[Comparative value of electroencephalography and computerized axial tomography in the diagnosis of cerebral tumors].
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Brain Neoplasms↗
Biomedical subjects
B Michel
Publications and source records attributed to B Michel.
[Etiological diagnosis of epilepsy: value of computerized axial tomography (C.A.T.) (author's transl)].
The authors appraise the value of CAT in the study of epilepsy from their personal experience and from the few published works that are available. The CAT confirms and supports a large number of already acquired facts:--the almost complete absence of cerebral lesions in "functional" epilepsies (primary generalized epilepsies and benign childhood epilepsy with rolandic paroxysms);--the large number of abnormalities in the secondary generalized epilepsies (West syndrome, Lennox-Gastaut syndrome) where the majority of patients present a bilateral fronto-temporal atrophy;--the high percentage of cerebral lesions in partial epilepsies. In this case, the CAT is especially notable in revealing etiologies in 63 p. 100 of cases. They include: tumors, abcesses, empyemas, angiomas, cerebral infarctions, cerebral atrophies, post-traumatic lesions, etc... From this study, it can be concluded that positive diagnosis of epilepsy is still made on the basis of clinical and electroencephalographic data, with the CAT used to facilitate the etiological diagnosis.
Adolescent↗
[Correlative study of E.E.G. and C.T. scan data during normal and pathological cerebral aging (author's transl)].
A total of 109 subjects aged 60 years or more and without any focalized cerebral lesions were studied by E.E.G. and C.T. scan recordings. An original type of planimetric study of the C.T. scan sections was used to obtain numerical ratios of the degree of cerebral atrophy. The planimetric ratios and the E.E.G. data were then studied as a function of age-group and clinical condition. Most of the data obtained was then treated in a computer. Ventricular dilatation is a constant and progressive feature of normal aging, and is therefore correlated with its, whereas it cannot be significantly correlated with senility changes. The E.E.G. shows no precise correlation with age during normal aging but reflects the functional disturbances of senility disorders, especially dementias. There is no correlation between the E.E.G. and C.T. scan results either during normal or pathological aging.
Aged↗
[Possible late-onset secondary generalized epilepsy. contribution of computed tomography (author's transl)].
Generalized tonic-clonic epileptic seizures appearing in elderly subjects have been recognized for a long time. The E.E.G. was able to distinguish two types: primary generalized epilepsy, and a secondary type of late onset which can be definitely separated from the group of partial epilepsies with generalized secondary fits by means of scanography. In fact, 60% of generalized attacks in the elderly are due to cerebral involution only. The authors suggest, therefore, that the group of secondary generalized epilepsies be enlarged to include this variety of late-onset generalized epilepsy, which appears to be related to the existence of diffuse cerebral lesions as shown by the cerebral atrophy demonstrated by the use of C.T. scan.
Aged↗
[Changes in sleep pattern in presenile and senile dementia (author's transl)].
Analysis of polygraphic recordings of nocturnal sleep in 21 patients with "degenerative" dementia led to the identification of two types of tracing. The first type was characterised by morphologically normal sleep with more marked quantitative changes than those caused by simple aging. In the second type, the criteria of identification of the physiological stages of sleep disappeared, requiring special definition of the E.E.G. appearances seen. These two types corresponded to two different stages of advancement and probably were indicative of the progressive extension of lesions.
Aged↗
Renal tissue angiotensins during converting enzyme inhibition in the spontaneously hypertensive rat.
To compare the effects of an angiotensin-converting enzyme inhibitor on circulating and tissue renin-angiotensin system (RAS), we measured different RAS parameters during the first day of treatment (Day1) as well as after two weeks of treatment (Day14). Ramipril was given orally once daily to adult male spontaneously hypertensive rats (SHR). Renin activity (RA), angiotensin converting enzyme (ACE) activity and levels of angiotensin I (ang I) and angiotensin II (ang II) in the plasma, renal cortex and renal medulla were assessed at Day1 and Day14 of the treatment. In the plasma, both RA and ang I increased 10 to 15 fold one to four hours after acute as well as at Day14 of ramipril treatment and then returned to basal values within 24 hours. Plasma ang II levels were not significantly decreased at Day1 or Day14. The decrease in the ang II/ang I ratio suggested a sustained inhibition of plasma ACE at Day14. In the renal cortex and medulla, a clearly different pattern was observed: in ramipril treated rats, RA in the renal cortex and medulla did not change at Day1 but at Day14 we observed a slight and sustained increase in RA. Despite very high basal levels of RA, ang I levels in the renal cortex were comparable to those in the plasma. The ang I level increased only one-fold one hour after ramipril intake at Day1 and Day14. This suggests that angiotensinogen may have a limiting role in the synthesis of ang I in the kidney. Ang II levels were slightly higher in the renal cortex and medulla than in the plasma suggesting local synthesis of the peptide. In the kidney, ang II levels decreased one and four hours after the acute or prolonged ramipril treatment and the ang II/ang I ratio was reduced at the same time. Our results show that the responses of the plasma and kidney components of the RAS to ACE inhibition are different in the plasma and the kidney suggesting that the circulating and tissue RAS are at least in part independent.
