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Biomedical subjects

P Allard

Publications and source records attributed to P Allard.

At least 127 records · Page 7Linked to original sources

Unaltered [3H]GBR-12935 binding after chronic treatment with dopamine active drugs.

Rats were injected intraperitoneally with haloperidol 0.5 mg/kg, raclopride 1 mg/kg, bromocriptine 2.5 mg/kg, d-amphetamine 2.5 mg/kg, or cocaine 10 mg/kg twice daily for 21 days. The animals were sacrificed 72 h after last injection. Control rats were injected with saline, following the same schedule. The radioligand [3H]GBR-12935 was used as a presynaptic marker for dopamine neurites. There were no significant differences in [3H]GBR-12935 binding to striatum between drug-treated rats and controls.

Animals↗

Loss of dopamine uptake sites labeled with [3H]GBR-12935 in Alzheimer's disease.

The binding of the dopamine uptake inhibitor [3H]GBR-12935 to postmortem putamen from a control group and patients with Alzheimer's disease/senile dementia of Alzheimer type (AD/SDAT) or vascular dementia (VD) was studied. The binding density (Bmax) in AD/SDAT was significantly reduced to 50% of control. A reduction of Bmax in VD was also noted, but it did not reach statistical significance. No differences in apparent binding affinity (Kd) between controls and dementia groups were obtained. The concentrations of dopamine (DA), dihydroxyphenylacetic acid (DOPAC), 3-methoxytyramine (3-MT) and homovanillic acid were also determined. The concentrations of DA and DOPAC were reduced by 30-40% in AD/SDAT and VD, but the reductions did not reach statistical significance. The concentration of 3-MT was reduced by 40% in AD/SDAT and by 30% in VD. The [3H]GBR-12935-binding densities correlated significantly with corresponding concentrations of DA in control brains. It is suggested that the loss of [3H]GBR-12935-binding sites in human putamen in AD/SDAT reflects a degeneration of dopamine neurites.

Aged↗

[Ewing's sarcoma and peripheral neuroectodermal tumors. Report of a case with laterothoracic localization].

The authors report the case of a 20-year old male patient presenting with a lateral thoracic tumour which at pathological examination looked like an extra-osseous Ewing's sarcoma. Strongly positive NSE immunolabeling suggested a recently described variant of this lesion: Askin's tumour. In 1979, F. B. Askin described a tumour made of round small cells, located on the side of the thorax and possibly derived from differentiated neuroectodermal tissue. Since that time, the ever wider use of electron microscopy and immunohistochemical methods has made it possible to demonstrate the existence of peripheral neuroectodermal tumours (PNETs) distinct from neuroblastomas. Askin's tumour being only, as it turned out, one of their clinical forms. Following a brief presentation of the clinical, pathological and therapeutic features of PNETs, the authors underline the great similarity between these tumours and Ewing's sarcoma. Owing to the successive discoveries of a cytogenetic abnormality common to these tumour--t(11;22)(q24;q12)--, of a similar expression of proto-oncogens and of identical neuroenzymatic characteristics, Ewing's syndrome can now be regarded as the most undifferentiated of all PNETs, probably arising from the postganglionic neuron of the parasympathetic system.

Adult↗

[Multifocal tuberculosis of bone. Apropos of an exceptional case].

Multifocal tuberculosis of bones (MTB) is exceptional in Europe. To the few cases found in the literature the authors add another case well documented by computerized tomography and nuclear magnetic resonance and remarkable for the number of bone lesions and their coexistence with extra-skeletal lesions. The patient was a 28-year old man native of the Ivory Coast in whom the imaging techniques demonstrated no less than 19 different bone lesions plus an abscess of the iliopsoas muscle and a prevertebral pus collection. The diagnosis of MTB was confirmed by the finding of alcohol- and acid-fast bacilli at needle aspiration of the bone lesions and by the presence of folliculo-caseous Ziehl-stained granuloma on bronchial biopsies. Fourteen months after treatment with specific 4-drug therapy, the outcome is favourable. This case is exceptional by the diffusion of bone lesions and by their association with bronchial lesions due to lymph node fistulization. Modern imaging techniques (CT, NMR), clearly demonstrated the bone lesions and their extent.

Adult↗

[Primary pseudotumoral pulmonary amyloidosis with Pierre-Marie syndrome].

