[A new case of birdshot retinochoroidopathy].
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Biomedical subjects
Publications and source records attributed to P Augustin.
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A patient developed a hematoma of the pyramidal muscle as a complication of anticoagulant treatment. The lesion provoked an entrapment neuropathy due to the compression between the muscle and the iliac spine of the great sciatic, inferior gluteal and pudendal nerves. Hyperalgic paralysis of the leg and buttock was associated with bladder sphincter disorders and impotence, a remarkable finding in view of the unilateral disturbance in nervous control. Pain, and urinary and sexual disorders were reversed dramatically by an early neurolysis. A CT scan enables the identification of the lesion.
It is rare to find an arteriovenous fistula of the dura mater associated with a venous sinus occlusion, but this may provide evidence of an etiology. In the case reported, the malformation was probably of congenital origin, the sinus thrombosis having occurred secondarily to the venous stasis adjacent to the fistula.
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A double-blind survey of isaxonine versus a placebo was carried out with two groups of diabetics on clinical and electrophysiological evidence of nervous system impairment. The active agent showed a particularly favourable effect on sensory disorders (paresthesia, pain, perception sensibility). The clinical results were correlated with the electrophysiological results (electromyograms, motor nerve conduction velocity). Even with a well-balanced glycemic regulation, which was taken into account for each case but which is not sufficient to rule out the development of neuropathy, improvements shown by patients treated with isaxonine were more numerous and of better quality.
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A nineteen year old man present an original clinical case of acute cerebellitis in infectious mononucleosis. Eighteen months after the acute phase of the illness, there persisted a large deficit in the circulating B lymphocytes. A short review of pertinent litterature is presented and current physiopathological hypothesis are discussed. Briefly, delayed immunity and personal predisposition appear to play important etiological roles.
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Interstitial edema in the alveolar septa is the first morphologically recognisable change to be observed in cases of shock. It is brought about by the altered function of the membranes of the damaged epithelium and endothelium in the alveolar wall. At the same time there is an impairment of gaseous exchange, which is rendered more difficult by the exudative process in the interstitium. Pari passu with these events there is injury to the cells of both the alveolar epithelium and the alveolar capillary endothelium. Both these processes are still reversible. The point of irreversibility appears to be reached--so far as time is concerned--at the end of the first week, after which the injurious effects on the cell are established, since the thin alveolar wall necessary for the exchange of gases becomes overgrown with bulky alveocytes (Tpye II), and the fibroblasts in thealveolar interstitium push the capillaries away from the surface of the alveolus. In most of the advanced cases of shock this process of thickening of the alveolar wall exceeds the critical value, and respiratory exchange is so impaired that satisfactory functioning of the lungs is no longer possible.
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