Biomedical subjects
Publications and source records attributed to G Martet.
The authors report a case of giant cell tumor. This case was unusual by its location (rib and vertebra), its size and its important inner thorax extension. This tumor was studied with different imaging methods and particularly MRI. The sensitivity of MRI is confirmed by the surgery in complete agreement with MRI findings.
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Polyorchidism is a rare abnormality. A case is reported of a small scrotal supernumerary testis associated with a large varicocele. A torsion of this testis probably occurred and the vascular pedicle seemed atrophic. Despite abnormal fertility with oligozoospermy the accessary testis was removed. A review of relevant literature is made giving details of embryology of this anomaly.
Meningoencephalitis caused by Coxiella burnetii is exceptional and its clinical presentation is varied. We report a case which presented as transient central neurological deficits and intracranial hypertension without fever. The condition was diagnosed by indirect immunofluorescence.
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The incidence and clinical aspects of malaria in patients returning from chemoresistance areas were evaluated by means of two studies. The first one was a prospective study of 145 subjects back from a 4 months' stay in Gabon and who had complied with an appropriate chemoprophylaxis regimen. Twelve of these subjects were found to have particulate P. falciparum antigens on the 3rd day following their return. Spontaneous negativation of parasitaemia was observed in 10 cases, whereas 2 subjects were about to develop a malarial attack. Forty-five days after the return home, 5 new cases of malarial attack and 3 cases of anaemia had occurred, although none of these 8 patients had haematozoa on the 3rd day. In the second study 31 patients admitted to hospital in 1987 were reviewed. The following clinical syndromes were detected: malarial attacks with high parasitaemia in 6 cases, malarial attacks with low or undetectable parasitaemia in 5 cases, anaemia, thrombocytopenia or pancytopenia in 5 cases, and febrile alteration of the general condition in 3 cases. Two aspects of malaria were identified: "malaria infection" with a latent and asymptomatic parasitic infestation likely to disappear spontaneously or to turn into "malaria disease". The latter has protean manifestations, but bouts of fever with low parasitaemia and blood disorders are predominant.
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The rectal administration of irritant substances can induce lesions which do not regress after removal of the cause. More or less severe and more or less extensive stenoses have been reported in the literature. The authors report a case of very extensive and very tight rectosigmoid stenosis developing after potassium enema administered to a chronically constipated 26 year old African woman with limited rectal stenosis of unknown origin. Rectosigmoid and left colonic resection with trans-anal recto-colonic anastomosis gave this patient normal intestinal transit and good faecal comfort.
Practical significance of serologic markers for hepatitis B virus and interpretation according to clinical stage and liver biopsy pattern in HBs Ag positive patients with or without chronic liver disease. Vidarabine is the treatment of choice actually available for patients with chronic persistent or chronic active hepatitis who demonstrate active replication of the virus. The authors review the technics actually necessary: to diagnose chronic hepatitis, to screen for hepatitis B virus, to demonstrate active replication of the virus. They report that these actually routine technics can be available in any biochemistry or pathology laboratory including those in tropical areas.
A spectrophotometer designed to measure simultaneously traces of deuterium oxide (12 mg.1-) and indocyanine green (0.12 mg.1-1) in flowing blood is described. Its symmetrical four-beam design enabled direct readings in optical density units to be obtained in the infrared region without interference due to atmospheric CO2 and water. This system was validated by the measures of pulmonary extravascular water in the rat in heart-lung preparations and in whole animals. An example of its application showed that, with this system, it was possible to evaluate correctly an alloxan edema in the rat a short time (105 min) after its induction. In these experiments lung water calculated by indicator curves represented 80% of the lung water content (r = 085, n = 10).
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The authors report on an outbreak of Schistosoma mansoni infestation involving 113 military men who had been contaminated together in a tributary of the Chari river in the Central African Republic. The patients were examined on their return to France 50 days after being contaminated and were compared with a control group of 25 subjects who had lived in Africa under the same conditions but were exempt of bilharziasis. All were subjected to a retrospective questionnaire, physical examination, examination of the faeces and serological test for bilharziasis by indirect haemoagglutination. All received two courses of praziquantel. Follow-up serology was performed after 1 year in 86 cases. The results of this study in both groups are presented and commented upon. With intestinal bilharziasis, prophylaxis against contamination is extremely difficult to carry out in endemic areas among people who visit and work "on the spot". Detection by routine serology must be performed upon return.
Recent events concerning blood transfusion (BT) have led to the number of BT being drastically reduced and to more rigorous checking of blood donations before their use for transfusion. Very few developing countries have been able to set up BT organizations that are both self-sufficient and capable of ensuring a high quality of blood testing. A central blood bank (CBB) was set up in Kabul (Afghanistan) during the 1980s. From 1992 onwards, its activities were curtailed due to the political turmoil, lack of funds and the fact that no blood collection policy was being implemented. A partnership between a development aid agency (Avicen), French public institutions and the local authorities has resulted in the rebirth of this CBB by the injection of financial resources and technical and scientific expertise. An independent committee of BT specialists was responsible for assessing the scientific validity and ethical acceptability of the project. In 1996, the objectives of the project, which had been in operation for one year, were achieved as far as the renovation of the laboratories was concerned. Work has focused mostly on setting up a proper cold chain and on training laboratory technicians in standard biological methods for testing blood from donors (blood group, HIV screening, Ag Hbs, HCV and syphilis). However, due to the shortage of blood donors, it has been difficult to set up a minimum blood bank stock. The results of the first biological tests carried out on the blood of the first 1,281 donors have made it possible to define an appropriate, detailed policy for preventing and controlling the main risks of infection from BT, involving routine testing for HIV, Ag HBs and HCV (0.3% prevalence). BT is a major component of any health care system and it must be reconstructed. The measures proposed here are long-term and require the ongoing participation of all those involved in this project including the local authorities and sources of financial support.