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Biomedical subjects

M Strobel

Publications and source records attributed to M Strobel.

At least 19 recordsLinked to original sources

[Recurrent metabolic encephalopathy, self-administered gastric lavage and Munchausen syndrome].

A case report of recurrent metabolic encephalopathy with disorders of hydro-electrolytic balance, predominantly severe hypochloremic alkalosis, resulting from self-induced vomiting and self-administered gastric tubage and lavage. Munchausen syndrome was diagnosed. Some established characteristics of this syndrome as well as some atypical features concerning patient-doctor relationship and natural history are discussed.

Brain Diseases, Metabolic

[Pathology of travelers in the Antilles. Role of imported metropolitan pathology].

A preliminary and retrospective review--with a southern perspective--of some traveller's pathologies, mostly imported, and leading to hospital admission in Guadeloupe (FWI). End stage patients (cancer, AIDS...) frequently travel for a last, "compassional" trip. Ischemic heart disease is the leading pathology imported from the mother country (France). As well as in diabetes or psychiatric illness, destabilization frequently occurs as a consequence of travel (jet lag). Compulsive tennis plus dehydration cause the very common stone passage of nephrolithiasis. Concern is growing for heroin withdrawal syndrome or cocaine (crack)-abuse, and for supply for rare and expensive anticancer, antigraft rejection or antinfective (AIDS) agents. Much more familiar to us are photodermatitis, larva migrans, dengue, or ciguaterra, locally acquired. On the other hand some pathologies are quite "exotic" to us: Kaposi sarcoma, Lyme, or Behçet disease, familial mediterranean fever, brucellosis.

Epidemiology

[Prurigo in tropical area. Importance of its association with HIV infection].

The term prurigo applies to a classic chronic skin disease of children (P. strophulus) which is becoming found very seldom in developed countries, but remains extraordinarily prevalent in tropical areas. This striking geographical distribution relies on its ectoparasitic origin. Some peculiar aspects of prurigo, observed in French Guyana (South America), are reported. The original point is a new aspect of adult acquired prurigo, associated with HIV infection, which appears to be one of the features characteristic of tropical AIDS. This HIV associated prurigo (HAP) is the revelating event, in as high as 20% of HIV infected people, significatively those with less than 200 CD4 cells. HAP appears as a marker of HIV infection with poor sensitivity, but much higher specificity (92%), with no correlation with acquisition's risk factors. Just like infantile prurigo, HAP can be considered an arthropod bite reaction which seems to be enhanced in HIV infected people living in tropical environment.

CD4 Lymphocyte Count

[Leprosy in Guadeloupe 1980-1990: development and management in the general hospital].

27 leprosy patients (19 adults, 8 children) from Basse Terre (Guadeloupe, FWI) were referred to General Hospital from 1975 to 1989: for diagnostic purpose in half the cases, for starting or modifying treatment regimens, or for complications (ENL). Lepromatous type was predominant (16/27), whereas ENL was the most serious diagnosis and therapeutic problem (7/27). Some epidemiological and psycho-social aspects are discussed.

Adolescent

[Infantile acropustolosis: unusual manifestation of scabies in the infant?].

Three pediatric cases of vesiculopustules persisting for several months or years after eradication of Sarcoptes scabiei are reported. This particular course of scabies in infants is underrecognized although probably common. Its clinical manifestations, natural history and histologic features are identical to those seen in infantile acropustulosis, a recently individualized syndrome whose pathogenesis is unelucidated. In the light of these cases and a review of the literature, the possible relationship between scabies and infantile acropustulosis is discussed.

Acrodermatitis

[Invasive pulmonary monitoring in acute necrotizing pancreatitis. A decision aid for indications for surgery?].

