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Biomedical subjects

C Parmentier

Publications and source records attributed to C Parmentier.

At least 109 records · Page 6Linked to original sources

[H-NMR spectroscopy of plasma cannot be used for cancer screening].

Water-suppressed proton nuclear magnetic resonance spectra were generated from plasma taken from 25 apparently healthy individuals, 103 patients with malignancies and 32 patients with benign thyroid tumors. Narrow linewidths from the lipoprotein methylene and methyl resonances were observed in only 61% of the patients with malignant tumors and in contrast to the results of Fossel et al., there was a considerable overlap of values between patients with and without malignant tumors. We studied the area of the CH2 and CH3 signals which was significantly increased in 83% of the patients with overt malignant disease. However this was also found in 20% of healthy subjects and in 47% of those with benign thyroid tumor. Lipoproteins (VLDL and chylomicrons) can reproduce these modifications. The present data suggest that considerable caution should be taken in interpreting water-suppressed proton NMR spectra for cancer detection.

False Positive Reactions↗

Detection and treatment of lung metastases of differentiated thyroid carcinoma in patients with normal chest X-rays.

Lung metastases were demonstrated by total-body 131I scans in 23 patients with differentiated thyroid carcinoma, at a time when chest x-ray was normal. This total-body 131I scan was performed after the administration of 2 mCi (in 11 patients) or 100 mCi (in 12 patients). Overall uptake of 131I in lungs was less than 1% of the administered dose in 11 patients. All patients were treated with radioiodine. No lung uptake was found in 20 patients at the last 100 mCi post-therapy scan. Among them, Tg level became undetectable during T4 treatment in eight, lung CT scan showed the disappearance of the micronodules in seven, and lung biopsy did not show evidence of disease in two patients. No patient developed radiation lung fibrosis. In conclusion, favorable responses to radioiodine treatment were observed despite relatively low overall uptake, in relation to the small size of lung metastases. This provides high concentrations of radioiodine and therefore high radiation doses.

Adenocarcinoma↗

Detection of activated ras oncogenes in human thyroid carcinomas.

Focus formation following DNA transfection of mouse 3T3-Vill cells was used to search for the presence of activated oncogenes in human thyroid tumors. Oncogenes belonging to the ras family were detected in four out of six thyroid carcinomas (Ki-ras in one anaplastic tumor and one follicular moderately differentiated tumor and Ha-ras and N-ras in two papillary tumors). Normal thyroid tissue samples obtained from two patients, one with an anaplastic tumor and one with a benign adenoma, and samples from 4 benign adenomas and from one toxic goiter of a patient with Graves' disease gave negative results. In one case, restriction enzyme analysis demonstrated the presence of a mutation in codon 12 of the activated Ha-ras oncogene. Our data show that all three ras proto-oncogenes can become activated in malignant thyroid tumors.

Adenoma↗

[Sensitivity and specificity of meta-iodobenzylguanidine (mIBG) scintigraphy in the evaluation of neuroblastoma: analysis of 115 cases].

Seventy children (3.7 +/- 3.3 y) with definitely confirmed diagnosis of neuroblastoma had 115 whole body scans carried out 24 h after injection of 3.7 MBq/kg of I-123 mIBG (83 scans) or 0.7 MBq/kg of I-131 mIBG (17 scans) or 0.9 to 4.5 GBq of I-131 mIBG (15 post-therapeutic scans). The scans were interpreted as positive in the presence of any non-physiological uptake area or of any bone uptake of the tracer, even at the level of the metaphyseal complex. For the primary tumour, the sensitivity of mIBG scans was 73%. Ten false negative patients had an overlap of the tumour with the bladder or heart images (4 cases) or with positive metastatic images (6 cases: liver, spine). Three false negative patients had neuroblastomas which did not secrete catecholamines. The specificity of mIBG was 94%. In our opinion, mIBG scans have a complementary role to assess the activity of post-therapeutic remnants. For the detection of hepatic and lymph node metastases, the sensitivity was about 50% and the specificity was 100%. The standard used for the detection of bone marrow metastases was the cytological and histological examination of 10 bone marrow aspirations and one or more biopsies (CHBMS). The sensitivity of mIBG scans was 90% and the specificity 68%. However, reviewing the data from the 16 false positive scans, we found 11 definitely proven bone metastases, 3 biological relapses and 2 cases of delayed abnormal CHBMS supporting the positivity of the mIBG scans, raising the specificity to 100%. Tc-99m diphosphonate bone scans had a sensitivity of 78% and a specificity of 51%. We suggest that positive mIBG scans may save other procedures since our data do not support false positive detection of bone or bone marrow metastases. In contrast, patients with negative mIBG findings should be further explored.

