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Biomedical subjects

M Fardeau

Publications and source records attributed to M Fardeau.

At least 217 records · Page 12Linked to original sources

[Diagnostic contribution of computer tomography in muscular pathology].

CT analysis in 26 patients with well-identified muscle diseases, and 4 normal controls was performed to evaluate its diagnostic interest. Scans were obtained through pelvis, thigh and calves at comparable levels in all subjects. Results showed that elementary changes were devoid of specificity and density measurements did not significantly increase the diagnostic significance of images. A good correlation was found between the degrees of CT changes and clinical evaluation of the muscles. However, CT allowed a more precise study of abnormalities in muscles difficult to assess clinically and, in all pathological cases, led to a clear analysis of the topography and the selectivity of the pathological process. If safety criteria are fulfilled, CT would allow a precise follow-up study of muscle atrophies.

Charcot-Marie-Tooth Disease↗

[Myopathy with tubular aggregates. Clinical, biological and histological study of 2 cases].

Two male patients, aged 46 and 48, presented with muscle pain on exercise, generalized or limited to the upper extremities. Physical signs were limited to mild muscle wasting in one case. There was no myoglobinuria. Electromyography was normal in one case, and showed some polyphasic units in the other. An ischaemic lactate test was normal in the one case in which it was performed. Serum creatine kinase activity was normal or only mildly elevated. Histochemical and ultrastructural study of muscle showed tubular aggregates in type II fibers in both cases, and otherwise gave normal results. Symptoms were unchanged with a follow-up of 2 and 16 years, respectively. Tubular aggregates are found in a number of unrelated clinical and experimental conditions, which are reviewed. In these cases and in 3 similar patients, previously reported, tubular aggregates seem to be the hallmark of hitherto unrecognized metabolic disorders.

Alcoholism↗

Double staining of the muscle fibers and interstitial tissue components for automatic analysis of muscle biopsies.

A staining technique is presented in order to facilitate the automatic analysis of muscle biopsies. It renders possible the visualization on the same section of the myofibrillary adenosine-triphosphatase (ATPase) activity under the microscope with transmitted light, and of the fluorescent staining of fibronectin which marks the outlines of the muscle fibers by a simple switch to ultraviolet (UV) light.

Adenosine Triphosphatases↗

Comparison between the growth pattern of cell cultures from normal and Duchenne dystrophy muscle.

The growth "in vitro" of muscle cells from 12 patients with Duchenne muscular dystrophy (DMD) was compared with that of muscle cells from 20 age-matched controls. In the DMD explants, the lag phase (3 days) was shorter than in controls (6 days). In dissociated cells, plating efficiency (20%) and doubling time (30 h) were identical in DMD and controls. In cultures from three DMD patients, cell clusters were occasionally observed. Myotube morphometry showed significant abnormalities in DMD cultures: the number of myotubes per field was 8.2 +/- 0.8 and 26.7 +/- 0.6 in controls, P less than 0.001; myotube length (151 +/- 20 micron) and diameter (8.2 +/- 0.9 micron) in DMD cultures were half the control values (312 +/- 46 micron and 15.6 +/- 1.2 micron, respectively, P less than 0.001). The number of nuclei per myotube in DMD was one-quarter of that in control muscle (4.0 +/- 0.2 vs 15.8 +/- 2.2, P less than 0.001). It is concluded that DMD cultures show cellular heterogeneity with the presence of fibroblasts and non-fusing myoblasts; furthermore they show delayed myoblast fusion and poor myotube differentiation.

Cell Differentiation↗

[Economic analysis of the dissemination of a medical innovation: prenatal diagnosis by early amniocentesis as an example. Part 2. Facilitating decision making in public health for optimal dissemination of an innovation].

Only a specific public health policy can resolve the technical, ethical, and financial problems posed by the diffusion of prenatal diagnosis by amniocentesis for the prevention of Down's syndrome. The purpose of this article is to facilitate decision making in this field by evaluating the costs and benefits associated with the different prevention strategies. Beginning with projections of the number of Down's syndrome births to be expected among women of 35 and older to the year 2000 (assuming that no prenatal diagnosis are made), various objectives combining the age of the target population and usage rates are presented and discussed. An evaluation of the overall costs of prenatal diagnosis and caring for Down's syndrome patients shows that a policy reaching a 50% usage rate for women 38 and older would save up to 66 millions French francs (using the 1981 franc value). On the other hand, it is shown that lowering the incidence of Down's syndrome in a target population of women over 35 to the level of the younger population would imply a usage rate of at least 80%. This goal is unrealistic unless amniocentesis were to become a compulsory examination. In such case, women would be deprived of an essential freedom, in view of the related ethical issues. The authors lastly discuss the different means of increasing usage rates without inhibiting women's freedom of choice.

Adult↗

[Economic analysis of the dissemination of a medical innovation: prenatal diagnosis by early amniocentesis as an example. Part 1. Epidemiologic, medical and socioeconomic bases. The dissemination of a diagnostic innovation].

