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L Laroche

Publications and source records attributed to L Laroche.

At least 91 records · Page 5Linked to original sources
PubMed2000

[Marginal corneal perforation associated with herpes simplex virus in a patient with essential cutaneous porphyria].

We report a case of herpetic perforated peripheral corneal ulcer in a patient with cutaneous porphyria and hepatitis C. The patient underwent peripheral lamellar keratoplasty. Antiherpetic antibodies were found at a significantly higher level in the aqueous humor than in the serum. Outcome was favorable with antiviral treatment. We discuss the causal role of the hepatitis C virus, porphyria and herpes simplex.

Anti-Bacterial Agents↗
PubMed2000

[Mooren ulcer].

Explore the source record for details and available documents.

Adrenal Cortex Hormones↗
PubMed2000

[Spontaneously favorable course of an epiretinal membrane].

A 28-year-old female patient presented a macular epiretinal membrane. Her visual acuity had fallen to 20/80. Five years earlier, she had undergone focal peripheral photocoagulation for retinal degeneration. During the following 5 years, the membrane contracted spontaneously and detached itself. Visual acuity returned to 20/20. Six fluorescein angiographies were performed during this 5-year follow-up. As demonstrated here in this young patient, an epiretinal membrane can evolve favorably, suggesting surgery should be carefully discussed when visual function is not excessively deteriorated.

Adult↗
PubMed2000

Regulation of human corneal epithelial cell proliferation and apoptosis by dexamethasone.

PURPOSE: To investigate whether human corneal epithelial cells express the glucocorticoid receptor (GR) and to assess the influence of dexamethasone (DEX) on these cells. METHODS: Human corneal epithelial cells were cultured in medium supplemented with various concentrations of DEX (ranging from 10(-10) to 10(-4) M). Cell proliferation was analyzed by 3-(4, 5-dimethylthiazol-2-yl)-5-(3-carboxy-methoxyphenyl)-2-(4-sulfop henyl) -2H-tetrazolium inner salt (MTS) assay at 2, 4, and 6 days of culture. Apoptosis was studied by nucleus labeling using a fluorescent dye and immunostaining by APO 2.7 at 6 days of culture. GR mRNA was detected in corneal epithelium and cultured corneal epithelial cells by means of reverse transcription-polymerase chain reaction (RT-PCR). Immunocytochemical staining of the epithelial cells was performed with a monoclonal anti-human GR. RESULTS: RT-PCR and immunocytochemistry showed the expression of GR (mRNA and protein) in corneal epithelial cells. DEX significantly increased corneal epithelial cell proliferation with concentrations ranging from 10(-10) to 10(-6) M, with a maximum effect at 10(-7) M (P < 0.005). However, DEX also induced apoptosis of cultured corneal epithelial cells at any concentration used. CONCLUSIONS: These results indicate that human corneal epithelial cells express the GR and proliferate in response to DEX stimulation which also induces corneal epithelial cell apoptosis.

Apoptosis↗
PubMed1999

The results of successful penetrating keratoplasty using donor organ-cultured corneal tissue.

BACKGROUND: The aim of this study was identification of predictive factors for postoperative visual acuity in patients with a clear organ-cultured graft and to analyze the change in visual acuity between 12 and 24 months after transplantation. METHODS: The study design was a prospective cohort study. A total of 342 consecutive penetrating keratoplasties using donor organ-cultured grafts, performed in 324 patients, were included. Visual acuity, graft thickness, and graft endothelial cell density were recorded in patients with clear transplants. RESULTS: At 24 months postoperatively, 25 (18.7%) of 134 patients had 20/200 or worse visual acuity and 66 (49.3%) had 20/40 or better visual acuity. Graft thickness took 1 month to decrease to normal values. A temporary graft thinning occurred at 6 months postoperatively, followed by recovery of normal graft thickness by 18 months. The average postoperative endothelial cell density was 1,533+/-598 cells/mm2 during the second year. The 24-month LogMAR (logarithm of minimal angle of resolution) visual acuity correlated with preoperative LogMAR visual acuity (beta=0.26, P=0.005), postoperative lens status (beta=-0.34, P=0.008), preoperative intraocular pressure (beta=0.50, P=0.020), and postoperative astigmatism (beta=0.17, P=0.040). Visual acuity (P=0.022) significantly improved between 12 and 24 months. Preoperative diagnosis (P < 0.0001) and postoperative lens status (P < 0.0001) significantly influenced the change in LogMAR visual acuity between 12 and 24 months. CONCLUSIONS: Donor variables do not influence the visual acuity results of penetrating keratoplasty using organ-cultured donor tissue, whereas they have a strong influence on graft survival and graft endothelial cell density. Visual acuity improves during the first 2 years after transplantation. After keratoplasty, organ-cultured corneal grafts undergo dramatic modifications of their thickness and probably of their transparency.

