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Biomedical subjects

C Roux

Publications and source records attributed to C Roux.

At least 163 records · Page 9Linked to original sources
PubMed1996

Analysis of the sex chromosomal equipment in spermatozoa of a 47,XYY male using two-colour fluorescence in-situ hybridization.

The sex chromosomes in spermatozoa of a 47,XYY fertile male were analysed simultaneously by dual fluorescence in-situ hybridization (FISH), with two probes (pHY2.1 and pXBR). Of the 100000 cells analysed, 95179 spermatozoa (95.18%) exhibited one or more hybridization signals. Of the hybridized nuclei, 85.37% showed a normal sex chromosome constitution (37.37% X-bearing cells and 48.00% Y-bearing cells), with an X:Y ratio of 0.78:1. A total of 14.63% of the hybridized nuclei exhibited sex chromosome aneuploidy with a majority of XY- and YY-bearing spermatozoa (9.37 and 4.65% respectively). Even if the majority of spermatozoa have chromosomal haploidy, a large proportion of them exhibits numerical errors for the sex chromosomes. These observations raise questions about the commonly-admitted notions concerning the absence of chromosomal risk for XYY male offspring.

Humans↗
PubMed1996

Forceful epidural injections for the treatment of lumbosciatic pain with post-operative lumbar spinal fibrosis.

OBJECTIVE: To evaluate the efficacy of forceful epidural corticosteroid injections in lumbosciatic pain ascribed to post-operative lumbar spinal fibrosis. METHOD: Randomized controlled study comparing forceful injections via the sacral hiatus of 125 mg prednisolone acetate + 40 ml saline (treatment group) and injections via the same route of 125 mg prednisolone acetate alone (control group). Results were compared after six and 18 months. The main evaluation criterion was a subjective assessment of overall efficacy done by the patient using a seven-level scale. RESULTS: After six months, the proportion of patients who were relieved of their sciatica was significantly higher in the forceful injection group (n = 29; 45%) than in the control group (n = 31; 19%) (p = 0.03). Success rates for low back pain were 29% and 6% in the forceful injection and control groups, respectively. Among secondary efficacy criteria, nerve root pain evaluated on a visual analog scale and by Schöber's index showed significantly greater improvement in the forceful injection group than in the control group. After 18 months, results were still in favor of the forceful injection group, with success rates of 39% for the sciatica and 31% for the low back pain. The proportion of patients who returned to work was similar in the two groups. CONCLUSION: Although mediocre overall, the results of forceful epidural corticosteroid injections are better than those of simple epidural injections of a corticosteroid alone. Given the paucity of effective treatments for lumbosciatic pain apparently due to postoperative fibrosis, forceful injections should be given a place in the treatment of this condition.

Adult↗
PubMed1996

Changes in serum sterols of rats treated with 7-dehydrocholesterol-delta 7-reductase inhibitors: comparison to levels in humans with Smith-Lemli-Opitz syndrome.

The impaired conversion of 7-dehydrocholesterol to cholesterol, as a result of a permanent inhibition of the activity of 7-dehydrocholesterol-delta 7-reductase, has been reported in the Smith-Lemli-Opitz (SLO) syndrome (1, 2). For the purpose of experimental teratology, an animal disease model consisting of the offspring of pregnant rats treated with AY 9944 or BM 15766, inhibitors of 7-dehydrocholesterol-delta 7-reductase, was established. The present study compares the profiles of sterols in rat serum, obtained after transient treatment with inhibitors, with profiles of sterols obtained from patients with the permanent enzyme defect. AY 9944 (single dose of 50, 75, or 100 mg/kg) or BM 15766 (60, 75, or 90 mg/kg per day for 11 days) induces hypocholesterolemia and accumulation of 7-dehydrocholesterol and aberrant sterols in rat serum. The aberrant sterols in the treated rats are similar to those detected in human SLO patients by gas chromatography coupled to mass spectrometry (1, 3, 4) and were identified as 7- and 8-dehydrocholesterol, two trienols (I and II), and 19-nor-5,7,9(10)-cholestatrien-3 beta-ol. The time- and dose-dependences of the biochemical alterations are compared to the teratogenic abnormalities induced by inhibitors. The dietary cholesterol supplementation that suppresses embryo malformations induced by AY 9944 prevents severe hypocholesterolemia and decreases the aberrant sterol levels. As a function of time after intoxication, the 8-dehydrocholesterol to 7-dehydrocholesterol ratio increases, suggested that 8-dehydrocholesterol is derived from the gradual conversion of the accumulated 7-dehydrocholesterol. The ratio of 8-dehydrocholesterol to 7-dehydrocholesterol is higher in human SLO than in the animal disease model. This may be explained by a permanent block in 7-dehydrocholesterol-delta 7-reductase in SLO compared to a transient inhibition of this enzyme in the animal model.

