Biomedical subjects
Publications and source records attributed to G Martet.
The authors report a case of a large ganglioneurinoma located in the mediastinum. The clinical course of this rare benign neurogenic tumour of the posterior mediastinum includes a low risk of medullary compression. The treatment is surgical resection.
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Authors have studied TNF alpha, IL1 bêta, IL6 and RIL2s in 28 malaria illness patients. Increased levels of TNF, IL1 bêta and RIL2s in serum, are observed on admission to hospital. These cytokine levels are decreased, eight days later, after patients are treated. In discussion, TNF levels as a prognosis component is evocated.
In a poorly equipped tropical setting, limb amputation is often considered as the only therapeutic solution for malignant tumors or large benign tumors. However it can be avoided by bone replacement using an avascular autologous fibular graft. This method was used in a young girl from Tchad presenting a giant cavernous hemangioma of the humerus. This technique allowed salvage of the extremity but resulted inevitably in radial paralysis. The time needed for bone healing was normal. This technique required minimum facilities and was perfectly biocompatible. It can be used in tropical settings where allograft techniques and prosthetic replacement are not available.
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Alveolar fluid absorption is a process driven by transepithelial alveolar Na+ transport. Since lungs produce significant amounts of lactate under anaerobic but also under aerobic conditions, glycolysis may conceivably contribute to producing the energy needed for transepithelial Na+ transport and fluid absorption. The effects of inhibition of oxidative phosphorylation or glycolysis on alveolar Na+ transport, fluid absorption, and preservation of alveolar epithelial barrier properties were examined using isolated, fluid-filled rat lungs. Basal lung lactate production was 65 +/- 1.0 mumol/h/g dry wt in the presence of 10 mmol/liter glucose. When oxidative phosphorylation was inhibited with rotenone, cyanide, or the uncoupler carbonyl cyanide m-chlorophenylhydrazone (CCCP), lung lactate production increased 5- to 7-fold within 30 min (P < 0.001). No significant decrease in alveolar Na+ transport was observed over 1 h, whereas a 3-fold increase in passive epithelial permeability was observed. With rotenone and CCCP, but not cyanide, fluid absorption from airspaces was decreased but never abolished. Inhibition of aerobic glycolysis with iodoacetate did not significantly affect alveolar Na+ transport or fluid absorption. In the presence of isoproterenol or dibutyryl cyclic adenosine monophosphate (cAMP) + isobutylmethylxanthine, which have previously been shown to stimulate alveolar Na+ transport, lung lactate production increased 2-fold (P < 0.001). Inhibition of glycolysis depressed stimulated alveolar Na+ and fluid transports (P < 0.001). Inhibition of ion transport by ouabain or amiloride decreased lung lactate production (P < 0.001) under stimulated but not under unstimulated conditions. These observations suggest that glycolysis does not significantly contribute to energy provision for alveolar epithelial Na+ transport in lungs under basal, aerobic conditions.(ABSTRACT TRUNCATED AT 250 WORDS)
Bronchoalveolar lavage (BAL) was performed in 34 consecutive patients with spondyloarthropathy (SA) compared with 9 controls. Lymphocytic alveolitis was found in the SA group with decrease in the ratio of the CD4/CD8 subsets in both lung and blood. Neutrophilic alveolitis was also found in 5 patients with SA of long duration. As with other inflammatory diseases, it seems that a subclinical alveolitis is present in SA patients.
The authors report about eleven cases, distributed over four years, of bronchial cancers with a normal thoracic image that were discovered on bronchial endoscopy. In this context, they sum up the limitations of medical imaging, the undisputed merits of bronchial endoscopy, and the major epidemiological and therapeutic features of this clinical form of bronchial cancer.
In countries where chemoresistance of Plasmodium falciparum is high (group III), mefloquine must be advocated for malaria prophylaxis for a stay less than 3 months. If it is more and particularly in Indo-china peninsular countries (Thailand, Birmania, Kamputchéa, Laos, Vietnam) and in Amazonia, advocated chemoprophylaxis is doxycycline 100 mg per day. Authors remind action mechanism, contraindication and side effects of this drug. Others publications underline the good tolerance of doxycycline now used by 1,400 french soldiers staying for 6 months with United Nations Organisation in Kamputchéa. An evaluation of tolerance and efficiency of this chemoprophylaxis is now in progress.
