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Biomedical subjects

M Vidailhet

Publications and source records attributed to M Vidailhet.

At least 145 records · Page 8Linked to original sources
PubMed1994

Middle cerebral artery occlusion due to hydatid cysts of myocardial and intraventricular cavity cardiac origin. Two cases.

BACKGROUND: Hemispheric strokes of hydatid origin are very rare. We describe two cases of middle cerebral artery occlusion by a cyst of cardiac origin. CASE DESCRIPTIONS: Cerebral angiography demonstrated occlusion of the initial segment of the middle cerebral artery. Myocardial and pericardial cysts were diagnosed by echography and pathological examination. Subsequent development of hydatid cysts within the necrotic area of the infarcted hemisphere suggests cerebral hydatid embolism of cardiac origin. CONCLUSIONS: In endemic areas, embolism of hydatid cysts should be considered in the diagnosis of stroke in young patients.

Adult↗
PubMed1994

Isolated motor control dysfunction related to progressive multifocal leukoencephalopathy during AIDS with normal MRI.

We describe the case of a human immunodeficiency virus-infected 34-year-old man with progressive multifocal leukoencephalopathy (PML). His case displayed unusual features, including a bizarre movement disorder, predominant involvement of the subcortical U fibers on neuropathologic examination, and the absence of MRI abnormalities suggestive of PML. Anatomic-clinical correlations are discussed.

AIDS Dementia Complex↗
PubMed1994

Do parkinsonian symptoms and levodopa-induced dyskinesias start in the foot?

Parkinsonian symptoms and levodopa-induced dyskinesias (LIDs) are often considered to occur first, and to predominate, in the upper limbs. We studied the topography, type, sequence, and severity of LIDs in 20 consecutive patients with Parkinson's disease (PD) experiencing LIDs for less than 6 months (Hoehn and Yahr stage II-III; average age at onset of PD, 57 years; average duration of PD, 7.2 years; percent of improvement with levodopa > 50) and compared them with the initial site, form, and evolution of the patient's motor disability. Parkinsonism started in the foot in six of 20 patients. Motor disability in the "off" state was similar in upper and lower extremities, except for akinesia, which was worse in the lower limbs. A careful interview indicated that LIDs had started in the foot in all patients. After administration of a single dose of levodopa ("levodopa test"), LIDs appeared in all patients as dystonia of the foot homolateral to the side most affected by PD (onset-of-dose dyskinesia). LIDs were preceded by "off" dystonia (dystonic foot) in six patients and were followed by mid-dose dyskinesia in eight. This is consistent with an early loss of dopaminergic innervation corresponding somatotopically to the foot area. The similarities among initial LIDs, early morning dystonia, and onset-of-dose dyskinesia suggest a similar pathophysiology.

Adult↗
PubMed1994

[Propriospinal myoclonus in a HIV seropositive patient].

We report axial myoclonic jerks causing flexion of the trunk, neck, left shoulder, hips and knees in a 28-years-old HIV positive patient. The clinical and electromyographic features of the jerks were consistent with a spinal origin and corresponded to the new concept of propriospinal myoclonus. No structural lesion was identified in this patient. Neurological examination was otherwise normal. HIV specific antibodies were detected in CSF, suggesting central nervous system infection. Spinal myoclonus should be considered an unusual and early manifestation of central nervous system HIV infection.

Adult↗
PubMed1993

[Towards preventive dietetics in children].

Our views on paediatric nutrition have considerably changed during the last 20 years. Some hereditary metabolic diseases testify to the remarkable efficacy of a specific preventive dietetics avoiding the development of mental retardation. Although certain deficiencies (in iron, fluorine, folates, vitamin D) are persisting in France, the major problems concern the prevention in childhood of allergy, obesity, atherosclerosis, high blood pressure, osteoporosis and even certain cancers, all diseases which play a crucial role in the morbidity and mortality of adults. Numerous uncertainties still exist, but in the present state of our knowledge we can already develop some recommendations which should replace the much abusive publicity that prevails in the information given to the public.

Age Factors↗
PubMed1993

Lipoprotein metabolism in marasmic children of northern Mauritania.

