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Biomedical subjects

M Laroche

Publications and source records attributed to M Laroche.

At least 91 records · Page 5Linked to original sources
PubMed1992

Intensive combined therapy for previously untreated aggressive myeloma.

A trial was initiated to determine the feasibility and efficacy of a three-phase treatment including: (1) induction chemotherapy (IC); (2) high-dose melphalan with total body irradiation supported by unpurged autologous bone marrow transplantation (ABMT); and (3) interferon (IFN) alpha maintenance treatment, in previously untreated aggressive myeloma. Thirty-five consecutive patients, ages under 65 years, were enrolled. Initial induction therapy was randomized between the VAD regimen (vincristine, doxorubicin, dexamethasone) or the VMCP regimen (vincristine, melphalan, cyclophosphamide, prednisone) that were found to give similar results as IC. Thirty-one of 35 (89%) patients, with good performance status and normal renal function after IC, received ABMT. IFN alpha was started soon after ABMT and was well tolerated. Fifteen of 35 (43%) patients achieved complete response (CR) and 14 of 35 (40%) achieved partial response (PR). Low pretreatment beta 2 microglobulin was the only predictive factor for accomplishing CR. The duration of response was significantly affected by the magnitude of response. The 33-month, post-ABMT probability of progression-free survival was 85% for patients in CR versus 24% for patients in PR. The 42-month, post-diagnosis probability of survival was 81%. This overall strategy may represent an advance in the management of multiple myeloma. Furthermore, the high rate and long duration of CR that we observed in patients with low beta 2 microglobulin suggest that such patients may preferentially benefit from this strategy.

Aged↗
PubMed1992

Lumbar and cervical stenosis. Frequency of the association, role of the ankylosing hyperostosis.

The authors report a study of 47 patients admitted for cervical myelopathy (N = 17) or symptomatic lumbar spinal stenosis (N = 30). Nine patients had clinical evidence of coexisting cervical myelopathy and lumbar spinal stenosis. Ten out of the 17 patients having cervical myelopathy had lumbar spinal stenosis as evidenced by sagittal tomography and/or computerized tomography. Nine out of the 30 patients admitted for symptomatic lumbar spinal stenosis had coexisting cervical canal stenosis as evidenced by sagittal tomography. Thirteen out of these 19 patients with both cervical and lumbar canal stenosis had also ankylosing spinal hyperostosis.

Humans↗
PubMed1992

Stenosis of the lumbar spinal canal in vertebral ankylosing hyperostosis.

Certain morphologic features frequently observed in radiography or computed tomography (CT) scan in patients with hyperostosis led us to study the association between a narrowed spinal canal and vertebral hyperostosis. Twenty-eight items were selected and studied by three different investigators (two rheumatologists and one radiologist) in radiographs and CT scans of 100 patients with acquired stenosis of the lumbar canal, with or without hyperostosis (46 and 54 cases, respectively). The most distinctive points that we suggest can be used as diagnostic criteria of the hyperostotic narrowed lumbar canal are anterior or posterior lateral marginal somatic osseous proliferations, proliferations of the nonarticular aspects of the posterior apophyses, and ossifications of the posterior articular capsule and of the ligaments (yellow ligament, posterior longitudinal ligament, and the supraspinal ligament). Four of these six criteria should be present to establish the diagnosis of hyperostotic lumbar stenosis. The appearance of lumbar hyperostosis on X-ray or CT scans differs from that of simple degenerative changes due to arthrosis, and the hyperostosis can be held responsible for dural compression.

Aged↗
PubMed1992

[Male osteoporosis, an unrecognised etiology: moderate idiopathic proximal tubulopathy (MIPT)].