Angiotensin I↗
[Cerebrospinal fluid in neurodegenerative dementia pathologies].
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Cerebrospinal Fluid↗
[Molecular bases of arterial hypertension induced by cadmium].
In order to establish at subcellular level the biochemical role of cadmium in the etiology of arterial hypertension, we studied the effect of this metal on some mitochondrial functions. The results showed that cadmium inhibits calcium uptake as well as stimulates calcium release in kidney mitochondria. By the same token Cd2+ inhibits the ADP and ATP exchange-reaction and also inhibits succinate oxidation. From these results it is proposed that C d2+ interacts with--SH groups that are important for energy--linked reactions and calcium transport; the above produces metabolic modifications that may result in hypertensive disease.
Adenosine Diphosphate↗
[Epilepsy in advanced age].
A study was performed on 174 epileptic patients aged of 65 years and over. This semeiology of seizures of 156 patients can be categorized according to the international Classification of the epilepsies. Correlations were made between epilepsy form and scan. We had found that majority (74%) of the patients manifested parital seizures either with elementary or a complex symptomatology. The generalized tonico-clonic seizures of the aged were less frequent: 9% consisted of partial seizures secondarily generalized, 1% of Grand Mal primary generalized epilepsies and 16% of secondary generalized epilepsies due to a cerebral involution which can be only detectable with CT-scan. By means of CT-scan we were able to define the true etiology in 63% of our patients.
Age Factors↗
[CT scan in acute vascular disorders of the cerebellum (author's transl)].
The clinical diagnosis of acute vascular disorders of the cerebellum (AVDC) is uneasy. Classical views emphasized poor prognosis and need for cranial decompression. These views were probably due to the fact that, in the past, a correct diagnosis was made in the cases with the most dramatic symptoms only. The authors report their findings in 13 cases of AVCD. The diagnosis was confirmed or established by CT scan, which showed cerebellar hemorrhage in 6 patients and cerebellar infarctus in 7 patients. CT scan lead to the recognition of AVCD cases with a more benign course than traditionally thought. In 12 out of 13 patients, there was no need for neurosurgical treatment. Finally, CT scans allowed the diagnosis of hemorrhage versus ischaemia and repeat scans demonstrated the evolution of the lesion.
Aged↗
[Perforating follicular mucinosis and immediate hypersensitivity to mechlorethamine in a patient with mycosis fungoides].
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Adult↗
[Cerebellar hematomas and infarcts. Clinical and cerebral computerized tomographic findings].
Vascular accidents of the cerebellum are traditionally considered to be very difficult to diagnose, and as spontaneously following a fatal course without neurosurgical decompressive intervention. Such views are undoubtedly due to the fact that usually only the most serious vascular accidents of the cerebellum are diagnosed prior to surgical intervention or autopsy. Following 12 observations (2 hematomas and 5 infarcts) using computerized tomography, which facilitates the diagnosis of less severe forms, the authors suggest that some changes are necessary in the classic view of these disorders. From a clinical point of view, they point out the consistency of a cerebellar syndrome in their series and the subtlety of disturbances of consciousness. They also stress the possibility, verified in 10 these 12 cases, of a favourable outcome with medical treatment alone. The CT scan not only facilitates the diagnosis of vascular accidents of cerebellum, but can distinguish between hematomas and infarcts (the incidence of the latter has certainly been underestimated until now). Furthermore, the CT scan allows direct clinico-anatomical surveillance of the lesion, and equally importantly of its possible obstructing effects on the ventricular system.
Aged↗
[Use of immunopathological studies in dermatology. Immunofluorescence in the diagnosis of bullous diseases, lupus erythematosus and some other diseases].
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Antibodies↗
[Viewpoint on the methodology of drug trials affecting cognition of elderly patients].
Clinical trials for cognitive disorders in the elderly require specific methodological guidelines. They must take into account the psychosocial dimension of the patient and his family and must be based on serious neurobiologic knowledge. In degenerative dementias the progress of research concern genetics, molecular intercellular recognition and astrocytic cells. Biology of cognition like hippocampal long term potentiation provides good pharmacologic basis for trials. In normal brain aging several ways must be developed: aminergic systems, free radicals, excitotoxic amino-acid, nerves growth factors. Clinical trials bring informations for pharmacology and epidemiology. Cholinergic neurons are the main pharmacologic target but there are many other ones: GABA-ergic system, Tau protein, amyloid. A rigourous selection of patients allows to precise the nosology of illness responsible of cognitive disorders and to point-out early clinical signs that represent a more sensitive target. Diagnostic criteria are useful in Alzheimer's disease, memory impairment, vascular dementias and other dementias. Evaluation of stage and evolution of dementia, comorbidity, limits of age and caregiver are practical problems. The effects of drugs used to treat cognitive functions are subtle so it is necessary to detect them to choose the best tests in function of each trial. Laboratory investigations can be used to evaluate the response to drug administration. Ethical point of view is represented by the fact that old people with cognitive impairment must not be away from therapeutic progress. In this field we must consider carefully the consequences of cognitive impairment on patient judgment and consent to clinical trial. Legal problems are regulated by supranational rules and French directives of Huriet law.
Aged↗