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Biomedical subjects

P Millet

Publications and source records attributed to P Millet.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Cutaneous-splanchnic neurofibromatosis].

BACKGROUND: Segmental neurofibromatosis (NF V) is ten times less frequent than Recklinghausen disease. Would the risk of visceral involvement in this uncommon form of neurofibromatosis warrant systematic imaging procedures? CASE REPORT: A 31-year-old man consulted for a voluminous plexiform neurofibroma in the left lumbar area. More ventrally, on the left side, there was also a café au lait spot. There were no Lisch nodules. The chest and abdominopelvic computed tomography and magnetic resonance imaging showed intramuscular tumoral extension, two neurofibromas in the 9th intercostal space and a voluminous 5-cm tumor situated in the left adrenal area. After resection pathology examination of the surgical specimen confirmed the diagnosis of ganglioneuroma. DISCUSSION: In this patient, all the neurofibromas and the café of lait spot developed in the territories of the left T10 and adjacent spinal roots. This was also true for the ganglioneuroma which developed on the deep sympathetic ramus to the adrenal gland which originates essentially from roots T8 to T11. This would place this case in the second subgroup of NF V in Roth's classification. Only six other cases have been reported in the literature. Such deep localizations are very likely to be underestimated, raising the problem of their detection and the correct protocol to follow asymptomatic forms, especially to detect disease progression to malignant degeneration which has a poor prognosis. Patients with a NF V should receive genetic counselling with a search for a family history, other signs of neurofibromatosis and Lisch nodules. In young patients, the risk of deep asymptomatic spread underlines the importance of regional computed tomographic or magnetic resonance explorations.

Adult↗
PubMed1998

[Cutaneous vasculitis disclosing cat-scratch disease].

BACKGROUND: We describe a case of cat-scratch disease ingnaugurated by vascular purpura and discuss the role of the causal agent, Bartonella henselae. CASE REPORT: A 49-year-old woman presented vascular purpura without fever. Skin biopsy demonstrated leukocytoclasic vasculitis. She owned a cat and a had a scratch scar on the back of her left hand. A few days later, two inflammatory epitrochlear lymph nodes suppurated. Catscratch disease was confirmed by serology and PRC analysis of pus aspirated from the nodes. The purpura resolved spontaneously in three weeks. Left axillary adenopathy developed and suppurated. In spite of four antibiotics, the nodes subsided only ten months later, leaving scars. DISCUSSION: Two arguments favor Bartonella henselae as the causal agent in this cutaneous vasculitis. The simultaneous onset of the two diseases and the absence of another cause of vasculitis. This patient did not have Bartonella henselae endocarditis which could have explained this vasculitis. Only one case of hypersensitivity vasculitis has been described during cat-scratch disease. The exceptional feature of this association is perhaps the result of the unawareness of moderate or asymptomatic cat-scratch disease. Bartonella henselae was possibility caused hypersensitivity vasculitis.

Bartonella henselae↗
PubMed1997

Detection of Loa loa-specific DNA in blood from occult-infected individuals.

