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Biomedical subjects

A Laplanche

Publications and source records attributed to A Laplanche.

At least 91 records · Page 5Linked to original sources
PubMed1983

The values of calcitonin and carcinoembryonic antigen in the treatment and management of nonfamilial medullary thyroid carcinoma.

Thirty-one patients were studied to evaluate the prognostic value of both calcitonin (CT) and CEA levels determined after the initial treatment in medullary thyroid carcinoma (MTC). Twenty-seven patients were evaluated three to nine months after initial treatment and four others afterwards. The CT and CEA levels were significantly higher and the survival rate lower in the eight patients with residual clinical disease as compared to the 19 patients in complete clinical remission. In patients in complete clinical remission, 11 had elevated CT level after treatment, and all had initial lymph node involvement. Five of these 11 relapsed and one died. None of the eight patients with normal CT levels after treatment relapsed. CEA levels were always abnormally high when patients relapsed. Fourteen patients in complete remission with high CT levels were followed for more than four years. Six had normal CEA levels and no relapse was observed. Eight of the 14 had pathological CEA levels and six of eight relapsed: five of these six patients presented CEA elevation from six to 36 months before the clinical relapse. In two of these six patients, a venous catheterization sampling method demonstrated infra clinical local recurrence. In two patients with liver metastases, the time course changes of CT and CEA levels were different and CEA appeared to be a more sensitive tumor marker than CT. These data are consistent with previous data concerning the values and limits of CT level for the management of MTC. Furthermore, this study demonstrates the prognostic significance of CEA determination in MTC. CEA appears to be a sensitive selective tumor marker capable of defining a high-risk subgroup.

Adult↗
PubMed1983

Medullary thyroid carcinoma: prognostic factors and treatment.

Seventy-five patients with medullary thyroid carcinoma (MTC) have been treated at Institut Gustave-Roussy from 1932 to 1979. Of these, 13 patients had distant metastases and received palliative treatment, their median survival was 3 years. Sixty-two patients with MTC limited to the neck received curative treatment; 6 had exclusive external radiotherapy for inoperable disease and 56 were surgically treated: 23 by total thyroidectomy and 33 by partial thyroidectomy. After surgery 29 patients received external radiotherapy for cervical lymph node involvement (25/29) and/or incomplete surgical resection (12/27). The survival rate was 69% at 5 years and 48% at 10 years. It was lower in patients with distant metastases at presentation (p less than 10(-5)), with tumoral infiltration of the posterior tissue planes (p less than 0.025) and in patients in whom surgical excision had not been satisfactory (p less than 0.01). It was not correlated with cervical lymph node involvement probably because those patients with lymph node involvement had been irradiated. The 29 patients who received post-operative cervical radiotherapy had initially more extensive local disease (p less than 0.05) than the 27 patients treated by surgery alone, nevertheless their survival was slightly higher. No difference in survival rate was observed between patients treated by total thyroidectomy or partial thyroidectomy, among whom only 4 local recurrences occurred. Three of the 6 patients treated with external radiotherapy alone experienced long survival (4, 7 and 10 years) and a fourth is still in clinical remission 4 years after treatment. The effectiveness of chemotherapy in patients with metastases was poor, only one patient out of 6 had a partial remission following a treatment by adriamycin. In the familial form and multiple endocrine neoplasia type II, total thyroidectomy appears to be indicated. In the sporadic cases, partial thyroidectomy is usually sufficient. External radiotherapy is effective in MTC and seems to be able to eradicate small foci of residual tumor; it is indicated when surgical excision is impossible or incomplete.

Adolescent↗
PubMed1982

[Psoriatic arthritis with renal amyloïdosis. A case-report. Review of the literature (author's transl)].

A case of severe psoriatic arthritis with both spinal and peripheral joint involvement is reported. The patient, an HLA B27-positive man, was thirty-one years old at onset. Both antiinflammatory drugs and immunosuppressive agents (chlorambucil followed by azathioprine) were ineffective and the patient became bed-ridden. Thirty-three months after onset a severe nephrotic syndrome developed. Renal biopsy let to diagnosis of secondary renal amyloïdosis. The patient died five months later in spite of chemotherapy with melphalan and prednisone. Autopsy could not be performed. A review of the literature showed twelve other cases of psoriatic arthritis with secondary amyloïdosis. Men are affected more often than women. Twelve years was the average interval between onset of joint involvement and diagnosis of amyloïdosis. In three instances, however, this interval was less than thirtyeight months. Arthritis often included both spinal and peripheral joint involvement. Amyloïdosis was evidenced by a nephrotic syndrome in eight out of twelve cases. Prognosis is poor with a fourteen months average interval between onset of clinical amyloidosis and death.

Adult↗
PubMed1982

[Hypertrophic pulmonary osteoarthropathy with paraneoplastic secretion of four hormones. Considerations on pathogenesis (author's transl)].

