[Benign pseudovestibular cerebellar infarction].
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Aged↗
Biomedical subjects
M Masson
Publications and source records attributed to M Masson.
[Physiopathologic mechanisms of coma].
The occurrence of coma betrays a deficiency of the ascending reticular activating system (ARAS) of the brain stem, which constitutes the neurophysiological support of wakefulness. Multiple factors, acting separately or jointly, may be responsible for coma. They include diffuse lesions or circumscribed lesions with repercussions on the ARAS metabolic and toxic factors, intracranial hypertension, cerebral oedema, epileptic activity, and so forth. Owing to the influence it exerts on the management of coma, the physiopathological approach is as necessary as the aetiological approach.
Brain Diseases↗
Long-acting propranolol in migraine prophylaxis: results of a double-blind, placebo-controlled study.
The efficacy and safety of long-acting propranolol (LA.P), 160 mg once-daily, in the prophylactic treatment of migraine have been tested against placebo in a multicentric, double-blind, randomized study. The two groups are compared in a parallel manner over a treatment period of 12 weeks, following a 4-week placebo run-in period. Fifty-five of the 74 patients who entered the trial were included at the end of the run-in period. Forty-one patients completed the study. None of the 14 patients who withdrew from the study did so because of side effects. The statistical analysis was done according to the "intention to treat" principle. LA.P was significantly more effective than placebo in reducing the frequency of migraine attacks (p = 0.01 by variance analysis). LA.P reduced the average number of monthly crises by 48% on day 84. There was a slight but significant reduction of the systolic blood pressure and heart rate in the erect position, but there was no significant difference between LA.P and placebo regarding either the number of complaints or the number of side effects elicited out of a 17-item questionnaire. None of the observed side effects led to a withdrawal from treatment.
Adult↗
Synopsis of French experimental and in situ research on the terrestrial and marine behavior of Tc.
Terrestrial environment studies have been essentially concerned with the evolution of soil deposition and soil-plant transfers. Experimentally determined coefficients of distribution in soils are low: 60-80% of Tc remains hydrosoluble during the first months. Technetium emissions resulting from microbiological activity have been quantified. Antagonistic effects on Mo and Tc retention by soils are dependent on their respective concentrations. Four areas of soil-plant transfers have been studied: 1) root absorption kinetics relative to deposition of Tc, 2) interaction of stable Mo (environmental parameter) with the transfer of Tc to plants, 3) interaction of some long-lived radioisotopes (effluent parameters) with the transfer of Tc to plants, and 4) long-term soil-plant transfer and aging of deposited material. Of aquatic systems, only the marine environment has been studied. Under anoxic conditions in the presence of reducing sediments, the distribution coefficients (Kd) were very high (10(3)). Concentration factors (CF) from water to organisms were generally very low (1 to 10); however, CF greater than 1000 have been observed for some biota such as macrophytic brown algae, worms and lobsters. Biochemical analysis showed that Tc was essentially free and partially bonded to proteins. The transfer factors between sediments and species were very low (TF less than 0.5). The biological half-time was determined in some marine organisms that had accumulated Tc from water, food or sediments; the loss is biphasic. Uptake in edible parts was low. The physiochemical form affects the accumulation and loss of Tc. Analyses have quantified 99Tc in marine fauna and biota in the English Channel in relation with releases of the reprocessing plant of La Hague. Brown algae are the best bioindicators for following 99Tc dispersion in marine ecosystems.
Animals↗
Calmodulin antagonist W-7 inhibits lysosomal sphingomyelinase activity in C6 glioma cells.
N-(6-Aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7) is known to be a potent calmodulin antagonist and inhibitor of calmodulin-dependent protein kinases. W-7 and 1-(5-isoquinolinyl-sulfonyl)-2-methylpiperazine (H-7) are inhibitors of protein kinase C and cyclic nucleotide-dependent protein kinases. In C6 glioma cells, W-7 and not H-7 inhibited dose-dependently acid sphingomyelinase, a result indicating the modulation of this lysosomal enzyme by a calmodulin-dependent system. Other lysosomal enzymes, such as beta-glucosidase, alpha-galactosidase, and arylsulfatase A, were unaffected by W-7 and H-7, a finding indicating a selective effect of W-7 on sphingomyelinase.
1-(5-Isoquinolinesulfonyl)-2-Methylpiperazine↗
[Cranial pachymeningitis of unknown origin. Study of 3 cases].
The clinical picture in three cases of chronic cranial pachymeningitis of unknown origin was dominated by headache, disturbed balance, a confusional state and cranial nerve lesions. The erythrocyte sedimentation rate was increased and the CSF showed inflammatory changes. CT scan imaging showed thickening of the tentorium cerebelli, which took up contrast intensely. Meningeal biopsy showed the dura-mater to be the site of a non-specific inflammatory process. No precise cause was found. Clinical manifestations in these three patients were remarkably corticosensitive but lesions did not regress on CT. The development of a state of corticodependence led to an attempt at treatment with radiotherapy and/or azathioprine, but follow up is insufficient to evaluate results.