Accurate and specific diagnosis of human loiasis is of crucial importance in an endemic area where two-thirds of infected individuals are without circulating microfilariae (occult loiasis). By using the polymerase chain reaction (PCR) and specific primers to the repeat 3 region (15r3) of the gene coding for Loa loa 15-kDa polyprotein antigen, DNA was amplified from total blood lysate of occult-infected subjects. A 396-bp DNA fragment was specifically detected. We tested the specificity of this method by qualitative hybridization to PCR products using blood lysates of the following subjects: (1) from Gabon (80 individuals residing in L. loa endemic area where loiasis exists sympatrically with Mansonella perstans); (2) from Togo (12 individuals infected with Onchocerca volvulus and M. perstans); (3) from Tahiti (12 individuals infected with Wuchereria bancrofti); and (4) from Mali (12 individuals infected with O. volvulus and M. perstans). Samples from Gabon included 60 L. loa amicrofilaremics and 20 L. loa occult-infected subjects. Qualitative hybridization carried out at 50 degrees C on PCR products, using a 15r3-specific oligonucleotide probe, revealed hybridization with L. loa-infected samples from Gabon and four samples from Togo after 2 days exposure to the film. The positive samples from Togo were characterized by the use of nested PCR. Three nested PCR products have been sequenced. No differences were observed between the three sequences and they are 99.72% identical to L. loa 15r3. None of bancroftian-infected individuals from Tahiti, nor O. volvulus- and M. perstans-infected individuals from Mali reacted after 1 week's exposure (overexposure) to the film. This allows us to conclude first that our 15r3 PCR assay is specific for L. loa and secondly that L. loa infections occur in Togo. The sensitivity of this 15r3 PCR assay was further investigated with occult patients and field-collected amicrofilaremic samples. We found that 19 of the 20 occult-infected individuals were positive on Southern hybridization, whereas 35/60 amicrofilaremics were positive. These results have shown that the sensitivity of this assay in detecting unequivocal, parasitologically proven occult loiasis was 95%, while the specificity with regard to the sympatric M. perstans was 100%.

Animals↗
PubMed1997

Plasmodium falciparum: sickle-cell trait is associated with higher prevalence of multiple infections in Gabonese children with asymptomatic infections.

Through PCR amplifications of the gene encoding the merozoite surface antigen 2, utilizing allele-specific 3D7 and FC27 probes, we have examined the prevalence of Plasmodium falciparum in children aged from 7 to 14 years living in a village located in the equatorial forest region of Central Africa (Gabon). Using this technique, 61% (100/163) of the blood samples were shown to be infected with P. falciparum with 24 alleles distinguished by size polymorphism and sequence type. The two main families (3D7 and FC27) and hybrid alleles were detected regardless of sex and hemoglobin phenotype. No age-related changes in prevalence of P. falciparum strains were observed; however, the prevalence of infection (42%) was significantly lower in individuals with the sickle-cell trait compared with their normal-hemoglobin counterparts (68%). Mixtures of genetically distinct parasite clones were present in 82% of children carrying the sickle-cell trait but in only 58% of normal-hemoglobin carriers. The significance of these observations regarding the design and interpretation of epidemiological investigations is discussed in the context of malaria transmission in the region studied.

Adolescent↗
PubMed1997

Therapeutic efficacy of clindamycin in combination with quinine for treating uncomplicated malaria in a village dispensary in Gabon.

The efficacy of a 3-day clindamycin-quinine regimen to treat clinical malaria attacks was investigated in 256 children from western Gabon. Treatment was well tolerated by all of the children and its efficacy was higher than 97% by day 20. Thus this 3-day clindamycin-quinine regimen might constitute a potential alternative to chloroquine for treating clinical malarial attacks in children from Gabon.

Adolescent↗
PubMed1997

Lack of malaria parasite transmission between apes and humans in Gabon.

The International Center for Medical Research (CIRMF) is located in an area highly endemic for malaria in southeastern Gabon, where humans and apes (gorillas and chimpanzees) are living in the same geographic area. The presence of the CIRMF primate center housing apes (59 chimpanzees and nine gorillas in 1994) within the city of Franceville provided an opportunity to investigate the capability of cross-transmission of malaria species from humans to apes. The main vector of human malaria, Anopheles gambiae, was found in the primate center and in a nearby populated area of Franceville. Despite high malaria transmission in humans of both Plasmodium falciparum and P. malariae (mean of 43% cumulative prevalence in schoolchildren), none of the apes were found infected with plasmodia during a six-month investigation. However, low antibody levels against sporozoite and blood stages of both P. falciparum and P. malariae were detected in a few chimpanzees and gorillas. These results demonstrate that only rarely would apes be bitten in the field by mosquitoes infected with human malaria parasites. In the case of infection proven by serology, we did not find any evidence that blood-stage malaria parasites were able to the gametocyte stage. The absence of any established malaria transmission cycle within the primate colony of CIRMF indicates that apes cannot be considered as animal reservoirs for human malaria parasites in this environment.

