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M Janier

Publications and source records attributed to M Janier.

At least 127 records · Page 7Linked to original sources
PubMed1984

[Acquired immunodeficiency syndrome, Kaposi's disease and cerebral toxoplasmosis in a young man. Review of the literature apropos of a case].

We report a new case of acquired immune-deficiency syndrome (AIDS) in a 43 year-old white homosexual man, characterized by the association of disseminated cutaneo-mucous Kaposi's sarcoma and cerebral toxoplasmosis. This man had Kaposi's sarcoma for about 10 years but evolution became quickly extensive in July 1981. Chlorambucil was prescribed at that time and was the cause of a pancytopenia. Death occurred in July 1982 due to a cerebral mass identified as toxoplasmosis on a left temporal biopsy. This observation is typical of AIDS, a new syndrome which suddenly developed in the last 2 years in the United States in homosexual men, Haitians and hemophiliacs, and is characterized by disseminated Kaposi's sarcoma and/or opportunistic infections, with a very high mortality rate. Severe toxoplasmosis of CNS has been reported in AIDS and appears to result from defects in cellular immunity which permit recrudescence of latent infection. Cerebral biopsy is necessary for the diagnosis of cerebral toxoplasmosis as seroconversion occurs infrequently in immuno-suppressed hosts. AIDS appeared in Western Europe in 1982. Most of the cases were reported in France, Denmark, Belgium and Great Britain. These cases differ from reported cases in the USA: fewer drug or poppers users, fewer homosexual men, an important number of people having lived or travelled in the Kaposi's endemic area (Mediterranean basin and Central Africa). The immunological profile of patients presenting AIDS in Europe doesn't seem to differ from the american profile: serious cellular immunodeficiency and marked increase in the suppressor/cytotoxic cell population. As in the United States, one may suspect, among several hypotheses, that it is caused by one or several transmissible agents now present in France. The nature of these agents, transmissible by sexual contacts and blood, is not yet known: the role of the CMV is now less probable and most of the studies look for the role of other factors such as the HTLV.

Acquired Immunodeficiency Syndrome↗
PubMed1982

[Carpal tunnel syndrome due to mycobacterium bovis BCG (author's transl)].

A 45-year-old woman, previously in good health developed chronic tenosynovitis with carpal tunnel syndrome a few weeks after wounding herself with a Pasteur pipette containing BCG cultures. She had received two injections of triamcinolone in the anterior annular ligament of the right carpa. The patient recovered after twelve months of antituberculous therapy associating isoniazid (300 mg/day), ethambutol (800 g/day), and rifampicine (400 mg/day). This is the first report of BCG tenosynovitis of the hand. The hazards of steroid injections into the tendon sheaths are pointed out.

Antitubercular Agents↗
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↗
PubMedDate not supplied

Influence of bolus volume and dose of gadolinium chelate for first-pass myocardial perfusion MR imaging studies.

First-pass MR myocardial perfusion measurements require a well-defined left ventricular (LV) blood pool input function. We used a peripheral intravenous (i.v.) injection of a gadolinium (Gd) chelate to obtain a well-characterized LV time-intensity curve. Using a strongly T1-weighted subsecond MR sequence, we performed cardiac MR imaging after administering an IV bolus injection of one of three different doses of the Gd chelate: a standard dose (0.1 mmol/kg, group I, n = 8); a low dose with two bolus volumes (0.01 mmol/kg, 1/10e bolus volume, group II, n = 7, and 0.01 mmol/kg diluted in saline, same bolus volume as group I, group III, n = 3); and an intermediate dose (0.05 mmol/kg, group IV, n = 5). Unlike in group I (high dose), in groups II and III (low dose), the LV curve had a well-defined first peak, followed by a downslope and a recirculation peak. With the intermediate dose (group IV), a saturation effect still remained on the LV curve. The signal intensity (SI) enhancement of the myocardium was respectively 580 +/- 77% at 0.1 mmol/kg, 362 +/- 95% at 0.05 mmol/kg, and at 0.01 mmol/kg, it was 184 +/- 33% in group II and 272 +/- 8% in group III. In conclusion, with subsecond T1-weighted MR imaging and a low dose of Gd chelate (i.e., 0.01 mmol/kg), the LV input function is a well-defined first step for MR perfusion modeling.

