Biomedical subjects
Publications and source records attributed to G Lasfargues.
Three cases of acute myeloblastic leukemia of FAB-M2 type revealed by an isolated otitis media are reported. This mean of revelation is valuable for early diagnosis and treatment of the disease. A karyotype was performed in two cases and showed an 8;21 translocation. As far as we know, these are the first acute myeloblastic leukemia cases with otitis media reported in which an 8;21 translocation was detected.
A neonate who was not given prophylactic vitamin K injection was admitted with acute anemia and hemoperitoneum. The evolution was favorable with medical treatment only. Vitamin K deficiency appears to be the main cause of this hemorrhagic disease. There is a controversy on this subject, as hepatic deficiency seems to be involved in certain cases.
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On the basis of 4 personal cases, the authors recall the principal features of pleural effusions caused by chronic pancreatitis. The pancreatic origin should be suggested in any case of recurrent exudative pleurisy. The assay of amylase in the pleural fluid is the key to the diagnosis. Investigation of pancreatitis benefits from modern methods of morphological investigations, essentially retrograde cholangiography and abdominal computed tomography. Treatment consists above all of that of the causal lesion : initially medical and sometimes requiring surgery.
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Imipenem, a new carbapenem (thienamycin) beta-lactam antibiotic which is clinically used in a 1:1 combination with cilastatin, an inhibitor of renal metabolism of imipenem, was evaluated in 25 patients; 11 children and 14 neonates. A mean daily dose of 60 mg/kg was given to children and the dose in neonates was 50 mg/kg. Clinically, 21 patients were cured, two failed to respond to treatment and two were not evaluable. Pharmacokinetic studies were performed in the 11 children and in 10 of the neonates. The mean elimination half-life of imipenem was 0.87 h in children and 2.1 h in neonates. The mean cilastatin elimination half-life was 0.73 h in children and 5.1 h in neonates. This difference in half-life between children and neonates is similar to the one noted between healthy adults and adults with renal insufficiency. No accumulation of imipenem was seen in neonates studied on the first and fifth days of treatment.
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Digital arterial circulation before and after administration of a vasodilator orally was explored by mercury gauge pulsed plethysmography and photoplethysmography in 12 patients with primary Raynaud's phenomenon and results compared with those of 10 healthy volunteers. The amplification factor F, ratio of amplitude in reactive hyperemia over amplitude at rest was determined in the index before and after 8 mg daily of dihydroergokryptine over 4 weeks. Before treatment, for each of the two plethysmographic technics, a significant increase in mean factor F values was noted in the patients with Raynaud's phenomenon when compared with healthy controls. This is due to a decline in digital arterial flow at rest. Using the mercury gauge plethysmograph, a significant reduction in factor F was observed after vasodilator treatment corresponding to an increase in digital flow at rest without increase in flow during hyperemia. Using photoplethysmography, no significant variation in factor F was noted after treatment. Mercury gauge plethysmography, which measures global digital blood flow appears to be a more sensitive method than photoplethysmography, which measures dermal and hypodermal blood flow, for follow-up of effects of vasodilator treatment on Raynaud's phenomenon.
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Bacterial adhesivity test to epithelial cells in vitro was studied, in order to investigate whether urinary, and buccal cells, from children prone to recurrent urinary tract infections (UTI) are better adhered to by uropathogen Escherichia coli (E. coli), as compared to cells from control children, non-prone to recurrent UTI. Cells were withdrawn from 75 children, divided into 3 groups: with recurrent UTI without uropathy, with recurrent UTI and uropathy, and controls, without recurrent UTI and without uropathy. Values obtained showed that most of the children, prone or not to recurrent UTI, have cells allowing good adhesivity of the 2 uropathogen E. coli used and that there is no significant difference among these results and no relation with the 3 described groups. Bacterial adhesivity appears dependent on individual genetic variations of cell donors, presumably related to membrane receptors. Studies on in vitro bacterial adhesivity do not seem to be able to explain pathogenesis of recurrent UTI.
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Macrodystrophia lipomatosa is the hypertrophy of a limb or of a limb-segment due to fatty infiltration. X-ray examination of the soft tissues which reveals the presence of fat, most often allows the easy distinction of this disorder from other causes of localized hypertrophy.
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The first case of painful abdominal crisis caused by hydrops of the gallbladder during sickle cell disease is reported. The cholecystosonography allowed diagnosis and supervision in a 4 year-old black boy with sickle cell anemia. The persistence of hydrops led to cholecystectomy. Pathophysiology is discussed according to the other etiologies reported in the literature.
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