Adolescent↗
PubMed1997

Species-specific sequence in the repeat 3 region of the gene encoding a putative Loa loa allergen: a diagnostic tool for occult loiasis.

A polymerase chain reaction (PCR)-based method to detect Loa loa DNA in the blood lysate of infected individuals is described. A set of primers was designed to amplify the repeat 3 sequence (15r3) of the gene encoding a putative L. loa allergen. The qualitative PCR was carried out using blood lysates from subjects from an L. loaendemic area of Gabon where loiasis exists sympatrically with Mansonella perstans, and from individuals from a loiasis-free area in Togo infected concomitantly with M. perstans and Onchocerca volvulus. No specific amplification was observed after ethidium bromide staining of a gel containing M. perstans and O. volvulus control samples. In contrast, a 396-basepair (bp) DNA was detected in all L. loa microfilaremic individuals and in seven of the 20 L. loa amicrofilaremic subjects diagnosed by leukoconcentration. Qualitative Southern blots carried out at high stringency (65 degrees C) using 15r3 oligonucleotide probe revealed hybridization only with L. loa samples (5 of 5 microfilaremic individuals and 15 of 20 amicrofilaremic individuals), confirming the results obtained with ethidium bromide staining of PCR products. We conclude that this 396-bp sequence could be used as a species-specific diagnostic tool for occult loiasis in an endemic area with concurrent filarial infections.

Allergens↗
PubMed1997

Imbalanced distribution of Plasmodium falciparum MSP-1 genotypes related to sickle-cell trait.

BACKGROUND: The sickle-cell trait protects against severe Plasmodium falciparum malaria and reduces susceptibility to mild malaria but does not prevent infection. The exact mechanism of this protection remains unclear. We have hypothesized that AS individuals are protected by virtue of being less susceptible to a subset of parasite strains; thus we compared some genetic characteristics of parasites infecting AS and AA subjects. MATERIALS AND METHODS: Blood was collected from asymptomatic individuals living in two different regions of Africa. The polymorphic MSP-1 and MSP-2 loci were genotyped using a PCR-based methodology. Individual alleles were identified by size polymorphism, amplification using family-specific primers, and hybridization using family-specific probes. Multivariate logistic regression was used to analyze allele distribution. RESULTS: In Senegalese carriers, age and hemoglobin type influenced differently the distribution of the three MSP-1 families and had an impact on distinct individual alleles, whereas the distribution of MSP-2 alleles was marginally affected. There was no influence of other genetic traits, including the HLA Bw53 genotype, or factors such as place of residence within the village. In a cohort of Gabonese schoolchildren in which the influence of age was abrogated, a similar imbalance in the MSP-1 allelic distribution but not of MSP-2 allelic distribution by hemoglobin type was observed. CONCLUSIONS: The influence of the host's hemoglobin type on P. falciparum genotypes suggests that parasite fitness for a specific host is strain-dependent, which is consistent with our hypothesis that innate resistance might result from reduced fitness of some parasite strains for individuals with sickle-cell traits.

Adolescent↗
PubMed1997

Adaptation of a strain of Plasmodium falciparum from a Montagnard refugee to Aotus monkeys.

A strain of Plasmodium falciparum from a Montagnard refugee was shown to produce large numbers of gametocytes in culture. Attempts were made to establish this strain in Aotus monkeys via trophozoite and sporozoite inoculation. The Montagnard S-1 strain was readily adapted to A. l. griseimembra monkeys via trophozoite inoculation. Other species of Aotus failed to support the development of high density parasitemia. None of 12 attempts to transmit the infection via sporozoites from Anopheles freeborni or An. dirus mosquitoes was successful; however, developing exoerythrocytic stages were demonstrated in hepatocytes of an A. lemurinus griseimembra monkey.

Adaptation, Physiological↗
PubMed1996

A controlled positron emission tomography study of obsessive and neutral auditory stimulation in obsessive-compulsive disorder with checking rituals.

