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Biomedical subjects

O Blin

Publications and source records attributed to O Blin.

At least 91 records · Page 5Linked to original sources

[Chronic polyradiculoneuritis. 25 cases].

Twenty-five patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) were studied in order to define the clinical, biological, electrophysiological and pathological features of this disease. There were 11 men and 14 women ranging in age from 15 to 82 years. The average follow-up was 43 months. Patients fulfilled the criteria laid down by Dyck et al. (1975), except that progression of weakness was at least 2 months and not 6. Fourteen patients had a progressive course and 11 a relapsing one. Weakness was almost constant (24/25), sensory impairment was present in 22/25 with deep sensation predominantly impaired. Areflexia was observed in all patients. A history of previous infection or other possible precipitating event was given by 7 patients. Cerebrospinal fluid examination showed a raised total protein count in 22 cases. Electrophysiological examination revealed a slowing down of nerve conduction velocities to an extent compatible with a demyelinating process in 23 cases; 2 patients only had prolongation of F-waves. Sural nerve biopsy was less informative: inflammatory process--the most specific finding--was observed in only 3 out of 20 biopsies. Six patients had benign forms or spontaneous remission, the others were treated with corticosteroids or with immunosuppressive drugs. Most patients (64%) recovered very well. Only one died during the time of study. Eight other patients were treated with high-dose intravenous immunoglobulins and 4 of them improved with administrations at regular intervals to maintain the benefits observed. The occurrence of CIDP in association with other conditions is reviewed and we discuss its nosological position among the acquired demyelinating neuropathies.

Adolescent↗

[Axonal neuropathy and salazosulfapyridine: slow-acetylator phenotype].

We report a case of an axonal sensorimotor neuropathy involving salazosulphapyridine in a slow-acetylator patient with ulcerative colitis. Rather than hypersensitivity the mechanism of the neuropathy can be assumed to be toxicity. The role played by the respective different metabolites in the occurrence of this uncommon side effect is uncertain.

Acetylation↗

[Rademaker and Garcin syndrome associated with pallidal calcifications].

We report gait abnormalities with exaggerated support against gravity in a 76 year-old woman. This exaggeration, and its demonstration by ankle dorsiflexion in supine position, was first described by Rademaker and Garcin (1933) as probably resulting from cerebellar and brainstem lesions. In the present case, quantitative analysis of locomotion showed a strong reduction in both stride duration and stride length. There was an increased variability between two consecutive locomotor cycles and a large increase in both stance duration and relative double-support duration. Electromyography clearly showed leg hypertension following ankle dorsiflexion, contrasting with normal leg mobility in the supine patient. This suggested that reflexive antigravity support abnormalities could explain this pattern of locomotor disabilities, differentiating them from other kinds of "marche à petits pas". The present case was associated with bilateral pallidal calcifications, suggesting an involvement of the basal ganglia in support reaction against gravity and in control of adequate postural muscle tone necessary for locomotion.

Aged↗

Nociceptive threshold and physical activity.

Previous studies using subjective tools to measure pain have shown that muscle exercise can have analgesic effects in man. The nociceptive leg flexion reflex (or RIII reflex) is a useful objective tool for assessing human pain. In this study, the pain threshold was assessed using the nociceptive flexion reflex in six high-level athletes 1) at rest in comparison with 8 control subjects and 2) after exercise requiring the production of a 200-Watt force over a period of 20 minutes. The nociceptive flexion reflex threshold at rest was found to be spontaneously higher in the athletes than in the controls. Physical activity resulted in a significant increase (+53%) in the threshold of the nociceptive reflex in the athletes. The role of stress-induced analgesia, the reduction in perceived intensity of stimuli during movement, and the release of opioids are discussed.

Adult↗

[Typical and atypical forms of neuralgic amyotrophy of the shoulder: 86 cases].

Eighty-six cases of neuralgic shoulder amyotrophy are reported. Among these, 67 cases were concordant with the usual semeiological description. The other cases were atypical in their anatomical distribution (extensive or restricted to peripheral nerve rami), in their course (chronic or recurrent or alternating from one side to the other) and in their cause, notably familial forms. The continuum existing between these variants is most probably due to an immuno-allergic mechanism.

