Nervous system manifestations and neuroradiologic findings in acquired immunodeficiency syndrome (AIDS).

We report a series of thirteen patients with nervous system complications out of a total of thirty AIDS patients admitted to our hospital over the last two years for which CT and/or MRI have been performed. Five were homosexual men and eight patients (5 men, 3 women) were of African origin (Zaïre and Rwanda) (n = 5) or had had sexual intercourse with the local African population (n = 3). The nervous system complications encountered included: toxoplasma gondii brain abscess (2 patients); cryptococcus neoformans meningitis + toxoplasmosis (1 patient); toxoplasmosis + lymphoma (2 patients); progressive multifocal leucoencephalopathy (1 patient); lymphocytic meningitis or encephalitis (3 patients); lymphoma (1 patient); polyradiculoneuritis (3 patients). Three of thirteen patients had multiple intracranial abnormalities: one had concomitant intraparenchymal toxoplasma abscess and cryptococcal meningitis; in one patient a lymphoma developed after the successful medical treatment of a toxoplasma abscess; conversely, one patient developed a toxoplasma abscess two years after mediastinal radiotherapy for a systemic non-Hodgkin lymphoma. In conclusion, in our experience, nervous system toxoplasmosis is the most frequent AIDS related CNS complication. Our series demonstrates the high frequency of a second neurological disease occurring either concomitantly or separately. In these cases, while CT may readily identify the intracranial abnormalities, it contributes little towards an etiological diagnosis. Finally, our series illustrates the importance of a central African endemic focus for AIDS.

Cryptococcal anal ulceration in a patient with AIDS.

We report the case of an African patient with acquired immune deficiency syndrome (AIDS) who had a chronic cryptococcal rectal abscess with anal fistula and a disseminated neurologic and bony fungal disease, associated with pulmonary infiltration due to Pneumocystis carinii. The anal lesion was surgically excised because of failure of the medical treatment. Although clinical intestinal cryptococcal involvement is quite rare, the experience here recorded should draw physicians' attention to the possibility of an insidious disseminated disease in AIDS patients.

Measurement of glomerular filtration rate by means of a 99Tcm-DTPA complex and a scintillation camera: a method based on the kinetics of the distribution volume of the tracer in the kidney area.

Glomerular filtration rate (GFR) may be computed using the kinetics of the renal distribution volume curve Vt = Rt/Pt and a power fit of the plasma curve Pt = Pot-B. It can be demonstrated that GFR = d(Vt)/d(t)(1-B). The method is largely independent of background subtraction, allowing nonequivocal renal function determination in all cases. In a preliminary series of 20 patients, the linear regression coefficient of computed GFR with true clearance measurement by multiple blood samples method was 0.97 with a standard error on the estimate of the clearance of 5.5 ml.

[Intrinsic autonomic innervation of the stomach during aging]. / L'innervation autonome intrinsèque de l'estomac au cours de la sénescence.

In the senescence the cholinergic network of the basal and interglandular lamina propria and of the muscularis mucosae and submucosa of the gastric wall undergoes small modifications, while the adrenergic innervation decreases severely in the muscularis mucosae and in the interglandular tissue. Having regard to this adrenergic failure we note histochemically a rupture of the cholinergic/adrenergic balance in favour of the cholinergic innervation. These modifications disturb the gastrointestinal motility but their influence on the secretory reflex has to be demonstrated.