The article offers a detailed analysis of the characteristics of the supply and demand of prenatal diagnosis by amniocentesis in order to identify the major problems that must be faced in formulating a policy designed to diffuse the use of this technique. The data collected for the whole of France made it possible to evaluate exhaustively the increase in the number of prenatal diagnoses during the years 1972-1981; to determine the number and geographic distribution of the diagnostic centers; to identify the medical criteria justifying the examinations. A comprehensive survey covering all examinations performed in the Ile de France (Paris region) in 1979--which constituted 46.5% of all the prenatal diagnoses performed in France that year--made it possible to determine the predominant socioeconomic characteristics of the women who took this examination, revealing, particularly, the significant inequalities of access, with an underrepresentation of the least privileged socioprofessional categories. The confirmation of the influence of socioeconomic status on access to this medical innovation is further reinforced by the fact that usage rates vary widely according to place of residence; furthermore, it adds to the financial barriers implicit in any policy of having reimbursement of the examinations dependent upon Social Security conventions. A public health policy regulating the diffusion of this innovation must take into account the discriminatory aspects of the first phase of diffusion, as analyzed here.

Adult↗

Scanning electron microscopic study of nerve-muscle junctions in embryonic rat cell cultures.

The morphology of neuromuscular junctions between embryonic rat spinal cord and muscle cells grown in vitro has been studied by scanning electron microscopy (SEM). Histochemical detection of acetylcholinesterase (AChE) spots and autoradiographic detection of acetylcholine receptor protein (AChR) were performed in parallel. At the scanning EM level the contacts exhibit a marked polymorphism; the nervous endings may present as a bulbous swelling, or often as a plexiform network on the surface of the myotubes. Many neuromuscular contacts seem to occur 'passing by'; in other places, neurites processes slide along myotubes without any differentiated contacts. The muscle cell surface does not look substantially modified in the contact area. The distribution of the contacts between nerve and muscle cells is at the same time convergent and divergent.

Animals↗

[Effort-induced malignant hyperthermia. Electromyographic anomalies with a myogenic component. 10 cases].

Exertion malignant hyperthermia, usually regarded as a form of heat stroke, is mainly observed in young apparently healthy men enlisted in the army and subjected to intensive physical exertion in a warm and damp environment. It is frequently lethal. Ten cases with favourable outcome are reported. In 8 patients, EMG tracings recorded several months after the acute episode showed myogenic abnormalities. Computer-aided analysis of motor units showed a 42% reduction in mean duration of the motor unit collected from the brachial biceps and a 44% reduction of signal energy as compared with controls. Two possible reasons for these abnormalities are discussed: they may result from rhabdomyolysis or from a pre-existing muscular pathology.

Adult↗

Severe childhood muscular dystrophy affecting both sexes and frequent in Tunisia.

The authors reported a large study of 93 children presenting a severe form of progressive muscular dystrophy. The first clinical symptoms were noticed between 3 to 12 years. The atrophy affects, predominantly, the girdle and truncal muscles. The hypertrophy of the calves is almost consistent. The progression of the disease is severe, often like that the Duchenne type. In most of the cases, inability to walk occurs between 10 and 20 years. The serum creatine kinase activity is markedly high in the first stages of the disease. There is a necrotic regenerative pattern at muscle biopsy, associated with a marked type 1 predominance. The disease appears to be inherited as an autosomal recessive trait, with equal distribution among the two sexes. There is a marked variability in the intensity of symptoms and in the severity of the course of the disease from one sibling to another, and from one family to another. This disease is frequent in Tunisia and seems to be related to the high degree of consanguinity in this country.

Adolescent↗

[Intrinsic muscles of the human larynx. Histoenzymological characteristics of the muscle fibers].

ATPasic, oxidative, and glycogenolytic activities were demonstrated in human laryngeal intrinsic muscles (a total of 15) employing a series of histoenzymatic investigational techniques. Staining methods applied to 10 of the muscles revealed the presence of motor plates on the fibers, either with or without associated ATPase activity. These findings enabled clarification of the different muscle fiber populations, enzymatic equipment, and type of innervation of the laryngeal muscles. Certain of these muscles (cricothyroid, thyroarytenoid, and posterior cricoarytenoid) possess remarkable particularities in relation to known skeletal muscles, and the significance of these features is discussed.

Adenosine Triphosphatases↗

[Autosomal recessive severe, proximal myopathy in children, common in Tunisia].

The genetic clinical, biological and histological study in five families with a muscular dystrophy are reported. The disease appears to be progressive, affecting both sexes, beginning often in infancy, severe at least in one of the siblings and variable from one case to the other. Hypertrophy of the calves, and weakness of the limb girdle as well as the trunk is present. CPK are much increased. Muscle biopsy shows active degeneration and regeneration. The genetic transmission is suggested to be autosomal recessive. Peculiar attention is drawn to the high incidence (75 per cent) of consanguinity of these cases.