The case of a patient with small-cell carcinoma of the lung, bone marrow metastases, and hypertrophic pulmonary osteoarthropathy is reported. Normal growth hormone serum concentrations contrasted with significant increases in ACTH, beta-MSH, calcitonin, and gastrin. A hormonal etiology has previously been suggested for hypertrophic pulmonary osteoarthropathy. Our findings indicate that the hormone responsible for hypertrophic pulmonary osteoarthropathy may be an APUD polypeptidic substance, that differs from immunoreactive GH but is related to somatomammotropins.

Adrenocorticotropic Hormone↗
PubMed1981

Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in french haemodialysis units: II, Haemodialysis patients.

A vaccine against hepatitis B surface antigen (Institut Pasteur Production) was assessed in 138 haemodialysis patients in a placebo-controlled randomised double-blind trial. In an interim analysis, hepatitis B infections were observed in 21% of the vaccine group and 45% of the placebo group (p less than 0.02). 2 of the infections in the vaccine group and 12 of the infections in the placebo group occurred after the third injection. 60% of the vaccine recipients had an immune response. 4 months after the first injection the mean titre of anti-HBs was 120 mlU/ml.

Adult↗
PubMed1981

Randomised placebo-controlled trial of hepatitis B surface antigen vaccine in French haemodialysis units: I, Medical staff.

A vaccine against hepatitis B surface antigen (Institut Pasteur Production) was assessed in staff members from forty-eight French haemodialysis units where the risk of hepatitis B was high. Of 318 subjects who completed the protocol, 164 received three monthly injections of vaccine and 154 received corresponding injections of placebo. Hepatitis B infection was observed in 3.6% of the vaccine group and 12.3% of the placebo group (p less than 0.005). The 6 infections in the vaccine group all arose within 63 days from the first injections, whereas the 19 in the placebo group arose throughout the 12 months of follow-up. The rate of side-effects after injection did not differ in the two groups. 94% of the vaccine recipients had an immune response ( greater than 10 mIU/ml in at least 5 successive specimens). 4 months after the first injection the mean + or - 2 SE peak level of anti-HBs was 2433 + or - 1077 mIU/ml.

Clinical Trials as Topic↗
PubMed1981

[Initial bone marrow involvement in Hodgkin's disease (author's transl)].

Twenty-five patients with Hodgkin's disease and evidence of bone marrow involvement (BM +) were compared with 25 other Hodgkin patients, chosen at random, who had visceral lesions but free bone marrow (BM -). Both groups were observed throughout the same period. The first evaluation showed that bone marrow involvement was more frequent in male patients and that it produced medullary hypoplasia with WBC and platelet counts lower than in BM - patients. However, bone marrow involvement can only be ascertained by medullar biopsy. BM + patients were treated with multiple chemotherapy (mostly MOPP). Positive response was obtained in 64% and complete remission in 50%, as compared with 70% and 50% respectively in BM - patients. There was no significant difference in overall survival rate between the two groups. It remained in plateau at 50.5% after two years in BM + patients and at 63% after 27 months in BM - patients. When complete remission was obtained the survival rate after one year was 90% for BM + patients and 100% for BM - patients. In the absence of complete remission, however, the median survival time was inferior to one year in both groups. The dosage levels and side-effects of chemotherapeutic agents were similar in both groups, but cytopenia was more pronounced in BM + patients.

Adult↗
PubMed1981

[Breast cancer and use of antihypertensive drugs and oral contraceptives: results of a case-control study (author's transl)].

A case control study in breast cancer was conducted in France between 1976 and 1980. 1 031 patients with histologically confirmed cancer of the breast were entered into the study. Each was matched on age (+/- 5 years) to two controls hospitalized in the same clinic for a benign disease. We have specially studied the anti-hypertensive drugs, and the oral contraceptives. We found no difference between cancer patients and controls concerning their consumption of anti-hypertensive drugs, whether containing reserpine or not, and their consumption of oral contraceptives. However, there is a relation between the use of oral contraceptives and the age, family status and social class of women. After adjustment on these factors, we found a 1.62 relative risk of developing a cancer of the breast among the women using oral contraceptives (p less than 0.02).

Adult↗
PubMed1979

Within-subject variability of human semen in regard to sperm count, volume, total number of spermatozoa and length of abstinence.

The within-subject variability of the semen sperm count (n), volume (v) and the total number of spermatozoa (N) was studied on 220 ejaculates from 36 normal subjects after an abstinence of 7 days or less. For each of the three variables, the within-subject standard deviation, sigma, was practically proportional to the mean, mu; the common value of the coefficient of variation sigma/mu for all subjects was very high: 0.39 for n, 0.28 for v and 0.55 for N. The 95% confidence intervals based on a single ejaculate were asymmetrical and very large, the lower and upper limits being respectively 0.5 x n and 2.3 x n; 0.7 x v and 1.8 x v; 0.4 x N and 2.9 x N. The three semen characteristics for a given subject were highly correlated with length of abstinence: for an increase in abstinence of 1 day there were mean increments of 13 x 10(6)/ml for n, 0.4 ml for v, and 87 x 10(6) for N.

Adult↗