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Biomedical subjects

J C Renier

Publications and source records attributed to J C Renier.

At least 55 records · Page 3Linked to original sources
PubMed1986

[3 cases of obliterating bronchiolitis during treatment of rheumatoid polyarthritis with D-penicillamine].

The authors report three cases of bronchiolitis obliterans occurring during treatment of rheumatoid arthritis with D-penicillamine after 4, 6 and 8 months of treatment and when the rheumatoid arthritis was in a state of remission. None of these patients (2 sero-positive and 1 sero-negative) present any past history of pulmonary or bronchial disease. The daily dosage of D-penicillamine never exceeded 600 mg. High dose corticosteroid therapy was unable to improve the clinical signs or the respiratory function tests, which were severely disturbed. After 15 months to 3 years, the respiratory signs deteriorated in 2 of the 3 patients. The onset of dyspnea and cough, in the absence of a seasonal infection, in a subject treated with D-penicillamine should raise the possibility of this very serious complication.

Adult↗
PubMed1986

[Estimate of the prevalence of rheumatoid arthritis based on a rheumatology study in the district of Angers].

The prevalence of rheumatoid arthritis is generally estimated to be 1 per cent, despite the marked differences between the various results published according to the survey techniques and the epidemiological criteria employed. The present survey consisted of patients from the target population (the 248,009 inhabitants of Angers over the age of 15 years), who had been examined by one of the hospital or private rheumatologists working in Angers between 1960 and 1984 and who were considered to be suffering from inflammatory rheumatism. The cases of rheumatoid arthritis included in this survey were still alive and were living in Angers between January 1 and June 30 1984 and corresponded to at least two of the New York criteria. The prevalence determined according to this technique was 0.17 per cent for two criteria and 0.11 per cent for three criteria. After discussing the bias and the particular conditions of the study, it appears that these particularly low levels are essentially related to: a recruitment bias due to the limitation of the survey to patients seen by rheumatologists, to the choice of New York criteria and more especially of 3 criteria which increases the specificity of the survey at the expense of the sensitivity, to the long observation (mean of 10.4 years) which contributed to a reduction in the number of false positives. The validity of this study is supported by the comparison with the study by O'Sullivan et al. also based 2 New York criteria with a follow-up of 3 to 5 years, which concluded on a prevalence of 0.24 per cent compared with 0.17 per cent in Angers.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

[Vertebral osteonecrosis. Apropos of 3 cases, 1 complicated by spinal cord compression and 2 associated with another necrotic localization].

The authors report three cases of vertebral osteonecrosis which presented the phenomenon of intra-vertebral space. These patients had osteoporosis with vertebral compression. Two received steroid therapy. One case progressively developed spinal cord compression and the two other cases had an associated osteonecrosis (femoral head and talus). After reviewing the literature, the authors stress the relative frequency of neurological complications, in particular spinal cord compression (7 per cent).

Adrenal Cortex Hormones↗
PubMed1985

[Bone densitometry by monochromatic photon absorption. Study of a normal population and values obtained in various pathological conditions].

Monophotonic absorption densitometry of the forearm is an exact method for the evaluation of the bone mineralisation, provided the positioning of the forearm is strictly controlled. It is also able to demonstrate progressive enlargement of the bones with age, up until the ages of about 60 to 70 years. The measurements should be performed in two sites: diaphyseal (cortical bone) and epiphyseal (cortical and trabecular bone). The curves obtained from 1,011 controls are in agreement with the current state of knowledge concerning the variations in bone mass during life in both sexes. In women, the number of pregnancies has no influence on the mineralisation index (MI). The values obtained in 156 osteoporotic patients and in 53 subjects with idiopathic hypercalciuria were appreciably lower than those obtained in age-matched controls. In individual subjects, this method appears to be much more discrimination than the measurement of the trabecular bone volume (TBV) for the diagnosis of osteoporosis and no statistically significant correlation was observed between the MI and the TBV. In male controls, there was a depression of the mean curves around the age of 45 years in all four sites of measurement. This depression was also observed in male subjects with hypercalciuria. They correspond to the generations born between 1930 and 1940. The responsibility of a relative nutritional deficiency affecting growing boys during the 1939-45 war is proposed.

