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Biomedical subjects

J Pasquier

Publications and source records attributed to J Pasquier.

At least 19 recordsLinked to original sources
PubMed1994

[Pilot study of screening of prostate cancer by the assay of prostate specific antigen in occupational milieu].

The goal of this study was to confirm the capacity of occupational medicine to become involved in cooperative screening programs with a dosage of the PSA (Prostate Specific Antigen) determined by immunoradiometric assay. Two thousands and five hundred seventy three salaried workers in the building sector, between 50 and 65 years old, participated in this investigation. Thirty seven individual ie 1.4% had a PSA level above or equal to 10 micrograms/l. Among them, 35 were checked within three months and 17 were found to have a persistently elevated PSA level. In this subgroup 15 pathologies including two cancers were found. We observed a great variability in the results of PSA determination in the groups of individuals whose initial assay level was above or equal to 10 micrograms/l. The linear correlation coefficient between the two assays (on the same individual), carried out at a six week interval on average, was low (r = 0.52 for N = 35). In our series, 3.5% of patients followed up had undergone a rectal examination less than a year previously. Occupational medicine seems to be an efficient setting for screening intervention. However, the people mainly concerned by our study, (salaried workers seen through the physicians interviewed) did not seem very aware of this type of action.

Adult↗
PubMed1991

[Surveillance of renal function by scintigraphy with 99m Tc-DMSA after a trans-ileal cutaneous ureterostomy].

The renal function of sixty one adult patients was monitored by 99mTc-DMSA renal scan after cystectomy for a malignant tumour followed by ileal conduit urinary diversion. The postoperative follow-up period was 10 years. The stenosis rate of the uretero-ileal anastomosis was 12.8% and the incidence of pyelonephritis was 8% The mean value for overall renal function and for the function of each kidney did not deteriorate significantly (p = 0.1 and p = 0.7, respectively) over time. However, 26% of kidneys evaluated at 1 year and at 5 years showed a markedly decreased uptake on the renogram. In 70% of cases, this decreased uptake was related to the development of stenosis of the uretero-ileal anastomosis or pyelonephritis. Renal function remained stable at 5 years in group A, corresponding to patients with good initial renal function (n = 22, p = 0.07), and in group B, corresponding to patients with poor initial renal function (n = 7, p = 0.9). Similarly, the function of solitary kidneys did not deteriorate over the 5-year postoperative follow-up period (n = 7, p = 0.5). The functional value of the kidneys was therefore not globally altered after ileal conduit urinary diversion. The existence of a mechanical or infectious complication should be systematically investigated in the presence of a deterioration in renal function. DMSA isotope renal scan is a complete, qualitative and quantitative, follow-up examination after this type of urinary diversion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Immunogenetics of Horton's disease and of rhizomelic pseudo-polyarthritis].

The etiopathogenesis of temporal arteritis and rhizomelic pseudo-polyarthritis still remains undefined. A genetic predisposition would seem probable in view of epidemiological data (higher frequency in white caucasian races and in certain countries), the existence of rare familial forms (25 families reported), and the significant increase in incidence in unconnected cases with HLA DR4 antigen (6 studies). Environment may intervene as a precipitating factor in the condition and the role of an infectious agent, to account for the seasonal incidence of this disorder and the rare existence of cases in non consanguineous couples, has been suggested but remains unproven. Disordered immune function probably plays an essential role in the creation of the vascular histological lesions characteristic of the condition. The disordered function involves cellular immunity (fall in OK T8. in blood) and especially humoral immunity with the very frequent presence of circulating immune complexes in the serum and deposition of immunoglobulins and complement at arterial wall level.

Antibody Formation↗
PubMed1988

Systematic association of PAP and PSA determinations to bone scintigraphy in prostatic cancer.

Prostate-specific antigen (PSA) was compared to prostatic acid phosphatase (PAP) in patients with prostatic cancer suspected to have bone metastases. Bone scans were classified according to metastatic skeletal involvement. The sensitivity of PSA in predicting the presence of metastatic disease (68%) was better than that of PAP (53%). Specificity was 79% for PSA and 90% for PAP. Thirty-five patients had a positive PSA level and a normal scintigraphy (false-positive); 14 of them had only endoscopic prostate resection. Thirty-eight patients underwent a further exploration 3-18 months later. PSA level during disease was correlated to scintigraphy in 32 of 38 patients.

Acid Phosphatase↗
PubMed1988

[Subclavian and axillary arteritis in Horton's disease and rhizomelic pseudopolyarthritis. 10 cases].

