[Multifocal osteo-condensation].
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Biomedical subjects
Publications and source records attributed to H Gil.
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INTRODUCTION: Cryptococcosis is an opportunistic infection, that rarely occurs in immunocompetent patients. CASE REPORT: We report a case of a 82 year-old woman who suffered from a bacterial pneumonia associated with lymphopenia. During the hospitalisation, she developed a cutaneous and ganglionnary cryptococcosis. No other cause of immunosuppression was found. The lymphopenia disappeared with the healing of the pneumonia treated with systemic antibiotics. Treatment with fluconazole was effective in 2 months on the cryptococcosis. COMMENTS: To our knowledge, this is the first case of cryptococcosis after a transitory lymphopenia, occurring in a immunocompetent patient.
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The nonenzymic glucation of most proteins occurs only at epsilon-amino groups of lysine residues. Hydrolysis catalyzed by bovine trypsin, porcine trypsin and pineapple bromelian were studied using native and glucated proteins as substrates. Glucosylated ovalbumin, human serum albumin, gamma-globulin and myoglobin show reduced susceptibility to degradation by trypsin as compared to the nonglucated proteins, apparently by direct modification of lysine residues. Trypsin cleaves at substrate arginine and lysine peptides bonds. Bromelian, a less specific enzyme, shows similar hydrolysis rates for native casein, ovalbumin and myoglobin, and identical rates for glucated hemoglobin and myoglobin. Bovine trypsin showed 100% decrease in enzymatic activity with glucated human serum albumin and gamma-globulin and pineapple bromelian with human serum albumin.
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Acute dysautonomia is a disorder characterized by severe sympathetic and parasympathetic failure with relative preservation of motor and sensory function. The disease is considered to be idiopathic in most cases, but there is now a trend towards considering the disorder as an uncommon variant of Guillain Barré syndrome. We report two cases of acute dysautonomia which did not fulfill the criteria of the idiopathic form. The first case was associated with Sjögren's syndrome and the second with thyroiditis and antiganglioside antibodies which were correlated with the severity of the disease. Intravenous gammaglobulin (IVGG) was effective in both cases, as has been reported for the idiopathic form, and in one case the treatment was associated with an increase in the supine and standing plasma norepinephrine levels, thus substantiating the positive effects of IVGG on the orthostatic blood pressure and heart rate. We conclude that the spectrum of acute dysautonomia is superimposable on that of the inflammatory peripheric neuropathies and should include both the idiopathic form and dysautonomia with autoimmune associated disorders. IVGG are effective and seems to act by increasing plasma norepinephrine levels.
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