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Biomedical subjects

M Malarme

Publications and source records attributed to M Malarme.

18 recordsLinked to original sources
PubMed2001

[AL amyloidosis].

AL amyloidosis is a systemic disease caused by the deposition of fibrillar proteins in organs and tissues. These deposits are responsible for organic dysfunctions and may be rapidly lethal. Current therapy is unsatisfactory. We describe three clinical cases of multisystemic AL amyloidosis but with different initial presentation: nephrotic syndrome, cardiac failure and hepatic insufficiency. We review the literature about the clinical features, diagnostic methods and treatment of the disease.

Aged↗
PubMed1996

[Pneumopericardium: a race against time! Case report and literature review].

An 81-year-old woman without any known previous disease was admitted for epigastralgia, nausea, vomiting and anorexia since 15 days. The investigations disclosed a pneumopericardium which was caused by the perforation of a gastric ulcer, situated on the collar of an hiatal hernia. A pericardial drainage and a suture of the ulcer were performed, but the patient could not be saved. Despite an optimal treatment composed of pericardial drainage, specific surgery and intensive care, the mortality rate of pneumopericardium is still around 50% proving the severity of this illness.

Aged↗
PubMed1992

Bone marrow scintigraphy in lung carcinomas using nanosized colloids: when is it useful and how useful is it?

Bone marrow scintigrams (MS) combined with single photon emission computed tomographic investigation of the liver (liver SPECT) were obtained using 99Tcm-labelled human serum albumin nanosized colloids in 52 patients with histologically proven lung carcinomas (adenocarcinomas = 17, squamous cell = 16, small cell = 14, large cell = 5, 31 generalized cases at the time of the first MS investigation among whom 13 patients had proven skeletal metastases). They were compared with conventional bone scintigrams (BS) as well as clinical, biological, radiological and follow-up data obtained for the same patients. In the present series, MS appeared as sensitive as BS in diagnosing skeletal metastases (77%) if all abnormal MS and BS presentations are considered as diagnostic, but more sensitive (77% versus 54%) if more restrictive analytical criteria are applied. The two investigations yielded the same specificities whatever the analytical criteria applied. These preliminary conclusions have, however, to be confirmed on larger populations than the present series. The most striking differences between BS and MS were observed in the case of small-cell lung carcinomas, with more lesions detected by MS than by BS. Liver SPECT also made it possible to diagnose seven and to suspect one out of the ten situations of hepatic metastases. The combination of liver spect and MS in the framework of a single injection of 99Tcm-labelled nanosized colloids thus allowed us to diagnose 80% of the patients with osseous and/or hepatic metastasis or 40% of all generalized cases.

Adenocarcinoma↗
PubMed1992

[Solitary splenic metastasis of endometrial adenocarcinoma. A case report and review of the literature].

The authors report one case of solitary metastatic endometrial carcinoma of the spleen. Carcinomatous metastatic involvement of the spleen usually indicates widespread malignant disease. Solitary metastatic lesions in this organ are exceedingly rare and the literature reveals up today only three cases having a endometrial origin. The authors take this opportunity to make a review of the literature.

Adenocarcinoma↗
PubMed1991

Bone marrow scintigraphy in prostatic carcinomas.

Bone marrow scintigrams (MS) were performed on 73 men with histologically proven prostatic carcinomas. Follow-up data were available in 24 cases. Thirty-six patients had skeletal metastases at the time of the first MS investigation. They were compared with conventional bone scintigrams (BS) as well as clinical, biological, radiological and other follow-up data obtained for the same patients. At the present stage of revision and of follow-up of our patients, MS appeared less sensitive than BS in diagnosing skeletal metastases (94% as against 100% if all abnormal MS and BS presentations are considered as diagnostic or 83% as against 86% if more restrictive analytic criteria were applied). On the other hand, MS showed slightly higher specificity (81% for MS as against 73% for BS) when all abnormal MS and BS presentations are considered as diagnostic. With more restrictive diagnostic criteria, BS remains more specific (100%) than MS (87%). Nevertheless, the likelihood of bone metastasis is low when a normal MS is found in case of dubious BS situations, but high when the MS is pathological. In 11 patients with skeletal metastasis for whom follow-up investigations were available, MS appeared better than (4 cases) or equivalent to (6 cases) BS for evaluating the responses and the ultimate evolution of the disease. Marrow scintigrams are thus a useful tool in cases of dubious BS and for evaluating the response of skeletal metastasis to treatment.

Aged↗
PubMed1989

Bone marrow scintigraphy in breast cancer.

