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Biomedical subjects

M Goulon

Publications and source records attributed to M Goulon.

At least 73 records · Page 4Linked to original sources
PubMed1980

[A fortultousness association: Bartter's syndrome and chondrocalcinosis (author's transl)].

Two adults patients presenting Bartter's syndrome have been studied for 9 years in one case, 7 years in the other. Both were affected with chondrocalcinosis. This association does not seem to be coincididental but suggests a pathogenic link between Bartter's syndrome and chondrocalcinosis; the two patients presented hypomagnesemia which, inhibiting intrasynovial pyrophosphatase, induces calcium pyrophosphate crystals deposits on fibrocartilages. Otherwise, excessive daily urinary excretion of PG E2 and PG F2 alpha was found in both patients. Indomethacin (150 mg daily) decreased urinary excretion of PG to normal values in the two cases, Kalaemia was completely normalized in one case, partially in the other.

Adult↗
PubMed1980

[Determination of anti-acetylcholine receptor antibodies in myasthenia and its treatment by plasma exchange and immunosuppressants].

Recent works have confirmed the auto immune mechanism in myasthenia gravis, that Simpson had hypothetized early as 1960. A post synaptic blockage, of which Ach-R antibodies seem to be chiefly responsible, is now accepted though the exact pathogenesis remains unknown. The immuno assay of these antibodies is still difficult; their blood level evaluates the course of the disease and the effectiveness of the treatment. The withdrawal of the antibodies by plasma exchange (P.E.) and the inhibition of their secretion by immunosuppression (I.S.) lead to remission in many cases. Principle of the immuno assay and results of P.E. and I.S. are reported in 21 cases.

Adolescent↗
PubMed1980

[Normal and abnormal response of the arterial pressure to standing (author's transl)].

Redistribution of blood volume during orthostatism is followed by a reduction in venous return and therefore cardiac output. A drop in the blood pressure following postural changes is normally prevented by the action of the baroreceptor reflex, which leads to an increase in total peripheral resistance and heart rate. Orthostatic hypotension may arise from a variety of causes. In some cases, the disorder of postural regulation is due to an autonomic nervous system disease, and various tests are available that enable the diagnosis to be confirmed and the mechanism of action to be elucidated. Certain of these investigations explore the function of the complete baroreceptor reflex arc, while others enable selective study of either the efferent parasympathetic or sympathetic pathways. Central zones and afferent pathways cannot be explored directly. Individual tests are of limited value only, and the results of overall investigations are necessary for a better understanding and therefore more effective therapy of orthostatic hypotension due to autonomic nervous system disease.

Autonomic Nervous System↗
PubMed1980

[Hyponatremia after very heavy beer drinking (author's transl)].

Severe water and electrolyte disturbances were observed in a patient after a bout of very heavy beer drinking (30 liters in 6 days). On admission she was found to have hypokalemia (2.2 mEq/I), metabolic alkalosis (pHa: 7.55-total CO2: 40 mEq/I), and more particularly hyponatremia (109 mEq/I), responsible for the typical neurological signs of water intoxication (hyponatremic encephalopathy). There was a positive cumulative return of sodium (570 mEq) and chloride (900 mEq) levels, and normal conditions were restored without significant modifications in water balance or weight. No other etiology, apart from the beer, was discovered. Heavy drinking of beer alone can therefore provoke chloride and sodium depletion, probably because beer, which is poor in NaCl, must produce urinary loss of these electrolytes. The high osmolarity of beer may explain this latter phenomenon. This particular cause of hyponatremia should be recognized, if only to avoid confusing the clinical signs of alcoholic intoxication with those due to water intoxication.

Alcoholic Intoxication↗
PubMed1979

[Polyradiculopathy associated with bullous pemphigoid (author's transl)].

