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Biomedical subjects

P Marx

Publications and source records attributed to P Marx.

161 records · Page 9Linked to original sources
PubMedDate not supplied

Prospective study on the complication rate of carotid surgery.

BACKGROUND: Randomized trials of carotid endarterectomy for high-grade stenosis have shown a benefit for surgery under the condition of low perioperative complication rates. Concerns have been expressed that the complication rates of carotid surgery are higher in everyday practice and may vary considerably between centers. We prospectively established the complication rate for carotid surgery in a single institution. DESIGN: Prospective 2-year study. All patients received pre- and postoperative neurological evaluation. Laboratory tests included pre- and postoperative brain imaging, intracranial and neck vessel sonography, conventional angiography, magnetic resonance angiography, and intraoperative monitoring. PARTICIPANTS: 108 consecutive patients: 54 symptomatic patients fulfilling the inclusion criteria of the European Carotid Surgery Trial (ECST) and 54 asymptomatic patients fulfilling the inclusion criteria of the North American Trial on Asymptomatic Stenoses (ACAS). SETTING: Single academic center with a high volume of carotid endarterectomies (>50 per year). Participating center in ECST. MAIN OUTCOME MEASURES: Stroke or death as defined in the randomized trials. RESULTS: The overall complication rate was 8.3% (95% CI 4.1-15.6%). Complications were more frequent in patients with symptomatic stenosis (11.1%, CI 4.6-23.3%) than in asymptomatic cases (5.6%, CI 1.5-16.4%). Three patients died (2 strokes, 1 myocardial infarction). Disabling strokes were found in 2 patients (Rankin scale scores 3 and 4). Nondisabling strokes (Rankin scale score 1 and 2) occurred in 4 patients. The complication rates for symptomatic and asymptomatic patients were higher than the ones reported in the randomized trials, but 95% confidence intervals showed that the differences were not statistically significant. The point estimates of complication rates still supported a benefit of surgery for patients with symptomatic stenosis, but denied a positive effect of endarterectomy for patients with asymptomatic stenosis. CONCLUSION: In this center, a beneficial effect of carotid surgery for asymptomatic stenoses cannot be safely assumed.

Adult↗
PubMedDate not supplied

Presentation and prognosis of bilateral infarcts in the territory of the superior cerebellar artery.

Unilateral cerebellar infarcts in the territory of the superior cerebellar artery (SCA) have been studied in recent years to delineate the clinical presentation and stroke mechanism, but most studies excluded bilateral infarctions. We have studied patients with bilateral SCA infarctions to provide data on clinical findings, stroke distribution and outcome. We collected data of 8 patients with bilateral SCA infarctions recognized by computed tomography and/or magnetic resonance imaging. The most common clinical presentation of patients with bilateral SCA infarctions were nausea, vomiting or vertigo (6 patients), often associated with ataxia and dysarthria (5 patients). Further symptoms were variable and depended on additional infarcts in other vascular territories. Infarcts were often partial or scattered with equal distribution between the medial and lateral branches of the SCA. Complete infarction within the SCA area occurred in less than half of the cases. Clinical outcome was either benign (full recovery in 3 patients) or fatal (5 patients). Predictors for a good clinical recovery were young age, few vascular risk factors, only partial involvement of the SCA territory without involvement of other vascular territories, and absent limb weakness on clinical presentation.

Adult↗
PubMedDate not supplied

Acute bilateral arm paresis.

OBJECTIVE: To study pure motor bilateral arm paresis of acute onset. This syndrome is as yet a barely described clinical feature attributed to ischemia in the territory of the anterior spinal artery (ASA). CASES: We present 2 patients with acute onset of pure motor deficit in both upper extremities. RESULTS: Magnetic resonance imaging of the cervical spinal cord revealed infarcts in the territory of the ASA. In 1 case, electrophysiology further suggested discrete gray matter involvement. CONCLUSION: In patients with acute weakness of both arms without further neurological deficits, an incomplete ASA syndrome should be considered with the anterior horns predominantly being affected. Magnetic resonance imaging and electrophysiology are valuable tools to further confirm both location and extension of the spinal lesion.

Acute Disease↗
PubMedDate not supplied

Immunoglobulins for intravenous use inhibit TNF alpha cytotoxicity in vitro.