Adolescent↗
PubMed1984

[Seasonal variations of vitamin D metabolites in man].

Studies concerning the influence of seasons and ultraviolet radiations on the metabolism of 1,25-dihydrocholecalciferol (1,25 (OH)2D), the active form of vitamin D, have given conflicting results. In the present study serum concentrations of the 3 main vitamin D metabolites--25-hydroxyvitamin D, 24,25-dihydroxyvitamin D and 1,25-dihydroxyvitamin D--were measured by radiocompetitive assay (a) monthly during one year in 7 normal subjects, and (b) before, during and after 4 weeks of "whole body" exposure to ultraviolet radiations in 11 other subjects. In study (a) parallel changes in 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D concentrations were observed during the year, with a rise in the summer; there were no significant monthly or quarterly changes in 1,25-dihydroxyvitamin D concentrations. In study (b), 25-hydroxyvitamin D and 24,25-dihydroxyvitamin D concentrations rose by 150% and 200% respectively after 4 weeks' exposure to ultraviolet radiations and again, there were no significant changes in 1,25-dihydroxyvitamin D concentrations. These results confirm that when synthesis of the substrate (25-hydroxyvitamin D) increases, synthesis of 1,25-dihydroxyvitamin D is inhibited by a regulatory process which does not apply to 24,25-dihydroxyvitamin D synthesis.

Adult↗
PubMed1984

Bone tissue in Paget's disease treated by ethane-1, hydroxy-1, 1 diphosphonate (EHDP). Structure, ultrastructure, and immunocytology.

Diphosphonates have been used in the management of Paget's disease of bone because of their experimentally demonstrated antiosteoclastic activity. Light microscopic examination of bone tissue from 13 patients with Paget's bone disease who were receiving (EHDP) treatment showed considerably reduced osteoclastic resorption accompanied by gradual replacement of irregular woven bone by lamellar tissue. Electron microscopic examination confirmed that pagetoid osteoclasts are morphologically abnormal cells and degenerate after EHDP treatment. EHDP does not affect the measles nucleocapsid-like inclusions in the osteoclast nuclei. Immunocytologic analysis showed that during EHDP treatment viral antigens of the measles type persist in the cytoplasm and nuclei of osteoclasts even when these cells are greatly altered. These findings support the hypothesis of a viral etiology in Paget's disease of bone.

Aged↗
PubMed1984

[Spinal cord compression in multiple myeloma. Study of 10 cases].

Ten cases of multiple myeloma with spinal cord compression are reported. The compression was located in the thoracic spine in 9 cases and in the cervical spine in 1 case. It led to the discovery of the myeloma in 4 cases. Three patients suffered, during several months, from local pain aggravated by activity and from slight and slowly progressive neurologic symptoms resembling intermittent claudication. At the time of diagnosis, sphincter dysfunction was observed only in patients with low thoracic cord compressions. In 4 cases, lesions were first treated by radiotherapy which did not produce regression of the compression. Tumor excision surgery was carried out seven times, once after failure of radiotherapy. In 6 cases an definite and steady regression of the neurological symptoms was achieved. Survival varied from 10 months to 7.5 years after identification of spinal cord compression. Survival was equal to or more than 3 years in 4 patients and will probably reach 3 years in another. Thus spinal cord compression is not by itself a sign indicating a poor short term prognosis in multiple myeloma. It should be treated by excision surgery, then by chemotherapy as in multiple myeloma at other sites.

Aged↗
PubMed1983

Bone tissue in reflex sympathetic dystrophy syndrome--Sudeck's atrophy: structural and ultrastructural studies.

Light and electron microscopic examination of bone in reflex sympathetic dystrophy syndrome confirms that vascular disorders play an important role in the genesis of bone lesions. These vascular disorders lead to degeneration of osteocytes and demineralization of bone, with the disappearance of hydroxyapatite crystals. The neo-osteogenesis that follows resembles the different stages of fracture repair, with precocious elaboration of irregular, replacement woven bone, followed by osteoclastic resorption and the laying down of lamellar bone trabeculae. The bone lesions clearly appear to be a consequence of autonomic nervous system circulatory disorders.

