrals.

Adult↗
PubMed1982

[Crossed aphasia in right-handed patients. II. Neuropsychological and neurolinguistic study of a case. Evolution over a 2 year period].

We present an unusual case of crossed aphasia in a doctor who is totally right handed, following an infarction which almost completely destroyed his right hemisphere. The observations--linguistic and extra linguistic--during a study over two years are presented. The aphasia evolved in three stages, taking semiological and evolutive aspects not commonly met with. In speech and writing there were: 1. an oral agrammatism and a written dyssyntaxia in the initial stage; 2. the evolution of a non-fluent speech typically agrammatic leading to a jargonaphasia; 3. a dissociation between oral and written language, characterised by phonemic paraphasias in speech and dyssyntaxia in writing. Comprehension was good except for a verbal class called "empty signs" of language, in which the lexic which refers to the notion of space and time has a primary role. On an extra linguistic level some of the usual signs of right hemisphere lesions were present indicating disturbances of a spatial type. The patient could no longer grasp the concept of numerical value and showed severe difficulties in relation to time. On a linguistic level, the discussion is first considered from a typological point of view; this allows to compare our patient's disorders with a Broca's then with a conduction aphasia, Secondly, the discussion is considered from a semiological point of view, taking into consideration the 10 selected cases in the literature and adding our own; a semiological formula of crossed aphasia is given: agrammatism and/or dyssyntaxia + phonemic paraphasia and/or dysorthographia. A suggestion concerning the role of each hemisphere in the language of our patient is proposed: the possible role played by a congenital deafness in the right ear (discovered in the patient at the age of 8) to explain this abnormal hemispherical functional specialisation is discussed. Original comprehension difficulties concerning the time-space lexic are replaced by a perspective of a cognitive type. We conclude that in our patient, there was a "breakdown" of time and space which comes close to the "indifferenciation" of spatial order and time which Piaget has described in children.

Aphasia↗
PubMed1982

[Multiple sclerosis From Charcot and Vulpian to the present time].

The present paper reports the isolation of multiple sclerosis and the evolution of ideas about this disease since the end of the 19th century. Charcot and Vulpian were close friends during their university years and both were appointed physicians at the Salpêtrière in 1862. It is difficult to sort each other part in the beginning of researches which both devoted to "tremors". When Vulpian left the Salpêtrière in 1865 the main point was settled: a clear cut distinction between paralysis agitans vs patients whose tremor appeared during movement and in whom post-mortem had disclosed disseminated lesions "en plaques". For the 20 ensuing years Charcot built up an impressive corpus of pathological and clinical data which were the basis of his celebrated "Leçons". This history shows the pathological clinical method at ist acme in the hands of a physician of genius. Pathogenetic hypotheses, from vascular to toxic and infectious, the role of immunological, genetic and viral factors are also briefly reviewed.

Central Nervous System↗
PubMed1982

[Bromocriptine as the 1st treatment of Parkinson's disease. Long term results].

Bromocriptine (mean dose: 48 mg daily) was studied during 38 months (mean value) in 20 patients with Parkinson's disease who had never received levodopa treatment. Eight of these 20 patients were treated during a period up to 4 years. Fourteen patients had an "excellent" or "good" improvement with a significant decrease of extrapyramidal symptoms. The side effects were those seen with levodopa but they did not lead to stop the treatment. The most important finding was the lack of long term side effects similar to those usually seen under levodopa treatment: in this group, dyskinesia, oscillations in performance (and specially "on-off" effect) were not noted. A tendency for deterioration of therapeutic efficiency was observed in 2 (or 3) cases. Bromocriptine could be an useful antiparkinsonian drug for previously untreated patients. The pharmacological (importance of the post-synaptic action of bromocriptine) and therapeutic (indications of bromocriptine versus levodopa) implications are discussed.

Adult↗
PubMed1981

[Hypotensive action of a dopaminergic agonist, bromocriptine, in the dog].

The effects of bromocriptine administered by peripheral or central routes were studied in neurogenic hypertensive dogs. The acute hypertension was elicited by deafferentation (sino-aortic denervation). Intravenous (0,15 to 0,30 mg/kg) bromocriptine induced an important decrease in blood pressure of the debuffered dog (Fig. I). Bromocriptine reduced the arrhythmia induced by deafferentiation, but not the tachycardia of the debuffered dog (Table I). Bromocriptine was active by intracisternal route, at a dose (0,15 mg/kg) effective by intravenous route (Fig. 2). This antihypertensive effect of bromocriptine was also observed in debuffered dogs with binding of both vertebral and carotid arteries (i.e. when an effect of the drug on central structures was ruled out) (Fig. 3), and was suppressed by pretreatment with haloperidol, a dopaminergic antagonist (Fig. 4). These results imply that the mechanism underlying the hypotensive effect of bromocriptine is dopamine receptor stimulation; we consider that an effect on central nervous structures does not play a significant role in the hypotensive effect of this drug following acute intravenous administration in the dog.

Animals↗
PubMed1981

[Carpal tunnel syndrome, amyloid tenosynovitis and periodic hemodialysis].