Animals↗
PubMed1996

[Use of antibiotics in pediatric surgery at the University Hospital Center at Yopougon, Abidjan (Ivory Coast)].

Considering 901 files of in-patients (68% of boys and 32% of girls, mean of ages: 2 days to 16 years) and prescriptions at the hospital of Yopougon during a period of two years (1991-1992), the authors have made a retrospective and critical study of the use of antibiotics in this department. Antibiotics, either demanded by strong presumption of infection, either indicated as a prophylaxis, have been administered to 54% of the patients. When this antibiotic therapy has been curative (56% of the cases of first intention), it was considered correct in 97% of the cases. On the other hand, it was ill-done when it was a matter of antibioprophylaxis. An antibiotherapy of second intention has been prescribed when antibiotherapy of first intention had failed and also when the antibiotic reserve of the hospital was over. The average number of antibiotics given to a patient was 2.12, frequently associating aminoside and penicillin. The total cost of antibiotics was 78% of the whole drugs used to cure these patients and among them, the biggest cost was for cephalosporines of third generation.

Adolescent↗
PubMed1995

Evolution of bone densitometry in patients with myeloma treated with conventional or intensive therapy.

BACKGROUND: Demineralization is a common hallmark of multiple myeloma (MM) that can be evaluated by dual-energy X-ray absorptiometry (DEXA). The evolution of lumbar and whole body bone density were investigated by DEXA in patients with MM treated by conventional or intensive therapy supported by autologous blood stem cell transplantation. METHODS: Sixty six patients younger than 66 years with MM were randomly assigned to either conventional (30 patients, Group A) or intensive therapy supported by autologous blood stem cell transplantation (36 patients, Group B). For all patients, lumbar bone mineral density (BMD) was measured by DEXA at diagnosis and 13.2 +/- 4.2 months after the initiation of treatment. Whole body examinations were performed in 45 patients; in addition to whole body BMD, independent BMD values were recorded for various skeletal sites. RESULTS: At diagnosis, mean lumbar Z score (lumbar mean BMD value) was low (-1.24 +/- 1.45) without any significant difference between the 2 groups. Under treatment, lumbar BMD increased 0.7% in Group A and 4.6% in Group B (P = 0.02). This difference was mainly related to nonresponders in group A who featured a lumbar BMD change of -3.9%, whereas patients in remission in both groups displayed a 4.1% increase (P < 0.001). There was a correlation between the variation of lumbar BMD and the decrease of the serum or urinary monoclonal component (r = 0.34, P = 0.006). After intensive therapy, increase of lumbar BMD was higher in men than in women (7.2% vs. 1%, P = 0.005) perhaps because of variations in hormonal status in women. Unexpectedly, whole body BMD decreased in responders (-3%) because of a decrease in appendicular BMD outweighing the increase in axial BMD. This suggests a redistribution from cortical to cancellous bone in patients with MM responsive to chemotherapy. CONCLUSION: Bone densitometry is a marker of treatment response that may be particularly useful in nonsecretory and light chain MM. Moreover, it provides new information on bone remodeling in patients treated for MM, which may have therapeutic consequences.

Absorptiometry, Photon↗
PubMed1995

[Diagnosis and treatment of osteoporotic vertebral collapses].

Vertebral fracture is a typical and frequent complication of trabecular osteoporosis. It is responsible for pain and disability. Diagnosis is supported by X-rays and some pitfalls must be known and avoided. Physical treatment is important in order to prevent recurrence. Among different treatments available in osteoporosis, ostrogenotherapy must be discussed, even after fractures have occurred.