We report a case of pseudotumoral, nodular, parenchymatous, primary pulmonary amyloidosis in a male patient under 50 years of age. The amyloidosis spread step by step, very progressively, over 12 years before Marie's disease developed. The pre-operative diagnosis was made by electron microscopy of an intrabronchial growth biopsy. Right pleuro-pneumonectomy was performed, resulting in regression of Marie's disease within 3 months. There was partial factor X deficiency. Four years after surgery, nodules have appeared in the left upper lobe, suggesting a recurrence.

Amyloidosis↗

[Severe varicella pneumopathy in health adults. Apropos of a case].

The authors report a new case of respiratory distress syndrome which occurred as complication of varicella in an otherwise healthy adult patient. The case is well documented by images and immunological studies which are discussed in the light of recently published data.

Acyclovir↗

[Primary malignant dysembryoma of the mediastinum].

The primary malignant dysembryomas of the mediastinum are highly malignant tumours, which originate from embryonal cells. This name excludes seminomas and dysgerminomas which derive from non-fecund germinal cells. In this general review only the dysembryomas will be touched on. They are relatively rare tumours found in young men and are characterised by the rapidity of their spontaneous growth. The absence of a gonadal tumour is sufficient to confirm the primary mediastinal character of malignant dysembryomas. There is little specific in the clinical data. The tumour markers, Beta HCG and above all alpha feto-protein play, at the same time, a leading role not only for diagnosis but also for therapeutic decisions and follow up under treatment. In spite of the appalling reputed prognosis of this disease, the malignant dysembryomas have benefited from the considerable therapeutic progress which has been made in recent years. It is vital to achieve a rapid and accurate diagnosis and to start on treatment without delay with a regime incorporating Cisplatin. As radical surgery as possible usually follows the initial chemotherapy. Post operative treatment depends on the anatomical observations made at the time of surgery.

Adolescent↗

[Severe forms of effort-induced asthma].

Severe reactions in exercise-induced asthma (EIA) seem to be underestimated in the published literature. We report two cases of near-miss death from EIA that occurred after a short run. We review 364 exercise tests that were performed between September 1987 and October 1988 by a standardised protocol on a treadmill, on patients with possible EIA. A positive test, defined by a fall of FEV1 of at least 20% was found in 173 patients. From 21 patients with a fall of greater than 50%, 4 presented severe signs of: Cyanosis. Intense dyspnea with impediment of speech. General malaise with hypertension. These 4 patients were not greatly different from patients of the 50% fall group when compared for FEV1 before the test and for heart-rate during the test. They differed in the duration of the asthma attack, which was more protracted, despite the use of beta-2 agonists. The onset of severe reactions is 2.3% of positive tests and seems to be unpredictable.

Adult↗

[Spontaneous hematoma of the mediastinum].

We report a case of spontaneous mediastinal haematoma. This unusual clinical entity, though uncommon, must be considered in any patient presenting with the typical triad of symptoms of acute superior mediastinal compression, widening of the superior mediastinum on chest radiographs, bruises on the neck appearing within 48 hours of exertion, sneezing, coughing or vomiting. The signs observed with computed tomography in mediastinal haemorrhage are described. The exact source of the haemorrhage remains unknown despite careful radiological investigation and thoracotomy.

Hematoma↗

Running patterns of juveniles wearing SACH and single-axis foot components.

Concerns have been raised about the capability of conventional prosthetic foot components to provide adequate support and function for activities other than walking to persons with lower limb amputations. Degenerative changes of the lumbar spine and knee joints have been linked to prolonged asymmetric loading, which may be accentuated when force magnitudes are high, as in running. This study evaluated the extent and location of kinematic and kinetic asymmetries relative to the foot component worn. The running patterns of six children with unilateral below-knee amputations were evaluated on two occasions: first, while wearing the solid ankle-cushioned heel (SACH) component, and second, wearing the single-axis (SA) component. Cinematographic and forceplate data yielded bilateral temporal data, vertical ground reaction forces, joint angular trajectories, and moments. Results indicated that the SACH and SA components performed almost identically, despite the greater excursion allowed by the SA foot. Slower step speed on the affected side was related to significantly lower vertical ground reaction forces (p less than .01). The ankle angular displacement and moment curves revealed the incapacity of either component to stimulate natural foot-ankle function, with resulting significant interlimb asymmetries. The ipsilateral knee displayed marked reduction of the initial flexor wave, paired with a reduced extensor moment. Compensations predominated ipsilaterally, as evidenced by the similarity of the contralateral patterns to those of an able-bodied runner, except for a decreased hip flexor moment before toe-off. This study showed that interlimb asymmetries were attributable to the inadequacies of both components.

