Biomedical subjects
Publications and source records attributed to A Rosa.
A 61 year-old man with severe hypertension present with a crural paresis and ipsilateral ataxia. CT scan showed a low density area suggestive of a lacuna in the posterior limb of the internal capsule.
Two cases of rubella with neurological complications are reported. In one case an extensive atypical polyradiculoneuritis was associated with a late albumino-cytologic dissociation. The other presented as a transverse myelitis with meningitis and radiculitis. In neither case was an history of contagion or recent vaccination elicited, and no eruption appeared in either patient. Clinical onset was sudden, with an acute meningitis followed several days later by neurological deficits. The course was marked by successive phases of early rapid deterioration, stabilization and slow regression over several months. Sequelae were minimal. Diagnosis was based on a sharp fall in the ratio of serum/CSF levels of specific antibodies to the rubeola virus. This was sure evidence of the presence of intrathecal synthesis of specific antibodies.
Twelve cases of benign intracranial hypertension (BIH) are reported, there being a higher proportion of women patients and a greater frequency of those in the 3rd decade of life. Symptoms were principally headache (11 patients) and/or transient or permanent visual disorders (10 patients). Bilateral papillary edema was often associated with diminished visual acuity (5 cases) and/or amputation of the visual field (5 cases). Cerebral venous occlusion was detected in 3 patients and an infective focus in 7 cases. Three patients were receiving some treatment but none of the women was taking oral contraceptives. Two were pregnant. The CSF was abnormal in 5 of the 7 patients (mixed cell reaction and red blood cells: 1 case; pleiocytosis: 3 cases; raised protein levels: 1 case), and CT scans were normal except for reduced ventricular system size in 9 patients. Follow-up for a mean of 1 year showed total disappearance of symptoms and signs in 4 cases. Papillary edema had not totally regressed at the last ophthalmological examinations performed on 5 patients, and visual sequelae (visual acuity and/or visual field anomalies) were present in 5 cases. Two patients relapsed. The conventional acceptance of the benign nature of BIH must be tempered by the possible onset of possible serious visual disorders. Two factors appear to be determinant: the presence of severe visual disorders initially and/or the existence of arterial hypertension. Various physiopathogenic hypotheses have been evoked to explain BIH. The essential mechanism appears to be an anomaly of absorption of CSF, either from increased pressure in the dural venous sinuses or lesions of the arachnoid villi, but the role of cerebral edema and/or increased cerebral blood volume cannot be excluded. Incomplete understanding of physiopathogenic mechanisms account for the numerous treatments proposed and for some confusion in their indications.
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UNLABELLED: In order to evaluate the respective role of dialysate aluminium and of oral aluminium hydroxide in the occurrence of hyperaluminemia in patients on chronic hemodialysis, plasma aluminium was measured in 19 of them selected for their reliability, before and then 6 and 12 months after the use of a double step reverse osmosis system which allowed to have dialysate aluminium always below 20 micrograms/l, whereas before it was between 20 and 120 micrograms/l. No significant decrease of their plasma aluminium concentration was observed (81 +/- SEM 12, 81 +/- 12 and 75 +/- 12 micrograms/l respectively). But a significant correlation between plasma aluminium and the total or daily prescribed dose of Al (OH)3 was found before and after 12 months of reverse osmosis. A significant negative correlation was observed between plasma aluminium and the mean corpuscular volume, before and 12 months after reverse osmosis. No correlation was found between plasma aluminium and the plasma PTH levels or with the administration of active vitamin D metabolites. CONCLUSIONS: These data suggest that oral Al (OH)3 plays a predominant role in the hyperaluminemia of hemodialyzed patients and that hyperaluminemia may contribute to their microcytic anemia.
In 1958, Kearns and Sayre described a syndrome characterized by external ophthalmoplegia, pigmentary retinopathy and cardiac conduction disorders. Subsequent publications have reported the presence of morphologic anomalies of muscle mitochondria and a spongiform encephalopathy. The study of folate metabolism in the present case demonstrated a marked drop in cerebrospinal fluid folate levels contrasting with normal plasma levels. The origin of this anomaly could be a disturbance in the active transport system of 5-methyl tetrahydrofolate (5 CH3 THF) in the choroidal plexuses. This compound is involved in brain metabolism at different levels: synthesis of purine and pyrimidine bases, serotonin metabolism, synthesis and methylation of membrane phospholipids. Therefore a deficit in brain 5 CH3 THF levels could be implicated in the pathophysiology of the spongiform encephalopathy. In the current state of knowledge a relation between folate transfer disorders and mitochondrial anomalies is difficult to establish.
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The clinical story and the results of radiological and angiocardiographic investigations in 2 patients with proven mitral valve prolapse and cerebral ischemia are reported. Significant risk factors for stroke other than mitral valve prolapse were lacking. Cerebral angiography showed in one case a distal occlusion suggesting embolic brain lesion and was normal in the other case. This report suggests: 1) that mitral valve prolapse is a real risk factor for stroke in young people; 2) that two-dimensional echocardiography or angiocardiography are valuable investigations in young patients with cerebral ischemia, when clinical or electrocardiographical findings of cardiopathy are present.
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The 250 patients of this series, whatsoever was the location of the aneurysm, were operated radically on the 6th and 7th day following the rupture. That is to say at the end of the brain swelling period and before the rebleeding period. During these 5 or 6 days the blood pressure was stabilized by a daily intake of diazepam (15 to 30 millig); 10% only of the patients were resistant; in these cases clonidine was used. During this period antifibrinolitic agents were not given as well as antioedematous therapy. No case of rebleeding was observed in this series under this therapy.
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The site of action of four metals (copper, lead, nickel and zinc) on the aminolevulinic acid dehydratase of human erythrocytes was studied. Data obtained after denaturation of allosteric sites with heat treatment and after simultaneous incubation with two metals suggest the following conclusions: copper acts on the catalytic site, whereas lead, nickel and zinc act on the allosteric sites; zinc and nickel act on the same allosteric (metallic) site; zinc and lead only partially act on the same metallic site; nickel and lead act on different allosteric sites.
The investigation evaluates the efficiency attributed to some measures (improvements in environment, individual health habits) in reducing the risk of lead poisoning in the ceramics industry. The evaluation of the average levels of lead in the blood of 154 exposed workers was carried out in four plants at a time interval of six to eight months. The study considers the variations in relation to possible measures brought about during the interval. A reduction of environmental risk was in effect shown by a clear improvement in the blood lead levels, which still, however, exceeded the internationally recommended limits in many of the subjects. It was concluded that further improvements can only be made by reducing the lead content of the glazes used.
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