A sensorio-motor polyradiculopathy of subacute onset and a bullous pemphigoid form of herpetiform dermatitis (Dühring-Brocq disease) developed simultaneously in a 71-year-old man. Both conditions regressed under the influence of prednisone and azathioprine. The immediate cortico-dependence of the skin condition should be noted. Death occurred 9 months later, related to diffuse pulmonary aspergillosis. A paraneoplastic aetiology was sought unsuccessfully.

Aged↗
PubMed1979

Humoral and cellular immunity to intrinsic factor in myasthenia gravis.

Myasthenia gravis (MG) is an autoimmune disease often associated with other autoimmune disorders. A case history of MG with a coexisting atypical megaloblastic anaemia with vitamin B12 deficiency and anti Intrinsic Factor (IF) antibodies, led to a study of humoral and cellular immunity to IF in 81 MG patients. Within this series, 3 other patients had a disturbed humoral and cellular immunity to IF. These 3 patients presented no other features of pernicious anaemia. The possible origins and significance of the anti IF antibodies in MG patients are discussed.

Adolescent↗
PubMed1979

[Myasthenia and pernicious anemia or Biermer's (author's transl)].

The association of myasthenia and Biermer's anemia is very rarely reported. In a series of 138 cases of myasthenia, this association was found in only one patient, in whom the anemia developed 19 years after the discovery of a calcified thymoma and 13 years after the appearance of the first signs of myasthenia. This led the authors to conduct a prospective study for the presence of intrinsic antifactor antibodies. A total of 81 patients (20 men and 61 women) with myasthenia were studied. The myasthenia had appeared after 35 years of age in 40 patients and 19 had a thymoma. The results of the study for the antibodies was positive in 3 women, as was the test of inhibition of leucocyte migration, but none of them had anemia, vitamin B12 malabsorption, achlorhydria, or gastric atrophy. The discovery of these immunological disorders raises the problem of their significance ; two hypotheses can be discussed : pre-Biermer state or immunological disturbance without pathogenetic significance. The problem can probably only be resolved by studying these antibody levels in a very much larger number of patients with myasthenia.

Adult↗
PubMed1978

Treatment of mediastinitis in children after cardiac surgery. A study of 20 cases.

Twenty-three cases of mediastinitis after cardiac surgery in children were treated by us between 1973 and 1976. Three patients died within 6 hours of admission. Treatment used in the tweny other cases are discussed. The mean age of the patients was three years and three months. The mediastinitis was evident an average of twelve days after extracoporeal circulation. A staphylococus was always responsible for the infection. Treatment was a combination of surgery, antibiotics and respiratory and nutritional supplies. The surgical treatment consisted of a careful mediastinal cleansing with resection of the sternal edges. In fifteen patients the thorax was closed after surgery, and an irrigation system installed using a solution of 4% Dakin in physiologic saline. Recovery was simple in 5 patients. In the 10 other patients of this group the thorax had to be reopened; one patient died after 90 days from Serratia marcescens endocarditis. The thorax was left open initially in five patients: one patient of this group died from candida endocarditis. All patients needed endotracheal ventilation through a nasotracheal tube (7 to 90 days of ventilation). Treatment with bactericidal antibiotics was pursued for three months and a monotherapy was kept for nine months. After reviewing the observed complications, our methods and results are compared with others in the literature.

Child↗
PubMed1978

Membrane oxygenators for acute respiratory insufficiency. Clinical use in 11 patients.

Extracorporeal circulation with a membrane oxygenator (ECMO) was used in 11 patients with acute respiratory insufficiency who did not respond to conventional treatment. By pass was veno-arterial in every case, seven times with femoral artery return, three times with axillary artery return, and once with both femoral and axillary return. Five patients died on ECMO. Six patients were taken off ECMO and two of them are long-term survivors. In nine cases ECMO allowed short-term control of respiratory failure. The respective roles of oxygen supply from ECMO and the haemodynamic changes incurred by its use are discussed. Although use of ECMO for long periods seems less hazardous now, present results are restricted by the lack of therapy for the underlying pulmonary lesions.

Acute Disease↗