Biomedical subjects
Publications and source records attributed to J Roland.
The following topics are discussed: 1. Pneumocystis carnii: appearance, antigenic structure, pathogenicity...; 2. Human pneumocytosis: clinical, diagnostic, prognostic and therapeutic aspects; 3. Pneumocystis carnii and the pneumocystoses: coexistence, theoretical and practical consequences, difficulties in interpretation of bronchiolo-alveolar lavage.
Mycosis fungoides is today classified amongst the cutaneous T lymphomas. The course of the disease is slow, first strictly dermatological, then with polyvisceral spread most often presenting as lymphadenopathy. Pulmonary involvement, with a poor prognosis, is often recognised only at autopsy. The differential diagnosis between pulmonary involvement by the disease and isolated or associated opportunistic infectious pathology is virtually impossible during the patient's lifetime except by surgical lung biopsy. The case reported here illustrates these data and has the particular feature of the onset of pulmonary involvement during cutaneous remission of the disease, contrasting with the visceral spread found at autopsy.
Diagnostic criteria of intracranial epidermoid cysts were established from the observation of 15 cases, confirmed by pathology, seen during the last 5 years. Tumors could be divided into four groups: posterior fossa, supratentorial spaces, transtentorial and extradural. Regions of hypodensity associated with the irregular nature of the outlines of the lesion are generally sufficient to suggest the diagnosis in a pre-operative scan, but certain tumors may be isodense or, more exceptionally, spontaneously hyperdense. Contrast images are extremely rare, and are seen only at the periphery of the lesions. The "mass-effect" is remarkably discrete when compared with the tumor size, sometimes of very large proportions.
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A rabbit was immunized with rabbit immunoglobulins of a different allotype. The anti-allotypic antibodies produced by this rabbit were used to immunize a second rabbit which produced anti-idiotypic antibodies. To explain the occurrence, among these anti-idiotypic antibodies, of "internal images" of the original immunizing allotype, a restricted and a more general hypothesis are developed. The first assumes that B-cells can be triggered when idiotopes on their receptor molecules are recognized by the paratopes of the immunizing antibody. The second denies the existence of a specially constructed combining site on the variable domain of an antibody molecule.
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During autopsies a few number of cases with coronary involvement by specific lesions of Horton's disease are found. It is very unusual that they may be responsible of death. In this case a white woman 79 years old present all symptoms and findings of temporal arteritis. Temporal artery biopsy proved affection. After prednisone therapy was started a tong necrosis appears and a myocardial infarction happens with collapse and death. Autopsy examination showed giant cell arteritis involving a coronary branch near myocardial fresh infarction. Four other cases of literature are summarized. In four times corticosteroide were started but coronary involvement was not stopped and coronary specific lesions responsible of death.
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Similar idiotopes are detected on anti-allotypic antibodies synthesized by all rabbits immunized against the b6 allotype. The expression of similar idiotypes on anti-b6 antibodies has been found in rabbits of all VHa allotypic types thus far studies. For their expression, these idiotypes require the interaction between VL and VH domains.
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Thanks to analysis of 46 observations and the review of the literature, the authors enumerate the main physiopathological mechanisms of this uncommon entity with its ambiguous clinical aspects and it too often severe evolution. They bring some new elements of the prognosis and emphasize the necessity of a rational utilization of neuroradiological investigations in order to avoid some diagnostic traps and purpose the better treatment of which indications are analysed and censured. Extra-intracranial by-pass represents a new therapeutic advance which will perhaps improve the prognosis of this condition.
Cerebral computed tomography of 45 infants has been carried out for a better assessment of the normal appearance of the different anatomical structures. The skull vault is often asymmetrical, the dura mater is very dense, and the ventricular system is small in contrast with the large subarachnoid spaces. The brain parenchyma contains zones of low attenuation, mainly frontal. These may well be a normal developmental feature.
Rare tumors are sometimes encountered in maxillofacial surgical practice and the operative approach, external, intranasal, or endocranial, may be difficult to choose. Preliminary angiography and particularly computer tomography can be of invaluable assistance in making the decision, especially in cases of nasofrontal glioma with heterotopic localization of glial tissue but without brain connections.
A 47-year-old patient with panlobular emphysema and insulin-dependent diabetes had an alpha-1-antitrypsin phenotype Pi ZZ deficiency. Liver function tests were abnormal, and postmortem examination of the liver demonstrated abnormal intrahepatocytic globules of A1AT (a typical finding when the allele Z is present), but also fibrosis with steatosis. The patient's sister, Pi ZZ, had neither diabetes nor bronchopneumopathy, and no anomalies in liver function. Needle puncture biopsy of the liver had not been conducted. The phenotype Pi ZZ is typically associated with panlobular emphysema in adults, and cholestatic hepatitis in children. From reports in the published literature, it appears that isolated hepatic lesions or those associated with emphysema are rare. The fortuitous association of diabetes and hepatic lesions in this typical case of pulmonary affection in an adult is discussed.