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Biomedical subjects

B Girard

Publications and source records attributed to B Girard.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Ocular prognosis in Behçet's disease].

The ocular prognosis of Behçet's disease was assessed in 31 French native patients with ocular involvement. The mean follow-up time was 6 years. Ophthalmologic manifestations revealed the disease in 61% of patients, and it was the first symptom in 29%. Two groups of patients could be identified: the minor forms (23%) which remained stable with colchicine alone and the severe forms (77%) which required steroid (32%) and/or immunosuppressive (45%) therapy. In the severe forms, 32 eyes were unchanged, 4 eyes showed improvement, and 12 eyes showed deterioration in visual acuity. Positivity of HLA B5, sex and complete form of the disease were not predictive factors of ocular involvement, or of its seriousness. At 6 years, 16% of the eyes (versus 14% at the beginning) had a visual acuity less than 1/10, and 71% (versus 74% at the beginning) had a visual acuity greater than 8/10. A close collaboration between ophthalmologists and internists allows a good visual prognosis in Behçet's disease.

Adult↗
PubMed1992

[Surgical decompression of the optic nerve in intracanal injuries. Indications and results].

Fifteen patients with traumatic optic neuropathy (anatomical section excluded) underwent surgical anterior decompression of the optic nerve, via the trans ethmoid-sphenoid approach. Improvement of visual function assessed by visual acuity and visual field measurements, was obtained in 10 patients. Results remained stable for a follow-up period of at least 6 months. There was a delay of several weeks before improvement in some of the patients. Thus a long follow-up period seems recommended. Trans ethmoid-sphenoid optic nerve decompression is a reliable procedure with low morbidity, and represents a promising therapy for indirect injuries of the optic nerve.

Adolescent↗
PubMed1992

[X-ray computed tomography in surgical indication of physiological section of the optic nerve. Apropos of 15 cases].

Optic nerve trauma induces loss of vision and absence of direct pupillary light reflex. Persistence of consensual pupillary light reflex excludes anatomical section. Trans ethmoidal-sphenoidal decompression relieves the optic nerve and allows an improvement of visual function. Ten patients among 15 surgical decompressions recovered visual function. There is a good correlation between improvement and the release of an anatomical nerve compression. Recognition of direct or indirect computed tomographic signs of optic nerve compression are essential in the surgical indications. The prognosis post-surgical improvement is dependent on the sensitivity of computed tomography scan.

Craniocerebral Trauma↗
PubMed1990

[Corticosteroids and ophthalmology].

Corticosteroids are widely used in the treatment of inflammatory and immunological diseases of the eye. They are given by three routes: topical application, periocular injection and systemic administration. Topical application, periocular injection and systemic administration. Topical application is used for anterior inflammatory diseases, such as conjunctivitis, keratitis or anterior uveitis. Posterior uveitis is treated with systemic and local injections. Herpetic keratitis is a contra-indications to the use of corticosteroids. Ocular side-effects are observed with systemic administration as well as with topical applications and local injections. They include posterior subcapsular cataract, rise of intraocular pressure and even glaucoma, failure in healing of corneal wounds and exacerbation of ocular infections. These side-effects are not always reversible when treatment is stopped. Prevention consists of repeated eye examination.

Adrenal Cortex Hormones↗
PubMed1990

Cotton-wool spots and AIDS related complex.

Twenty-nine patients with the AIDS Related Complex (ARC) were studied retrospectively. Cotton-wool spots (CWSs) were the main ophthalmological finding, present in 9 patients (31%) at this stage of the disease. The CWSs were asymptomatic and were therefore discovered during a routine examination. The proportion of patients with significant weight loss was greater among ARC patients with CWSs than among those with normal fundi. Leukocyte counts were found to be significantly lower (p = 0.03, odds ratio 10.0 [1.24 to 80.4]) among ARC patients with CWSs. Lymphocyte counts and the CD4/CD8 ratio were also found to be diminished in these patients. Among the nine patients with CWSs during ARC, seven developed major opportunistic infections or HIV (Human Immunodeficiency Virus) related neoplasias during the following months (3.8 +/- 3.5 months). These findings are consistent with a poorer prognosis for HIV infected patients who have CWSs.

AIDS-Related Complex↗
PubMed1990

Reversal of diabetic somatic neuropathy by whole-pancreas transplantation.