Adolescent↗

A comparison between the effect of intentional modulations and the action of L-dopa on gait in Parkinson's disease.

The aims of the present study were to analyze how L-Dopa allows parkinsonian patients to increase their gait velocity and to compare these L-Dopa-induced modifications with those achieved by consciously attempting to walk as fast as possible (intentional modulations). The 'intentional modulations' of velocity were also compared with those of healthy elderly subjects. The results showed that parkinsonian patients walked more slowly, with shorter strides and shorter durations of swing phase, and longer durations of stance and double support phases, although no differences were observed for cycle duration. The mechanisms involved in increasing gait velocity were found to differ according to whether this was achieved through the action of L-Dopa, or by intentional increases in velocity. Intentional increases in velocity were greater than those caused by the effect of L-Dopa. The patients, however, used efficient strategies to increase their velocity when under the influence of L-Dopa. As L-Dopa leads to a ceiling effect on stride length, the patients can increase their velocity by modifying the cycle to such an extent that it compensates for the limitation in stride length. This strategy effectively increases velocity, despite the L-Dopa ceiling effect. The effects of L-Dopa on locomotion and, more generally, on motor control aspects are discussed.

Aged↗

Dopa-sensitive and dopa-resistant gait parameters in Parkinson's disease.

Quantitative analysis of gait was performed in 20 parkinsonians before and 1 h after the acute administration of L-Dopa in order to discriminate between the Dopa-sensitive and the Dopa-resistant kinematic gait parameters. The stride length and the kinematic parameters (swing velocity, peak velocity) related to the energy were Dopa-sensitive. The improvement of the bent forward posture by L-Dopa may explain the stride length increase. Temporal parameters (stride and swing duration, stride duration variability), related to rhythm, were Dopa-resistant. Experimental data argue for the importance of force control in maintaining the posture. The stride length variability, possibly related to the variability of force production shown to exist in parkinsonians was not significantly improved by L-Dopa. In Parkinson's disease different hypotheses might explain the inexorable aggravation of gait disorders along the course of the disease: (1) an advancing disorder of coordination between postural control and locomotion, (2) if some gait parameters like stride length and kinematic parameters are Dopa-sensitive, the others are Dopa-resistant and thus may involve other mechanisms than dopamine deficiency.

Aged↗

Apomorphine-induced yawning in migraine patients: enhanced responsiveness.

Migraine patients usually exhibit hypersensitivity to dopaminergic agonists, but the tests used (such as the so called "piribedil test") preferentially assess the sensitivity of the peripheral dopaminergic receptors. Apomorphine-induced yawning may be useful in the evaluation of central dopaminergic receptor sensitivity. Nine migraine patients were included in an age- and sex-matched control study. They had been without treatment for 1 month and free of a migraine attack for at least 7 days. Apomorphine hydrochloride (5 micrograms/kg) was administered subcutaneously, and yawning was recorded by two observers. The cumulative number of yawns as a function of time was studied. The comparison of the regression graphs showed a significant difference between migraine patients and controls. Migraine patients exhibited enhanced responsiveness to apomorphine challenge. This finding supports the hypothesis of a constant central dopaminergic hypersensitivity.

Adult↗

Selective effects of low doses of apomorphine on spatiotemporal contrast sensitivity in healthy volunteers: a double-blind placebo-controlled study.

1. Apomorphine (1 and 5 micrograms kg-1) and placebo were given to nine normal volunteers, using a Latin-square design and double-blind procedures. The visual perception of static and moving patterns (static and motion contrast sensitivity) was evaluated before and 15 min after the dose administration. 2. Apomorphine (1 and 5 micrograms kg-1), as compared with placebo, led to a significant overall reduction of the visual perception of movement. This effect was dose-related, and apomorphine (5 micrograms kg-1) induced a more pronounced decrease in the visual perception of movement than apomorphine (1 microgram kg-1). With apomorphine (5 micrograms kg-1), the reduction was more pronounced for low spatial frequencies, and was linearly inversely correlated to the spatial frequency for a temporal frequency of 3 Hz. Finally, no significant effect of apomorphine was observed for sensitivity to static patterns. 3. Several non exclusive hypotheses may be suggested: The effects of apomorphine may result from stimulation of retinal D1- and/or D2-dopaminergic receptors. Apomorphine may increase the surround inhibition of ganglion cells' receptive-fields. This modification of the centre-surround balance may explain the decrease in contrast sensitivity for low spatial frequencies. The specific effects of apomorphine on the visual perception of movement support the hypothesis that apomorphine preferentially affects the magnocellular pathway which mediates sensitivity to moving patterns.

