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Biomedical subjects

R Dumas

Publications and source records attributed to R Dumas.

At least 307 records · Page 17Linked to original sources

[Discrete distal gangrene].

The authors present their statistical findings from 114 cases of discrete distal gangrene. They stress the importance of a rigorous methodology to detect mechanical causes from the thoracic outlet syndrome and immunological causes, predominantly scleroderma, especially in women. It is important not to overlook blood diseases nor those cases which are a presentation of underlying cancer. Finally, the iatrogenic cause is now well known. Treatment depends on the causes of this distal lesion. However, in cases of severe connective tissue disease, the use of plasmapheresis is beginning to give interesting results.

Adult↗

[Language disorders in a right frontal lesion in a right-handed patient. Incoherent speech and extravagant paraphasias. Neuropsychologic study].

Clinical, neuropsychological, and CT scan data are reported in a patient with a right prefrontal hematoma following meningeal hemorrhage due to the rupture of an aneurysm of the anterior communicating artery. Over a period of six weeks, before and after surgery, the patient presented a particular type of language disorder characterized by incoherent speech, verbal paraphasias, unexpected or guided along ideic perseverations, emphatic and affected terms, and impossibility of brief responses, particularly in denomination tests. Contrasting with the absurdity of the discourse, the respect of oral comprehension, the absence of grammatical disorders, and the perfect phonemic and phonetic organization provided evidence of the integrity of the linguistic code. The purely semantic disturbance, however, was the cause of the apparent alteration in reasoning and judgment. A major amnestic syndrome was also present. It improved concomitantly with the language disorders. The explanation proposed is that of a disturbance of an attention process and of word selection due to a prefrontal lesion.

Cerebral Hemorrhage↗

[Membranous glomerulonephritis in two brothers associated in one with tubulo-interstitial disease, Fanconi syndrome and anti-TBM antibodies (author's transl)].

Anatomical and immunological studies were performed in two brothers with membranous glomerulonephritis. The older child presented with renal failure, Fanconi syndrome and anti-TBM antibody in his plasma. Renal biopsy revealed severe tubulo-interstitial disease with membranous glomerulonephritis. Because of rapidly progressive renal insufficiency the patient was started on hemodialysis. A cadaver renal allotransplantation was performed without success. Renal transplant biopsy showed severe lesions of vascular rejection without recurrence of the primary disease. The younger child was examined at six months for a nephrotic syndrome with mild renal insufficiency, and died at nine months. Anti TBM antibodies were not detected in his serum. The patient's mother presented with asymptomatic proteinuria, and anti TBM antibodies in her plasma. In the same family the uncle died at 3 months with a steroid resistant nephrotic syndrome. The relationships between the familial membranous glomerulonephritis and the tubulo interstitial disease are discussed.

Autoantibodies↗

Glomerular lesions in the branchio-oto-renal (BOR) syndrome.

Three cases: two adults and one child, with histologically confirmed branchio-oto-renal syndrome showed prominent glomerular lesions. Typically there was segmental and focal hyalinization associated with dense deposits along the basement membrane and in the mesangium. Variable deposits of immunoglobulins IgG, IgM, and IgA as well as C3 were present. The branchio-oto-renal syndrome appears to be a familial nephropathy which may lead to renal failure.

Adult↗

Hypertension and segmental renal hypoplasia causing a syndrome of haemolysis and uraemia.

An 11-year-old girl presented with acute renal failure and severe hypertension. The blood film showed thrombocytopenia, numerous fragmented red blood cells, and a reticulocyte count of 10%. An intravenous pyelogram showed a small contracted left kidney, and plasma renin activity was increased in the left renal vein. Treatment with minoxidil and propranolol controlled the hypertension. After nephrectomy the hypertension resolved. Light microscopical examination of the left kidney showed a segmental renal hypoplasia. Malignant arterial hypertension can provoke a syndrome of haemolysis and uraemia in children. Aggressive lowering of blood pressure leads to an improvement in renal function.

Child↗

[Confabulatory anomia from visual and tactile agnosia in a case of multi-infarct dementia. Neuropsychological study (author's transl)].

Observation of a patient suffering from a double softening of the brain (inner side of right temporal lobe, left occipital lobe). Clinically, Korsakoff's syndrome, right quadranopsia, pure alexia, tactile and visual agnosia concerning objects, colors and faces. Relative integrity of elementary perceptions (matching tests), impairments of stimulus identification (Lissauer's associative agnosia). Phenomena of sensoriphasic interactions are reported: normal speech in conversation, contrasting with confabulant anomia when naming or describing visual or tactile stimuli: then, escaping the control of sight, a relative "autonomy" of speech appears, with word perseverations and semantic "slipping" and filiations. Discussion of optical aphasia.

Agnosia↗

[Clinical and pathological study of a case of subacute combined degeneration of the cord with folic acid deficiency (author's transl)].

Clinical and pathological findings in a case of subacute combined degeneration of the cord are described. The patient was a severe alcoholic but there was no vitamin B12 deficiency. Lesions were similar to those observed in Lichtheim's disease. Biological tests demonstrated frank folic acid deficiency, with very low serum and red cells levels. Clinical features included only mild macrocytic anemia, and flexion quadriplegia after a period of disorders of equilibrium. Higher functions were unaffected. Apart from alcoholism, no other toxic or digestive causative factors were found.

Adult↗

[Beta blockers and disturbances of the microcirculation (author's transl)].

Study of 192 cases of hypertensive patients, 89 of whom were treated by diet, general advice and correction of risk factors for an average period of 8 months. The group of patients treated beta blockers consisted of 103 subjects, 28 of whom received Propranolol, 29 Oxyprenolol, 20 Atenolol and 26 Practolol. The prevalence of Raynaud's phenomenon was markedly greater in the patients treated with beta blockers, in comparison with the group not receiving any drugs. The highest incidence of vasomotor problems was seen in the group of subjects treated with Propranolol, with 57% of patients having a Raynaud-type paroxysmal acrosyndrome. In more than half of the cases attributed to Propranolol, the clinical picture of Raynaud's syndrome was severe. Discussion of the mode of action of beta blockers on the microcirculation.

Adrenergic beta-Antagonists↗

[Kearns' syndrome: a case study (author's transl)].

An anatomoclinical study of a case of Kearns' syndrome is reported. Neuro-ophthalmic symptoms appeared when the child was 13 year-old. Two and a half years later occurred an episode of paroxystic atrioventricular block, after which the triad characterising the syndrome was completed: retinitis pigmentosa, ophthalmoplegia, disorder of heart conduction. The course was unfavorable despite pacemaker insertion. Study of the central nervous system showed spongiosis of the subcortical white substance, of the basal ganglia and of the cranial nerve nuclei. The specialized heart conduction tissue was the site of apparently primary degeneration. The extension of the visceral involvement is discussed in the light of published data.

Adolescent↗