To answer the crucial question regarding reversibility of diabetic somatic neuropathy by whole-pancreas transplantation, metabolic studies and electron microscopic morphometry of the sciatic and testicular nerves were performed monthly for 2 years in three groups of highly inbred rats: (1) NC, 47 nondiabetic controls; (2) DC, 90 untreated alloxan-induced diabetic controls; and (3) DT, 230 diabetic rats given syngeneic pancreaticoduodenal transplants 6, 9, 12, 15, 18, and 21 months after induction of diabetes mellitus (DM). Six diabetic nerve lesions were quantitated by a "blind" protocol: (1) loss of myelinated axons, (2) intraaxonal glycogen deposits, (3) axons with glycogen deposits, (4) demyelinated axons, (5) degenerating axons, and (6) loss of intact axoglial junctions in paranodal terminal myelin loops. In the DT group, testicular nerve specimens were obtained just before transplantation and at death so that each animal served as its own control. As we have observed previously in untreated diabetic controls, all six nerve lesions progressed relentlessly for 2 years, in contrast to nondiabetic controls (p less than 0.01). Whole-pancreas transplants produced complete metabolic control of DM for life and reversed all six lesions in both sciatic and testicular nerves, even when done late in the course of DM. There was complete reversal of the nerve lesions when pancreatic transplantation was done within 15 months of the onset of DM. These results provide the first demonstration of reversal of diabetic somatic neuropathy by any form of DM therapy and extend our previous work in which whole-pancreas transplants were found to prevent both diabetic neuropathy and nephropathy and reverse mesangial enlargement in the kidney.

Animals↗
PubMed1990

[Post-traumatic decompression of the optic nerve. Ophthalmologic and x-ray computed tomographic evaluation. Results in a series of 23 cases].

Post traumatic optic nerve compression gives a Clinic picture of physiological section. CT Scan is consistent with optic canal lesion when considering direct signs (bony fragments compressing the nerve) or indirect (fractures and hematoma of posterior orbital wall, of posterior ethmoid, and sphenoid). 23 patients had a surgical decompression through transethmoidosphenoidal approach. A lesion of optic canal was found in 22 out of 23 cases. Improvement of vision was noted in 12 cases.

Adolescent↗
PubMed1990

[Bouchut's tubercles. A clinical and angiographic study].

Four patients (3 young adults and 1 child) with disseminated tuberculosis had choroidal tubercles; none of them was immunodepressed. The clinical and angiographic aspects of these nodules and their evolution are described. Their clinical interest is discussed: fundus examination is always indicated in cases of disseminated tuberculosis and, more generally, in cases of systemic granulomatosis.

Adolescent↗
PubMed1990

[Ophthalmologic manifestations of the Pierre Robin syndrome. Report of a case of microphthalmia].

The classical description of the Pierre Robin syndrome includes micrognathia, glossoptosis, airway obstruction, and usual presence of a cleft palate. The Pierre Robin syndrome is currently defined as the combination of retrognathia, cleft palate, and respiratory distress. This last is mixed, with a peripheral component due to glossoptosis and a central component due to brain stem immaturity. The main ocular manifestations found in the Pierre Robin syndrome are congenital glaucoma and severe congenital mypopia responsible for retinal detachment. Microphthalmia is infrequent. We report the case of a neonate with severe Pierre Robin syndrome and major microphthalmia documented by CT scan.

Female↗
PubMed1989

Foscarnet in the treatment of cytomegalovirus retinitis in acquired immune deficiency syndrome.

Cytomegalovirus (CMV) retinitis is the major cause of visual loss in acquired immune deficiency syndrome (AIDS). Thirty-one patients with active CMV retinitis were treated with the new antiviral drug, Foscarnet (trisodium phosphonoformate). After a 3-week course of induction therapy, the retinitis improved in 29 of 31 patients (93.5%). Complete resolution of the retinitis was seen in 19 cases (61.3%). Ten patients had partial resolution (32.2%) and two (6.5%) failed to respond. After induction therapy, six patients were put on a low-dose maintenance regimen. All patients without maintenance therapy relapsed within 3 weeks after discontinuation of Foscarnet. The rate of relapse on maintenance therapy was 50% (3/6) within the first 5 weeks. The three other patients of Foscarnet maintenance did not relapse after a follow-up period of 12 weeks. In contrast to ganciclovir, Foscarnet did not induce neutropenia but it produced kidney toxicity that led to reversible renal insufficiency in three cases. Thus, Foscarnet appears to be a useful alternative to ganciclovir, particularly when combined with bone marrow toxic drugs, such as zidovudine (azidothymidine).

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Decompression of the optic nerve through the trans-ethmoid-sphenoidal approach in orbital injuries. Technic and results apropos of a new series].