Adult↗

[Anomaly in the neurotransmitter amino acids in amyotrophic lateral sclerosis: a therapeutic application].

Although the cause of amyotrophic lateral sclerosis remains unknown, the excitatory amino acids may be involved in its pathogenesis. Glutamate level analysis shows a differential distribution of the amino acids. One of the therapeutic methods consists of reinforcing the inhibitory amino acid activity using L-threonine which has been shown to improve some symptoms and signs of ALS.

Adult↗

Quantitative analysis of gait in Parkinson patients: increased variability of stride length.

Analysis of the spatio-temporal and kinematic parameters of locomotion recorded in 21 parkinsonian patients compared to 58 normal elderly subjects showed significant differences in all the recorded parameters. However the relationship between these parameters was preserved, as was the basic locomotor pattern. The variability of stride length, more marked in parkinsonian patients, increased as a function of the clinical stages of Hoehn and Yahr. This index could be useful in assessing the course of the disease in patients.

Aged↗

Pain relief achieved by transcutaneous electrical nerve stimulation and/or vibratory stimulation in a case of painful legs and moving toes.

A patient is described with painful legs and moving toes. The pain had been occurring for more than 15 years, and a variety of therapies had been attempted with only partial, if any, success. Only morphine had succeeded in relieving the pain, but it had to be discontinued to avoid tolerance and dependence. We devised a treatment consisting of transcutaneous electrical nerve stimulation (TENS), vibratory stimulation (VS), and a combination of the two methods (TENS + VS). TENS brought about partial pain relief, but was less effective than VS; dual stimulation (TENS + VS) led to complete alleviation of the pain. Four months later, the patient was applying dual stimulation himself at home and was thus able to maintain complete relief with 3 or 4 weekly sessions. We suggest that dual stimulation results in a large-scale recruitment of large-diameter afferent fibres and may thus set up a powerful inhibitory control of nociception in our patient.

Adult↗

Akathisia, motility, and locomotion in healthy volunteers.

Apomorphine (10 micrograms/kg subcutaneously with oral domperidone 10 mg), oral sultopride (50 mg), and placebos were given to nine normal volunteers, using a Latin-square design and double-blind procedures. A battery of tests was applied before the dose, and after the dose after time lapses of 15, 45, 90, 105, 120, and 180 min. Spatiotemporal and dynamic gait parameters, gait stability, and modulations remained unchanged with all three treatments. Apomorphine induced repeated yawning in all subjects. Akathisia was observed in four of nine subjects with sultopride. Sultopride was associated with drowsiness and sleepiness on visual analog scales. Akathisia may be related to decreased dopaminergic activity in the prefrontal cortex and mesocortical dopamine system blockade. The imbalance between mesocortical and nigrostriatal dopaminergic systems might explain the fact that sultopride in our experiment modified spontaneous behavior but not volitional behavior. Thus, it is possible to discriminate between two types of increased motor activity, and motility must be distinguished from locomotor activity.

Adult↗

Apomorphine-induced blinking and yawning in healthy volunteers.

Yawning and spontaneous blink rate (SBR) are two physiological reflexes which have been incompletely examined but one neurobiological step of these two behaviours seems, at least in part, dopamine-dependent. The reference dopaminergic agonist, apomorphine hydrochloride (0.5, 1, and 2 micrograms kg-1 s.c.), was compared with a placebo in a double-blind latin-square design, and was shown to induce yawning and increase SBR in a population of eight healthy volunteers. These two behavioral effects were not dose-related. The individual SBR differences were correlated with the individual number of yawns for all the four treatments at the 10-30 min interval. Thus, parallel yawning and SBR behaviour suggests a similar pharmacological mechanism. Apomorphine-induced yawning and blinking may be therefore of use in the evaluation of central dopaminergic pathways in man.

Adult↗