Lipid metabolism in marasmus has been poorly studied compared with that in kwashiorkor. Published studies show normal or high plasma triglycerides and low cholesterol concentrations. We studied some plasma lipid indexes, including total, HDL, and LDL cholesterol; triglycerides; apolipoproteins A-I, A-II, B, C-III, and E; and lipoprotein particles containing apo A-I, apo A-I and A-II (Lp A-I:A-II) Lp C-III:B, and Lp E:B in Mauritanian marasmic children compared with a control group. We found in patients low total, HDL, and LDL cholesterol and normal Lp A-I concentrations, which suggest that the cholesterol reverse transport system is not altered. We observed normal triglyceride concentrations and significantly increased Lp C-III:B and Lp E:B, which are triglyceride-rich particles. These data suggest that the marasmic state led to quantitative and structural modifications of the triglyceride-rich lipoproteins, defined by their apolipoprotein composition, and was probably related to undercatabolism.

Anthropometry↗
PubMed1993

Loss of brain 5-HT2 receptors in Alzheimer's disease. In vivo assessment with positron emission tomography and [18F]setoperone.

Using [18F]setoperone and positron emission tomography (PET), alterations in serotonergic 5-HT2 receptor binding were studied in cerebral cortex of nine unmedicated patients with probable Alzheimer's disease and 37 healthy controls. The kinetics of unchanged radioligand in plasma and 18F-radioactivity in blood and brain were obtained for 90 min following tracer injection. The specific binding of [18F]setoperone to 5-HT2 receptors in the cerebral cortex was quantitated by subtraction using cerebellum as reference. In controls, a significant reduction in specific binding was associated with age and similar linear regression slopes were obtained in all the cortical regions studied. No significant difference was observed between patients with Alzheimer's disease and age-matched controls in the injected mass of setoperone, percentage of unmetabolized [18F]setoperone in plasma, 18F-radioactivity in blood fractions and cerebellar 18F-radioactivity concentration, indicating similar non-specific brain kinetics and metabolism of the radioligand. In contrast, there was a significant reduction in specific [18F]setoperone binding in the cerebral cortex in patients with Alzheimer's disease relative to control values (temporal, 69%; frontal, 69%; parietal, 55%; temporo-parietal, 54%; occipital cortex, 35%). The results demonstrate that the loss in 5-HT2 receptor binding in the cerebral cortex of patients with Alzheimer's disease, long documented by post-mortem studies, can now be assessed in vivo using PET.

Aged↗
PubMed1993

Arbitrarily primed polymerase chain reaction as a rapid method to differentiate crossed from independent Pseudomonas cepacia infections in cystic fibrosis patients.

We used DNA fingerprinting by the arbitrarily primed polymerase chain reaction (AP-PCR) technique for an epidemiological investigation of 23 Pseudomonas cepacia isolates obtained from 11 cystic fibrosis (CF) patients attending our CF center. This approach was compared with ribotyping, pulsed-field gel electrophoresis (PFGE), and conventional phenotypic typing. AP-PCR and ribotyping were identical in resolving power, since the two methods generated four different profiles and identified the same group of strains. Six patients on the one hand and four on the other harbored strains of the same genotype, thus raising the possibility of either patient-to-patient transmission or acquisition from a common hospital environmental source. PFGE results were in good agreement with those of the other two methods, but PFGE seems more discriminative since it generated a fifth profile for a single strain in a group of four. Our results show in vivo stability for the three methods during a period extending from 3 to 41 months. These genotypic techniques are particularly promising for clinical laboratories to help to clarify the epidemiology of P. cepacia in CF patients. The AP-PCR method constitutes an easier alternative to the well-established ribotyping method. AP-PCR provides the quickest results with minimal technical complexity. However, our results suggest that it is less discriminative than the labor-intensive PFGE method.

Base Sequence↗
PubMed1993

MRI in 31 patients with Behçet's disease and neurological involvement: prospective study with clinical correlation.

Thirty one patients with Behçet's disease and neurological manifestations were prospectively studied with MRI. Cerebral venous thrombosis was diagnosed in 10 patients. MRI performed during the acute illness in eight patients showed an abnormally high signal on the T2 weighted sequences in the occluded sinus. MRI showed minor flow abnormalities suggestive of partial recanalisation of the sinus in two cases at a later clinical stage. MRI can be an alternative, non-invasive, investigation to intravenous cerebral angiography. In 13 patients with central nervous system involvement, MRI performed during the acute illness showed multiple hyperintense lesions on T2 weighted sequences. They were usually less than 5 mm, scattered and confluent, mainly in the white matter, distributed in the hemispheric white matter in nine cases, brainstem in eight, basal ganglia and thalamus in five, and cortex in two. MRI abnormalities were usually associated with appropriate clinical deficits, but were larger and more disseminated than expected.