Ten nondepressed patients with obsessive-compulsive disorder (OCD) who were characterized by predominant checking rituals were compared with 10 age- and sex-matched control subjects. Hemispheric and regional cerebral blood flow levels (rCBF) were measured with positron emission tomography (H2 15O) across four conditions: rest, auditory stimulation with idiosyncratic normal or abnormal obsession, auditory stimulation with neutral verbal stimuli, and rest. Order of neutral and obsessive stimulation was randomized. Higher subjective responses to obsessive than to neutral stimulation were found in both groups; subjective response was higher in OCD patients when obsessive stimulation was presented first. A four-way analysis of variance (group x stimulation order x hemisphere x condition [neutral or obsessive stimulation]) was performed on stimulation minus rest normalized rCBF values. Control subjects had significantly higher rCBF in the thalamus and putamen. A trend toward higher rCBF in OCD patients was found in the superior temporal regions. When neutral stimulation was presented first, rCBF was significantly higher in the caudate region of control subjects. Obsessive stimulation was associated with higher rCBF than neutral stimulation in orbitofrontal regions in both groups of subjects. Under obsessive stimulation, superior temporal and orbitofrontal activities were correlated in OCD patients but not in control subjects. Our study suggests specific abnormalities of information processing in the basal ganglia and temporal structures of compulsive checkers.

Adult↗
PubMed1996

[Incontinentia pigmenti].

Incontinentia pigmenti (IP) is a hereditary syndrome characterized by specific skin lesions occurring mostly during the neonatal period (96% of the cases before 6 weeks of age). These skin lesions have four steps of evolution: inflammatory or erythemato-bullous stage (very often associated with peripheral blood hyper-eosinophilia), proliferative or verruco-lichenoid stage, pigmentary or terminal stage characterized by "fountain" or "firework" features (with a picture of pigmentary incontinence at histological examination), sometimes there is a fourth stage referred to as "involutive". Ocular and neurological involvement is the main determinant in the prognosis. Eye lesions include corneal flecks, cataracts, uveitis or optical atrophy with retrolental fribroplasia. The neurological involvement includes pyramidal syndrome, cerebral ataxia, microcephalia, and mental retardation. The disease has mainly an X-linked dominant transmission and is usually lethal for males. Rare cases are observed in boys, some being associated with Klinefelter syndrome. Research is ongoing to identify the IP gene on the X chromosome. In the family form of IP, the gene has been located on chromosome Xq28, which allows prenatal diagnosis using trophoblast biopsy.

Eye Diseases↗
PubMed1996

Error analysis on parameter estimates in the ligand-receptor model: application to parameter imaging using PET data.

Positron emission tomography and compartmental models allow the in vivo analysis of radioligand binding to receptor sites in the human brain. Benzodiazepine receptor binding was studied using a three-compartmental model and [11C]flumazenil. Four and five parameters were estimated from a single kinetic curve obtained with a multi-injection protocol, and parametric maps of receptor density and of the individual kinetic parameters were created with four-pixel sampling of the experimental images. The coefficient of variation on each estimated model parameter was calculated using the diagonal elements of the covariance matrix. However, these estimates are valid only under some statistical hypotheses which are not always verified with PET data. Thus, in order to verify the validity of the coefficient of variation of each parameter calculated with the covariance matrix, these results have been compared with the more rigorous statistical results provided by a Monte Carlo simulation. The study showed a negligible difference between the results obtained by the two methods for a low noise level in time-concentration curves encountered using large ROIs. However, this bias becomes less negligible when the noise level is high and some estimations of the coefficients of variation were unacceptable (> 100%) with the five-parameter model. Such difficulties did not occur with the four-parameter model which led to parametric images with good quality and acceptable estimates of coefficients of variation (less than 20% in about 75% of the ROIs).

Brain↗
PubMed1996

[Evolution of blood glucose control and retinopathy during long-term treatment of insulin-dependent diabetes mellitus with intraperitoneal infusion of insulin].

