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Biomedical subjects

D Michel

Publications and source records attributed to D Michel.

At least 217 records · Page 12Linked to original sources
PubMed1982

[Left paramedian thalamic infarct. Memory and language study].

Unusual findings in a patient with a paramedian infarct of the left thalamus, shown by CT scan were the elective nature and long duration of memory disorders. Mild amnesia has been relatively stable for two years, and is apparent during tests as an anterograde verbal memory deficiency for all modalities (serial, associative, logical), without facilitation during learning or recall by semantic or phonologic cues. On the other hand, anterograde visual, gestual or tactile memory, and particularly retrograde verbal and visual memory are well retained. The worsening effect of verbal interferences on word learning is emphasized, whereas no similar phenomenon has been observed for visual material. The antero-internal thalamic lesion in the dominant hemisphere results in a memory disorder of a particular type which cannot be explained by the cognitive disorder, or by the very transient initial aphasic disturbance. Prolonged verbal amnesia with persistent reduction in fluency most probably results from a deficiency of specific incitation in using and memorizing verbal material, without other negligence phenomena. The role of the thalamocortical and particularly frontocingular connections are discussed, according to the semiology.

Association Learning↗
PubMed1981

[Surgery for rectum carcinoma in the very aged (author's transl)].

There are no principal restrictions concerning surgery of the large bowel in the very aged. Report on 212 patients more than 75 ys. old, who had to undergo surgery for rectum-carcinoma. Results on morbidity and lethality and considerations about the quality of life in the remaining short time of the old patients life are referred. There is no borderline of age for operations of palliative nor curative intention in large gut surgery of the aged to be accepted. Instead one should follow the simple rules of tumor surgery, where there is an absolute indication for radical surgery if there are no general nor local contraindications on the tumorectomy.

Age Factors↗
PubMed1981

[Acute, recent and sometimes persistent Mycoplasma pneumoniae infections associated with neurologic manifestations. Discussion of causal relations].

Neurological disorders associated with recent and sometimes persistent Mycoplasma pneumoniae infections were present in 9 patients, examined within the course of a year, during the 1980 epidemic in Saint-Etienne, France. Cases included 5 with acute polyneuritis, 2 with lymphocytic meningitis, 1 with a bilateral optic neuritis, and 1 with mild encephalitis presenting as an amnesic disorder. Causal relationships are examined with respect to semiological, biological, therapeutic and epidemiological data. Clinically an initial infection compatible with the mycoplasmic etiology and its time relationship with the nervous system lesion appear to be more significant than the inflammatory neurological symptoms and signs. It is often impossible to ascertain the efficiency of the antibiotic therapy, which thus cannot help to the aetiological diagnosis. From the biological point of view, though seroconversion by complement fixation test remains the basis of the diagnosis, it has been completed by the isolation of Mycoplasma pneumoniae in the blood of 3 of the patients, and by a longitudinal study of specific blood IgM levels in the 6 others. Presence in the CSF of these locally synthesised specific IgM during the early stages of the neurological disorders in 2 patients, constitutes a new significant fact for the physiopathological discussions and a basic fact to clarify the aetiological diagnosis. The concept of persistent infection is discussed with respect to the isolation of Mycoplasma pneumoniae in the blood at a late stage, and the abnormally long presence of high levels of specific serum IgM levels. This biological persistence does not always correspond to a chronic course of the clinical disease which was observed in only 3 of the patients. The mixed viral infection, present in 3 cases, is linked with immunity disorders due to Mycoplasma pneumoniae, which are mainly a cell immunity depression: this markedly complicates the analysis of causal relationships. Finally, the chronological order of the clinical and biological events remains of prime importance when studying each case individually, whereas epidemiological data are essential for establishing a posteriori that the neurological manifestations were true complications of the microorganism.

Acute Disease↗
PubMed1981

[Peptic ulcer surgery in the aged].