We carried out in 1989 a non randomized comparative study in French army units which had been in Central Africa (Central African Republic and Gabon) for 4 months, in order to compare in 758 men on return from malaria areas the usual strategy of chemoprophylaxis with chloroquine and a radical cure by halofantrine (Halfan). Chloroquine was taken by 278 men (100 mg daily for 6 weeks after their return to France); the other 480 men were given two doses of 1,500 mg halofantrine on the third and on the tenth day after their return to France. In Africa both of the units were on chloroquine prophylaxis (100 mg daily for 4 months). The Plasmodium falciparum attack rates were, during a period of 5 months after the return to France, 0.2% in the halofantrine group (1/480) and 4.7% (13/228) in the chloroquine group (P < 10(-4)). The radical cure by halofantrine was more effective than chloroquine prophylaxis in preventing falciparum malaria on return from malaria areas.
The authors report a case of grade I-II giant-cell tumour of the ribs extending to the thorax and the vertebral column. The tumour was treated by surgical resection followed by vertebral curettage in two stages and adjuvant regional radiotherapy. Giant-cell tumours of the ribs are exceptional and rarely found in the literature. They raise a therapeutic problem (surgery is essential, but radiotherapy is controverted), and a prognostic problem (there is always a potential risk of recurrent malignancy).
From a series of 100 patients hospitalized for chronic hepatitis B infections (HBV), 51 chronic carriers of the HBs antigen without elevated aminotransferases or circulating HBV DNA were studied retrospectively. They had no unusual epidemiological or clinical features compared to the other patients, but were distinguished by their normal liver function tests, except for 5 cases of isolated hypergammaglobulinemia. Hepatic biopsies performed on 28 patients showed minor lesions or normal tissue in 61% of the cases and persistent chronic hepatitis (PCH) in 39% of them. No clinical or biological abnormality was significantly associated with PCH, which was attributed to a delta hepatitis (HDV) superinfection in only one case. There were no cases of active chronic hepatitis or cirrhosis. The significance of the histological lesions in the absence of HBV replication or other symptoms of hepatocyte aggression was not elucidated; their longterm prognosis is not known even if no other difference, identifiable by usual methods, seems to exist between these "pseudo-healthy" carriers and real healthy carriers of HBV.
Two patients with post-traumatic osteolysis of the distal end of the clavicle undergoing surgery 5 months and 22 months respectively after the initial trauma were evaluated histopathologically. The lysed zone was replaced by tissue of fibrous appearance, with little blood supply and non-inflammatory, the presence of which could be suspected by magnetic resonance. The synovial membrane, non-inflammatory but hypervascularised, participated in the process but did not appear to be directly responsible for the osteolysis. The osseous tissue of the patient, operated upon early, showed signs of osteoclastic resorption but there was neither stasis, vasodilatation nor signs of osteogenesis. These various findings suggest that post-traumatic osteolysis of the distal end of the clavicle does not result from local ischemic events. These appearances seem identical to those described in multifocal primary osteolysis, the cause of which also remains unknown.
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The authors report the results of a valuation of paludometric indices during mai 1990 in Democratic São Tomé e Príncipe Republic (RDSTP). These investigations (parasitic index and spleen index) suggest that malaria is mesoendemic in these area. Plasmodium susceptibility to chloroquine at posology of 25 mg/kg per os was evaluated (WHO standard 7 days field test). Among 58 children, ranging from 5 to 11 years old, resistance at level R I was observed in 9% of cases, at level R II in 14%. Among 10 strains of P. falciparum, 9 were chloroquine resistant in vitro. 2 strains were also less sensible to quinine.
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The authors describe a case of post-traumatic osteolysis of the clavicle. The clinical and roentgenographic aspects are well known. But regarding the lytic X ray aspect, another diagnosis, particularly a tumor may be evoked. Scintigraphy and computed tomograms can take a part in the diagnosis. But scanograms are uneasy to do in this region. The MRI allows to delimit the lesion, and the hypointense signal in T1 and T2 weighted sequences directs to a fibrosis in the area between the end of the clavicle and the acromion. In this case report, the relation between the MRI findings and the pathological aspects was good.