Routine renal tubular investigations in 8 osteoporotic men, in whom phosphorus/calcium balance studies were normal or almost normal revealed moderate phosphorus (PD) or bicarbonate (BD) diabetes possibly responsible for their decalcification. Osteoporosis affected the spine and lower limbs, resulting in clinical pictures of frequently recurrent spontaneous algodystrophy. Histomorphometric studies revealed an increase in surface areas of resorption, the diagnosis of PD being based upon the finding at several successive investigations, in the absence of any drug treatment, of a phosphorus clearance of greater than 20 ml/min and/or a phosphorus reabsorption level of less than 80%. Arterial HC03 levels of greater than 21 mEg/l and a fractional bicarbonate excretion (FBE) of greater than 15% enabled the diagnosis of bicarbonate diabetes (proximal tubular acidosis). These cases of PD and BD appeared to be secondary to proximal tubulopathies for which no known etiology was found.

Acidosis, Renal Tubular↗
PubMed1992

[Lower limb arteriopathy and male osteoporosis].

There are close links between bone metabolism and bone circulation. Osteoblasts are derived from the walls of the venous sinuses. As shown by Burkardt, osteoporosis is accompanied by a decrease in the number of intra-osseous capillaries, and intra-osseous arterioles may be the site of arteriosclerosis lesions. In order to determine the existence of a possible link between arteriosclerosis and male osteoporosis, the etiology of which is often poorly defined, the authors studied phosphorus-calcium balance, X-rays of the spine, and bone density of the spine and the femoral neck in 17 male arterial disease sufferers with a mean age of 61 and at Leriche stage 2, 3 or 4. These 17 patients were compared with 15 age-paired controls. Wedge fractures, absent in the control group, were seen in 9 of the 17 patients. Bone mineral content in the femoral neck was significantly reduced in the arterial disease group.

Arteriosclerosis↗
PubMed1991

Side-effects of fluoride therapy.

Fluoride stimulates bone formation and is used in the treatment of vertebral osteoporosis. Epidemiological and experimental studies have shown that fluoride bone is denser but not always stronger than normal bone, and the main side-effects attributed to this drug involve bone tissue. True fractures, with cortical rupture, are few (near 5%); their rate seems to correspond to that generally found in osteoporotic patients without treatment. On the other hand, stress fractures and arthralgia of the lower limbs are much more frequent (near 30%), but they often follow a benign course. Digestive tolerance of fluoride is now good, improved by the introduction of gastro-resistant industrial galenicals. However, the question of whether the risk/benefit ratio is positive is always under discussion.

Bone and Bones↗
PubMed1991

Isolation from Candida albicans of a functional homolog of the Saccharomyces cerevisiae KRE1 gene, which is involved in cell wall beta-glucan synthesis.

The KRE1 gene of Saccharomyces cerevisiae, sacKRE1, appears to be involved in the synthesis of cell wall beta-glucan. S. cerevisiae strains with mutations in the KRE1 gene produce a structurally altered cell wall (1----6)-beta-glucan, which results in resistance to K1 killer toxin. We isolated the canKRE1 gene from Candida albicans by its ability to complement a kre1 mutation in S. cerevisiae and confer sensitivity to killer toxin. Sequence analysis revealed that the predicted protein encoded by canKRE1 shares an overall structural similarity with that encoded by sacKRE1. The canKRE1 protein is composed of an N-terminal signal sequence, a central domain of 46% identity with the sacKRE1 protein, and a C-terminal hydrophobic tract. These structural and functional similarities imply that the canKRE1 gene carries out a function in C. albicans cell wall assembly similar to that observed for sacKRE1 in S. cerevisiae.

Amino Acid Sequence↗
PubMed1991

[Late myopathies located at the spinal muscles: a cause of acquired lumbar kyphosis in adults].

A primary myopathy limited to the spinal muscles and of late onset was suspected in 14 patients with a mean age of 66. These patients had an anterior inflection of the trunk and were unable to rotate the lumbar spine on the pelvis. This incurvation of the trunk, starting at around age 60, was reducible in a horizontal position and increased with tiredness. The CT scan appearance of the spinal muscles of these patients was hypodense and heterogeneous, different from the atrophy found in the elderly with lumbar osteoarthrosis, comparable with the lesions described in primary myopathies. Histologically, lesions of fibro-adiposis were major, accompanied by mitochondrial abnormalities. The frequent existence of a family history would be in favour of a genetically transmitted condition.