Adolescent↗
PubMed1993

Assessing tremor severity.

A clinical rating scale which measured the severity of tremor in 20 patients (12 with essential tremor and 8 with "dystonic" tremor) was assessed at specific anatomical sites for both inter and intra-rater reliability using four raters. The scores obtained with the scale were compared with the results of upper limb accelerometry, an activity of daily living self-questionnaire and estimates of the tremor induced impairment in writing and drawing specimens. The results show that, for the purposes of routine assessment and therapeutic trials, a clinical rating scale can produce reliable results which are a more valid index of tremor induced disability than standard postural accelerometry.

Activities of Daily Living↗
PubMed1993

The Bereitschaftspotential preceding simple foot movement and initiation of gait in Parkinson's disease.

We compared the Bereitschaftspotential preceding a simple foot movement while sitting and a stepping movement while standing in a group of normal subjects and seven patients with mild to moderate Parkinson's disease (PD) while off medication. None had major difficulties stepping to initiate gait. Electromyographic signals from tibialis anterior triggered the averaging of electroencephalographic signals from the scalp. Bereitschaftspotential preceding a standing stepping movement were larger than those before a foot movement while sitting in normal subjects, but no difference was observed in patients with PD. The absence of an increase in the Bereitschaftspotential when stepping in PD may reflect an impairment of the preparation and assembly of the complex sequences of movement necessary to initiate walking, even in the early stages of the illness.

Adult↗
PubMed1993

[Hydroxy-methyl-glutaryl-coenzyme A lyase deficiency manifesting as Reye's syndrome in a 3-year-old girl].

The authors report on one case of 3-hydroxy-3-methylglutaryl-coenzyme A lyase (HMG-Co A lyase) deficiency in a 3 year-old girl, presenting as Reye's syndrome. Urinary organic profile suggested this inherited metabolic disease; decreased activity of HMG-Co A lyase was demonstrated in cultured fibroblasts. The metabolic etiologies of Reye's syndrome are summarized; clinical, biological, and therapeutic assessment of HMG Co A lyase deficiency are developed. The pattern of organic aciduria must be studied in all patients presenting with Reye's syndrome.

Child, Preschool↗
PubMed1993

[Trace elements balance in treated phenylketonuria children. Consequences of selenium deficiency on lipid peroxidation].

We studied Ca and Mg and trace elements (Zn, Cu, Fe, Mn, Se) in 15 P.K.U. children treated with strict Phe-reduced diet and in a control group. P.K.U. children are significantly lower (p < 0.01) plasma and erythrocyte Se as well as significantly lower (p < 0.01) activities of Glutathione-Peroxidase (GSH-Px), a seleno-dependent enzyme in erythrocytes and in plasma. Concomitantly with defective GSH-Px activities we observe significantly (p < 0.01) increased levels of lipid peroxidation products: malonaldialdehyde (MDA) and organic hydroperoxides (O.H.P.). So, Se supplementation appears to be necessary in low phenylalanine products used in P.K.U. treatment.

Child↗
PubMed1993

[Trigeminal neuropathy and connective tissue diseases].

Connective tissue diseases are a rare and poorly understood etiology of trigeminal neuropathy. In a retrospective multicentric study covering 12 years. 12 cases were identified in the archives of the Departments of Neurology, Rheumatology and Internal Medicine: 4 were associated with progressive systemic sclerosis. 4 with mixed connective tissue diseases and 4 with Sjögren's syndrome. In 9 of the cases, the neuropathy led to the diagnosis of connective tissue disease. Trigeminal neuropathy usually developed during the evolution of the connective-tissue disease but, in 3 cases, it preceded other clinical signs. As a rule, the connective tissue disease was relatively inactive when the trigeminal nerve was involved. The neuropathy was usually unilateral (9 times), localized to the inferior branch(es) of the trigeminal and manifested itself by an isolated sensation of cutaneous numbness associated with paresthesias. Only one patient had mixed motor and sensory involvement. The topography of the lesions (peripheral, truncal, radicular or central nuclear) remains unknown in most cases, however, electromyographic study of the blinking reflex in 2 patients confirmed peripheral neuropathy in both of them. Corticotherapy had only a minor effect: neuralgia was rare and carbamazepine was ineffective. The pathogenicity of trigeminal involvement is discussed and these observations are compared to the 151 cases reported in the literature.

Adult↗