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Biomedical subjects

J C Rénier

Publications and source records attributed to J C Rénier.

At least 19 recordsLinked to original sources
PubMed1995

A new anatomic index based on current knowledge for calculating the cumulative percentage of pagetic bone per subject and other parameters.

New data provided by dual-energy X-ray absorptiometry, together with discordances between Howarth's and Coutris' tables for estimating the percentage of bone tissue affected with Paget's disease in a given individual, prompted us to reevaluate the percentage of bone tissue contained in each segment of the skeleton. We weighed each bone in the skeleton of a 30-year-old male, calculated weight ratios from a collection of 48 bones, performed dual-energy X-ray absorptiometry measurements in 22 patients using a Hologic QDR 2000 apparatus, and obtained information from a company that supplies medical schools with human skeletons. We used these data to develop a new anatomic index. The percentage of bone tissue in the skull was 17 in males and 21 in females versus only 11 in Howarth's table; differences were also found at other sites, including the spine (8.5% versus 11%), the femur (9.5% versus 8%), the sacrum (2% versus 3%), and the ribs (5% versus 9%). Our index is useful for calculating the percentage of pagetized bone (i.e., bone in which pagetic lesions develop during follow-up) but underestimates the total percentage of pagetic bone because of the increase in bone mass associated with Paget's disease.

Absorptiometry, Photon↗
PubMed1995

Current prevalence of Paget's disease of bone in a region of France (Anjou).

To study the prevalence of Paget's disease in a region of France (Anjou) we conducted a two-part study. 1) One hundred randomly selected medical records of Paget's disease patients managed in a rheumatology department were studied to determine the rates of occurrence of pagetic lesions at each skeletal site. Availability of a radionuclide bone scan done before treatment initiation and of radiographs of hyperactive areas was required for inclusion into the study. In 91% of patients, pagetic lesions were visible on the lumbar spine-pelvis-femoral head film. 2) We looked for pagetic lesions on intravenous urograms done in 600 urology department patients (to minimize recruitment bias). The 307 males and 293 females had a mean age of 65.4 +/- 8.7 years (range 50-91). Films classified by the evaluator as showing definite or doubtful pagetic lesions were read by five other evaluators in a blind manner. Among the 11 patients (seven males and four females) found to have Paget's disease, only one was younger than 65 years. Prevalence was higher in males (2.50 +/- 0.79% than in females (1.50 +/- 0.5%). These prevalences are lower than those reported in the United Kingdom.

Aged↗
PubMed1994

[Osteomyelitis in the pagetic tibia].

Osteomyelitis developing in pagetic bone is a very rare event, of which only one instance has been reported to date, in a patient with mandibular disease. We have managed three patients with osteomyelitis of a pagetic tibia. The portal of entry was a skin lesion in all three cases. A Gram-negative organism was found in all three cases and was associated with the anaerobe Bacteroides melaninogenicus in one case. One of the patients was lost to follow up before eradication of the infection. Amputation was required in the other two after unsuccessful antimicrobial therapy for 23 and four years, respectively.

Aged↗
PubMed1993

[Transient painful lumbar blocks].

Recurrent painful locking of the lower back is suggested as an appropriate term for designating sudden episodes of jabbing low back pain with locking of the spine occurring in the absence of unusual exertion, resolving within one or two minutes, and recurring many times over several weeks or months. This retrospective study included 20 outpatients classified as having recurrent painful locking of the lower back between 1978 and 1992. Inclusion criteria were availability of roentgenograms taken at the time of the acute symptoms and a follow-up of at least two years. Two typical cases are reported with diagrams to show the timing of recurrent painful locking of the lower back with respects to other low back symptoms. Mean age at onset was 56 years. Seventy per cent of patients were females. A 10-year to 30 year history of lumbago was found in every case. Recurrent painful locking of the lower back occurred substantially later than lumbago suggesting that it denoted more advanced damage to the lumbar spine. Pathophysiologic hypotheses are discussed: the causative lesion may be a mobile flap at the posterior aspect of the anulus. In most patients, the symptoms resolved within six months.

Adult↗
PubMed1991

[Bone density in idiopathic hypercalciuria in men. Study by dual photon absorptiometry, X-ray computed tomography and histomorphometry].

Lumbar bone mineral density (BMD) of the L3 vertebra was evaluated by double photon absorptiometry or tomodensitometry (TDM) in 55 hypercalciuric individuals in two separate studies. In the first, in a department of nephrology, 29 lithiasis patients were studied by TDM of L3. By this technique, trabecular density was 75 +/- 23% of normal. It was lower in the 17 patients in whom hypercalciuria persisted after calcium restriction (66 +/- 15% of normal and below the "fracture threshold" in 9 cases) than in the 12 patients in whom it disappeared after the prescription of such a diet (88 +/- 26%, below the "fracture threshold" in 3 cases), this difference being significant (p less than 0.01). In another 26 patients, seen in a department of rheumatology, three of whom had osteoporosis with vertebral fracture, density was measured in 21 cases by double photon absorptiometry (mean Z score -1.9 +/- 1.0) and in 5 cases by TDM (mean BMD of L3 69 +/- 21% of normal). Mean iliac trabecular volume, measured in 8 cases only, was 70 +/- 25% of normal and was below the "fracture threshold" in 3 cases. Comparison of the two study groups was not possible because of differences in recruitment and methods of investigation. These two studies nevertheless show the existence of significant vertebral bone rarefaction during hypercalciuria in the young man. Confirmed and quantified in patients in whom the metabolic disturbance was discovered as a result of radiological abnormalities, this quantitative abnormality was also seen in patients in whom hypercalciurie was found because of renal lithiasis.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1987

[Ankylosing panarthritis].