Since 1975, various entrapment neuropathies have been reported in patients undergoing periodic haemodialysis, the most frequent being the carpal tunnel syndrome. Ten patients on chronic haemodialysis developing 15 carpal tunnel syndromes (5 unilateral and 5 bilateral) are reported. Various causes for the renal failure were present and clinical signs of the carpal tunnel syndrome developed at a late stage. The arteriovenous fistula required for extrarenal epuration was antebrachial and of the laterolateral type, except in one case when it was lateroterminal. The carpal tunnel syndrome was always on the same side as the fistula, developing at a later stage on th contralateral side in the 5 cases of bilateral disorders. Lesions were severe, in 11 of the 15 cases. Some patients noted fluctuations in pain symptoms during haemodialysis, either improving or becoming worse. Gross pathological findings during operation (13 cases) were tenosynovitis with epineural hypervascularisation on the opposite side. In 9 cases, however, atypical hypertrophic tenosynovitis was observed. Histological examination in 12 cases demonstrated typical tenosynovitis in 3 patients, but granulomatous tenosynovitis with amyloid deposits was reported in 9 patients. Lesions were bilateral in 2 cases thus present, on the side opposite to the fistula. Ultrastructural study confirmed the amyloid nature of the deposits in 3 cases, the microfibrillary appearance (80 to 100 A) being characteristic of amyloid substance. This rare complication does not represent a common carpal tunnel syndrome, and three mechanisms may be involved in its induction : peripheral uraemic neuropathy, haemodynamic modifications resulting from the antebrachial arteriovenous shunt, and amyloid formation in the flexor synovial sheaths. In the latter case, the type of amyloid disease may be a primary systemic amyloidosis not previously detected, or an elective amyloid process localised to the tenosynovial and periarticular tissues.

Adult↗
PubMed1980

Evaluation of syringomyelia with metrizamide computed tomographic myelography.

Nineteen cases of cervical syringomyelia, five surgically confirmed, were examined with metrizamide computed tomographic myelography. While a collapsed cord appeared to be a very reliable finding in this series, those cases with distended cords can be studied with sequential scans (at 3 and 24 hr), allowing the distinction between syrinx and cystic intramedullary tumor by the presence or absence of delayed cyst opacification.

Adult↗
PubMed1980

Intravenous angiography of the extracranial cerebral arteries.

Intravenous angiography with systematic subtraction is a simple, physiological method of simultaneously studying the common carotids, carotid bifurcations, internal carotids (up to the carotid siphons), and vertebral arteries. It can be employed in fasting patients without anesthesia or premedication and without the risks of an arterial approach. Used in 500 patients (of whom 30% were outpatients and some were older than 80), it was tolerated well, easily repeated, and gave 80.6% good or excellent results and only 19.4% poor or uninterpretable results. This is a practical method of screening atheromatous lesions and monitoring their development, particularly after surgery.

Adult↗
PubMed1980

[Cerebral ischemic accidents during migraine attacks. A report on "complicated migraine"].

The authors use the term "complicated migraine" to describe the onset of neurological disorder occurring during an acute attack in a patient with chronic migraine. The disturbance may last for long periods or may be permanent, and these irreversible cerebral lesions have to be differentiated from the transient neurological effects characteristic of ophthalmic on secondary migraine. Patients with migraine and retinal lesions, as well as those with ophthalmoplegic or familial hemiplegic migraine, were excluded from the study. The seven cases reported included 5 women and 2 men with an average age of 30 years (from 14 to 51 years). A more or less severe lesion in a hemisphere was present, which led to sensory-motor signs of a hemiplegia (4 cases), an aphasia (4 cases), and a homonymous lateral hemianopia (3 cases). Exploration revealed the presence of an ischemic cerebral lesion in all cases. One or more arterial occlusions were also noted in 5 out of the 6 patients who were investigated by angiography. All cases showed the presence of the criteria thought to be essential for associating the cerebral ischemic lesion with migraine. 1) the patient had true migraine, 2) there was a close chronological relationship between the migraine attack and the lasting neurological disorder, 3) no other associated vascular disease was present (atheroma, cardiopathy). The very severe and prolonged spasm, which could be the cause of neurological disturbances in secondary and ophthalmic migraine, does not appear to be sufficient for producing an irreversible ischemic lesion and, more especially, a persistent vascular obstruction. The roles played by edema of the arterial wall and parietal changes in the vessels are discussed. It could be that thrombosis formation is encouraged by the changes in blood coagulability which may be associated with a migraine attack. The fact that anomalies in platelet aggregation have been demonstrated merits closer study.

Adolescent↗
PubMed1979

Delayed hypersensitivity to human encephalitogenic protein as assayed by agarose leucocyte migration in multiple sclerosis patients.

Using a leucocyte migration test (Clausen's direct agarose gel migration method) hypersensitivity to human encephalitogenic protein has been examined in 50 multiple sclerosis patients (group 1), 50 healthy persons (group 2) and 25 patients with other neurological diseases (group 3). In group 1, 30 MS patients (60%) show an abnormal migration index, manifested either as inhibition or stimulation of migration; 29 controls in group 2 (58%), 11 O.N.D. patients in group 3 (44%) show an abnormal migration index. These results mean that lymphocyte hypersensitivity to myelin basic protein appears neither to be constant nor specific to multiple sclerosis. Three migration index curve types at different antigen concentration are obtained: monophasic curves within the normal index zones; monophasic curves staying in the inhibition or stimulation zone and biphasic curves with dose-effect relationship. Whatever the antigen used, this dose-effect relationship implies that the test must be carried out at different concentrations. The meaning of spontaneous sensitisation in healthy controls is discussed.

Adolescent↗