Contrast Media↗
PubMedDate not supplied

Myocardium extraction in positron emission tomography based on soft computing.

This paper presents an efficient and accurate approach to myocardium extraction in Positron Emission Tomography (PET) images based on a careful application of soft computing techniques. PET images present a noisy background, making the automatic myocardium extraction and uptake quantification a difficult task. In this work a Self Organized Radial Basis Function Network (SRBFN) is designed to focus on the myocardium in an iterative process until the total extraction of the myocardium from the noisy background is achieved. Fuzzy sets and fuzziness measures are used to compute the error of the network. The method was tested on a set of nine images of different patients and its effectiveness is illustrated in two patients showing tracer uptake defects.

Fluorodeoxyglucose F18↗
PubMedDate not supplied

An evaluation of the polymerase chain reaction amplicor Chlamydia trachomatis in male urine and female urogenital specimens.

BACKGROUND AND OBJECTIVES: The new commercially available polymerase chain reaction (PCR)-based assay, Amplicor C. trachomatis, was compared with cell culture of C. trachomatis, for the detection of chlamydial urogenital infections. GOAL OF THIS STUDY: To evaluate whether the Amplicor C. trachomatis PCR could improve the diagnosis of chlamydial urogenital infections, compared with cell culture of C. trachomatis considered as the reference method. STUDY DESIGN: A total of 466 men and 290 women attending a sexually transmitted disease (STD) clinic were tested by the Amplicor test in urine in men, and in the cervix and urethra in women, and by cell culture in the urethra of both men and women and in the cervix of the women. RESULTS: The prevalence of C. trachomatis was 13.7% by cell culture and 14.4% by the Amplicor test in men, and 3.5% by cell culture and 4.5% by the Amplicor test in women. After resolution of the discrepant results, the sensitivity of culture was 91.4% in male urethral specimens and 83.3% in endocervical and female urethral specimens. The resolved sensitivity of the PCR assay was 92.7% in male urine, 91.7% in endocervical samples, and reached 100% in testing both endocervical and female urethral specimens. CONCLUSION: This rapid PCR-based assay showed an improvement in quality for diagnosing C. trachomatis infections.

Adolescent↗
PubMedDate not supplied

Male urethritis with and without discharge: a clinical and microbiological study.

BACKGROUND: The definition of male urethritis in the absence of urethral discharge has not been well established. The sensitivity of urethral swabs and first-catch urine is controversial. GOAL OF THIS STUDY: To correlate clinical data (discharge or not), urethral swabs, and first-catch urine examinations with the microorganisms found within the urethra in a cohort of men attending the sexually transmitted disease clinic of Hôpital Saint Louis (Paris) for treatment of urethral symptoms with or without discharge. STUDY DESIGN: Two-hundred-seventy-three consecutive male patients entered this prospective study between October 1, 1992 and November 30, 1992. Fifty-two patients were excluded because they had been treated with antibiotics in the previous 3 months. All patients were screened for Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium, Trichomonas vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, and Candida albicans. RESULTS: Two-hundred-nineteen patients were eligible for the study (122 with discharge and 97 with no discharge). The prevalence of microorganisms was as follows: Chlamydia trachomatis in 13%, Neisseria gonorrhoeae in 11%, Ureaplasma urealyticum in 7%, Mycoplasma genitalium in 17%, Trichomonas vaginalis in 1%, and indeterminate pathogens alone in 20%. All major pathogens and Mycoplasma genitalium were more common in patients with discharge. Stratification of results according to the presence of polymorphonuclear leukocytes on the urethral swab and first-catch urine showed a low sensitivity of both tests for Chlamydia trachomatis (29%), Mycoplasma genitalium (50% and 62%), and Ureaplasma urealyticum (33%) in patients with no discharge. CONCLUSION: A specific and sensitive search for Chlamydia trachomatis should be done in every patient with urethral symptoms whether or not the classic symptoms of urethritis are present (discharge, presence of polymorphonuclear leukocytes in the urethra or first-catch urine).