Cornea↗
PubMed1999

Prognostic factors in primary cutaneous lymphomas other than mycosis fungoides and the Sézary syndrome. The French Study Group on Cutaneous Lymphomas.

Prognostic studies of primary cutaneous lymphomas (PCL) other than mycosis fungoides (MF) and the Sézary syndrome (SS; non-MF/SS PCL) have been mainly performed on subgroups or on small numbers of patients by using univariate analyses. Our aim was to identify independent prognostic factors in a large series of patients with non-MF/SS PCL. We evaluated 158 patients who were registered in the French Study Group on Cutaneous Lymphomas database from January 1, 1986 to March 1, 1997. Variables analyzed for prognostic value were: age; sex; type of clinical lesions; maximum diameter, location, and number of skin lesions; cutaneous distribution (ie, local, regional, or generalized); prognostic group according to the European Organization for Research and Treatment of Cancer (EORTC) classification for PCL; B- or T-cell phenotype; serum lactate dehydrogenase (LDH) level; and B symptoms. Univariate and multivariate analyses were performed using a model of relative survival. Forty-nine patients (31%) died. The median relative survival time was 81 months. In univariate analysis, EORTC prognostic group, serum LDH level, B symptoms, and variables related to tumor extension (ie, distribution, maximum diameter, and number of skin lesions) were significantly associated with survival. When these variables were considered together in a multivariate analysis, EORTC prognostic group and distribution of skin lesions remained statistically significant, independent prognostic factors. This study confirms the good predictive value of the EORTC classification for PCL and shows that the distribution of skin lesions at initial evaluation is an important prognostic indicator.

Adolescent↗
PubMed1999

A prospective study of cutaneous intolerance to topical mechlorethamine therapy in patients with cutaneous T-cell lymphomas. French Study Group of Cutaneous Lymphomas.

OBJECTIVE: To study the exact frequency and the histological features of cutaneous intolerance to mechlorethamine (CIM) hydrochloride therapy in patients with cutaneous T-cell lymphomas, including Langerhans cell histiocytosis. DESIGN: A multicenter prospective study was conducted from January 1, 1994, to May 31, 1996, in 12 different hospitals in France. PATIENTS: Of the 52 patients with cutaneous T-cell lymphomas or Langerhans cell histiocytosis, 35 were men and 17 were women, aged 18 to 87 years. Of the 52 patients, 35 had mycosis fungoides, 8 had nonepidermotropic cutaneous lymphoma, 7 had lymphomatoid papulosis, 1 had Sézary syndrome, and 1 had Langerhans cell histiocytosis. METHODS: Patients were treated with topical applications of a 0.02% aqueous solution of mechlorethamine. The diagnosis of CIM was determined by the presence of erythema and pruritus. Patients who developed CIM underwent closed patch testing with three 10-fold dilutions of 0.02% mechlorethamine solution. A positive patch test result was the presence of erythema and pruritus, a weak result was the presence of simple erythema without pruritus, and a negative result was the absence of erythema and pruritus. Skin biopsy specimens from patients with positive patch test results were obtained in patients who developed CIM. The biopsy specimens were reviewed, and the results determined by 2 pathologists (E.T. and J.W.). The histopathological findings were classified in 3 categories: (1) spongiotic dermatitis, (2) irritant dermatitis, and (3) insignificant or normal. In September 1998, the referring physicians were contacted if mechlorethamine therapy had been continued in patients with CIM. RESULTS: Of the 52 patients, 43 were evaluated for tolerance to mechlorethamine therapy. Of the 43 patients, CIM developed in 23, from 4 days to 9 months after the initiation of mechlorethamine therapy. Of those 23 patients, CIM developed within 3 months in 21 and within 1 month in 13. Closed patch tests were performed in 21 of the 23 patients who developed CIM. The results of the patch test were positive in 12, weak in 4, and negative in 5. Of these 21 patients, 14 skin biopsy specimens were obtained in 14 different patients who had positive or weak patch test results. The specimens showed histological features that were consistent with spongiotic dermatitis in 9 patients, irritant dermatitis in 2, and insignificant or normal in 3. All 9 patients with histological features of spongiotic dermatitis discontinued mechlorethamine therapy. All 5 patients without histological features of spongiotic dermatitis were able to resume mechlorethamine therapy. These results do not correlate with those of previous study results. CONCLUSIONS: Mechlorethamine therapy is a cost-effective and easily administered treatment for cutaneous T-cell lymphomas. Our study shows that allergic dermatitis caused by mechlorethamine therapy is an early and frequent adverse reaction in patients with cutaneous T-cell lymphomas. The most common histological feature of patients with CIM is spongiotic dermatitis.