Aged↗
PubMed1991

[Narrow cervical canal and lumbar canal. Frequency of the association, role of hyperostosis].

The authors undertook a retrospective study involving 47 records of patients hospitalised for cervical myelopathy as the main clinical feature (n = 17) or symptomatic narrow lumbar canal (n = 30). Nine of these patients had clinical signs of both cervical myelopathy and of narrow lumbar canal, 10 of the 17 patients with a cervical myelopathy had lumbar stenosis as shown by midline sagittal tomography and/or CT scan, 9 of the 30 patients hospitalised for symptomatic narrow lumbar canal had cervical stenosis as shown by midline sagittal tomography, 13 of these 19 patients with both cervical and lumbar stenosis had enveloping vertebral hyperostosis.

Cervical Vertebrae↗
PubMed1991

Phosphate diabetes associated with bone metastases of oat cell lung cancer.

Although the link between phosphate diabetes and neoplasm or benign mesenchymal tumors has been well documented, the nature of the phosphaturia factor remains unknown. We describe two cases of phosphate diabetes associated with bronchogenic cancer. In these case reports, we suggest that fibroblasts or osteoblasts synthesize a phosphate eliminating substance.

Aged↗
PubMed1991

Maintenance treatment with recombinant alpha interferon after autologous bone marrow transplantation for aggressive myeloma in first remission after conventional induction chemotherapy.

Twenty patients (median age 57 years) with high tumor mass myeloma in first remission after conventional chemotherapy received a two-phase treatment: autologous bone marrow transplantation (ABMT) using a preparative regimen of high dose melphalan plus total body irradiation followed by maintenance treatment with recombinant alpha interferon. Before ABMT all patients were in partial remission, while after ABMT 10 (50%) achieved complete remission, and 10 remained in partial remission (with a 90% decrease in measurable paraprotein in 7/10). With a median follow-up of 19.8 months (12.2-33.5) after diagnosis and 13 months (4-25) after ABMT, the Kaplan-Meier 2-year post-ABMT probability of progression-free survival was 85% (95% CI = 58.7-95.8%). None of the 10 patients in complete remission has relapsed. No toxic death occurred. Alpha interferon was introduced early after ABMT (2.7 months) and was well tolerated. This strategy may represent an advance in the management of aggressive myeloma.

Adult↗
PubMed1991

[Association of lumbar canal stenosis and ankylosing vertebral hyperostosis. Results of a multicenter study].

The authors report data collected in a study of the association of narrow lumbar canal and vertebral hyperostosis. Five centres (Montpellier, Toulouse, Lille, Lyons and Paris) participated in this cooperative study which was both retrospective and prospective. Grid case forms were sent to homogenise the date provided. Two hundred and sixty nine cases of symptomatic lumbar canal stenosis were collected; 89 (33 per cent) had hyperostosis. Hyperostosis was definite in 74 cases and probable in 15 other cases. Certain radiological and/or CT scan morphological factors seen frequently in the hyperostosis patients group led us to undertake a second study in 2 of the 5 centres (Montpellier and Toulouse) in order to identify their specificity. Twenty eight items were adopted and studied by 3 different evaluators (2 rheumatologists and one radiologist) in the X-ray films and CT scan documents of 100 patients with acquired lumbar canal stenosis with or without hyperostosis (46 and 54 cases respectively). The most discriminative appearances, which we suggest as diagnostic criteria of narrow lumbar canal with hyperostosis concern anterior and/or posterolateral marginal somatic bone proliferations on the non-articular surfaces of the posterior apophyses and ossifications of the posterior joint capsule and of the ligaments (ligamentum flavum--posterior longitudinal ligament--supraspinous ligament). Four of these 6 criteria are necessary to make the diagnosis of lumbar stenosis with hyperostosis. The radiological and CT scan appearances of lumbar hyperostosis appear to differ from ordinary degenerative changes of osteoarthrosis and hyperostosis may be held responsible for compression of the dural cul-de-sac.

Humans↗