Biomedical subjects
Publications and source records attributed to M Guillot.
A particular progeroid syndrome with severe acro-osteolysis, cutaneous changes, failure to thrive, and early death is described in a young boy. Progeria and mandibulo-acral dysplasia are discussed, but early death is unusual in these two syndromes. This observation raises the question of a large spectrum including all of these syndromes.
Arthritis in mucoviscidosis has been described as aseptic arthritis with the picture of oligo or polyarticular intermittent rheumatism, independent of the pulmonary course of the disease, often accompanied by skin signs, sometimes in the form of vasculitis, and without radiological signs. Chronic forms with the presence of rheumatoid factor and/or radiological signs have also been described. The authors found 4 cases of arthritis (incidence 2%) in a retrospective study of 208 patients with mucoviscidosis. These included one case of typical intermittent rheumatism, one of chronic arthritis of the wrist with positive rheumatoid factor, one case associated with purpura, the course of which was linked to pulmonary secondary infections, and one case of polyarthritis with spinal pain which was difficult to classify. Arthritis in mucoviscidosis appears to be a clinically heterogeneous entity, the pathophysiology of which could involve various immune reactions, secondary to a chronic bacterial stimulus of bronchopulmonary origin.
In a double-blind controlled multicentric study involving 94 patients with an intrauterine fetal death, we investigated the efficacy and tolerance of mifepristone (RU 486), a steroid compound that antagonizes progesterone action at the receptor level. Success of treatment was defined as the occurrence of fetal expulsion within 72 hours after the first drug intake. Mifepristone treatment (600 mg per day for 2 days) was considered to be effective in 29 of 46 patients (63%). There were only eight successes in 48 patients (17.4%) in the placebo group (p = 0.001, chi 2 test). Tolerance was good in the mifepristone group. In the placebo group, disseminated intravascular coagulation occurred in one woman for whom the investigator waited several weeks for spontaneous expulsion. This large double-blind controlled study provides evidence that mifepristone is of interest in the management of intrauterine fetal death. It could provide a pharmacologic alternative to the use of prostaglandins in this indication.
A randomized, multicenter clinical trial comparing two oral rehydration solutions (ORS) with different sugar content and total osmolality was carried out in France. Solution A had 168 mmol/L of sugar and a total osmolarity of 326 mosm/kg; solution D had 90 mmol/L of sugar and a total osmolarity of 240 mosm/kg. Weight gain, stool output, and biologic variables were analyzed. This interim analysis included 49 infants (27 in group A and 22 in group D). Patients in both groups gained weight without any significant difference between the two ORS. Between admission and day 4, the overall number of stools and the number of liquid stools decreased. Laboratory values were within the normal range on admission and remained unchanged. The weight increase during the first 24 hours and the reduced frequency of stools was similar in both groups.
Applying the principles of mechanics, the authors have studied and compared the bony structures of the temporo-mandibular joint. Using the means of investigation usually implemented in the metallurgical sector, they have tried to establish a link between the morphology and mechanical strength of the various components of this joint in some subjects belonging to the mammals classification and with various feeding modes. The results obtained by hardness micrometry tend to show that during masticatory movements, the temporo-mandibular joint works in a hanging rather than in a compressed mode.
Since MAGENDIE in 1816, it has been a common assertion in books of Anatomie that curves of the spine increase its strength. This increase in strength has been estimated by a formula attributed to EULER: R = nc2 + 1 in which R is the strength and nc2 stands for the square of the number of curves. Applying the actual law of Euler on the strength of beams submitted to a vertical effort, the authors conclude that strength is increased by about 30% and not multiplied by 10, 16 or even 17 as is often falsely written.