Administration, Cutaneous↗
PubMed1999

Influence of fetal calf serum, fibroblast growth factors, and hepatocyte growth factor on three-dimensional cultures of human keratocytes in collagen gel matrix.

BACKGROUND: We set out to evaluate the influence of fetal calf serum, acidic fibroblast growth factor (aFGF), basic fibroblast growth factor (bFGF), and hepatocyte growth factor (HGF) on three- dimensional cultures of human keratocytes in type I collagen gel matrix. METHODS: Polymerized gels were cultured at 37 degrees C for 35 days. Gel contraction and integrated optical density were assessed 3 times weekly for 5 weeks using an image analysis system. Gels were studied at the end of the culture period by means of transmission electron microscopy (TEM) and immunochemistry. RESULTS: Serum significantly increased gel contraction and decreased gel optical transmittance. Keratocyte density was significantly increased by serum and HGF. In TEM, collagen density was higher with serum-supplemented media than with serum-free media, and higher with HGF-supplemented media than with HGF-free media. Immunoperoxidase staining of keratocyte-populated gels showed positive staining for vimentin, connexin 43, and type I, type V, and type VI human collagen, whereas no expression of desmin, alpha smooth muscle actin, and type IV collagen was observed. Expression of type I collagen was significantly increased by aFGF and HGF, expression of type VI collagen by serum and bFGF. CONCLUSION: Serum and HGF improve ultrastructural and immunochemical features of human keratocyte-populated collagen gels.

Aged↗
PubMed1999

Surgical correction of postkeratoplasty astigmatism with the Hanna arcitome.

PURPOSE: To report the results of arcuate keratotomy performed with the Hanna arcitome in patients with postkeratoplasty astigmatism. SETTING: Department of Ophthalmology, Saint-Antoine Hospital, Paris VI University, Paris, France. METHODS: This retrospective study comprised 22 eyes (22 patients) with postkeratoplasty astigmatism. Paired symmetrical arcuate keratotomy was performed with the Hanna arcitome. Outcome measures included refraction, videokeratography, and keratometry. RESULTS: At 6.6 months +/- 8.9 (SD) after surgery, the mean increase in best spectacle-corrected visual acuity (BSCVA) was 2.1 +/- 2.4 lines. Thirteen eyes gained 2 lines or more of BSCVA, and 15 gained 3 lines or more of uncorrected visual acuity. Two patients had a decrease in BSCVA: 1 had lens opacification unrelated to arcuate keratotomy and 1, increased corneal irregularity. Mean refractive astigmatism was 6.94 +/- 2.11 diopters (D) preoperatively and 3.85 +/- 1.95 D postoperatively (P < .01). Mean change in keratometric astigmatism was -51 +/- 36%. Astigmatism decreased in 21 eyes as measured by manifest refraction, keratometry, and videokeratography; it increased in 1 cornea with a microperforation. CONCLUSIONS: The results of arcuate keratotomy performed with the Hanna arcitome were comparable to those with freehand relaxing incisions. The instrument made safer and more uniform arcuate incisions than a freehand technique.

