Biomedical subjects
G Decaux
Publications and source records attributed to G Decaux.
Chronic alcoholism: a predisposing factor for hypocalcemia in acute pancreatitis.
The serum levels of calcium, corrected for serum albumin, were investigated in 65 consecutive patients with acute pancreatitis. Hypocalcemia was present in 55% of 38 patients in whom chronic alcoholism was the associated etiology, and in 26% of 27 other patients (p less than 0.02). In the alcoholic patients, the mean duration of hypocalcemia was significantly longer than in the non-alcoholic patients (5 vs. 1--2 days; p less than 0.001). The severity of pancreatitis seemed to be comparable in both groups of patients. This suggests that chronic alcoholism may be a predisposing factor for hypocalcemia in acute pancreatitis.
In vitro regulation of ornithine decarboxylase in dog thyroid slices.
Ornithine decarboxylase (ODC) activity in dog thyroid slices incubated in vitro disappears when protein or RNA synthesis is inhibited. Thus, as in other tissues, the level of the enzyme reflects a balance between rapid synthesis and catabolism. TSH, dibutyryl cAMP, prostaglandin E1 (PGE1), and cholera toxin all stimulated dog thyroid ODC activity. These actions were potentiated by the inhibitor of phosphodiesterases, 4-(3-butoxy-4-methoxy-benzyl)2-imidazolidinone (Ro 20-1724), and reproduced by high concentrations of this inhibitor, while 1-methyl-3-isobutylxanthine inhibited ODC induction. Iodide blocked the action of TSH; this inhibition was relieved by methimazole. Calcium depletion or manganese addition depressed enzyme levels in control and stimulated tissue. In some cases (ionophore A23187 addition and calcium depletion), total protein synthesis was also depressed. Carbamylcholine and the ionophore A23187, which can raise cGMP in thyroid slices, inhibited TSH and dibutyryl cAMP induced ODC increases, PGF1 alpha was inhibitory to ODC stimulation. Indomethacin, which had no effect on TSH action, relieved carbamylcholine inhibition. These results show that dog thyroid ODC is stimulated by TSH through cAMP, and suggest that cholinergic stimulation of the tissue blocks TSH activation of the enzyme, possibly at a step beyond cAMP synthesis, by increasing PGF synthesis. The effect of carbamylcholine is not due to cGMP, since it can be obtained under conditions where basal cGMP levels are not increased.
Hypouremia in the syndrome of inappropriate secretion of antidiuretic hormone.
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Fludrocortisone in orthostatic hypotension.
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Neurosyphilis yesterday and today.
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Thyroid function and laboratory tests.
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Hyponatremia in the intensive care: from diagnosis to treatment.
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High 6-thioguanine nucleotide levels and low thiopurine methyltransferase activity in patients with lupus erythematosus treated with azathioprine.
Azathioprine (AZA) is characterized by a high interindividual variability in bioavailability and metabolism. AZA is converted into 6-thioguanine nucleotides (6-TGN) to which the immune modifier activity is attributed. The 6-TGN levels are known to be affected by the activity of the key enzyme, thiopurine methyltransferase (TPMT), which is under genetic dependence. The authors measured a significantly lower TPMT activity in 53 women with systemic lupus erythematosus (SLE) (12.2 +/- 2.4 pmol/h/ml RBC; P < 0.01) when compared with 30 healthy control participants (13.15 +/- 3.1 pmol/h/ml RBC) but not with 28 patients with other dysimmune diseases (non-SLE; 13.0 +/- 3.0 pmol/h/ml RBC; P = 0.10). To evaluate the impact of TPMT activity on the concentrations of AZA metabolites, we measured the TPMT activity and 6-TGN levels in a subgroup of 26 patients in remission and treated with a stable dose of AZA (mean value: 1.9 +/- 0.5 mg/kg/day) for at least six months (n = 13 with SLE and n = 13 with other dysimmune diseases, ie, non-SLE). In such a subgroup, no correlation between 6-TGN levels and TPMT activity was observed. However, patients with SLE presented lower TPMT activity and higher 6-TGN levels (215 +/- 123 versus 140 +/- 75 pmol/8 x 10(8) RBC in non-SLE patients; P < 0.04). It must be noted that transient increase in 6-methylmercaptopurine levels (6-MMP), a putative toxic metabolite (up to 21.7 nmol/8 x 10(8) RBC), was more frequently observed in the non-SLE group (P < 0.01). Even if a relationship was observed between low TPMT activity and 6-TGN levels in SLE, its clinical impact appears to be limited as far as regular hematologic controls are performed.
