Search PubMedSearch

Biomedical subjects

J Kofman

Publications and source records attributed to J Kofman.

At least 19 recordsLinked to original sources

Ocular manifestations of Sotos syndrome.

BACKGROUND: Sotos syndrome (cerebral gigantism) is a congenital syndrome characterized by large body size for patient age, advanced bone age, and unusual facial characteristics with varying levels of cognitive, developmental and perceptual deficits. While more than 150 cases have been reported, only a single case report has been published in the ophthalmic literature. This study briefly reviews the pertinent aspects of this syndrome and reports on the medical, physical, developmental and ocular manifestations of 32 subjects. METHODS: Our patient population was obtained from several schools and colleges of optometry and private offices and clinics of optometrists and ophthalmologists. The Sotos Syndrome Support Association assisted in obtaining patients for this study as well. All children had been previously diagnosed as having SS. Commonly accepted methods for evaluating young, non-verbal, and/or handicapped children were used. RESULTS: Our findings indicate that moderate to high refractive error (hyperopia), nystagmus, and strabismus (esotropia) are commonly associated conditions of this syndrome. CONCLUSIONS: Since many of our subjects exhibited these amblyogenic precursors, a routine optometric vision evaluation should be an essential part of the individual educational and habilitation plan for all children with Sotos syndrome.

Abnormalities, Multiple

[Which therapeutic attitude should be adopted in the presence of non-small cell bronchopulmonary cancer?].

Complete surgical excision is the best method of obtaining cure. However, this is only possible in less than one quarter of the patients. In all of the other patients, the hopes for cure are based on combinations of chemotherapy-radiotherapy-surgery, in particular preoperative chemotherapy. Phase II trials of chemotherapy are underway. Real progress will only be achieved when joint multicentric studies can be conducted.

Adenocarcinoma

[Acute disseminated tuberculosis with pancytopenia and a favorable outcome].

The authors report a case of febrile pancytopenia of tuberculous origin with a normal chest X-ray at the outset. The diagnosis was virtually confirmed by bone marrow biopsy, even before the result of AAFB cultures. The course was rapidly favorable under the influence of triple anti-tuberculous therapy, with normalisation of the bone marrow biopsy. The degree of thrombocytopenia would seem to be of considerable prognostic interest.

Acute Disease

Evaluation of foot deformity using a three-dimensional geometric model.

A three-dimensional geometric model of the foot's bony structure based on the use of a stereoradiographic technique is presented. To illustrate the potential of such a model it has been applied here to the study of cavus foot in a patient having Friedreich's ataxia. This model permits an accurate evaluation of this complex spatial foot deformity.

Foot Deformities, Acquired

[Histamine-release: present data and practical interest (author's transl)].

Histamine remains the best known humoral marker of hypersensitivity phenomena. Stored in blood basophilic cells and mast cells this histamine can be released under the influence of an immunitary factor with humoral or cellular mediation or under the dependance of irritative factors either chemical or medicinal. The authors recall the innermost mechanism of the main stages of histamine-release: recognition of membrane receptors, multiple enzymatic activations, opening of calcic membrane pores, synthesis of unpreformed mediators (SRSa and PAF), finally granular extrusion with release of histamine and of numerous mediators, among which the neutrophil chemotactic factor, one of the main responsible ones of the late phase of hypersensitivity phenomena. The regulation of histamine release is mostly done by cyclic AMP and GMP and the membrane receptors H2. The test of histamine release on whole blood or on leucocypte suspension enables by the study of effect-dose curves to differentiate the histamine release mechanisms: bell shaped curve in the case of immunitary processus and ascending curve for an irrative phenomenon. Practically this test can be used for diagnosing drugs allergies, professional asthmas or to study the pharmacological activity of a drug.

Adult

[In vitro comparative study of the protective effect of different theophyllines on the leucocytes' histamine-release induced by antigen (author's transl)].

The recent discovery of the protective action of xanthic bases towards histamine-release consecutive to the antigen-antibody reaction led the authors to study the importance of this protection induced by various theophylline derivatives. The technique used was that described by LICHTENSTEIN and OSLER: isolation of leucocytes, measurement of histamine liberated in the presence of antigen, same measurement done in the presence of antigen and theophylline. The antigens used were: house dust, Dermatophagoides pteronyssimus (DP), graminaceae pollens. The tested theophyllines were: the theophylline base, aminophylline, bamiphylline, diprophylline, thio theo, piperazine acefilinate. All these substances studied brought a reduction of the histamine-release but according to a variable frequency and intensity: the thio theo, the diprophylline and the piperazine acefilinate gave the best results. Besides the latters are clearer when the antigen was dust or DP. This study enables the confirmation of the inhibiting action of theophyllines on histamine-release induced by antigen, but complementary studies on a larger number of cases seem necessary in order to determine precisely the most efficient derivatives.