Fractures, Spontaneous↗
PubMed1995

Comparative prospective, double-blind, multicenter study of the efficacy of tiludronate and etidronate in the treatment of Paget's disease of bone.

OBJECTIVE: To compare the efficacy and safety of tiludronate and etidronate at the same dosage (400 mg/day) for the treatment of active Paget's disease of bone. METHODS: We studied 234 patients with radiologic lesions characteristic of Paget's disease of bone and serum alkaline phosphatase (AP) concentrations at least twice the upper limit of normal, in a prospective, randomized, double-blind, multicenter clinical trial lasting 6 months. Patients were randomly allocated into 1 of 3 treatment groups: tiludronate for 3 months followed by placebo for 3 months, tiludronate for 6 months, or etidronate for 6 months. Serum AP levels and urinary hydroxyproline excretion were measured at baseline and after 3 months and 6 months. Patients with a reduction of at least 50% in the serum AP concentration were considered to be responders. RESULTS: After 3 months, the proportion of responders was higher in the tiludronate group (57.4%) than in the etidronate group (13.9%) (P < 0.0001). In the etidronate group, this percentage was lower among patients who had received previous treatment with a bisphosphonate (2.3%) than among those who had not (28.6%) (P < 0.01). Previous bisphosphonate treatment was not associated with response in the tiludronate group. After 6 months, the proportion of responders did not differ between the 2 tiludronate groups (60.3% and 70.1%), but was lower in the etidronate group (25.3%) (P < 0.0001). There was a higher proportion of patients with treatment-resistant disease (< 25% reduction of serum AP) in the etidronate group (51.9%) than in the tiludronate 3-month group (17.9%) or the tiludronate 6-month group (19.5%) (P < 0.0001). Gastrointestinal disturbances were more common, and occurred earlier, with tiludronate, but they were mostly mild, requiring no treatment. CONCLUSION: Tiludronate at 400 mg/day for 3 months or 6 months is more effective than the same dosage of etidronate for 6 months in the treatment of Paget's disease.

Adult↗
PubMed1995

Bone loss in patients with inflammatory bowel disease: a prospective study.

To assess the rate of bone loss in patients with inflammatory bowel disease, we prospectively studied 35 patients (17 women) aged 36 +/- 13 (range 17-60) years, 14 of whom had Crohn's disease and 21 with ulcerative colitis (including 12 with ileoanal anastomosis). Bone mineral density was measured by dual-energy X-ray absorptiometry at the lumbar spine and femoral neck. The follow-up was 19 +/- 8 months. During this period, 14 patients received oral steroids. Lumbar bone density changes expressed as a percentage per year were -3.1 +/- 4.9%, -6.4 +/- 7.5% and +2.0 +/- 4.0% in Crohn's disease and ulcerative colitis without and with ileoanal anastomosis respectively (p = 0.007). The same pattern was observed at the femoral neck. Mean annual lumbar bone density changes were -6.2 +/- 7.0% and +0.9 +/- 3.9% in patients with and without steroids during follow-up (p = 0.002). We conclude that patients with inflammatory bowel disease are at risk of lumbar and femoral bone loss. However, bone loss is not observed in patients with ileoanal anastomosis.

Absorptiometry, Photon↗
PubMed1995

Bone loss during gonadotropin releasing hormone agonist treatment and use of nasal calcitonin.

Gonadotropin releasing hormone (GnRH) agonists have shown to be effective in the treatment of several sex-hormone-dependent conditions. However, their use could be limited by the bone loss they induce. To evaluate the use of nasal salmon calcitonin (sCT) in preventing this bone loss, 40 patients with endometriosis were treated for 6 months with triptoreline (3.75 mg monthly) and calcium (1 g daily), and randomized in three groups-placebo, sCT 100 IU daily and sCT 200 IU daily-in a prospective double-masked study. Dual-energy X-ray absorptiometry and biochemical parameters were used to evaluate the benefit of the treatment. At baseline, there were no statistically significant differences between the groups. After 6 months, estradiol and biochemical markers of bone metabolism were at postmenopausal levels, with no difference between the groups. There was no difference in bone loss in the three groups, at all sites. Mean lumbar bone loss was 4.01 +/- 2.59% (mean +/- SD) in this population. In this study dosages of 100 IU and 200 IU daily of nasal sCT were insufficient to prevent bone loss during GnRH agonist treatment.