Adolescent↗

[Pleurisy and sarcoidosis].

Two cases of sarcoidosis associated with pleurisy are presented. The pleural effusion had the same characteristics in both cases. Histology showed non-caseating epithelioid and giant cell granulomas in the parietal pleura. The first case was consistent with sarcoid pleurisy, but in the second case culture of a pleural biopsy specimen fragment demonstrated tuberculous pleurisy. Pleurisy may complicate sarcoidosis in about 2.5% of patients, notably in extensive pulmonary sarcoidosis with extrathoracic lesions. The clinical presentation and the appearance of the pleural fluid are varied. In most cases, a predominantly lymphocytic sero-fibrinous exudate is present. Thorough bacteriological studies, best performed on pleural tissue cultures, must follow the discovery of non-caseating tuberculoid granulomas which are also found in tuberculous pleurisy. Among the various pathogenetic theories considered, the immune reaction theory deserves special mention.

Adult↗

[Data of broncho-alveolar lavage and pulmonary histiocytosis X].

The data obtained from broncho-alveolar lavage in 12 cases of pulmonary histiocytosis X explored between 1978 and 1986 are reported. The usefulness of this simple and reliable examination to the diagnosis and follow-up is emphasized. The diagnosis, suggested by radiography of the chest, may be suspected on cytological findings of hypercellularity, macrophage alveolitis and eosinophilia. The occurrence of neutrophilic hypergranulocytosis indicates an unfavourable course towards fibrosis. An increase of cells marked with monoclonal OKT6 antibodies (70% of the cases in this series) contributes to the diagnosis of histiocytosis X and is a good indicator of granuloma activity during the follow-up period. Electron microscopy of the alveolar fluid often confirms the diagnosis by showing the specific organelle: the X granule (60% of the cases in this series), thus avoiding exploratory thoracotomy in many patients.

Adolescent↗

[Simultaneous or successive primary multifocal bronchial cancer. Apropos of 12 cases].

Twelve cases of bifocal and bilateral bronchial carcinoma are presented. The two tumours developed successively in 6 cases and simultaneously in 6 cases. Patients' mean age (60 years) was the same as in other lung cancers. Four out of 12 patients produced a history of old ENT or skin cancer. In 11 out of 12 cases the second tumour, undetectable by radiology, was discovered at bronchoscopy. In 2 patients the two tumours had a different histology: adenocarcinoma and squamous cell tumour. In all other cases, both tumours were of the squamous cell type. Treatment of the second contralateral tumour was difficult to determine, especially when the first tumour had been widely excised. However, radiotherapy focused on small endobronchial tumours seemed to give interesting results.

Adenocarcinoma↗

Natural history of scoliosis in Friedreich's ataxia.

Does scoliosis associated with Friedreich's ataxia behave like an idiopathic or a typical neuromuscular scoliosis? Should it be treated like an idiopathic or a neuromuscular curve? Since no precise information to answer these questions could be found in the orthopaedic literature, a retrospective study was undertaken of seventy-eight patients with Friedreich's ataxia who had been followed at our neuromuscular clinic. Fifty-six of these patients were found to have typical Friedreich's ataxia in accordance with the criteria of Geoffroy et al., and their cases were retained for analysis. Their mean age was twenty years (range, eight to thirty-three years). The average length of clinical follow-up was nine years and the average duration of radiographic follow-up of the scoliosis was 3.5 years. A scoliosis of more than 10 degrees was found in all patients and was associated with a hyperkyphosis in 66 per cent. Both sexes were equally affected. Fifty-seven per cent of the curves were double thoracic and lumbar; 14 per cent were thoracolumbar; 7 per cent, double thoracic and thoracolumbar; 7 per cent, thoracic; 4 per cent, lumbar; and 11 per cent, multiple small curves. Of the fifty-six patients whose cases were studied, thirty-six had been followed for at least ten years. Among these thirty-six, there were twenty whose curves were more than 60 degrees and progressed (Group I) and sixteen whose curves were 40 degrees or less and did not progress (Group II).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