To evaluate the efficacy on blood glucose control of long-term peritoneal insulin infusion and its consequences on the evolution of diabetic retinopathy, we analyzed retrospectively the values of glycosylated haemoglobin measured quarterly and the retinal angiograms obtained after 1, 5 and 9 years from seventeen insulin-dependent diabetic patients treated by this technique during 9.0 +/- 2.2 years. Blood glucose control was significantly improved from the first year of treatment (p < 0.01). Seventy-one per cent of patients had a level of glycosylated hemoglobin below one standard deviation of normal values after five years and ninety-two per cent of 12 patients treated up to nine years remained in the same near-normal range. Glycaemic excursions below 0.5 g/l and over 2 g/l were limited to 5-7% and 15-17% of four times-daily capillary glucose measurements respectively, along the whole IP insulin infusion period. Among 7 patients with no retinopathy (n = 1) or with mild to moderate nonproliferative retinopathy, requiring no specific ophthalmological treatment, (levels 20 to 40 on worse eye according to a simplified version of ETDRS classification, n = 6), 3 remained stable, 2 improved and 2 impaired although remaining under level 50 of the classification, after 5 to 9 years. Nine patients with severe nonproliferative (level 50, n = 1) or proliferative (level 65, n = 8) retinopathy, all treated by panretinal photocoagulation before initiation of IP treatment, improved and one patient with severe nonproliferative retinopathy, incompletely treated by laser photocoagulation, remained stable, after 5 to 9 years. No macular edematous reaction or impairment of existing macular edema occurred after panretinal photocoagulation under IP treatment. These data indicate that a sustained near-normal blood glucose control can be achieved under long-term peritoneal insulin infusion, without significant impairment of diabetic retinopathy when an initial ophthalmological evaluation, and a specific treatment if necessary, are performed.

Adolescent↗
PubMed1996

[Ultrasound-guided biopsies for breast nodules: value of automatic biopsy needle].

Within 18 month, 83 solid breast nodules were biopsied with a long throw biopsy gun with 18 gauge needle (Monopty, Bard Urological, Covington) and a 13 Mhz real time AU 530 (Easote Biomedica, Italy) for the ultrasound guidance. The biopsy procedure was well tolerated with no serious complications, and with no insufficient material. US guided biopsy detected 9 cancers, 47 specific benign lesions (39 fibroadenomas, 1 lipofibroadenoma, 4 sclerosing adenoses, 1 fibromatosis, 1 cyst, 1 lymphadenopathy) and 27 non specific benign fibrocystic dystrophy. In 14 out of the 15 nodules surgically removed, the histological diagnoses were identical. In the one remaining case a fibroadenomas was assessed. In the 36 other cases no evolution occurred. US guided core biopsy with automatic device is probably a very useful approach of uncertain pathological diagnoses in mastology.

Adolescent↗
PubMed1995

Current Status and Prospects of Malaria Vaccines.

Malaria is a parasitic disease caused by four Plasmodium species infecting humans, Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae. The parasite is transmitted by the Anopheles mosquitoes that flourish in warm climates. These vectors thus are present in many tourist areas of the world, including Africa, Asia, and South America. Known in China, as far back as 2700 BC, malaria was controlled by medicinal plants or drugs. This was until drug resistance occurred, beginning in Asia with chloroquine in the 1960s and spreading quickly all over the world. Today, the status of malaria drug resistance is critical and has lead to the appearance of virulent and deadly P. falciparum strains that are difficult to control. In addition, the number of cases of malaria has increased owing in part to an increase in the spread of malaria caused by another flying vector: the airplane. Airplanes can carry not only infected travelers, but also, sometimes, mosquitoes. As an example, more that 1000 cases of imported malaria were reported in 1992 in the United States, where malaria had previously been eradicated. The mosquito vector (personal communication, Centers for Disease Control, Atlanta, GA) still exists in the U.S., and recent acquisitions of malaria among persons living in New Jersey and Texas, who had no risk factors for malaria, underscores the potential for imported malaria to affect the nonimmune host population in any country in the world.

Journal Article↗