3-Iodobenzylguanidine↗

[Role of ultrasensitive TSH assay and ultrarapid total thyroxine assay in the thyroid studies].

The diagnostic value of high sensitivity thyrotrophin assay (HS-TSH) and that of ultra-short determination of total thyroxine (T4) by fluorescence polarization (T4-TDX) were evaluated in 284 patients (29 hyperthyroid, 137 euthyroid without treatment and 118 under substitutive therapy). After comparing the clinician's first impression with the results of these laboratory tests the proportion of correctly classified untreated euthyroid patients was the same with T4-TDX as with HS-TSH (90%). In contrast, this proportion in hyperthyroid patients was about twice as low with HS-TSH (23%) as with T4-TDX (42%). While HS-TSH gives a better diagnostic evaluation, T4-TDX is an excellent indicator of the degree of hyperthyroidism. In patients under suppressive therapy HS-TSH and T4-TDX provide a better evaluation of therapeutic effectiveness.

Adolescent↗

[Postoperative surveillance of differentiated thyroid epithelioma. Contribution of the ultrasensitive determination of TSH].

Ultra-sensitivity TSH assays were performed, using Behring's kit (sensitivity: 0.03 microU/ml, in 183 patients operated upon for differentiated thyroid carcinoma and followed up while under treatment with L-thyroxine. Clinically, all patients were euthyroid. TSH was undetectable in 38 patients and within normal limits in 93. A negative correlation was found between the logarithm of thyroxine plasma levels and that of TSH levels, but there were many discrepancies (normal thyroxine level with undetectable TSH, high thyroxine level with normal TSH level). This study shows that the ultra-sensitive TSH assay provides accurate information on the inhibition of TSH secretion. Clinical evaluation and plasma thyroxine assays are needed to make sure that the patient is in a euthyroid state.

Adolescent↗

Cytogenetic studies on patients with medullary carcinoma of the thyroid.

Cytogenetic studies were carried out on stimulated lymphocyte cultures of patients with medullary carcinoma of the thyroid. Of 32 patients studied, seven had a hereditary carcinoma, and five had multiple endocrine neoplasia type 2A and two had type 2B. Neither a constitutional chromosome abnormality nor an increase in chromosomal breakage were detected in these patients.

Adolescent↗

Differentiated thyroid carcinoma in childhood: long term follow-up of 72 patients.

Seventy-two children with differentiated thyroid cancer who were 16 years old or younger at the time of initial treatment were followed for a median time of 13 yr. Initially, 18% had lung metastases, and 74% had palpable lymph nodes. Capsular invasion was found in 67%, and histological lymph node involvement in 90%. The recurrent laryngeal nerve chain and the jugulo-carotid chain were involved with the same frequency (greater than 80%). The anterior superior mediastinum was involved only in patients with involvement of the recurrent laryngeal nerve chain. Forty-three patients had a complete remission after initial treatment. In patients without distant metastases for whom surgery was macroscopically incomplete, relapses occurred 5 times more frequently than in patients whose surgery was complete. Six patients died from thyroid carcinoma at ages ranging from 19-44 yr, 12-33 yr after initial treatment, and 1 died from intercurrent disease. Despite favorable long term survival (90.3% at 20 yr), the standardized mortality ratio was equal to 8.1. This study underlines the need for complete surgical treatment and compulsive follow-up, which should be continued throughout the patient's life, in order to detect and effectively treat relapses of thyroid cancer.

Adenocarcinoma↗

Incubation of autologous bone marrow graft with ASTA Z 7557: comparative studies of hematological reconstitution after purged or nonpurged bone marrow transplantation.