Adolescent↗

[Progressive external ophthalmoplegia and Hashimoto's thyroiditis].

Signs of moderately increased metabolism in a patient with progressive external ophthalmoplegia and mitochondrial anomalies on muscle biopsy revealed the presence of Hashimoto's thyroiditis. The relations between ophthalmoplegia plus and thyroid dysfunction are discussed.

Adult↗

Acrylamide neuropathy and changes in the axonal transport and muscular content of the molecular forms of acetylcholinesterase.

Acetylcholinesterase (AChE) is present in nervous and muscular tissues of normal chickens in four main molecular forms (G1, G2, G4, and A12), distinguishable by sedimentation analysis. In the sciatic nerve of acrylamide-poisoned chickens, the anterograde axonal transport of A12 AChE was reduced by 60%, and that of G4 by 21%, compared to control values whereas the slow axoplasmic transport of G1 and G2 was unaffected. Regarding the leg muscles, only the tibialis anterior revealed dramatic alterations in the distribution of it AChE forms coinciding with a large reduction in the number of nerve endings. In acrylamide poisoning, the AChE molecular forms were considered as very sensitive markers of both axonal transport phases and of the innervation state. Our results support the hypothesis that a defect in the fast axonal transport of proteins might be involved in the degeneration process of the disease.

Acetylcholinesterase↗

The risk of diabetic control: a comparison of hospital versus general practice supervision.

Two groups of insulin-treated outpatients (one followed up at the Hotel-Dieu Hospital and the second mainly supervised by general practitioners) were chosen at random in 1978. The two populations were comparable in age, age at diagnosis, sex, level of education, overall activity and socio-professional and economic status. Outpatients followed up in the diabetic unit had better blood glucose control, with about the same number of hypoglycaemic reactions as patients followed up in general practice. This better control was associated with more social activity and less visits to the physician, despite the fact that patients attending the hospital spent more money on their diet and had more daily insulin injections. All these differences remain significant after adjustment for the duration of diabetes. It may be inferred that attempts to improve control in insulin-treated patients are associated with a more active life and with no increase in the frequency of hypoglycaemic reactions.

Blood Glucose↗

[Birth and metamorphosis of Landouzy-Dejerine progressive atrophic myopathy].

On June 20th, 1880, was admitted at the "Hôpital de la Charité" in Paris, a 21 years-old man showing a very severe atrophy of most of his muscles. This case was going to mark the history of the neuromuscular diseases. In the present article are presented the main clinical, genetic, electrophysiological and anatomical data of this patient. It was tried to reconstitute how they were presented to Landouzy and Dejerine, who found in these data some of the features previously reported by Duchenne, de Boulogne, in 1852 as "atrophie musculaire progressive", and considered after the first post-mortem examination by Cruveilhier (1853) as being of neurogenic origin. In opposition with this theory, Landouzy and Dejerine proposed to refer to their case as "myopathie atrophique progressive", emphasizing thus the concept of "myopathy without neuropathy". The criteria proposed for the recognition of the new entity were perfectly described in their two memoirs (1885 and 1886). The characters of facial involvement, the occasional early onset, the selective and often asymmetrical weakness and atrophy of the limb muscles, the variability in severity from one member to another in the same family, were clearly showed. Furthermore, two cases reported in the 1886 memoir presented some involvement of the facial muscles which was demonstrated only by histological examination. The present article evokes the polemical discussion about the relationship of the "myopathie atrophique progressive" with the juvenile form of muscle dystrophy described by Erb at the same time, but without any anatomical or histological data. It is indicated also how the different views about the "scapulo-humeral" forms led to some metamorphosis of the "myopathie atrophique progressive" in "facio-scapulo-humeral dystrophy" in further classifications. This article is illustrated with micrographs taken from the original sections of Dejerine, which could be traced up to now and probably are reproduced photographically here for the first time.

Adult↗

A new case of phosphoglycerate kinase deficiency: PGK Creteil associated with rhabdomyolysis and lacking hemolytic anemia.

A new case of phosphoglycerate kinase (PGK) deficiency is described. The propositus displayed episodes of rhabdomyolysis crises and acute renal failure but did not exhibit any sign of hemolysis. A severe deficiency in phosphoglycerate kinase was revealed in muscle and was also found in erythrocytes, white cells and platelets. A partial defect in the same enzyme was present in the mother's and the two daughters' erythrocytes, indicating a X-linked recessive genetic transmission of the enzyme defect. In the propositus, erythrocyte ATP concentration was normal, although 2,3-diphosphoglycerate and triose phosphate levels were moderately increased. Lactate production from glucose, in vitro, was close to normal in intact red cells. The partial PGK was characterized by an increased Km for ADP and more especially for ATP, reduced thermostability, and diminished electrophoretic mobility. Lack of this enzyme, which is a key step in the glycolytic process (generation of one molecule of ATP), is thought to be responsible for rhabdomyolysis, a fact that has not been reported previously.

Acute Kidney Injury↗