Bone marrow scintigrams (BMS) have been performed in 101 women with histologically proven breast cancer (36 stage IV among them at the time of the first investigation, follow-up examinations available in 41, disease evolution observed in 17). They have been compared to conventional bone scintigram (CBS) as well as to radiological, clinical, biological and follow-up data obtained in the same patients. Only three (7.4%) out of the 41 patients with radiologically or/and histologically proven skeletal metastasis had normal BMS and 33 had corresponding bone marrow scintigraphic defects (BMS ++). On the other hand, only three patients of the 32 with normal BMS had documented skeletal abnormalities. Abnormal bone marrow extension, observed in 61.4% of the patients (62/101), seems to represent a reaction of the reticulo-endothelial system to the disease dissemination - even microscopic - and, as such, to have prognostic implications. As BMS demonstrated skeletal invasion earlier or more precisely than CBS in ten cases, the technique appears of value and of interest in breast cancer management.

Adult↗
PubMed1985

Phase I-II evaluation of carminomycin in adults with acute leukemia.

Twenty courses of carminomycin were administered to 18 evaluable adult patients with acute leukemia (14 ANLL, 2 ALL, 2 CGL-BC). All but one received daily doses of 6-14 mg/m2 for 5 consecutive days. Two patients older than 60 yr had not prior chemotherapy and the others had refractory or relapsed disease. The median age was 60 yr. Three ANLL patients achieved complete remission for 8, 9 and 9 months respectively, with no maintenance therapy. None of these had proven clinical resistance to daunomycin and/or doxorubicin. Mucositis was dose-related and dose-limiting. Nausea and vomiting were rare. Alopecia was constant. Cardiac arrythmia was ascribed to carminomycin in two patients. One episode of cardiac failure seemed clearly drug-related and recovered with symptomatic treatment. In conclusion, encouraging antileukemic activity was observed with carminomycin in poor-risk patients. At doses up to 12 mg/m2 day X 5, extramedullary toxicity remained acceptable.

Acute Disease↗
PubMed1982

Scientific basis and criticism of current therapy of acute leukemia.

The factors which are thought to determine the response of acute leukemia (AL) to therapy are: 1) tumor size 2) drug dose 3) sensitivity to drug, 4) scheduling of drugs and 5) suppression of normal hemopoiesis. Each of these factors is considered in terms of the scientific data supporting their importance. Inability to measure the size of the tumor mass during all phases of treated AL continues to weaken rational strategies for therapy especially maintenance chemotherapy. Increasing the drug dose improves cell kill and potentially the cure rate up to the limits of toxicity. These limits may be extended by bone marrow transplantation. Various systems to study the drug sensitivity of leukemic cells are in experimental use, including stem cell assays but as yet they do not give a guide to altering therapy. The scheduling of multiple drugs is designed to increase cell kill by recruitment into the cycle, but "sanctuaries" appear to exist for resting cells. The suppression of normal hemopoiesis apparently due to leukemia-associated inhibitors is associated with favorable prognosis in childhood ALL but use of this information to improve treatment protocols is still unclear.

Acute Disease↗
PubMed1980

Treatment of brain giomas with high dose of CCNU and autologous bone marrow transplantation.

Seven patients with recurrent brain gliomas were treated by a single dose of CCNU 390 mg per m2. In five cases, chemotherapy was followed by autologous bone marrow transfusion containing 1.5 to 3 X 10(8) nucleated cells, 2.8 to 18 X 10(4) clusters plus colonies and 0.4 to 5 X 10(4) colonies forming cells per kg of body weight. Two patients were not grafted. None of these patients showed a clear cut response to the treatment as judged by clinical improvement and changes of the brain CT-scan. In 3 patients blood toxicity occurred early and was severe. In 4 others, it was milder and delayed. The duration and the severity of blood toxicity were modified by bone marrow transfusion but only slightly.

Bone Marrow Transplantation↗
PubMedDate not supplied

[Paraneoplastic gastroparesis].

A 53-years-old woman with bilateral untreated breast cancer is admitted for intractable vomiting. No obstructive gastric disease is found but a marked delayed gastric emptying, suggesting the diagnosis of gastroparesis. No classical cause being demonstrated, the diagnosis of paraneoplastic gastroparesis is proposed. Treatment with cisapride and chemotherapy lead to regression of digestive symptoms and of breast tumor. This uncommon entity, usually described in association with small cell lung cancer, may involve the whole gastrointestinal tract, sometimes in association with abnormalities of the autonomous nervous system. Destruction of the myenteric plexuses by auto-antibodies could be responsible for this pathology.

Breast Neoplasms↗