["Bullous" detachment of the macula (idiopathic serous detachment of the macular neuroepithelium)].
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Biomedical subjects
Publications and source records attributed to M Bonnet.
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Amniotic fluid or/and serum alpha-foeto protein (AFP) determination is used as a test-system for screening of neural tube defects. The physiologic basis of this screening are described taking into account the evolution of AFP concentration in foetal and maternal blood, and in amniotic fluid. As for all the biologic screening systems, the acquired experience reveals a lack of sensibility and specificity. First the authors analyse the analytic and biologic problems which have an effect upon sensibility; then, they consider the mechanisms which explain the specificity lack showing itself in some foetal malformations. Practically, interpretation of AFP results requires necessarily familial story and echography results. Taking into consideration the different problems concerning AFP, a programme to utilize the test-system is presented for prenatal diagnosis of malformations of central nervous system.
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We study the arterial vascularization of the trunk of the optic nerve partialarly in its anterior part in human. We injected in the carotids, a mass of colored an radio opaque substance, in the whole cadaver that allows simultaneously a visual study and a radiologic control of the results. This one is completely insufficient to allow a study of details; so we used the diaphanisation as described by Spalteholz; we were able to confirm Hayreh's results: the ophthalmic artery has a variable pathway according to individus but overcrosses the most frequently the optic nerve. The posterior ciliary arteries have also an origin pathway very variable; the posterior external ciliary is the most commonly present. The central retinal artery takes its origin the ophthalmic artery no more than half of the cases, and elsewhere from a common trunk with the ciliary arteries, or even from branches of those last arteries. It always penetrates the nerve in its inferior face and is responsable of its vascularization in periphery by the man of its pial branches and in depth by its intra neural branches.
12 patients suffering from Behçet's disease have received immunosuppressive therapy. All patients have been given chlorambucil. In addition 5 patients who were threatened by an acute and permanent blindness from severe retinal vein involvement received antilymphocyte globulins. The follow-up ranges from 1 year up to 71/2 years with an average of 31/2 years. Complete recovery from ocular inflammation has been achieved in all patients. Visual acuity remained unchanged or improved in all patients but 1. Ocular recurrences occurred in 2 patients after decreasing the daily dose of chlorambucil and in 1 patient 2 years after the end of a 1-year treatment. The action of chlorambucil was not so constant upon systemic involvement of the disease than upon ocular inflammation. Nevertheless, 1 patient recovered from severe central nervous system involvement with hemiplegia. The review of the literature and comparison with our own experience leads to suggest that the discrepancy of the published results should be related to the variety of the immunosuppressive drugs which have been tried in Behçet's disease. Chlorambucil seems to be the most effective and the less toxic drug. But its action upon eye inflammation requires 2-3 months to take place. Therefore, in the most severe cases threatened by an acute and permanent blindness, the treatment should be started with antilymphocyte globulins.
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The authors studied the variations in levels of copper and ceruloplasmin in the mother and in products of conception during the first trimester of pregnancy, during the 4th month of pregnancy and near term, having a series of 12 pregnancies with the copper I.U.D. in position. No change was observed between the levels of copper and ceruloplasmin in comparison with a control series.
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The 595 angiographic lesions observed in 233 eyes of 169 patients affected with central serous retinopathy have been classified upon their localization. 498 angiographic lesions (83.7 percent) are located within a three optic disc diameter area centered by the foveola. Among them 20 are located right behind the foveola, 113 are located in the upper temporal quadrant, 166 in the upper nasal quadrant and 85 in the lower temporal quadrant. The relative density of the angiographic lesions decreases from the center of the macula to the periphery. 97 angiographic lesions (16.3 percent) are located beyond the three optic disc diameter central area. 41.1 percent of the lesions are situated behind the macula or/and behind the papillo-macular bundle. Therefore only 58.9 percent of the angiographic lesions observed in central serous retinopathy can be treated without any risk by means of photocoagulation.
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