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Biomedical subjects

H Petit

Publications and source records attributed to H Petit.

At least 127 records · Page 7Linked to original sources

[Amnesic syndrome caused by limited infarction in the right anterior thalamus].

A case of global and persistent amnesia due to a right polar and anterior thalamic infarction is reported. There was a moderate impairment of attention and categorization ability. The amnesia was primarily anterograde, with partial disturbance of short-term memory and severe deficit of long-term memory for verbal and visuo-spatial materials. A severe increase of pro-active interference was present. Retrograde memory was mildly affected. Two years later, a second infarction in the right thalamo-sub-thalamic territory occurred, increasing the deficits of attention, short-term memory and recall.

Adult↗

[Mental akinesia and memory disorders following carbon monoxide poisoning].

A 32-year old woman presented with serious memory impairment and a mental syndrome named loss of psychic auto-activation or psychic akinesia following carbon monoxide poisoning. The MRI findings were bilateral pallidal lesions probably associated with thalamic lesions. The evolution was favourable.

Adult↗

[Parkinsonian syndrome caused by carbon monoxide poisoning. Preliminary results of the treatment with bromocriptine].

Parkinsonism is the most frequent neurological complication of carbon monoxide intoxication. Its prognosis is severe and Dopa is ineffective. We treated 9 patients (mean age 60.89 +/- 6.10 years) with bromocriptine (5 à 30 mg daily). Webster's scores were improved under treatment. Our study suggests that early administration of bromocriptine might be an effective therapy of carbon monoxide induced parkinsonism.

Adult↗

[Right unilateral auditory agnosia following left lenticular hemorrhage].

A 33-year old patient who had had left lenticular hemorrhage presented with an inability to understand with the right ear oral language and, in a less dramatic way, nonverbal sounds. This unilateral auditory agnosia was first associated with a right motor underutilization and right motor, sensitive, visual and auditive extinctions. Speech discrimination scores were 100% with the left ear and 15% with the right ear, even less in dichotic conditions. Tonal audiogram, as well as early and late components of the auditory evoked potentials were normal. Cerebral regional perfusion and metabolism were impaired over the left parietotemporal area. There was severe hypoactivation of the left hemisphere with right monaural verbal stimulations. Rehabilitation consisting of non-specific attention tasks and repetitions of words reaching only the right ear was undertaken 15 months after the stroke. The oral language comprehension improved, as did the left hemisphere activation, and the extinction phenomena disappeared, except for the auditory one. The unilaterality of the auditory agnosia could be due, in part, to a peculiar physiological processing in this patient, such as poor performance of his right ipsilateral auditory pathway which could be improved with practice. A striatal lesion could induce a spatial hemi-inattention as reflected by the multimodal extinction in this case. Besides, a lack of selective activation for verbal stimulation of the left hemisphere is suggested.

Adult↗

Periventricular and white matter magnetic resonance imaging hyperintensities do not differ between Alzheimer's disease and normal aging.

We studied normotensive and nondiabetic subjects, free of cardiac disorders, to determine whether Alzheimer's disease is a possible factor of magnetic resonance imaging (MRI) white matter or periventricular hyperintensities, and to investigate relationships between computed tomographic scan and MRI changes. We failed to reveal (1) any difference in the severity of MRI white matter and periventricular hyperintensities between patients and controls, (2) any correlation of MRI white matter and periventricular hyperintensities with either ages or Mini-Mental State Examination scores. We found (1) a poor interobserver agreement, and (2) a correlation between computed tomographic scan and MRI white matter changes but not between computed tomographic and MRI periventricular changes. We conclude that MRI periventricular and white matter hyperintensities are frequent incidental findings in the elderly and do not significantly differ between patients with Alzheimer's disease and healthy controls.

Aged↗

Percutaneous atherectomy with the Kensey catheter: early and midterm results in femoropopliteal occlusions unsuitable for conventional angioplasty.

Forty-six femoropopliteal occlusions in 44 patients (aged 45-95 years) were recanalized with the percutaneous rotating tip atherectomy catheter completed by balloon dilatation. Thirty-one patients had tight intermittent claudication of the lower limbs, five had resting pain and 10 had skin disorders. The length of the occlusion ranged from 2 to 24 cm. Of 46 procedures, 40 (87%) were immediately successful (increase of mean Doppler systolic ankle-arm index from 0.44 to 0.89) and six (13%) were failures. In two it was impossible to pass through the lesion and in four arterial perforation occurred without any clinical consequences. Of the six failures, five occurred in calcified arteries. Five recanalizations (11%) reoccluded within 48 hours, bringing the total number of early failures to 11. Of these 11 failures, nine were treated by femoropopliteal vein bypass and two by medical treatment only. Two postoperative asymptomatic posterior tibial artery embolisms were treated medically, and one popliteal artery embolism was treated using a Fogarty catheter. At the present time, 25 of 35 primary successes had been followed for six months, and 20 for 12 months with primary patencies 18 of 25 (72%) and 14 of 20 (70%), respectively. If massively calcified lesions are excluded, femoropopliteal recanalization with the percutaneous rotary Kensey atherectomy catheter followed by balloon catheter dilatation is efficacious and reliable with an 80% primary success rate and a 70% patency rate at one year.

Aged↗

Management of focal intracranial infections: is medical treatment better than surgery?

Three groups of patients with single hemispheric brain abscesses or subdural empyemas, from 1 to 5 cm large, with similar initial prognosis, have been treated either by medical treatment alone (20), aspiration (21), or excision (15). Differences in survival were not found, but medical treatment alone was better for long term sequelae. Surgical procedures (either aspiration or excision) were better for both isolation of the organism and the hospital stay before discharge. In spite of good results, it is unwise to conclude too strongly in favour of no surgical treatment as this study was not randomised.