Absorptiometry, Photon↗
PubMed1995

Metabolic bone assessment in patients with inflammatory bowel disease.

BACKGROUND/AIMS: Patients with inflammatory bowel disease are at risk for osteopenia. To study the metabolic bone status of these patients, a cross-sectional study was conducted. METHODS: Eighty-four patients (49 women, 35 men) with inflammatory bowel disease, 34 of whom had Crohn's disease and 50 ulcerative colitis (including 18 with prior coloproctectomy and ileoanal anastomosis), underwent clinical, dietary, and spine radiological assessments. Bone metabolism was assessed by measuring serum levels of calcium, phosphate, parathyroid hormone (1-84), 25-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, and osteocalcin. Lumbar and femoral neck bone mineral densities were measured by dual energy X-ray absorptiometry. RESULTS: Serum osteocalcin level was decreased in 29 patients (34%), 12 of whom had never undergone steroid therapy. The other biochemical markers of bone metabolism were in the normal range. Thirty-six patients (43%) had osteopenia, and 6 patients (7%) had vertebral crush fractures. Osteopenia was observed in 27 patients (52%) and 9 patients (28%) with and without corticosteroid therapy, respectively. No patient had clinical or biological signs of osteomalacia. Analysis of bone density (lumbar Z score) by a multiple regression analysis showed a statistically significant correlation with age, cumulative corticosteroid doses, sedimentation rate, and osteocalcin level (R2 = 0.76; P = 0.05). CONCLUSIONS: The results suggest that bone turnover in inflammatory bowel disease is characterized by low bone formation in the presence of normal levels of calcium-regulating hormones.

Adolescent↗
PubMed1995

The methodology of clinical trials of oral tiludronate in Paget's disease of bone.

Tiludronate, a potent bisphosphonate, has been extensively evaluated in the treatment of Paget's disease of bone. Its ability to normalize bone turnover without impairing mineralization suggests that tiludronate represents an important therapeutic advance in the treatment of this progressive and disabling disease. Recent attention has focused on the development of appropriate short- and long-term treatment goals: namely the control of clinical symptoms, such as bone pain, and the reduction of bone turnover to within normal range, to lessen the risk of developing later complications, such as deafness, deformity and walking difficulties. This reduction of bone turnover is the primary aim of treatment. The clinical development of tiludronate has involved large-scale international multicenter trials. To allow the comparison of results obtained in a variety of clinical settings, great emphasis was placed on the use of consistent methodology across the program. This applied to patient selection, trial design, the evaluation of clinically meaningful effects of treatment and statistical analysis of results. Strict adherence to these principles has allowed us to compare the results of treatment with tiludronate in 85 centers in six countries across Europe. This paper illustrates the importance of clinical trial design in the evaluation of tiludronate and etidronate in the treatment of Paget's disease of bone, with a brief summary of results obtained from a recent comparative, prospective, double-blind, multicenter clinical trial. Effective suppression of bone turnover was assessed by monitoring the reduction in serum alkaline phosphatase and the ratio of urinary hydroxyproline/creatinine. Reduction in bone pain was assessed using Huskisson's visual analog scale. The results clearly show that tiludronate 400 mg/day for 3 months is more effective and as equally well tolerated as etidronate 400 mg/day.

Adult↗
PubMed1995

Administration of a gonadotropin-releasing hormone agonist during pregnancy: follow-up of 28 pregnancies exposed to triptoreline.

OBJECTIVE: To evaluate the teratogenic or fetal risk of a long-acting GnRH agonist (GnRH-a) triptoreline acetate (Decapeptyl; Ipsen-Biotech, Inc., Paris, France), inadvertently administrated in the first weeks of pregnancy. DESIGN: Prospective follow-up of exposed pregnancies and case reports. SETTING: Teratology information service of a public hospital and pharmacovigilance department of the firm. PATIENTS: Inadvertent pregnant women receiving a treatment, mainly for endometriosis or IVF. INTERVENTIONS: Case by case, individual estimations of the risks have been provided. MAIN OUTCOME MEASURE: Each pregnancy issue has been analyzed. RESULTS: No teratogenic or fetal toxic effect has been noted. CONCLUSION: No specific hazard has been observed among newborns after inadvertent exposures to a GnRH-a during the first 20 weeks of pregnancy.