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Retrospective analysis of 63 patients with mucoviscidosis (age: 11 to 21 years), treated with pefloxacine, shows the occurrence of arthropathies ascribed to pefloxacine in 9 patients (age: 9 to 20 years), or 14% of the patients under treatment. The dose of pefloxacine was normal (9 to 16 mg/kg/day) in all cases, except one case of overdose (29 mg/kg/day). Mechanical arthralgias, affect the knees, elbows and wrists, resulting in functional discomfort, and frequently accompanied by mechanical synovial extravasation. They always subside after pefloxacine is discontinued. The role of age is essential as the incidence of arthropathies reaches 45% when pefloxacine is first administered between the ages of 15 and 20 years. Retrospective analysis of 37 patients with mucoviscidosis (age: 2 to 20 years), treated with ofloxacine, failed to show any joint complication. In this study, the best joint tolerance of ofloxacine, compared with pefloxacine is statistically significant. Arthropathies induced by pefloxacine represent an original entity which seems related to the cartilage toxicity of quinolones, observed in animal experiments, during growth.
The intention of this article is to review and to comment some of the historic and recent informations regarding the lymphatic drainage of brain and cerebrospinal fluid, and to try to specify the different pathways of this drainage.
The authors in a review of the literature and their personal studies, report the various measurements methods of the stresses exerted on the lumbar spine, with their results. This study comprises three chapters: study of an isolated spinal segment, static study of the lumbar spine and dynamic study of the lumbar spine.
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We report for the first time a case of Crohn's enteritis associated with a chronic tubulo-interstitial nephritis in an adolescent. The illness started insidiously in an 11 year-old boy who had suffered from failure to thrive and protracted watery diarrhea. At presentation the patient had an inflammatory bowel disease located to the left colon but no renal dysfunction. Until the age of 15, the intestinal symptoms were stable but a progressive renal insufficiency developed. A percutaneous renal biopsy was then performed which showed a widespread chronic tubulo-interstitial nephritis. Following a 6 months corticosteroid treatment, renal dysfunction seemed to be stabilized. However, delayed growth and corticosteroid dependency led to total colectomy. Pathologic examination showed granulomatosis involvement of the entire colon and severe interstitial nephritis with neither linear nor granulous deposits along tubular basement membranes. After a 2 year-delay following the colectomy, renal function was stabilized and a catch up growth was achieved.
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A current view of "pigeon fancier's lung" in children is reported through a familial case presenting as a severe denutrition in a 9 year-old boy. Cellular and biochemical analysis of broncho-alveolar lavage fluid is essential to proper diagnosis. Treatment is based upon the eviction of inhaled antigenic organic materials issued from pigeon's droppings, corticosteroid treatment being only additional. Pulmonary fibrosis is a rare but possible complication in the outcome of the disease.
The dexamethasone suppression test (DST) has been used in psychiatric pathology for about 10 years. Carroll et al. consider this test to be specific of endogenous depression. According to these, and many other authors, approximately 55% of patients with endogenous depression show a positive response to the test, whereas a positive response is observed in only 4% of normal subjects or patients with psychiatric disorders other than major depressive disorders. The DST was performed in 162 psychiatric inpatients (5 with organic disease, 28 with schizophrenic disorders, 17 with major affective disorders, 5 with obsessive compulsive disorders, 103 with dysthymic disorders and 4 unclassified). Dexamethasone (1 mg) was administered orally at 11 p.m., and plasma cortisol concentration was measured the following day at 16 p.m. Response to the test was positive in 53% of patients with major affective disorders, 25% of those with schizophrenic disorders, 60% with obsessive compulsive disorders and 18% with dysthymic disorders. There was no statistical difference in the results according to age, sex ratio, family history of depression or duration of the disorders. Only two variables were close to the P less than 0.05 level of statistical significance: severity of the disorders and early morning awakening. DST sensitivity, therefore, would appear to be about 50% in major affective disorders, but this test is not specific as it may also be positive in other psychiatric disorders. A positive dexamethasone suppression test may be regarded as a sign of severity of psychiatric disorders.
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Explore the source record for details and available documents.