[Adult onset Still disease and subacute thyroiditis].
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Biomedical subjects
Publications and source records attributed to M Imler.
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An acute isolated myelitis occurring at the post-eruptive phase of measles is reported. This unusual complication of measles has a favourable outcome in the most of cases. An immunological mechanism, identical to this responsible of perivenous encephalitis seems to be involved.
The authors present the case of an 83 year-old man with cerebral amyloid angiopathy who had three successive lobar intracerebral hematomas within 4 weeks. There were neither a predisposing familial factor nor cardiovascular risk factors nor any other cause favouring cerebral bleeding. The autopsy revealed amyloid deposits in small cortical and meningeal arteries. No other lesions of the Alzheimer's disease was found.
A case of desmoid abdominal tumor is reported. This is a rare benign tumor often found in association with Gardner's syndrome. The radiological features with ultrasonography, computed tomography and magnetic resonance imaging are presented. These explorations illustrate the infiltrating characteristics and the high potentially recurrence rate of desmoid tumor.
To evaluate the influence of blood transfusion on the serum levels of different nutrients, the levels of total iron binding capacity, ferritin, cobalamin and folate were determined before and 24 hours after 2 or 3 packed red cell transfusions, by forty patients with anemia of various causes. No significant change was found in these levels before and after blood transfusion, except for iron and folate.
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The finding of a low basal concentration of thyroid-stimulating hormone (TSH) in the absence of high thyroid hormone levels is difficult to understand. In order to elucidate the meaning of such a dissociation, 22 patients without history of thyroid disease and showing clinical signs compatible with thyrotoxicosis were explored by the thyrotrophin-releasing hormone (TRH) test, by thyroid radioisotope scanning and, in case of high nodular uptake, by the triiodothyronine suppression test. A specific surgical, isotopic or medical treatment was instituted in the 17 patients who had a high nodular uptake unsupressible by triiodothyronine. During a clinicobiological re-evaluation carried out 6 months later, a significant clinical improvement was observed in 8 patients, and 12 patients whose free thyroxine level had decreased showed normal TSH levels. These results underline the value of thyroid radioisotope scanning in patients with isolated diminution of TSH. They confirm the reality of occult hyperthyroidism with normal thyroid hormone levels by the benefits observed after specific treatment.
The intestinal ammonium production and the intestinal uptake of circulating glutamine were investigated in anesthetized intact rats and rats with resected small intestine or colon by simultaneous measurements performed on portal and arterial blood. It was shown that ammonium release into the portal blood by the small intestine is of equal magnitude to that released by the colon, and that circulating glutamine participates in ammonium production by the small intestine. Increased levels of circulating glutamine induced by its i.v. infusion to intact rats were not accompanied by an increase in intestinal ammonium production.
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Injection of anesthetized rats with the uncoupling agent, 2,4-dinitrophenol (2,4-DNP) 10 or 20 mg/kg induced a systemic hyperammonemia unaccompanied by blood acid-base status changes and related to an increased release of ammonium from the kidney into the renal vein. Ammonium excretion into the urine did not increase. The renal uptake of circulating glutamine rose. The antiepileptic drug sodium valproate (VPA), a short-chain, branched fatty acid, had the same effects on rat and man. These findings suggest that VPA stimulates renal ammoniagenesis by the same mechanisms as 2,4-DNP.
The aim of this study was to investigate the influence of acid and alkali food supplementation on systemic ammonemia to explain the hyperammonemia previously observed in rats fed a high protein diet. In normal rats, arterial ammonia concentration significantly increases after 4 days of HCl-supplemented diet. Following a NaHCO3-enriched food, there is only a slight but not significant decrease in arterial ammonia level. These changes occur before any variation in arterial acid-base status and are of renal origin. Indeed, there is a positive linear correlation (r = 0.946; P less than 0.001) between arterial ammonia level and the ammonia concentration difference between the renal vein and artery (which varies proportionally to the urinary ammonium excretion). Hindquarter uptake and intestinal release of ammonia do not significantly participate in the arterial ammonia changes observed. Following HCl-enriched diets, increased renal glutamine uptake, enhanced hindquarter glutamine release, and perhaps decreased intestinal glutamine uptake occur simultaneously. In conclusion, acid and alkali food supplementation intervenes on the renal ammonia release into the circulation with concomitant arterial ammonemia changes.