Biomedical subjects
Publications and source records attributed to M Roy.
Anaesthetic procedures for successful separation of pygopagus twins are described. A bony union in the sacral region and communication of the subarachnoid space in this region were the main abnormalities. Various anaesthetic problems during the operation and in the immediate postoperative period are discussed.
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Two groups of patients with unilateral tuberculosis, either pulmonary (36 cases) or pleural (75 cases) were studied. The clinical and functional results were compared statistically. These two groups were similar in terms of age, sex, tobacco consumption, the radiological unilaterality of their disease and the global reduction of respiratory function (assessed by VC, FEV1, TPC and TLCO), which can be considered to be essentially due to the local disease. In both groups, the radiological image (extent of the lesion, shape of the lesion) is the only clinical factor statistically related to the functional values. The two groups differ in terms of two functional parameters which reflect different pathophysiological mechanisms in the affected lung. The group with pulmonary tuberculosis presents an obstructive ventilatory syndrome (reduction of the FEV1/VC ratio and increase in the RV/TPC ratio), which reflects the bronchial involvement in the disease. The group with pleural tuberculosis presents a pulmonary distention (increased RV/TPC ratio), which is related to disturbed transmission of the pleural pressure to ventilated alveolar zones. Secondly, in the group with pulmonary tuberculosis, the ventilation and perfusion deficits are equivalent, while in the pleural tuberculosis group, the ventilatory deficit is predominant. Thus the global reduction in ventilatory function which is the same in the two group is caused by fundamentally distinct pathophysiological mechanisms in the two groups of patients.
In a previous paper (2), we had demonstrated the existence of familial cases of Parkinson's disease. We have now identified two main patterns to these familial cases within our own clinical material. The total familial subgroup of 50 kinships that we report represents 13% of our 342 kinships personally examined in detail. Only 2 of these familial cases turn out to be phenocopies of Parkinson's disease. A further 34 kinships (10% of all Parkinson's disease) are classified within the essential-tremor related Parkinsonism subgroup that we have previously described and 10 kinships (3% of all Parkinson's disease) form what we now call the recessive akineto-rigid syndrome. A further 4 kinships (called pseudodominant) are probably examples of this same entity. These subgroups have quite distinct inheritance patterns and deserve more thorough metabolic investigations and clinical characterization. On the basis of these studies, we propose that a genetic type of Parkinson's disease be included in any classification of the disorder.
In a recent paper (Barbeau and Pourcher, 1982) we demonstrated that so-called "idiopathic" Parkinson's disease is not a homogeneous entity, and defined the existence of a sub-group of patients with genetic parkinsonism. To investigate this last possibility, and to uncover possible metabolic clues as to the etiology of such cases, we carried out a prospective study of 50 kindreds with "familial" parkinsonism. Two control groups were similarly studied: 50 kindreds with essential tremor (neurological control group) and 50 kindreds originating from spouses of the previous patients (non neurological control group). We uncovered two main patterns of genetic transmission within the parkinsonian patients: a parkinsonism related to dominant essential tremor (34 kindreds; 10% of all Parkinsonians) and a recessive "akineto-rigid syndrome" (10 kindreds; 3-4% of all Parkinsonians). A further 4 kindreds assumed a pseudo-dominant pattern but were probably recessive. Finally 2 kindreds were obviously other entities presenting as "phenocopies" of Parkinson's disease. Metabolically, hyperthyroidism appeared to be more frequent in essential tremor and "essential-tremor related parkinsonism" kindreds, while hypothyroidism and possibly hypoparathyroidism (post surgery) seemed more frequent in the recessive akineto-rigid syndrome kindreds.
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Threonine supplementation (500 mg/day) was given to 6 patients with genetic spasticity syndromes for a period of 12 months, followed by a 4-month observation period without medication. All 6 patients showed partial improvement of spasticity, intensity of knee jerks and muscle spasms without changes in true pyramidal tract signs. The improvement in motor performance, objectively measured, averaged 29% (19% in upper limbs and 42% in lower limbs). The range of overall improvement was 19--35% (7--30% for upper limbs; 25--67% for lower limbs). No toxic clinical or biochemical side effects were encountered. Thus threonine, a precursor of glycine, produced the same effect on spasticity than that previously observed with glycine. It is concluded that threonine supplementation is feasible and safe and that it deserves a controlled trial in well defined (preferably genetic) cases of spasticity.
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In our clinic, as a rule, we do not treat vaginal condylomata. They are usually subclinical and asymptomatic. When atypia is present on biopsy, they should be treated in the same manner as vaginal intraepithelial neoplasia. When vaginal discharge and pruritus are present, infection should be searched for and treated. When condylomata are seen with the naked eye, colposcopy has shown that there were many more, too small to be seen, so that local therapy seems a waste of time. If on colposcopic examination only a few condyloma acuminata are located, then therapy is defendable. CO2 laser therapy should be preferred to other modalities until a systemic treatment is available and safe.
The peroxidase-antiperoxidase technique with the use of paraffin sections of 67 cervical biopsy specimens and an antiserum cross-reactive with all papillomaviruses provided immunologic confirmation for the observation that papillomavirus infection of the cervix is not uncommon and that it most often presents as a flat, colposcopically unremarkable lesion. Papillomavirus antigen was detected in 21 or 35 condylomata of the cervix. Antigen-positive nuclei were found in the upper layers of the epithelium. Electron-microscopic examination of five reprocessed antigen-positive sections revealed, in each instance, papillomavirus particles in the nuclei of the most superficial layers of the condylomatous epithelium. The viral antigen was not detected in dysplasia, carcinoma in situ, or invasive carcinoma.
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Two thousand eight hundred thirty-nine patients who had been treated by cryotherapy for cervical intraepithelial neoplasia (CIN) in nine different institutions were followed longitudinally after three negative Papanicolaou smears to ascertain the risk of recurrence. The cumulative risk of developing CIN after successful cryotherapeutic management of CIN was 0.41% at year 5, 0.44% at year 10, and 0.44% at year 14. There was no significant difference in risk between patients originally treated for CIN 1, CIN 2, or CIN 3.
Histosol is a non-flammable solvent mixture of synthetic aromatic hydrocarbons with a flash point of 124 degrees F (T.C.C.). It has a lower vapor pressure and evaporation rate than other organic solvents, such as xylene, routinely used as clearing and deparaffinizing agents. Although both xylene and Histosol clear and deparaffinize soft organ tissues effectively in the preparation of permanently mounted stained slides, Histosol appears, in many instances, to be the choice solvent: tissues are easier to section; cell borders and cell surface modifications are most distinct; cytoplasmic eosinophilia is more vivid; and nuclear detail is improved. Of prime importance, Histosol is a safer and more efficient solvent for use in histological and pathological laboratories.
Bovine lutropin and its subunits were submitted to oxidation by sodium periodate or chloramine T. Methionine residues were easily oxidized but partial destruction of fucose was observed. After oxidation treatment most of the lutropin exhibits the same elution volume in gel filtration as the native hormone. Sucrose gradient sedimentation or gel filtration experiments show however that the oxidation of isolated subunits is accompanied by aggregation of conformational changes even in the case of porcine beta subunit which contains only one methionine residue, unit and intact alpha subunit exhibit very low residual activity.