[Orchitis, the only manifestation of a paratyphoid B fever].
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Biomedical subjects
Publications and source records attributed to F Dumont.
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INTRODUCTION: Hartmann's procedure (HP) is a simple operation, which can be performed by all the surgeons. However, it remains criticized (high morbimortality, low rate of intestinal continuity restoration). The aim of this study was to analyse natural history of HP and intestinal continuity restoration for sigmoid diverticulitis, and to assess risk factors for mortality, morbidity and absence of intestinal continuity restoration. PATIENTS AND METHODS: In three centers, from 1992 to 2002, 85 patients underwent HP. A retrospective analysis was performed on mortality, early and late morbidity of HP and intestinal continuity restoration. RESULTS: 22% of patients (mean age, 68 years) presented comorbidity, 17% of them, an altered immunity, and 3 or 4 Hinchey score for 64%. ASA score was > or =3 in 49% of the cases. Mean AFC and Mannheim scores were 2 and 21 respectively. Mortality rate was 14% and in-hospital morbidity, 50%. Main complications were: cardiorespiratory (18%), wound abcess (14%) and stomal (6%). No rectal stump fistula was noted. Mean hospital stay was 19+/-13 days. Late morbidity rate was 29%, mainly due to stomal complications (12%) and small bowel obstruction (7%). Intestinal continuity restoration was done in 77% of the cases, followed by only 1 fistula. Mortality rate for intestinal continuity restoration was 0% and morbidity was 13%. Mean hospital stay was 10+/-3 days. Age >75 years, ASA score > or =3 and comorbidity were risk factors for morbidity and mortality and for absence of intestinal continuity restoration. CONCLUSIONS: HP is associated with a high morbidity and mortality rates. Intestinal continuity restoration rate was high in this series. HP is a simple operation in high-risk patients with advanced peritonitis. This study allows to precise natural history of HP. Knowledge of this history is crucial for choosing the best operation (between HP and anastomosis) for patient with peritonitis complications sigmoid diverticuitis.
Serotonin (5-HT) and more specifically the 5-HT(2A) receptor is involved in cognitive and non-cognitive behavior and plays an important role in Alzheimer's disease (AD). The objective was to assess the 5-HT(2A) binding potential (BP) in healthy volunteers and AD with SPECT and 123I-5-I-R91150, a selective radio-iodinated 5-HT(2A) receptor antagonist. Twenty-six controls and nine AD patients were included. A semiquantitive analysis with normalization on cerebellar uptake provided estimates of BP for 26 cortical regions of interest. An age-related decline of neocortical BP was found (11.6% per decade). Compared to age-matched controls, a generally decreased neocortical BP in AD was found with a significant regional reduction in the orbitofrontal, prefrontal, lateral frontal, cingulate, sensorimotor, parietal inferior, and occipital region. These results are in line with previous postmortem, in vitro, and PET findings. The age-related decline highlights the necessity for matched advanced age study samples. The fact that the 5-HT(2A) receptor is differentially affected in AD patients has implications for both the etiological basis and therapeutic management of AD.
This case report describes the use of the 99mTc-labeled radiopharmaceutical ciprofloxacin (Infecton) in a case of hip prosthesis loosening in a dog. Serial planar radiographs were not conclusive, and culture of the synovial fluid was negative. Antibiotic treatment did not result in improvement of the lameness. Scintigraphy was performed with 99-Tc-Infecton, a tracer claimed to be specific for infection. Antibiotic treatment was interrupted 6 weeks prior to the examination. Planar and tomographic images at 3 h and at 24 h postinjection showed increased activity along the acetabulum and the proximal femoral bone surrounding the femoral prosthesis, indicating focal infection. Bacteriology performed after removal of the implant revealed Pseudomonas aeruginosa.