Adult↗
PubMedDate not supplied

[Localized bullous pemphigoid induced by thermal burn].

BACKGROUND: Induced bullous pemphigoid is known to be triggered by drugs and some physical agents. Six cases of bullous pemphigoid induced by thermal burns have been reported since 1991. CASE REPORT: We observed a bullous eruption around thermal burns of the left leg in a 89 year-old woman. Bullous pemphigoid was diagnosed by histological and immunohistochemical findings with a sub-epidermal blister and linear IgG and C3 deposition at the dermal-epidermal junction. Indirect immunofluorescence was negative. The eruption rapidly resolved with topical steroids. DISCUSSION: We describe a bullous pemphigoid induced by a thermal burn. This case is original because the eruption was localized only around the site of the burn and healed with topical steroids. In the literature, there are 6 other cases reported but only one localized. We discuss the hypothesis of asymptomatic bullous pemphigoid exacerbated by presentation of bullous pemphigoid antigen by thermal burns or self immunization against antigens altered by burns.

Aged↗
PubMedDate not supplied

[Prophylactic antiretroviral therapy after sexual exposure to HIV: 93 cases].

PATIENTS AND METHODS: We studied prospectively the feasibility of post exposure prophylaxis against HIV in 93 subjects consulting after sexual exposure at STD Center of Hopital Saint-Louis. Among the 93 subjects, 76 were men (45 homosexual) and 17 women. RESULTS: Delay to consultation was 38 h. Among sexual exposure 90 p. 100 were anal or vaginal intercourse and 10 p. 100 oral intercourse. Fifty percent were unprotected. Seventy-five percent of source subject HIV status was unknown, but controlled negative in 14 p. 100 of cases. Three subjects were infected initially. Seventy-two subjects were treated, with triple regimen, for 30 days without severe adverse event. Twenty-five percent were lost to follow up before the end of treatment, only 54 controlled their serology after the end of treatment (after 1 month: 70 p. 100, after 2 months: 51 p. 100 and after 4-6 months: 13 p. 100). DISCUSSION: This study underlines the difficulty in obtaining clinical and serological control after post exposure prophylaxis, even in a STD Department involved in prevention and counseling.

AIDS Serodiagnosis↗
PubMedDate not supplied

[1801-2001: two centuries of dermatology and venereology in the Assistance Publique-Hôpitaux de Paris].

The specialization "Dermatology" was born at the Saint-Louis hospital in France in 1801, in the light of the revolutionary reforms that led to fundamental changes in the functioning of the hospitals in Paris. Hence, the Saint-Louis hospital occupies an eminent position in the history of dermatology in France, reinforced by the role of Jean-Louis Alibert, who founded the French school of Dermatology. Despite the place occupied by the physicians of the Saint-Louis Hospital in the creation and development of the French school of dermatology, other physicians in other hospitals contributed to the expansion of the dermatology school. The work of Pierre Rayer, in the nineteenth century, at the Saint-Antoine and subsequently the Charité hospitals, are within this scope. More recently, the re-organization of the Faculty of Medicine into University Hospital Centers has permitted the creation of various treatment, teaching and research centers within the structure of the public hospitals in Paris. From the start, syphilis was part of the Dermatology teaching and practice. In Paris, several so-called "specialized" hospitals were created to house patients presenting with syphilis. Later on, the existence of these hospitals was questioned notably because of the constraints that their functioning imposed on the patients. Anti-venereal care centers were developed in response to the request of the practitioners to facilitate the access to treatment.

Dermatology↗
PubMedDate not supplied

[Gonococci].

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Female↗