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Biomedical subjects

J Meynadier

Publications and source records attributed to J Meynadier.

At least 37 records · Page 2Linked to original sources
PubMed1991

The treatment of 45 patients with cutaneous T-cell lymphoma with low doses of interferon-alpha 2a and etretinate.

Forty-five patients with cutaneous T-cell lymphomas (CTCL), 32 with mycosis fungoides (MF) and 13 with Sézary syndrome (SS), were treated with interferon-alpha 2a (IFN-alpha 2a) (6-9 x 10(6) IU daily) for 3 months. Those responding to treatment were then treated with interferon-alpha alone (6-9 x 10(6) IU three times weekly), and non-responders received a combination of etretinate (0.5 mg/kg/day) and IFN-alpha 2a in similar concentrations. After 12 months of treatment, 28/45 patients (62.2%) were in complete or partial (greater than 50%) remission. Of these, 17 (60.7%) were receiving IFN-alpha alone and 11 the combined interferon-retinoid therapy. Of the patients with MF stage I and II, 20/25 were responders (12 receiving IFN-alpha alone and eight on combined therapy), whereas only 8/20 with stage IV or SS responded to treatment (five receiving IFN-alpha 2a alone and three combined therapy). These results suggest that the association of etretinate with low-dose recombinant IFN-alpha 2a is an effective means of treating epidermotropic CTCL, particularly in the early stages.

Adolescent↗
PubMed1990

[Then physiopathology of atopic dermatitis].

Atopic dermatitis is transmitted as an autosomal dominant trait. Its expressivity is variable, and flare-ups are triggered by environmental factors such as air-borne allergens, cutaneous flora or foodstuffs. Elevation of serum IgE levels is inconstant and not specific; it is associated with a deficiency of suppressor T cell population. The epidermis contains IgE bound to the surface of Langerhans cells; this abnormality seems to be specific as it is not found in atopic or non atopic healthy subjects. The lack of beta-adrenergic response is partially explained by the hyperactivity of the cyclic AMP-degrading phosphodiesterase. Disturbances in essential fatty acid metabolism (inactivation of delta 6 desaturase) are thought to be responsible for abnormalities in the permeability of epithelial structures. The relationships between pharmacological, biochemical and immunological dysregulations are unknown.

Dermatitis, Atopic↗
PubMed1990

[Stereotaxic radiosurgery:methods and indications in the treatment of cerebral arteriovenous malformations].

After Leksell and Steiner's pioneering experience with the use of the gamma units, another technically different system has been developed, using a linear accelerator. It's a very precise stereotactic radiosurgical approach which allows to deliver the necessary dose of radiation to the target volume while sparing the surrounding structures from potentially dangerous levels of radiation. This hyperselective irradiation is a new and complementary method of treatment of arteriovenous malformations located in central or functionally critical areas of the brain. The aim is to obtain a progressive and total obliteration of the lesion. The place of radiosurgery is obviously reserved for the patients who do not seem able to profit from the benefits of open surgery and/or embolization techniques.

Dose-Response Relationship, Radiation↗
PubMed1989

[Intracerebroventricular morphine therapy. Apropos of 79 patients].

The authors report their experience in the treatment of 79 patients suffering from intractable cancer pain with intra-cerebro-ventricular morphine. They obtain a long-lasting analgesia (34.2 hours at the beginning of treatment and 27.9 hours at the end; mean follow-up of 65 days) with a very low daily morphine consumption. The results obtained, good and very good in 95% of the cases, could be explained by patients' selection criteria and quality of the follow-up (prospective sheet given to the patients, regular phone calls and consultations in the pain clinic). The authors discuss the indications of this technique in relation with other neurosurgical procedures, taking into account the neurophysiological mechanism of action of morphine.

Female↗
PubMed1988

[Probable association of HLA-DR5 with bullous pemphigoid].

HLA typing was performed in 35 French Caucasoids with bullous pemphigoid and compared with 160 healthy controls. 47 HLA antigens were characterized by a lymphocytotoxicity micromethod. Analysis of the results only reveals one statistically significant difference: an increased incidence of HLA-DR5, which reaches 51.43% in patients versus 22.42% in controls, with P = 0.0007 and Pc = 0.0329. Several bullous dermatosis are associated with various HLA-DR antigens. These data suggest a direct role of HLA-DR molecules in the constitution of these autoimmune disease. An abnormal expression of DR products on some skin cells membrane would permit the presentation of a non self peptide, accumulated in skin cells, to helper T lymphocytes. An heteroimmunization against the non self peptide could lead to lesion of self cells. This peptide perhaps derives from food protein.

HLA-D Antigens↗
PubMed1988

[An intercenter study of the validity of nutritional evaluation].

Malnutrition is one of the most frequent consequences of neoplastic disease. During specific therapies, in order to improve the quality of life of cancer patients, it is necessary to correct their bad nutritional status, allowing thus a better quality of response to the treatment and a better survival. Therefore, it may be needful to realize repetitive nutritional evaluations. The authors have tested the validity of a nutritional assessment in patients with head and neck cancer undergoing radiotherapy, and known to have a progressive impairment of pre-existent nutritional alterations during this therapy. Results show the interest of ponderal curve and serum prealbumin level monitoring, associated with a quantified evaluation of alimentary practice of the patients ("Nutritional Status Index") during cancer therapy. Those investigations are cheap and easy to realize, and could be done often and regularly, giving thus essential data for nutritional status evaluation; the consequence is the possibility of improving the correction of malnutrition.

Adult↗
PubMed1988

[Does plasma exchange have a place in the treatment of necrotizing angiodermatitis?].

Necrotizing angiodermatitis is of characteristic clinical expression and is often difficult to treat. It is associated with microcirculatory disorders of hypertensive or diabetic origin. A particularly long course (m = 8 months) in 8 patients with necrotic angiodermatitis (of hypertensive origin in 6 cases and diabetes in 2) resulted in treatment by plasma exchange, two other patients with immunological angiodermatitis being treated similarly because of very similar symptomatology. The 10 patients (3 men, 7 women age range 55 to 80 years) received between 4 and 18 small volume plasma exchanges over 2 to 12 weeks. Results were evaluated from pain and duration of healing, absence of pain being reported by 7 patients and a beneficial effect on healing by 6 patients. No correlation existed between ESR and hematocrit values during treatment and the clinical course. The question arises as to whether the mode of action of plasma exchange in angiodermatitis is related to the purifying of serum factors or a rheological role.

Aged↗
PubMed1987

[Multiple trichoepitheliomas, cylindromas and milia. An entity].

Four patients from two different families presented with multiple papular trichoepitheliomas of the face associated with cylindromas of the scalp and, in one of them, milium. This association, first described by Adamson, has now become classical. It is transmitted as an autosomal dominant trait with variable penetrance. Histochemical studies gave the following results: ATPase negative in the two types of tumour, phosphorylase weakly positive, NADH diaphorase positive in the basal cells of the trichoepitheliomas and diffusely in cylindromas. These results suggest that the cylindromas are of apocrine origin. Using monoclonal antibodies, it has been possible to demonstrate the presence of Langerhans cells in both trichoepitheliomas and cylindromas. The BL9 and KL3 antikeratinocyte monoclonal antibodies were negative, whereas the KL3 antibody, which recognizes the 55-57 Kd polypeptides of keratin, marked the suprabasal part of the tumours. These results are in favour of incomplete cell differentiation. Treatment with retinoids was ineffective, as in all other cases reported. Electrocoagulation or surgical excision om request for cosmetic reasons seem to be only possible treatments.

Antibodies, Monoclonal↗