The pattern of the specific 5-HT2A (5-hydroxytryptamine 2A receptor) antagonist 123I-5-I-R91150 was measured in 10 healthy dogs without neurologic and behavior abnormalities. Eight cortical regions (left and right fronto-, temporo-, parieto-, and occipitocortical area), one global subcortical region (including the thalamic system) were compared with a reference region lacking receptors; that is, the cerebellum. The 123I labeled radioligand was injected intravenously 100-200 minutes before acquisition. Both transmission and emission data were obtained with a triple head gamma camera equipped with high-resolution fanbeam collimators. The emission data were corrected for scatter and attenuation. To delineate different cerebral regions more accurately, the regions of interest (ROI) defined in a former study on brain perfusion measured with 99mTc-ethyl cysteinate dimer (ECD) in the same dogs were used. The co-registration of the 99mTc-ECD and the 123I-5-I-R91150, obtained from each dog, was realized with the help of corresponding transmission maps. By normalizing each regional cerebral activity to the activity observed in the cerebellum, the regional radioactivity (binding index) could be relatively quantified. Highest brain uptake was noted in the frontocortical brain areas (right: 1.85, left: 1.89), followed by the temporocortical region (right: 1.58, left: 1.56). Least uptake was noted in the more caudal and middle brain regions [occipito- (right: 1.46, left: 1.41), parietocortical (right: 1.30, left: 1.26), and striatal region (1.19)]. No gender nor age influence was noted in this series. The 123I labeled serotonin-2A receptor ligand seems to have similar cortical binding in the normal canine brain, as shown in humans and other animal species. A frontocortical to occipitocortical (rostrocaudal) binding index gradient was identified within the dog, which has not been seen in imaging studies from humans and other animal species. The significance of these results will need further investigation. This normative data can be used to compare regional brain uptake of the 123I-radioligand to dogs with behavioral disorders related to the serotonergic system, in future studies.
Nude spleen (B) cells were cultivated in vitro in a serum-free medium, without or with lipopolysaccharide (LPS) and their surface-charge was measured by cell electrophoresis. In the absence of LPS, surface-charge did not vary significantly with time, whereas, in the presence of LPS a biphasic modification was observed. Thus, after 4 hours of culture with LPS, surface-charge was diminished by 14%. Subsequently, when DNA synthesis and blast formation were activated, it increased by up to 19-23% over control value, whether LPS was present continuously in the medium or had been eliminated by washing after 4 hours of incubation.
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Lymphocytes from axillary and brachial lymph nodes (LN) were fractionated on the basis of electrophoretic mobility (EPM) differences by means of free-flow electrophoresis and the fractions were analysed for size distribution with a "Coulter" counter. The data were combined to form a contour map (fingerprint) representative of the various LN cell types. LN fingerprint from adult mice exhibited a distinctly bimodal pattern with a low-mobility (LM) population corresponding to B cells and a high-mobility (HM) population (80%) corresponding to T cells. These 2 populations peaked 8 to 10 electrophoretic fractions apart. In marked contrast, LN fingerprint from neonatal mice regularly presented a single peak in the HM region which was by 3 electrophoretic fractions slower than in adult mice. These neonatal HM(T) cells possessed a larger modal volume (Coulter channel no 44) than that of adult HM(T) cells (Coulter channel no 37). Moreover, these early appearing LN-T cells were found to be endowed with the same EPM as OHC-resistant thymocytes which might suggest some connection between both populations.
The application of the 06-26-1990 law for the protection of mentally ill persons has confronted the psychiatrists working in general psychiatry wards with the problem of keeping up patients hospitalized against their own will and following a judiciary authority decision. Having to deal with this problem, the authors first reviewed the literature about the use of restraint techniques in psychiatry. They observed that these universally used techniques were strikingly denied in the psychiatric literature so that their accurate application was made difficult because of the lack of information about their indications, contra-indications and application modalities. Afterwards, the authors have compared the different restraint techniques in a retrospective study over a one year period among voluntarily hospitalized patients and patients admitted against their wil in application of the 06-26-1990 law. They reported that the application of the law undoubtedly increased the number of restraint but did not modify either the population characteristics of the treatment modalities. These results have to be further confirmed in a prospective study.