The authors report 4 cases of "Sheathing Panarthritis" (S.P.): two female patients with a positive rheumatoid serology, presented a complete ankylosis of the articular system, including the temporo-mandibular joint and the spine; two male patients presented a complete articular ankylosis of the lower extremities and a more or less total spine ankylosis, by only a slight involvement of the upper extremities. The study of the HLA system, carried out in ten cases--3 in this series--showed the presence of B27 in six cases, and the presence of A2 in five cases out of eight. A single study of locus DR revealed the presence of DR 1. On the nosological point of view, this radio-clinical picture, individualized by Forestier, was successively considered as an autonomous affection, a rheumatoid polyarthritis (P.R.), an ankylosing spondylarthritis (AS). The author's opinion is dual since, from the analysis of the cases, they do not feel that it is possible to classify all cases either with P.R. or with A.S. After studying the various radio-clinical aspects of P.R., they believe that, in patients with S.P., it exists an ankylosing "factor X" which exacerbates the ability of P.R. and A.S. to manufacture sclerosis, transforming these diseases into S.P.

Adult↗
PubMed1987

[A case of very destructive dorsal spondylodiscopathy surgically treated in ankylosing spondylitis complicated by amyloidosis].

An ankylosing spondylarthritis was complicated by a D9-D10 spondylo-discopathy, with severe destructive alterations. After strict immobilization for three months, when the lesions partly regressed, non-steroid anti-inflammatory (NSAI) drugs were unable to cause a cure. An excellent result was obtained with a surgical arthrodesis after 5 years. The vertebral location was filed with fibrous tissue. The patient died from an amyloid disease with renal insufficiency. The presence of amyloid tissue in the vertebral location did not prevent a good healing of the vertebral arthrodesis.

Adult↗
PubMedDate not supplied

[Evans' syndrome caused by D-penicillamine in rheumatoid arthritis. Value of the corticoids-danazol combination].

The authors report the development of thrombocytopenia purpura in one patient with seropositive and erosive rheumatoid arthritis treated successfully for 11 months with D-penicillamine. Anti-platelet-bound antibodies were present, but also: anti-erythrocyte antibodies with hemolytic anemia (then defining Evans's syndrome): higher level of antinuclear antibodies; intermittent neutropenia. The responsibility of D-penicillamine is discussed, but thrombocytopenia purpura evolved for itself. Glucocorticoids alone, intravenous immunoglobulin, vincristine did not induced remission, which at least occurred under the association danazol-glucocorticoids, without toxicity, especially on the liver function.

Anemia, Hemolytic, Autoimmune↗
PubMedDate not supplied

[Palindromic rheumatism. Immunologic survey and study of development in 43 cases].

43 patients (18 females, 25 males) presenting palindromic rheumatism were given follow-up examinations after a mean lapse of 14.75 years. 16 subjects still presented palindromic rheumatism and of these six showed complete remission. 27 patients had developed chronic inflammatory rheumatism after seven years (mean value) of palindromic rheumatism, but resolution of PR was seen in four cases. Male predominance was more marked in the palindromic subgroup (PAL) but was also seen in the subgroup of subjects who had developed PR (PAL-PR). Laboratory tests demonstrated a constant homogeneous increase in immunoglobulins (notable IgAs) and in the T4/T8 ratio in the PAL and PAL-PR subgroups. Rheumatoid serodiagnostic tests were positive significantly more frequently in the PAL-PR subgroup, which also comprised a high proportion of cases of erosive arthritis. Overall the frequency of HLA-DR 4 antigen did not increase in the subjects studied. Subjects in the PAL subgroup (cf. PAL-PR subgroup) were characterized by a twofold increase in frequency of DR 5 antigen, with a relative risk of 3.5 to 4.5, a significant increase in B35 and B5 and a clear decrease in B12.

Adult↗
PubMedDate not supplied

[The natural development of osteoporosis. 30 patients with a median follow-up of 11 years].

The authors present a sketch of the natural development of osteoporosis based on a retrospective study over a mean period of eleven years of 30 osteoporotic subjects (23 females, 7 males) who had received little or no treatment. Development was rapid during the three years following diagnosis, as was shown by the annual number of attacks of acute spinal pain, months of functional handicap and vertebral compression fractures, as well as by changes in size and the two vertebral radiologic indices used. Development slowed after the fourth year, but subsequent deterioration was unaffected. This spontaneous change seemed to depend less on etiological factors than on a decrease in bone mass to below the threshold at which fractures may develop. Slowed development of osteoporosis after the fourth year appeared to be due to an adaptation of the subject's way of life to the fragility of the spine. The results of treatment and monitoring of three years or less should be viewed in light of this slowed osteoporotic development.

Activities of Daily Living↗