Adult↗
PubMed1999

Newborn screening for human immunodeficiency virus infection in the Bronx, NY, and evolving public health policy.

New advances in the diagnosis and treatment of HIV infection continue to propel changes in public understanding of HIV infection and the administration of public health law. Over the past decade, New York State has moved from a policy of blind newborn screening for seroprevalence data to mandatory HIV testing as part of the statewide Newborn Screening (NBS) Program. A new statewide program of expedited HIV testing (48-hr turnaround results) of pregnant women and newborns (whose HIV status is unknown at the time of delivery) began in the summer of 1999. To better understand the impact this program might have on the patients who receive health care at Lincoln Medical and Mental Health Center (Lincoln Hospital), we evaluated our experience with the current NBS program prior to inauguration of the new expedited testing program. We evaluated the NBS program from February 1, 1997, to January 31, 1999, including total number of HIV-exposed/infected infants born, mother's HIV status (if known) at the time of delivery, amount of time between blood sampling and return of the test results to the Hospital, and medical follow-up of infants with positive newborn screening test results. This was a retrospective study of the NBS registry and the medical records of patients who receive primary health care from the Pediatric Immunology Service of the Department of Pediatrics at Lincoln Hospital. One hundred and four newborns were identified with positive-HIV antibody (HIV-Ab-positive), and 13 (12.5%) were confirmed to be HIV-infected by positive polymerase chain reaction (PCR) test of viral DNA. Sixty-five (62.5%) of the newborns with positive NBS screening test results were born to mothers who were known to be HIV-infected prior to delivery; 39 (37.5%) were unanticipated. Four (30%) of the 13 HIV-infected babies were born to mothers who were known to be HIV-infected prior to delivery, and 9 (70%) were born to mothers whose HIV status was unknown at the time of delivery. Eighty percent (80%) of HIV-Ab-positive infants continued to receive follow-up care at Lincoln Hospital. Relocation to other health-care facilities occurred as a result of parental choice or due to foster care placement. No babies were "lost" from the NBS program. The average time between sampling and receipt of results for all blood tests was 16 days (range 10 to 141). Nearly 40% of newborns who acquired HIV infection from their mothers were unanticipated because the mother's HIV status was unknown at the time of delivery. These unanticipated HIV-infected infants represent missed opportunities for prevention of maternal-to-child transmission of HIV infection and early therapeutic intervention for HIV-infected infants. The new expedited HIV-testing program for New York State will facilitate early diagnosis, prevention and treatment of the HIV-exposed/infected infant for whom maternal HIV status is unknown at the time of delivery.

Female↗
PubMed1999

The Spectrum of Cutaneous Lymphomas in HIV infection: a study of 21 cases.

We studied 21 HIV-associated lymphomas with cutaneous presentation to determine whether they showed features of primary cutaneous lymphoma arising fortuitously or whether they represented the cutaneous involvement of AIDS systemic lymphoma. Besides rare mycosis fungoides (n = 3), which shared typical clinicopathologic lesions, nonepidermotropic large-cell lymphomas (n = 18) were predominant. They frequently presented as a solitary nodule or tumor. Seven of the eight large T-cell lymphomas had a CD30-positive (CD30+) phenotype but did not express ALK protein. Overexpression of p53 protein was observed in six cases. Although EBV-EBER transcripts were detected in two of them, LMP1 protein was absent. Except for their original prevalence, the features of these T-cell CD30+ cutaneous lymphomas were the same as in immunocompetent patients. The 10 B-cell cutaneous lymphoma were immunoblastic or centroblastic lymphomas, with a differential expression of BCL-6 and Syndecan. Four of them expressed CD30, EBER-EBV transcripts, and LMP1 and p53 proteins. This B-cell CD30+ EBV+ phenotype contrasts with cutaneous lymphoma in immunocompetent patients. Human herpesvirus 8 was not involved in lymphomagenesis since its sequences were detected in a single patient with Kaposi's sarcoma and Castleman's disease. These lymphomas occurred in severely immunocompromised patients with a low CD4 count. Death was due to immunodepression rather than to lymphoma spread, suggesting avoiding aggressive immunosuppressive treatment in such patients.