Adult↗
[Unilateral paralysis of saccades caused by pontine tuberculoma].
A unilateral lesion of the paramedian pontine reticular formation results in an ipsilateral laterality paralysis with abolition of all saccadic movements directed to the side of the lesion. It is generally accepted that the oculocephalic reflex alone enables the eyes to be deviated beyond the median line of the affected side. In the present case of a paramedian pontine tuberculoma, a paralysis of laterality in accordance with the above mentioned opinion was observed initially. Treatment led to recovery of an ipsilateral pursuit of normal amplitude, contrasting with the persistent abolition of ipsilateral saccadic movements. The significance of this dissociation is discussed together with that of the later reappearance of slow voluntary movements (slow saccadic movements) towards the affected side.
Adult↗
[Myelopathy, polymyositis and systemic manifestations associated with the HTLV-I virus].
A case of HTLV-I associated myelopathy in a 51 year-old Haitian woman is reported. MRI showed high signals in the cerebral white matter on T2-weighted images. There also was clinical and electrophysiological evidence of myositis, and a biopsy of the quadriceps muscle showed dense inflammatory infiltrates surrounding several small perimysial blood vessels. The virus was not demonstrated in the muscle. The presence of several systemic abnormalities (polyclonal gammapathy, circulating immune complexes, Sjögren's syndrome) and the vasculitis suggest an immunopathological mechanism for this HTLV-I associated myositis.
Antigen-Antibody Complex↗
[Cerebral infarct and pure sensory deficit].
Twenty cases of pure sensory deficit of vascular origin are reported in patients aged 36 to 79 years. This type of attack in usually presumed to be due to a thalamic lacuna in the ventro-postero-lateral nucleus. However, other reported cases have shown other causal mechanisms and lesional sites. In the present series, CT scan and MRI in 11 cases demonstrated: infarctions in 9 and hemorrhages in 2 patients. The ventro-postero-lateral nucleus was involved in only 4 cases. An infarct of the posterior limb of the internal capsule (anterior choroidal artery territory) was present in 4 cases. The lesions in the other patients were: a thalamic hemorrhage and a small pontine hemorrhage lesion. The likely cause was embolism of cardiac origin in 4 cases, hypertension in 11 cases and diabetes in 4. One patient had an aneurysm of the posterior cerebral artery.
Adult↗
Molecular pharmacology of niaprazine.
1. The pharmacological profile of niaprazine was investigated using in vitro ligand binding techniques. 2. Niaprazine exhibits a low affinity for the vesicular monoamine transporter and for D2, alpha 2, beta, H1 and muscarinic cholinergic receptors. Niaprazine, particularly the (+)stereoisomer, has a higher affinity for alpha 1 (Ki = 77 nM) and 5-HT2 (Ki = 25 nM) binding sites, but is poorly recognized by 5-HT1A and 5-HT1B binding sites (Ki sigma mciroM). In contrast, p-fluoro-phenylpiperazine, a major metabolite of niaprazine, exhibits a higher affinity for the 5-HT1 subclasses than for the 5HT2 class. 3. These results suggest that the pharmacological properties of niaprazine reflect both its non-reserpinic catecholamine depletor effect and its action on alpha 1 and 5-HT2 receptors. A role of p-fluoro-phenylpiperazine via 5-HT1 sites cannot be excluded.
Adrenal Medulla↗
Benzyl alcohol metabolism and elimination in neonates.
Reports on fatal benzyl alcohol poisoning in premature neonates implied that the toxicity may be due to larger doses per kilogram than for adults. It has been postulated that the load of benzoic acid (metabolite of benzyl alcohol) may exceed the capacity of the immature liver or kidney for detoxification through glycine conjugation to form hippuric acid. To test this hypothesis, 14 term and 9 preterm neonates receiving loading doses of phenobarbital containing benzyl alcohol were studied. Urine and serum benzoic and hippuric acid levels were measured by GC and HPLC methods, respectively. There was greater accumulation of benzoic acid in the serum of preterm compared to the term neonates which was reflected in higher normalized peak levels (2130.6 vs. 237.8 kg/l, p less than 0.001) and larger normalized AUCIV (1,253.2 vs. 483.0 kg.h/l, p less than 0.01). Furthermore, larger percentages of benzyl alcohol doses were found in urine as benzoic acid in preterm babies, while less hippuric acid appeared in their urine than term newborns. These results indicate that hippuric acid formation is deficient in preterm neonates. Although we did not encounter in our patients the specific toxic signs described as part of the benzyl alcohol toxicity syndrome, we cannot directly answer the issue of safety of 'low doses' of benzyl alcohol as found in some medications administered to neonates. This study confirms the immaturity of the benzoic acid detoxification process in premature newborns.
Benzoates↗
[Eales' disease with neurologic disorders].