Adult↗

[Refsum's disease. Apropos of 2 cases disclosed by myocardiopathy].

Refsum's disease is a polyneuropathy due to a hereditary error in the metabolism of a fatty acid, phytanic acid, usually leading to cardiac failure only at an advanced stage of the disease. The authors report the case of two brothers with Refsum's disease revealed by a heart failure before the clinical stage of the peripheral neuropathy. In the younger brother, the affection started at the age of 22 years by an acute pulmonary oedema which revealed a dilated, hypokinetic myocardiopathy, associated with retinitis pigmentosa, ptosis, anosmia and biological myolysis. The normal plasma concentration of phytanic acid measured several times led to the conclusion of Kearns-Sayre syndrome even if certain aspects were atypical (moderate conduction disorders, no characteristic aspect in the muscle biopsy). Five years later, the older brother, aged 28, presents a dyspnea on effort which leads to the discovery of a hypokinetic, hypertrophic myocardiopathy, slightly dilated, associated with cardiac conduction disorders, retinitis pigmentosa, anosmia and biological myolysis. The plasma concentration of phytanic acid being very high. Refsum's disease was diagnosed and the diagnosis of younger brother was corrected. From the study of these two cases, the characteristics of the cardiac disorders can be specified: the cardiopathy can reveal the disease and correspond to a dilated or hypertrophic myocardiopathy. The diagnosis of the disease can be difficult because the plasma phytanic acid may remain at normal level, thus requiring the assay of the activity of phytanate oxydase. The existence of ophthalmologic signs (retinitis pigmentosa or progressive ophthalmoplegia externa) associated with a myocardiopathy must systematically lead to a search for Refsum's disease, this diagnosis having fundamental therapeutic implications (died, even plasmapheresis).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Peripheral arterial recanalization using a Kensey catheter].

Between June 6 1988 and September 30 1989, 46 superficial femoral obliterations in 44 patients were treated by rotary atherectomy, completed by conventional dilatation in 40 patients. The 44 patients (27 males and 17 females), mean age over 66.5 years (45 to 90), presented symptomatic superficial femoral obliterations (17 tight stage, two occlusions, 5 stage III, and 10 stage IV occlusions), with mean length of 9.8 cm (2 to 24 cm). Vascular echography was performed systematically before the procedure, to assess the extent of intraluminal calcification. Moreover, a control venous angiography was performed on the third day. Of the 46 treated arteries, the occlusions which had remained impermeable with a traditional guidewire were traversed successfully and without incident in 40 cases (87%). In case 20, the massively calcified obliteration could not be traversed, and perforation occurred in four cases, but without clinical consequences. In five other cases (11%), precocious reocclusion occurred before the 48th hour. It should be pointed out that, in 2 of these 5 cases, no additional conventional dilatation had been performed at the beginning of the trial. In 35 cases (76%), satisfactory permeability with residual stenosis less than 30% was thus obtained upon discharge from the hospital. For these patients, the lower limb/upper limb Doppler index rose from 0.44 to a mean 0.89 after treatment. 2 embolism were observed: one popliteal treated by embolectomy. The mid term permeability at 6 months is 80% among the 25 primary successes.

Aged↗

[Fulminating cryptococcal meningoencephalitis. An anatomo-clinical case].

We report a case of cryptococcal meningoencephalitis in a 52 year-old man. The patient had complained of headache and drowsiness for a few hours before he became comatose with a bilateral sixth cranial nerve palsy. The cerebrospinal fluid contained less than one lymphocyte per cubic millimeter, a low glucose level (0.20 g/l) and numerous Cryptococcus neoformans encapsulated yeasts. A neuropathological study showed that the cortex and midbrain were involved. To our knowledge, such an acute case with death within the first 20 hours has not yet been reported.

Brain↗

Dystrophic peptidergic neurites in senile plaques of Alzheimer's disease hippocampus precede formation of paired helical filaments.

The relationship between peptidergic dystrophic neurites and paired helical filament (PHF)-positive neurites in Alzheimer's disease (AD) senile plaques (SPs) was studied using combined fluorescence and bright-field optics. Cryostat sections of AD hippocampi were first stained with thioflavine-S and immunolabelled with antisera raised against different neuropeptides: somatostatin-28(1-12), somatostatin-14, neuropeptide Y, cholecystokinin (CCK) and substance P. Secondly, using the elution-restaining procedure, sections were immunolabelled with anti-tau/PHF. In immature SPs, clusters of abnormal, swollen neurites were found. The dystrophic, strongly peptidic-positive neurites contained fewer PHFs than the poorly positive ones. Cell bodies, exhibiting a peptidic content, could be found within SPs without any alteration. These results suggest the following sequence of events: an extracellular poisoning mechanism, perhaps the amyloid substance, first changes the structure of presynaptic endings and causes the formation of ballooning dystrophic neurites filled with their normal peptidic content. Subsequently, intracellular degradation occurs with formation of the PHFs. Then the other structures such as dendrites and perikarya are damaged by the same mechanism. Therefore, this phenomenon seems to precede any formation of PHFs in SPs.

Alzheimer Disease↗

Condition scoring scheme for small east African goats in Zimbabwe.

A body condition scoring for Small East African type goats in Zimbabwe is described. This measure is less affected by confounding variables than is body weight as an estimate of animal's condition and nutritional state. Furthermore, it requires no special equipment. Using this scheme it is shown that condition score is significantly correlated with a parametric measure of condition (r = 0.5, P less than 0.01) in adult females and that changes in condition score are significantly correlated to percentage changes in body weight (rs = 0.5, P less than 0.01) for all ages. A change of condition score of 1 represents on average a 12% change in body weight.

Animal Husbandry↗