Adult↗
PubMed1999

Effects of penetrating keratoplasty suture removal on corneal topography and refraction.

PURPOSE: To study the refractive and topographic modifications induced by penetrating keratoplasty suture removal. METHODS: We retrospectively studied 50 corneas from 50 patients who had undergone penetrating keratoplasty. All of the eyes were examined before and after all sutures were removed at 10.8+/-4.7 months and 20.3+/-7.9 months after keratoplasty. Subjective refraction, best spectacle-corrected visual acuity (LogMAR units), and corneal topography (EyeSys 2000R device) were recorded. RESULTS: Suture removal decreased the subjective cylinder by an average of 0.91+/-2.32 D (p = 0.004) and modified the corneal topographic pattern (p = 0.03) and shape (p < 0.001) distribution. The change in subjective cylinder correlated with the variation of the steepest meridian power (r(s) = 0.46; p < 0.001). It correlated with the change in topographic pattern (r(s) = 0.59; p < 0.001). The subjective spherical equivalent increased (hyperopization) by an average of 0.61+/-2.24 D (p = 0.01). After suture removal, the prolate shape was less frequent, and the oblate shape was more frequent than before suture removal. Best spectacle-corrected visual acuity increased by an average of 0.8+/-2.0 lines (p = 0.004). The change in subjective cylinder correlated with the change in visual acuity (r(s) = 0.36; p = 0.006). CONCLUSION: Suture removal modifies the corneal topographic pattern and shape. It decreases the subjective cylinder and induces an hyperopization. Visual-acuity improvement after suture removal mainly is explained by the decrease in astigmatism. Suture removal seems particularly helpful in corneas with a bow-tie pattern.

Adolescent↗
PubMed1999

The triple procedure: in the bag placement versus ciliary sulcus placement of the intraocular lens.

AIMS: To evaluate the influence of intraocular lens (IOL) placement on triple procedure clinical results and to investigate whether it is appropriate to use phacoemulsification in patients with large lens nucleus. METHODS: 40 consecutive penetrating keratoplasties combined with cataract extraction performed in a single institution were studied. Whenever possible a capsulorhexis was performed and the IOL was placed into the capsular bag. Phacoemulsification was used when the nucleus was too large to pass through the capsulorhexis. RESULTS: Out of 25 patients with an intact capsulorhexis phacoemulsification was used in 13 (52.0%) whereas the entire nucleus passed through the capsulorhexis in the remaining 12 patients (48%). The average 12 month visual acuity was 0.46 (SD 0.21) in patients with in the bag IOL (n = 23) and 0.29 (0.08) in patients with ciliary sulcus IOL (n = 13) (p = 0.04). Elevated intraocular pressure occurred in 26.1% (6/23) of patients with in the bag IOL and 61.5% (8/13) of patients with ciliary sulcus IOL (p = 0.08). The average postoperative graft thickness at 18 months was 552 (27) microns in the former group and 650 (29) microns in the latter group (p = 0.04). No significant difference in graft survival, postoperative endothelial cell density, astigmatism, and videokeratoscopic measurements was found between both groups. CONCLUSION: In the bag placement of the intraocular lens during the triple procedure results in better outcome of transplantation than ciliary sulcus placement of the IOL. Phacoemulsification allows removal of large nuclei through a 5 mm capsulorhexis without performing relaxing incisions out towards the periphery of the capsule.

Adolescent↗
PubMed1999

In vitro effects of dexamethasone on human corneal keratocytes.