Intravenous immunoglobulins (IVIg) have been used as an immunomodulatory therapy in a variety of diseases. Several mechanisms of action have been proposed, one of which is interference with the cytokine network. We have investigated the effect of IVIg on the cytotoxicity of human TNF alpha. IVIg was capable of protecting L929 fibroblasts from TNF alpha induced cell death. This effect was not species specific and was mediated by both the Fc and the Fab portion of immunoglobulins. Since the effect was also seen when IVIg was added after the removal of TNF alpha from the culture medium, it seems to be independent of the interaction of TNF alpha with its receptor. We conclude that IVIg either act on some point of the TNF alpha signalling pathway or influence the cell cycle unspecifically. The cytoprotective effect of IVIg potentially could contribute to the beneficial effect described for various diseases.

Cell Cycle↗
PubMedDate not supplied

[Maine de Biran (1766-1824), founder of the Société médicale de Bergerac].

Maine de Biran is essentially well known as a great philosopher but he was a prefect too - a high civil servant who represents the government in the French 'departments" - and a politician. In 1806, he founded, for physicians and chemists of his district the "Société médicale de Bergerac", one of the earliest created in France. The Society hold two meetings every year. At that time, it was considered that diseases were essentially caused by climatic ans topographic factors. The vaccination against smallpox, discovered by Jenner in 1796, was often debated. Sixty years before Charcot, a hysterical crisis of a young girl was perfectly described by a member of the Society. There was no professional secret and the patients' names were given. Recent publications were analysed; it was the case for the percussion of the thorax recently described by an Austrian physician. The Society took end in 1810, by lack of members and communications.

France↗
PubMedDate not supplied

[The practice of medicine at the end of the Second Empire: according to a book, appearing in 1865, by Dr. Camille Delvaille, physician in Bayonne].

Dr Camille Delvaille (1835-1904) was a physician in Bayonne. He wrote many books about scientific problems and social medicine; he was one of the first to suggest medical control at school. In a book, written in 1865, he studied everyday practice in France. He complained against the "Officiers de Sante" who exercised medicine mainly in the countryside but were not doctors and had followed very short medical studies. Dr Delvaille deplored that it meant two kinds of cares: doctors for top people and Officiers de Sante for poor patients. In fact, the end of the Officiat de Sante occured only in 1892. Dr Delvaille studied also some problems related to medical demography; he purposed for our country a law cutting down foreign practice in France. Then, he put forward nomination of Professors or hospital's physicians through an examination instead of routine cooptation. Some of his minds are ahead and were applied later.

France↗
PubMedDate not supplied

Cerebrospinal fluid cell preparation methods. An evaluation.

Although the cells from cerebrospinal fluid are widely used for diagnostic purposes, the cell yield on the microscopic slide is only rarely considered and mostly unsatisfactory. A reevaluation of several preparatory methods showed a very low yield with the Sayk-type chamber, a modest yield with the cytocentrifuge and the best yield with a simple, self-adhering chamber on slides coated with a polycation.

Cerebrospinal Fluid↗
PubMedDate not supplied

Tumorigenic behaviour of c-Ha-ras oncogene transfected CaCo 2 cells is associated with increased proteolytic potency.

BACKGROUND: Point mutations within the family of the ras genes are detected in approximately 50% of human colorectal adenomas and carcinomas. Therefore, it is generally accepted that the occurrence of ras-point mutations constitute an important step in colorectal carcinogenesis. In addition, many studies have demonstrated that the tumorigenicity of the human colorectal carcinoma cell line, CaCo 2, strongly increases after transfection with the c-Ha-ras oncogene. This cell line is suitable for gaining more insight into the mechanism of c-Ha-ras induced tumorigenesis. MATERIAL AND METHODS: Proliferation, differentiation, and proteolytic capacity of c-Ha-ras oncogene transfected CaCo 2 cells were studied in vitro. RESULTS: It was found that gelatinolytic capacity and production of urokinasetype plasminogen activator increased, whereas the production of tissue-type plasminogen activator was similar. Proliferative activity, as measured by the potential doubling time, did not alter. The expression of the differentiation markers sucraseiso-maltase, mucin, and chromogranin A was not different from that of the parental CaCo 2 cell line, which indicates that an increased tumorigenic capacity of c Ha-ras oncogene transfected CaCo 2 cells is not accompanied by loss of differentiation. CONCLUSION: These data demonstrate that the highly increased tumorigenic capacity of c Ha-ras oncogene-transfected CaCo 2 cells is associated with an enchanced proteolytic capacity.

Caco-2 Cells↗