An orbital injury can be responsible for compressing the optic nerve in the optic canal. This compression leads to a syndrome of physiological division with homo-lateral blindness and absence of pupillary reaction of light during stimulation of the injured eye, whereas the light reflex is present with contralateral stimulation. Computed tomography studies show the compression site directly: optic canal fracture, or indirectly: hematoma of posterior ethmoidal cells and sphenoidal sinus, fracture of the posterior part of the orbit. This type of injury can be improved by surgical decompression of the optic nerve via a trans-ethmoid-sphenoidal approach. The surgical technique will be first described. Then, the authors will report a series of 13 cases. In 6 cases, surgical decompression allowed recovery of visual acuity. The authors emphasize the uncomplicated post-operative course. Indeed, no complication was recorded and the hospitalization time was very short.

Adolescent↗
PubMed1989

[Diffuse retinoblastoma--apropos of a case].

We report a case of diffuse retinoblastoma in a 6 years old boy. The diagnosis should be suspected in front of the very evocative clinical picture itself. The aspect of the tyndall phenomenon, and of the convex pseudo-hypopyon, with iris pearls and nodules, together with a peripheral, imprecisely limited, retinal mass, non calcified on ultrasonographic examination, are typical. Aqueous paracentesis shows increased levels of Lactic Dehydrogenase (LDH), but most of all the cytologic examination confirms the diagnosis. The only treatment is enucleation. The clinical picture which may simulate uveitis, especially as this particular type of retinoblastoma has a late onset.

Child↗
PubMed1989

[Pathologic study of the eye and central nervous system in 25 cases of AIDS].

We have reviewed the clinical and pathologic findings of 25 patients with the acquired immunodeficiency syndrome (AIDS) who had a complete post-mortem examination including a study of the nervous system and of one or both eyes. Cytomegalovirus (CMV) retinitis was the most frequent type of ocular infection observed fundoscopically (9 of 18 cases examined clinically). There were only 3 cases of CMV encephalitis amongst the 8 cases of CMV retinitis documented pathologically. Cerebral toxoplasmosis was found in 12 of the 25 cases and in only one of these could Toxoplasma gondii cysts be demonstrated in the optic nerve. Cotton wool spots were the most frequent lesion observed fundoscopically (10 of 18 cases examined clinically). In the 3 cases where they were observed microscopically they corresponded to cytoid bodies which represented axonal swellings within the nerve fiber layer. The pathogenesis of this lesion in patients with AIDS is not understood. Intraocular lymphoma was present in only one case.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Diffuse infiltrating retinoblastoma].

We report 3 new cases of diffuse infiltrating retinoblastoma, and we review the 21 cases of the literature. Clinical features are typical but must not be confused with uveitis. The average age of onset is about 7 years, later than the usual retinoblastoma. Clinical features associate ocular redness, pseudo hypopion, iris nodules, clusters on the pupil and in the anterior chamber, opacities on the posterior face of the cornea. Hypertension appears resistant to medical treatment. The vitreous is hazy but the retina is still visible. The ophthalmoscopic examination reveals exudates covering the peripheric retina, and gray infiltrated retina. Usually there is no focal tumour mass, but totally diffuse tumoral infiltration. Echographic examination does not reveal calcification as in typical retinoblastoma. Neoplastic cells are demonstrated in anterior chamber paracentesis. Cytologic examination of aqueous humor aspirates may be misinterpreted and should be evaluated carefully. Because of tumor cells seeding, lactate dehydrogenase assay is of diagnostic value, prior to considering definitive therapy. None of the tumors were bilateral. The prognosis after enucleation appears good.

Child↗
PubMed1989

[Homonymous lateral quadranopsia disclosing cerebral toxoplasmosis in a patient with AIDS].

A case of Homonymous lateral quadranopsia revealing cerebral toxoplasmosis is reported in AIDS patient. Neuro-ophthalmologic manifestations must be explored by neuro-radiologic examination. Nuclear magnetic resonance would rather be performed than CT scan. Frequencies of cerebral and ocular toxoplasmosis localisations are compared. Severity of toxoplasmosis localisation justifies an early diagnosis based on immunological assay detecting the infection. Prophylactic treatment has to be instored.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Microphthalmos in Pierre Robin syndrome. Clinical and x-ray computed tomographic study].

The Pierre Robin Syndrome is characterized by three defects (8,9): micrognathia, cleft palate and glossoptosis responsible for respiratory failure. The new definition of this syndrome associates retrognathia, cleft palate and respiratory distress. This respiratory distress is mixed: obstructive due to glossoptosis, and central, secondary to brainstem immaturity (1,2). The main ocular manifestations associated with the syndrome are congenital glaucoma, high congenital myopia and retinal detachment. Microphtalmia has already been reported, but is infrequent. We present a clinical case of a major microphthalmia in a Pierre Robin Syndrome, confirmed by CT scan exploration.

Eye Diseases↗