PURPOSE: To investigate whether cultured human keratocytes express the glucocorticoid receptor (GR) and to assess the influence of dexamethasone (DEX) on these cells. METHODS: Human keratocytes were cultured in medium supplemented with various concentrations of DEX (ranging from 10(-10) to 10(-4) M). Cell proliferation was analyzed by 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxy-methoxyphenyl)-2-(4-s ulfophenyl)-2H-tetrazolium inner salt (MTS) assay at 2, 4, and 6 days of culture. Some experiments were performed in the presence of mifepristone (RU38486), an antiglucocorticoid molecule. The early phase of apoptosis was studied by means of keratocyte staining with a fluorescein conjugate of annexin V and propidium iodide, and cells were analyzed by flow cytometry. Glucocorticoid receptor mRNA was detected in keratocytes by means of reverse transcription-polymerase chain reaction (RT-PCR). Immunocytochemical staining of the cells was performed with a monoclonal anti-human GR. RESULTS: RT-PCR and immunocytochemistry showed the expression of GR (mRNA and protein) in cultured keratocytes. Dexamethasone significantly increased keratocyte proliferation with concentrations ranging from 10(-9) to 10(-5) M, with a maximum effect at 10(-7) M (P < 0.005). Dexamethasone's proproliferative effect was inhibited by RU38486. However, DEX also induced apoptosis of cultured keratocytes at any concentration used. CONCLUSIONS: These results indicate that cultured human keratocytes express the GR and proliferate in response to DEX stimulation (10(-9)-10(-5) M), which also induces keratocyte apoptosis.

Apoptosis↗
PubMed1999

[Treatment of unilateral limbal stem cell deficiency syndrome by limbal autograft].

PURPOSE: To evaluate the improvement of the ocular surface after limbal autograft in patients with unilateral limbal stem cell deficiency related to chemical burns. MATERIALS AND METHODS: Limbal autograft was performed in five patients with unilateral limbal stem cell deficiency related to chemical burns. Thereafter, four patients underwent penetrating keratoplasty. The limbal graft was obtained from the fellow eye, and was secured with interrupted sutures. Patient follow-up ranged from 10 to 47 months. Limbus and corneas were studied by means of light microscopy. RESULTS: All five patients reported subjective improvement. Vascularization decreased in one cornea. Visual acuity improved in one eye and did not change in the remaining four eyes. After penetrating keratoplasty, graft reepithelialization was achieved after respectively 3, 4, 21, and 30 days. Light microscopy showed the presence of goblet cells in the limbal epithelium in four cases. After limbal autograft, the corneal epithelium was devoid of goblet cells in three out of four cases. CONCLUSION: Limbal autograft improves the ocular surface and the prognosis of subsequent penetrating keratoplasty in patients with unilateral limbal stem cell deficiency related to chemical burn.

Adult↗
PubMed1999

Ultrastructure of cultured and cryopreserved human corneal keratocytes.

PURPOSE: To describe the ultrastructural features of cultured and cryopreserved keratocytes. METHODS: Isolated human keratocytes were cultured with 10% fetal calf serum and 10 ng/ml acidic fibroblast growth factor. The 10% Me2SO and 10% human albumin were used as cryoprotective agents. Cells were cooled at 2 degrees C/min, then thawed at 37 degrees C, and subsequently recultured. They were studied by means of transmission electron microscopy (TEM). RESULTS: TEM of cultured keratocytes before cryopreservation showed a network of intact connecting cells. The average cell thickness was 2.4 microm in cross sections and 5.8 microm in frontal sections. The average nuclear thickness was 1.6 microm in cross sections and 3.7 microm in frontal sections. Nuclei appeared regular and oval in cross sections and indented in frontal sections. Organelles were found in greater amounts in frontal sections than in cross sections. Gap junctions, fenestrations along the cell surface, omega-shaped structures, fibrils, and filamentous networks also were found. Most of the just-thawed, suspended cells were elongated and condensed but had intact plasma membranes. These cells were surrounded by a granular material, corresponding to the albumin-containing thawing medium. Scattered isolated round cells displayed nuclear damage, cell edema, loss of organelles, and cell-membrane disruption. By the end of reculture after cryopreservation, cultured keratocytes displayed the same ultrastructural features as before cryopreservation. CONCLUSION: Cultured human keratocytes display many ultrastructural features of in situ keratocytes. These features are still present after reculture after cryopreservation. Cryopreservation induces necrosis in a small percentage of cells, which seems to be related to a relative lack of cell-membrane protection by the cryoprotectants used.

Cells, Cultured↗