Adolescent↗
PubMed1983

[An unusual cause of sciatica: soft tissue desmoid tumor. Apropos of 2 cases].

The authors report 2 cases of sciatica resulting from nervous compression by a desmoid tumour in women aged 33 and 27 years. In each case, careful exeresis did not prevent recurrence as shown by tomodensitometry. Eight other well-documented cases were found in the literature. The desmoid tumour penetrates the buttock and thigh muscles and presses the sciatic nerve. The patients often suffer from previous and persistent sciatica which can combine with hip restriction. The responsible tumour made up of abundant bundles of collagenous fibers, a small number of fusiform cells without mitosis or atypics and on the periphery degenerative and dissociated muscle fibers is usually discovered late. Tomodensitometry is the best means of detection, evaluation of the extent, adhesions and recurrence during the observation period. Treatment is usually surgical and success depends on the quality of the exeresis. Other methods, corticoid, anti-oestrogen and radiotherapy, sometimes effective in desmoid tumours of the abdominal wall, do not prevent recurrence in the buttocks or thighs which are of sciatic derivation.

Adult↗
PubMed1983

[Bone and phosphoro-calcium metabolism in reflex sympathetic dystrophy].

A combined study organised by the French Society of Rheumatology was devoted to the investigation of bone and phosphoro-calcium metabolism in cases of reflex sympathetic dystrophy. The following observations were made: the usual phosphoro-calcium parameters are not altered, apart from a slight elevation of the urinary calcium in multifocal forms of the disease, during the 3rd and 4th months; the level of PTH, studied in 11 patients, was normal in each case; the examination of 8 bone biopsies, one performed in the 7th week and six others performed during the 3rd and 4th months of the disease, showed, initially, invasion of the spongy tissue by oedema, signs of marrow stress and bone stress, with a reduction in the number of osteoblasts, without any marked alteration of bone remodelling. At a later stage, the biopsy shows intense bone remodelling with hyperosteoclastosis and hyperosteoblastosis and the formation of irregular bone tissue which later becomes lamellar. Electron microscopic study of two biopsies revealed signs of acellular demineralisation with normal appearance of the osteoblasts and osteoclasts.

Bone and Bones↗
PubMed1983

Relationship between rheumatoid arthritis and monoclonal gammopathy.

The incidence of monoclonal gammopathy (MG) developing after the onset of rheumatoid arthritis (RA) was found to be 4.1%. Comparison of 12 patients with both diseases and a group of 215 control cases of RA showed the age of onset of RA was higher when MG was going to develop. In such cases, MG was heralded by lower or diminishing serum rheumatoid factor titers. Comparison of these 12 patients with 971 control cases of MG showed the same high frequency of patients with IgM-MG as that recently reported for a series in Western France. An unusually high but not significant incidence of patients with lambda light chains was observed. The reasons for this remain to be elucidated.

Adult↗
PubMed1983

[The joint in algodystrophy. Joint fluid, synovium, cartilage].

The joint fluid in cases of algodystrophy was studied in 17 samples. It is poor in cells (275/mm3 with a mean of 15% polymorphs). The protein level was studied 4 times and was equal to or greater than 40 g/l, i.e. double the normal value. A detailed histological examination of 33 biopsies of synovial tissue reveals a typical appearance of the synovium in algodystrophy, defined by 6 features, 2 negative and 4 positive: absence of hyperplasia of the synovial lining, absence of any real inflammatory cell infiltrate, presence of a marked hypervascularity, an oedema of the chorion, especially marked in the first weeks of the disease, hyperplasia of the walls of some arterioles, and fibrosis of the chorion which becomes more marked as the disease progresses and which is predominantly in the deeper layers. The authors recall that articular cartilage can show superficial alterations of structure with areas of fibrosis.

Biopsy↗