Possible association between deep infection and hypertrophic osteoarthropathy. Report of three cases and review of the literature.
Hypertrophic Osteoarthropathy is classically associated with chronic pulmonary disease, cancer or inflammatory bowel disease. However, deep infection such as vascular graft infection is an etiology important to recognize because of the risk of life-threatening complication (aorto-enteric fistula). In this study, we reported two cases of aortic graft infection and one case of para-anal abscess associated with hypertrophic osteoarthropathy. The previously reported cases are reviewed.
Electrolyte and acid-base disturbances in diabetes mellitus.
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Myopericarditis revealing adult-onset Still's disease.
We report the case of a 33 year-old man presenting with fever, arthralgias, sore throat, dyspnea and chest pain. Myopericarditis was diagnosed on the basis of electrocardiogram, echocardiography and cardiac magnetic resonance imaging (MRI). The dramatic increase in ferritinemia suggested the diagnosis of adult-onset Still's disease (AOSD), which could be established according to criteria of Yamaguchi. Rapid improvement occured under corticosteroids. Myocarditis is very rare in AOSD, pericarditis being more frequent. We report herein the first description of AOSD associated myocarditis evidenced by cardiac MRI.
Very high elevation of CA19-9 level in a patient with steatosis.
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[Blood volume and urinary sodium, potassium and uric acid in cirrhosis. Evidence of the hypersensitivity of the nephron to aldosterone].
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[When can one consider the use of urea in cirrhotic patients with ascites?].
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Sequential trigeminal sensory neuropathy.
In a patient presenting bilateral sensory neuropathy, sequential involvement of the two sides of the face with spontaneous recovery on the initially altered side is a peculiar feature which emphasizes the benign character of this unusual condition. Provided that repeated clinical evaluation discloses no underlying pathological process, sensory trigeminal neuropathy may be considered a self-limited benign condition, comparable to Bell's palsy.
Hyponatremia in the syndrome of inappropriate secretion of antidiuretic hormone. Rapid correction with urea, sodium chloride, and water restriction therapy.
In the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), rapid elevation of serum sodium concentration may be imperative to correct neurological symptoms. Seven patients with hyponatremia secondary to SIADH were treated by oral intake of two to three doses of 30 g of urea over 24 hours or infusion of 80 g of urea as a 30% solution of over six hours, water restriction (500 mL/24 hr), and sodium supplements (120 to 360 mmole/24 hr). Serum sodium concentration increased from 117 +/- 2 to 126 +/- 1.4 mmole/L (mean +/- SEM) after eight hours, to 130 +/- 1.3 mmole/L after 12 hours, and to 134.5 +/- 1.2 mmole/L after 24 hours. The normalization of serum sodium was secondary to osmotic diuresis and to sodium retention induced by urea. Use of urea should be considered when symptomatic hyponatremia in SIADH must be quickly corrected.
[Chronic fatigue syndrome].
The major and minor diagnostic criteria of the chronic fatigue syndrome are described. The stages of the differential diagnosis, the diagnostic strategies and the controversies, while insisting on certain sleeping disorders are discussed. The cause of the syndrome may be a viral infection, and an anxious-depressive state may increase somatic complaints. Patients with chronic fatigue syndrome did not demonstrate a specific response to therapy. Spontaneous remission after a few years is a typical feature of this syndrome.