Allergens

[Respiratory functional tests in professional asthma. Value of realistic tests (author's transl)].

The diagnosis of professional asthma raises problems that cannot be solved in many cases either by anamnestic data or by skin tests: realistic can then prove very useful. Reproducing in the laboratory the professional surroundings, these tests consist in studying the ventilatory variations induced by allergens inhaled during work. The authors report the results of these examinations done on 30 patients whose realistic tests were performed with controls of ventilatory variations by body plethysmography. Confirming the professional etiology of asthma was reached 16 times out of 30 by these tests. These substances concern: chemical products (9 cases), dust of plant or animal origin (4 cases), various saw dusts (2 cases), tissue extracts (1 case). These results enabled the authors to underline the interest of these tests which nevertheless have limits: a negative realistic test is not enough to eliminate this diagnosis, because it is not always possible to reproduce exactly the workshop atmosphere in the laboratory. On the contrary, a positive test does not necessarily mean that the asthma is truly and predominantly a professional asthma. Results must therefore always be interpreted in relation with the clinical context, although the mechanism involved is known to be variable. A positivity can be attributed to an allergic mechanism, a non immunological release of mediators, or simple irritative reactions. In spite of these draw-backs, realistic tests represent one of the best means of diagnosing professional asthma.

Acetylcholine

[Complications with rifampicin treatment: one case with anuria (author's transl)].

The authors report a new case of acute renal insufficiency with Rifampicin. They evoke the clinical background which is characteristic of these anuric tubular nephritis. They recall the different complications with Rifampicin to which they can be associated and the different mechanisms which can be at the origin of this affection as well as the difficulties to reveal them. Then, they insist on the prevention of renal accidents within the frame of our present knowledge.

Acute Kidney Injury

[Bronchial cytology of "occult" lung cancers (author's transl)].

Having underlined the value of bronchial cytology for the early diagnosis of lung cancers, the authors report 7 observations concerning a particular clinical form: the "occult" lung cancer with a malignant cytological precession more or less in advance in relation with the radiological or fibroscopical data. Malignant cells can be found in sputum from 9 months to 8 years beforehand. All histological types can be seen but no cancer of the anaplasic type with small cells was identified either in this series or in the literature. The authors insist also on the difficulty in localizing these cancers in situ at a very early stage. They set apart the insufficiencies of the X-ray results in several observations and the limits of other investigating techniques (bronchography, scintigraphy, echotomography, ...). These tumours seem to have a mild evolutivity.

Aged

[Nieman-Pick disease revealed by a pulmonary miliary tuberculosis (author's transl)].

A diagnosis of Niemann-Pick disease was made in a 26 years old man with chronic pulmonary miliary tuberculosis and splenomegaly. It was confirmed by the drop of sphingomyelinase level in leucocytes and fibroblasts of the skin. The authors showed the presence of foamy cells with sphingomyelin in the spleen and bone marrow. They underlined the value of dosing sphingomyelinase in leucocytes for diagnosis purposes. They also observed blue histocytes in the spleen and bone marrow, next to the foamy cells which are not specific of Niemann-Pick disease and can be found in numerous other affections. This pure visceral form with delayed development without neurological involvement, corresponds to the phenotype B of Crocker.

Adult

[Tumours or mediastinal pseudo-tumours of Castleman? One observation (author's transl)].

Through a routine examination a Castleman tumour of left hilary topography was discovered in a 30 years old man. No recurrence followed exeresis. With regard to this case, the authors underlined the infrequency of these tumours with no preferential mediastinal topography and its occurrence at any age. Diagnosis is often reached after surgery by histological analysis of the tumour which enabled the distinction in two types according to Flendrig: type I plasmocytic with inflammatory signs; type II hyalino-vascular without any inflammatory signs. Surgery usually advised is not without any drawbacks because of the vascularization of the tumour and its adherence to neighbouring organs. But Castleman tumours still set nosological problems and the debate remains opened on the question of a nodal origin or a true neo-formation.

Adult