Particular problems are discussed in 257 patients over 75 years of age, who were treated for peptic ulcer disease between 1960 and 1979. In elderly patients the peptic ulcer is complicated, often requiring emergency surgery. A special problem in the aged is simultaneous appearance of various sicknesses, which produces further complications. The chosen method of surgery is described and the post-operative period and its general and surgical problems are discussed. The result is a concept of indication for surgery, particularly for the elective operation of chronic ulcers not responding to therapy, before the ulcer becomes complicated.

Aged↗
PubMed1981

[Effects of physostigmine on amnesic syndromes (author's transl)].

Eserine sulphate (physostigmine) tests were conducted in 23 patients with amnesia due to cerebral lesions. Psychometric examinations were performed before and after treatment. Results were analysed statistically for the whole group, and after distribution of patients as a function of the etiology, of the mechanism involved, and of the presumed lesions: 1) amnesias related to lesions along Papez' circuit as shown on CT scans were compared with those with normal CT scans; 2) amnesias of the "hippocampic" types were compared with other neuropsychological types. After eserine sulphate learning ability rapidly improved, in all cases, whereas spontaneous or assisted recall was only slightly improved. No significant differences in learning or recall were noted between the group with normal CT scans and that with evidence of bilateral lesions. In contrast, the efficiency of physostigmine was clearly related to the nature of neuropsychological disorders both for learning and recall of verbal material : a positive effect occurred only in the group with obvious evocation and recall disorders (mamillary, thalamic, or cingular lesions). For improvement to occur the product had be be injected before learning. The role of cholinergic mediators in memory is discussed with regard to these observations. Overall benefit was poor since lasting improvement in fixation was noted in one case only. Thus eserine sulphate appears of little value for prolonged therapy. It may be useful for a functional test during neuropsychological investigations.

Adult↗
PubMed1981

[Preliminary results for a 434 MHz microwave hyperthermia applicator (author's transl)].

Laboratory tests on inert gel and gel of different compositions were conducted to determine the distribution of isothermal temperature zones. The repartition in depth and along a perpendicular plane to the applicator axis was studied as a function of different parameters: the skin cooling water temperature of the applicator, the incident microwave power, the application time, the gel composition and the antenna position. Experimental results were compared to theoretical values corresponding to a plane microwave penetrating into a tissue-equivalent medium. To take into account in vivo temperature regulation phenomena, the same measurements were made in vivo in pigs and humans and compared to in vitro results.

Animals↗
PubMed1980

[Primary postural hypotension. Physiopathological study of 8 cases (author's transl)].

Physiological tests showed that both branches of the baroreflex arc-vagal cardiomoderator and, predominantly, sympathetic vasoconstrictor--were affected. There was no rise in serum and urinary noradrenaline levels in standing position, and adrenaline concentrations were rarely increased under induced hypoglycaemia. Dopamine beta-hydroxylase activity and reactivity of the renin-angiotensin-aldosterone system remained normal in most cases. Physiopathologically, the two clinical forms described (i.e. with and without central nervous symptoms) cannot be differentiated.

Aged↗
PubMed1979

[Surgical treatment of rectal neoplasms in the very old patient].

Efforts and results of curative and palliative treatment of rectum carcinoma in the very aged (more than 75 years old) are shown by a follow-up study including 212 patients operated in our clinic. Establishing an absolute indication for radical resection of the malignant tumor the contraindications in this collective are pointed out. There is practically no difference between the results of curative and palliative treatment of rectum carcinoma in the very aged regarding letality and morbidity if contraindications are strictly considered and accurate pre- and postoperative treatment is guaranteed.

Aged↗
PubMed1979

[Cardiac surgery in patients older than 60 years (author's transl)].

If indicated cardiac surgery can be performed in geriatric patients with success. Among 525 own patients there were 63 older than 60 years (12%), especially patients with stenosis and/or incompetence of aortic or mitral valve, instable angina pectoris, and certain congenital malformations (atrial septal defect). The poor prognosis of these diseases in the elderly must be compared with the higher early mortality in surgically treated aged patients.

Age Factors↗