Two cases of Eale's disease, with neurological involvement have been studied with magnetic resonance imaging (MRI). In the first case the ophthalmological disease had been diagnosed ten years before the onset of a cerebellar ataxia. In the second case the characteristic ocular changes were followed eight years later by a myelopathy. MRI in both cases showed multifocal white matter abnormalities. The nosological interpretation of such cases remains uncertain: association of Eale's disease with multiple sclerosis or vasculopathy involving the central nervous system and the retina?
Adult↗
[Epilepsy with bilateral cortical calcifications. Discussion of a durable post-critical deficit].
The epilepsy-bilateral cortical calcifications syndrome includes epilepsy with onset in childhood or adolescence and symmetrical calcifications of cerebral cortex with a predilection for the occipital cortex. The calcifications are sometimes visible on plain radiograph images but may be detected only by CT. Literature perusal revealed reports of 16 cases. We report a case with an aperceptive visual agnosia and marked but resolutive CT anomalies developed during a partial status epilepticus episode.
Adolescent↗
[Hypersomnia ictus as a symptom of posterior thalamic hemorrhage].
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Adult↗
Prevalence of late potentials in patients undergoing Holter monitoring.
UNLABELLED: High-frequency, low-amplitude signals detected in the terminal portion of the surface QRS, called late potentials (LP), have been shown to correlate with inducible sustained ventricular tachycardia and to be absent in normal subjects. We studied LP in 152 patients without a history of sustained ventricular tachycardia who underwent 24-hour Holter monitoring for varying clinical indications (chest pain 21%, syncope 17%, palpitations 32%, dizziness 20%, other 10%). Twenty-one patients (14%) had a positive test. Of the 152 patients, 84 (55%) had complex ventricular arrhythmias and 68 (45%) had simple or no ventricular arrhythmias. Complex ventricular arrhythmias were present in 71% of patients with and in 52% of those without LP. IN CONCLUSION: patients without history of sustained ventricular tachycardia who demonstrate complex nonsustained ventricular arrhythmias on Holter monitoring have a low prevalence of LP; the presence of LP on signal-averaged ECG indicates an electrical property of the heart, which is distinct from complex ventricular arrhythmias detected on Holter monitoring.
Arrhythmias, Cardiac↗
[Amnesia and stiff-man syndrome. Manifestations disclosing paraneoplastic encephalomyelitis].
The authors report a case of hypertonia, the clinical and electrophysiological features of which were identical to those of the Stiff-man syndrome first described by Moersch and Woltman in 1956. This and the five other previously reported cases can be attributed to encephalomyelitis of the anterior horns of the spinal cord. All of these cases had severe but partial involvement of the anterior horns and the probable physiopathological mechanism of the resulting contractures was elective destruction of the small inhibitory neurones. In the present case, the association of a limbic encephalitis and secondary exteriorization of a carcinoma of the pharynx, strongly suggested a paraneoplasic encephalomyelitis. This is the first report indicating an association between the Stiff man syndrome and a paraneoplastic syndrome. Another point of interest was the spectacular response of the hypertonia to steroid therapy suggesting a central neuropharmacological effect quite apart from the non specific anti-inflammatory action on the encephalomyelitis.
Amnesia↗
C-reactive protein as biochemical indicator of bacterial infection in neonates.
Serial quantitative measurements of C-reactive protein (CRP) were performed, using an automated enzyme immunoassay method, in 127 neonates (114 premature and 13 full-term) classified in three groups: neonates with a normal postnatal course (group 1, n = 69), neonates with clinical suspicion of bacterial infection but with negative cultures (group 2, n = 49), and neonates with proven bacterial infection (group 3, n = 9). A total of 545 serial serum CRP concentrations were determined. In group 1, CRP concentrations were below the detection limit of the method (10 mg/L) except in one neonate who suffered from neonatal anoxia but whose clinical course was uncomplicated (CRP: 31 mg/L within 24 h of life). Thirty-three neonates of group 2 had CRP values consistently below 10 mg/L while 16 had elevated CRP concentrations at least on one occasion ranging from 10 to 70 mg/L. Diagnoses other than bacterial infection could explain the raised CRP concentrations in neonates of group 2. CRP concentrations were found to be elevated (greater than 80 mg/L) during the course of infectious diseases in all neonates with proven bacterial infection (septicemia (4), pneumonia (1), multiple micro-abscesses (1), urinary tract infection (3]. Serial measurement of CRP concentrations are shown to be valuable in detecting bacterial infection in neonates as well as in following the efficacy of antimicrobial therapy.
Bacterial Infections↗
The lysine pathway as a target for a new genera of synthetic antibacterial antibiotics?
Unsaturated analogues of diaminopimelic acid have been synthesized. The amino acids were designed so that they would be reversible or irreversible inhibitors of both of the two last enzymes of the lysine pathway. The compounds were tested with meso-diaminopimelate decarboxylase. trans-3,4-Didehydrodiaminopimelic acid (2) was found to be the most potent inhibitor. The antibacterial activities did not correlate with enzyme inhibiting activities. 4-Methylenediaminopimelic acid 4 showed strong antibacterial properties. It is suggested that L,L-diaminopimelate epimerase could be the target enzyme.
Amino Acid Isomerases↗