Ten patients aged from 60 to 73 years presenting with Horton's disease or polymyalgia rheumatica had arteritis of the upper limbs. Asymptomatic abolition of pulse in the upper limbs (1 case) or claudication at rest or exercise (9 cases) and/or Raynaud's phenomenon (5 cases) preceded (4 cases) or accompanied (1 case) the discovery of giant cell arteritis, or complicated the reduction or discontinuation of corticosteroid therapy. Diagnosis rested on the regular association of an inflammatory syndrome with multiple arterial tapered stenoses and/or arterial thrombosis in the post-vertebral subclavian, axillary or brachial arteries and, chiefly, on the demonstration (in 7 cases) of a giant cell granuloma at biopsy of the temporal artery. Corticosteroid therapy (1 mg/kg/24 h in 8 cases and 0.5 mg/kg/24 h in 2 cases) initially combined with anticoagulants in 4 cases resulted in rapid regression of ischaemic and systemic signs in all patients, thus avoiding surgical revascularization of the upper limbs.

Aged↗
PubMed1987

[Re-permeation of deep venous thrombosis of the lower extremities: comparison between plethysmographic indices and phlebography scores. Preliminary results].

A prospective study, now pursued, has the aim of determining anatomical features (permeability of deep venous trunks and/or development of a collateral venous circulation) related to improvement in plethysmographic indices and comparing these with phlebographic data. Twelve patients have been investigated by occlusive plethysmography and bilateral phlebography of lower limbs on the day of diagnosis, after 10 days of heparin therapy and after 6 months of antivitamin K anticoagulant treatment started on the 11th day. Whereas a progressive improvement in plethysmographic indices and phlebographic scores exists during the course of treatment, no correlation has been observed between plethysmographic indices and degree of phlebographic obstruction. This suggests that the emptying rate indices cannot be considered as an absolute criterion for the decision to discontinue anticoagulant therapy.

Collateral Circulation↗
PubMed1987

[Involvement of arterial trunks of the upper limbs in giant cell arteritis. Apropos of 7 cases].

On 91 patients with temporal arteritis (TA) and/or polymyalgia rheumatica (PMR), we observed 7 females aged 62 to 73 years with upper extremities ischemia. Arm claudication and/or Raynaud's phenomenon were the initial manifestations of the disease in 2 cases, or appeared simultaneously with other symptoms in 2 cases, or complicated decreasing corticosteroid therapy in 3 cases. A temporal artery biopsy was performed on 6 patients with, in all of them, typical giant cell granulomatous arteritis pathology findings. Angiograms showed, in all cases, multiple bilateral smooth stenosis and/or obliterations of post vertebral subclavian arteries and/or axillary arteries. Symptoms always improved on corticosteroid treatment and no patient needed reconstructive surgery. In conclusion, large arteries involvement, which can occur in TA and/or PMR, affect in our experience most commonly the subclavian and axillary arteries, with female predominance as found in Takayasu's arteries. These disorders should be considered in cases of occlusive disease of the arms in elderly women and the response to steroids is usually adequate to eliminate the need for early surgical intervention. Early recognition of asymptomatic large artery involvement by Doppler evaluation, in all TA and/or PMR patients, and transient anticoagulant therapy might prevent vessels occlusions.

Aged↗
PubMed1986

[Long-term improvement of exercise performance in patients with activity-dependent pacemakers].

Exercise performance after implantation of the pacemaker with physical activity dependent pacing rate (Activitrax, Medtronic) was assessed by treadmill tests one month afterwards in 10 patients and a further 6 months later in 6 of them, who had long been VVI pacing dependent (reimplantation subgroup). In the 1 month test exercise performance had improved in 7 of 10 in activity pacing mode compared to VVI mode. After 6 months of physical activity dependent pacing the patients in the reimplantation subgroup showed an improved exercise test in VVI mode compared to the 1 month test in VVI mode. In activity pacing mode there was an additional improvement (increase of exercise duration from 12.1 +/- 2.5 to 14.5 +/- 2.7 min, p less than 0.005, and of accumulated work from 31.1 +/- 15.1%, p less than 0.002) compared to the VVI mode. Since Activitrax PM allows better exercise performance at longterm follow-up, it becomes a pacing mode of choice when double chamber pacing is impossible.

Adolescent↗
PubMed1986

[X-ray computed tomography in central pontine myelinolysis. 2 cases].

Two cases of central pontine myelinolysis were studied by computerized tomography (CT). One patient had chronic alcoholism, the other porphyria variegata; both initially presented with water-and-electrolyte disorders, notably hyponatraemia. The neurological disorders consisted of acute pseudobulbar syndrome which totally regressed within 15 days to 1 month. CT demonstrated a low density area in the pons, extending to the mesencephalon in one case. Despite clinical cure, this low density persisted for 16 and 20 months respectively, counting from the onset of neurological symptoms. In central pontine myelinolysis, CT images only are of diagnostic value in cases with suggestive neurological symptoms and aetiology. CT can recognize minor forms of the disease and confirms that in some cases severe forms may follow a regressive course.