Thirty-three patients with advanced solid tumors were treated by high-dose chemotherapy (combined high-dose melphalan), followed by cryopreserved autologous bone marrow transplantation (ABMT). Thirteen of them had bone marrow (BM) tumor involvement at diagnosis, and BM harvest was purged with 50 micrograms/ml ASTA Z 7557 before cryopreservation. Following incubation, in vitro growth of granulomonocytic colony-forming cells (GM-CFC) was regularly inhibited (greater than 99%). Hemopoietic reconstitution after purged and nonpurged ABMT was studied. All patients experienced engraftment. However, peripheral leukocyte and granulocyte recoveries were delayed significantly in patients receiving purged BM (mean 27 and 26 days) compared with those observed in patients receiving nonpurged BM (mean 18 and 18 days). These results confirm that purged BM, despite GM-CFC depletion after in vitro treatment, ensures engraftment after high-dose chemotherapy, but prolonged pancytopenia is observed and postgraft hemopoietic recovery is delayed. A clinical trial is necessary to evaluate the efficiency of the purging technique in eradicating residual tumor cells.

Adult↗

Normal human serum-stimulating activity on granulocyte-macrophage colony formation in vitro.

The action of human serum on granulocyte-macrophage progenitors (CFC-gm) from normal human bone marrow has been studied. When human serum was added to a culture of nonadherent bone marrow cells, no colony formation was observed in the absence of exogenous colony-stimulating factor (CSF); however, the number of colonies increased with the addition of exogenous CSF. When serum was added to a culture of unseparated bone marrow buffy coat cells, colony formation appeared even in the absence of exogenous CSF. These results show a synergic effect of serum and exogenous CSF and suggest that adherent cells, when stimulated by a serum component, secrete endogenous CSF.

Blood Proteins↗

Long-term results of treatment of 283 patients with lung and bone metastases from differentiated thyroid carcinoma.

We assessed the results of treatment in 283 patients with lung or bone metastases from differentiated thyroid carcinoma who were followed for up to 40 yr (median, 44 months) after the discovery of the metastases. The survival rates from the time of discovery of the metastases were 53% at 5 yr, 38% at 10 yr, and 30% at 15 yr; 156 patients died. Multivariate analysis revealed that only 4 variables had an independent prognostic significance for survival. They were extensive metastases, older age at discovery of the metastases, absence of radioiodine uptake by the metastases, and moderately differentiated follicular cell type. The site of metastases (lung or bone) was not a prognostic factor for survival after treatment of metastatic disease. Remission was achieved in 79 patients after metastases were found. The only predictive factor for 5-yr disease-free survival after treatment of metastases was the initial extent of disease. Our results suggest that the aim of management should be to detect and treat metastases in patients with thyroid cancer as early as possible.

Adult↗

[Study of the distribution of HLA antigens within a population and a comparison between 2 populations].

HLA complex is made up of numerous loci whose alleles are codominant. Several associations between HLA antigens and diseases have been identified. Analysis of these associations require statistical methods taking into account the number of tests and the existence of alleles which have not yet been identified. Statistical methods for the estimation and the comparison of alleles frequencies are presented for genotypic, phenotypic and marginal data. An example concerning patients with medullary thyroid carcinoma illustrates these methods.

Alleles↗

Long-term results and prognostic factors in patients with differentiated thyroid carcinoma.

A multivariate analysis of the prognostic factors was carried out on a series of 546 differentiated thyroid cancers followed for 8 to 40 years. For survival, the highest risk factor was associated with age; tumors diagnosed in patients younger than 45 years had higher relapse-free survival (RFS) and total survival (TS) rates and a slower growth rate. In children, although the RFS and TS at 15 years were high, they decreased later. The second independent prognostic factor was histology. There was no difference between papillary and follicular well-differentiated (FWD) tumors, but follicular moderately differentiated (FMD) had lower TS and RFS. Among FMD cancers, relapses occurred earlier and the interval between relapse and death was shorter. The third factor was sex. Tumors tended to disseminate more in male than in female patients. The survival rate after relapse was the same, however, suggesting that the growth rates are not different. The presence of palpable lymph nodes also had a significant independent impact on both TS and RFS. Patients treated after 1960 have a better outcome than patients treated earlier, although they did not differ in age distribution, histologic characteristics, sex ratio, or incidence of palpable lymph nodes. The distribution of time intervals between treatment and relapse was not compatible with an exponential failure time model but fit with a log-logistic model. Relapses can occur as late as 30 years or more after initial treatment. Elevated levels of circulating thyroglobulin have been observed in about 12% of the patients who had been in complete remission for longer than 20 years.

Adolescent↗