Abnormalities, Drug-Induced↗
PubMed1995

Morphological classification of human in-vitro fertilization embryos based on the regularity of the asynchronous division process.

A previous study detailed the morphometric characteristics of living in-vitro fertilized human pronuclear zygotes and cleaved embryos. A comparison of the different embryo cell stages confirmed the asynchronous division process during early embryo development. Global results showed no evidence of morphometrical differences between embryo subpopulations according to their classical microscopical grading. In this report, further information on illumination of human embryos and analysis of image processing is given. Some examples of embryo images belonging to a normal asynchronous division process are shown. A new parameter was retrospectively attributed to each cleaved embryo based on whether or not they were considered to have undergone asynchronous division that qualified as normal. A non-parametric analysis of this preliminary sample showed that this qualifier was correlated with implantation and acted complementarily with embryo grading. In conclusion, the asynchronous division process qualified as normal and its deviations seem to be a new parameter to take into account during embryo scoring.

Cell Division↗
PubMed1995

Morphometric parameters of living human in-vitro fertilization embryos; importance of the asynchronous division process.

A total of 304 human pronuclear zygotes and cleaved embryos from the 2- to 9-cell stages, obtained during invitro fertilization attempts, were photographed and retrospectively analysed after transfer for their morphology and size in relation to their developmental stage, using the Imagenia programme of a Biocom 500 image analyser. Morphometric parameters were calculated from the perimeters, surface measurements, theoretical diameters and circularity factors for the different structures analysed. This report provides the morphometric characteristics of living embryos. For the whole population the mean values were: 157.4 microns for the external zona pellucida diameter, 121.8 microns for the internal zona pellucida diameter, 17.9 microns for the thickness of the zona pellucida and 117.2 microns for the embryo cell mass diameter. The morphometric characteristics of the pronuclear-stage population were significantly different from the cleaved cell stages. If the zona pellucida and cell mass embryo diameters increased slowly from the 2- to 9-cell stages, embryonic external diameters were higher and zona pellucida thicknesses were lower in odd than even number blastomere embryos. Preliminary results show that in cases where implantation occurs, the embryo has a lower zona pellucida thickness. A comparison of the different embryo cell stages confirmed the existence of an asynchronous division process during early embryo development. Global results show no evidence of morphometric differences between subpopulations of the embryos according to their microscopic grading. Deviations from the normal asynchronous division process, however, appear to be a new parameter to take into account during embryo scoring.(ABSTRACT TRUNCATED AT 250 WORDS)

Blastocyst↗
PubMed1995

Adult-onset idiopathic phosphate diabetes. II. Time-course of clinical, laboratory test, and bone mineral density abnormalities under combined phosphate and calcitriol therapy.

STUDY OBJECTIVE: to investigate the time-course of clinical, laboratory test, and bone mineral density abnormalities in patients with mild phosphate diabetes treated for at least one year with calcitriol, 0.5 to 1.5 micrograms, and oral phosphate, 788 to 2300 mg per day, in three divided doses. PATIENTS AND METHODS: we studied eight patients with mild phosphate diabetes defined as a rate for tubular reabsorption of phosphate of less than 18% with a maximal rate for tubular reabsorption of phosphate (Tm) of less than 0.77 in the absence of any detectable cause of secondary tubular disease. Treatment efficacy was evaluated on the basis of pain severity, pain-related functional disability, serum phosphate and calcium levels, maximal rate for tubular reabsorption of phosphate, and dual-photon absorptiometry-measured bone mineral density. RESULTS: three patients experienced complete relief of pain and fatigue and were able to resume their normal activities. Partial relief was seen in two other patients. The three remaining patients had no response to treatment. Renal colic occurred in one patient. None of the patients developed hypercalcemia.

Adult↗