Adult↗
PubMed1986

[Study of 2 markers, keratin and neuron-specific enolase, in bronchial cancers].

In an immunohistochemical study 31 patients with bronchial cancer (squamous cell 9, large cell 4, small intermediate cell 11 and oat cell 7) were investigated for keratin and NSE. Keratin seems to be a valuable marker since only oat cell cancers and 45% of small intermediate cell cancers were negative. In contrast, marking with NSE seems to be non-discriminating. The low value of NSE as marker was confirmed by 133 serum NSE assays performed in 39 bronchial cancer patients. Although NSE values were significantly higher in oat cell cancer, in any given patient serum assays can, at best, detect relapses.

Bronchial Neoplasms↗
PubMed1986

[Pulmonary metastases of a placental choriocarcinoma].

Pulmonary metastases of a placental choriocarcinoma are common but they are rarely the presenting factor, and whenever there are pulmonary metastases in a young woman a systematic search is required. We report on 7 cases and emphasize several important points. The diagnosis rests on the level of Beta H.C.G. One should be cautioned about transparietal aspiration or fibreoptic biopsy in view of the haemorrhagic nature of the lesion. An extensive work-up should be performed before classifying patients as low, medium or high risk as on this will determine the type of chemotherapy, either monotherapy with Methotrexate or polychemotherapy. The duration of treatment will depend on the clinical, radiological and biological outcome.

Adult↗
PubMed1985

Clinical comparison of 99mTc-HMDP and 99mTc-MDP. A multicenter study.

99mTc-Hydroxymethylene diphosphonate (HMDP) was compared to 99mTc-methylene diphosphonate (MDP) with respect to image quality, lesion detectability, and the uptake ratios of normal bone to soft tissue (B/S), metastatic bone to soft tissue (M/S) and bone metastases to normal bone (M/B) at 2 and 3 h after injection in the same subjects. Thirty-three patients with bone metastases were examined in six nuclear-medicine departments, with each center using its usual bone-scanning protocol which was identical for both compounds in the same patient. The uptake of 99mTc-HMDP in normal bone (B/S) was significantly higher than that of MDP at 2 and 3 h, but there were no significant differences between the two compounds with regard to the M/S or M/B ratios. The M/B of HMDP at 2 h was not significantly different from that of MDP at 3 h, the latter showing a significantly higher B/S and M/S ratio. All lesions were detected with both compounds, even at 2 h. The image quality was rated as follows (in decreasing order): HMDP (3 h), MDP (3 h), HMDP (2 h), and MDP (2 h). HMDP was shown to be a useful bone-imaging agent, especially when shorter intervals between injection and recording are required.

Adult↗
PubMed1985

[The fate of patients with carotid stenosis. Comparative study, based on the literature, of their natural history and evolution under medical treatment or following endarterectomy].

The aim of therapy of carotid artery stenosis is to reduce the number of cerebral ischemic accident complications, but marked uncertainty exists at the present time as to the spontaneous course of these stenotic lesions and the efficacy of the different treatments proposed. After a transient ischemic accident (TIA) there is a 37% risk of a vascular accident (CVA) of a more definite type occurring within 5 years but only 1/4 of these patients die of cerebral complications, death in half of the cases being of coronary origin. Very rapid treatment with anticoagulants after TIA slightly diminishes the number of established cerebral ischemic accidents, but increases the risk of cerebral hemorrhage. Among the anti-aggregant agents, only Aspirin at high dosage (1 to 1.3 g/24 h) appears to be effective in preventing relapses of TIA and/or of CVA and/or on mortality which results from it. Carotid endarterectomy after TIA does not alter long-term survival, dependent on the increased cardiac mortality, but appears to reduce markedly the long-term recurrence rate of TIA and/or CVA. Globally, however, benefits of surgical treatment can be obtained only if post-operative cerebral mortality and morbidity are extremely low, conditions obtained in highly specialized centers only. Spontaneous course of angiographically detected asymptomatic stenosis shows, for a mean 4-year survival, a relatively low level of TIA (3,3 to 19%) and of CVA (0 to 12%) whatever the anatomic type of the stenosis. Prophylactic endarterectomy in practised hands has a low operative mortality (0 to 2%), a limited perioperative cerebral morbidity (1.3 to 4.5%) and a satisfactory later relapse rate of CVA (less than 5% at 4 years). These findings indicate comparable courses for spontaneous and treated cases globally, as well as with respect to cardiac mortality. In the absence of randomized trials it is a controversial point as to whether carotid surgery is superior to a spontaneous course in cases of asymptomatic stenosis.

Anticoagulants↗