From January 1986 to September 1988 16 patients with necrotizing forms of acute pancreatitis underwent invasive pulmonary monitoring at the Departments of General Surgery and Anesthesiology of Münster University Hospitals. Six patients had Stage II and ten Stage III disease according to the Mainz Clinical Classification for acute pancreatitis. Mortality was 37.5% in the reported series. Acute pancreatitis is characterized in cardiopulmonary terms by elevated levels for Cardiac Output (CO), Cardiac Index (CI) and Intrapulmonary Shunting (vAdmix), whereas Systemic Vascular Resistance (SVR) is significantly reduced. A decrease of SVR of more than 200 dyn s cm-5 may be an early indicator for a septic period, and, therefore, warrant operation.

Abdomen, Acute

Effects of tRNA-intron structure on cleavage of precursor tRNAs by RNase P from Saccharomyces cerevisiae.

RNase P derived from S. cerevisiae nuclei was tested for its ability to cleave a variety of naturally occurring and selectively altered precursor-tRNA molecules to yield matured 5' termini. Precursors were synthesized in vitro in order to test which aspects of substrate structure are crucial to recognition and cleavage by RNase P. Base modifications in the precursor substrates are not required for cleavage by the enzyme, but deletion and substitution mutations affecting any portion of the precursor tertiary structure reduce cleavage. In particular, a number of alterations in the intervening sequence (IVS) reduce the susceptibility of the substrate to cleavage by RNase P. The significance of these results is discussed in reference to the contribution of the IVS to the structure of the precursor-tRNA.

DNA Mutational Analysis

Magnetic resonance in cartilaginous lesions of the knee joint with three-dimensional gradient-echo imaging.

Diagnosis of chondromalacia of the patellofemoral joint using three-dimensional gradient-echo sequences was investigated in 41 patients, with arthroscopic verification in 25 patients. In vitro examinations in human cadaveric patellae were performed in order to determine optimal imaging parameters. FLASH (TR = 40 ms, TE = 10 ms, flip angle = 30 degrees) and FISP (TR = 40 ms, TE = 10 ms, flip angle = 40 degrees) were used in clinical studies. Advanced stages of chrondromalacia could be visualized with high sensitivity. In less advanced disease, overstaging was observed. The therapeutically relevant differentiation of major and minor degrees of chondromalacia seems to be possible. 30 degrees FLASH-images in the axial plane proved to be the most efficacious technique for the diagnosis of chondromalacia.

Arthroscopy

Chronic learning problems and maturation.

An analysis of test scores of a longitudinal sample of normal children, who placed in the lowest quartile of the class on the California Achievement Test and children in the highest quartile yielded significant differences on three perceptual-motor tests and on Piaget's preoperational and precausal tests at Kindergarten level. Although matched for IQ in Kindergarten, significant IQ differences appeared in Grade 1 and continued to increase over 5 yr., as those on other tests. Cattell's Early School Personality Questionnaire indicated that low achievers were significantly less mature and more tense and anxious than high achievers from Grades 1 through 5. Maturational lag is hypothesized for retardation of learning.

Child

[High prevalence of antiHTLV-1 antibodies in the Boni, an ethnic group of African origin isolated in French Guiana since the 18th century].

Antibodies to HTLV-1 (ELISA test using disrupted virus) were studied in different ethnic groups in French Guiana, including 135 blood donors from Cayenne, 97 Boni Blacks and 57 Wayana Indians from Maripasoula area, and 57 Hmong from Cacao village. We observed significant differences between Boni Blacks and Wayana Indians, having respectively 10.3% versus 0% of high antibody titers. The Hmong, recent refugees from Kampuchea, exhibited an intermediate level (3.5%) of infection. These results favour an African origin of HTLV-1 and raise, for the Hmong, the question of an infection acquired in Guiana.

Adolescent

[Brazilian pemphigus in a child in French Guyana. Discussion on the clinical polymorphism and epidemiology of the disease].

The observation in French Guyana of pemphigus foliaceus having long mimicked eczema or psoriasis and turning 5 year later as an exudative erythroderma, points out the clinical polymorphism of the disease. Several clinical features are analysed that might support the hypothesis of autonomy of the Brazilian type: such as for example joint involvement. But the main point concerns epidemiology since this disease seems to spread out from the classical endemic Brazilian provinces to northern countries as socio-economical conditions improve in the south.

Administration, Topical