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Biomedical subjects

A Dupont

Publications and source records attributed to A Dupont.

At least 55 records · Page 3Linked to original sources
PubMed1991

Prostate specific antigen and prostatic acid phosphatase for monitoring therapy of carcinoma of the prostate.

Serial serum prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) measurements were performed in 871 patients treated with hormonal combination therapy for stage C (95 patients) or stage D2 (776) prostate cancer for an average followup of 26 months. The relative efficacy of serum PAP and PSA for predicting recurrence of the disease was evaluated by 2 statistical methods at the time of progression as well as 6 and 12 months before clinical relapse of disease using optimized cut-off values of 2.0 and 4.0 micrograms/l. for serum PAP and PSA, respectively. At the time of progression the sensitivity (plus or minus standard deviation) of the 2 tests was estimated at 61.1 +/- 3.2% and 86.7 +/- 3.1% for PAP and PSA, respectively, while the specificity (plus or minus standard deviation) was calculated at respective values of 79.6 +/- 1.3% and 92.4 +/- 4.1%. Receiver operating characteristic analysis disclosed a greater accuracy for PSA at 89.2 +/- 1.7% versus 78.7 +/- 1.6% (plus or minus standard deviation) for PAP. The somewhat lower positive predictive value of the PSA test (81.4% versus 89.6%) is more than compensated by its superior negative predictive value (92.4% versus 79.6%). The present data also show that serum PSA measurements are superior to those of serum PAP for predicting disease recurrence in stages C and D prostate cancer patients treated by combination endocrine therapy and they indicate that measurement of serum PAP does not add significantly to single measurement of serum PSA alone.

Acid Phosphatase↗
PubMed1991

Effect of combination endocrine therapy (LHRH agonist and flutamide) on normal prostate and prostatic adenocarcinoma. A histopathologic and immunohistochemical study.

The histopathology of 23 radical prostatectomies from patients with prostatic adenocarcinoma pretreated for 3-6 months with combination therapy including a luteinizing hormone-releasing hormone agonist and the antiandrogen drug flutamide was reviewed and compared with the pretreatment biopsies or transurethral resection material. After combination therapy, benign prostatic glands showed marked atrophy with prominent basal-cell layers, basal-cell hyperplasia, and epithelial-cell vacuolization. Immature squamous-cell metaplasia was present in seven cases. Residual carcinoma, on the other hand, was found in 19 of the 23 cases, and in 8 of these, tumor cells were either vacuolated or had scanty cytoplasm. Residual tumor was present as only one focus in 13 cases, and in 3 of these it was composed of single cells with a "hemangiopericytoma-like" pattern. An immunohistochemical study for prostatic acid phosphatase and prostatic-specific antigen could be carried out on paraffin blocks from 19 biopsies and 18 prostatectomies. After combination therapy, a reduction in staining (intensity and number of positive cells) was observed for the two markers in both normal prostate and carcinoma but with more pronounced effects on the latter. The present data show that temporary combination therapy before radical prostatectomy causes marked and very characteristic changes in normal prostatic tissue as well as in the prostatic tumor. These histologic patterns enter the differential diagnosis of a variety of atrophic, metaplastic, and proliferative lesions of the prostate gland. The pathologist must be aware of these histologic changes when looking at biopsy or resection material of treated patients.

Adenocarcinoma↗
PubMed1991

Changes in plasma lipoprotein and apolipoprotein composition in relation to oral versus percutaneous administration of estrogen alone or in cyclic association with utrogestan in menopausal women.

Sixty-three postmenopausal women were assigned to four treatment groups and received either Premarin or percutaneous 17 beta-estradiol (Oestrogel) alone or in combination with micronized progesterone (Utrogentan). The oral administration of estrogen alone to hysterectomized women resulted in: 1) a significant increase in triglyceride levels in plasma and all major lipoprotein fractions, 2) a significant increase in very low density lipoprotein cholesterol, 3) a significant decrease in low density lipoprotein (LDL) cholesterol but not LDL apo B concentration, 4) a significant increase in all the lipid components of high density lipoprotein (HDL) as well as apo AI, 5) and a significant increase in HDL2 cholesterol. In contrast, percutaneous administration of estrogen to hysterectomized women only increased HDL2 cholesterol and the triglyceride and cholesterol content of the whole HDL fraction. These results suggest that the route of estrogen administration is important in determining effects on lipoprotein metabolism. The same two estrogens were given to women with natural menopause, along with utrogestan, a micronized progesterone. The simultaneous administration of Utrogestan reversed the HDL cholesterol elevating effect of percutaneous estrogen alone, but it had no effect on other plasma lipoproteins. On the other hand, utrogestan in combination with oral estrogen had several potential beneficial effects on plasma lipoproteins. This combination did not negate the effects of oral estrogen alone on HDL, rather it further increased the concentrations of HDL cholesterol and apo AI. It also did not negate the LDL cholesterol lowering effect of oral estrogen alone. Furthermore, utrogestan lowered the magnitude of hypertriglyceridemia induced by oral estrogen alone. These results suggest that Utrogestan has lower potency of androgenic action and has desirable effects when given in cyclic combination with estrogen.

Administration, Cutaneous↗
PubMed1991

[Currarino syndrome: an association not to be overlooked].

The Currarino triad consists of an anorectal malformation, a presacral tumor and a sacrum defect. A new case is reported in a female neonate. The diagnosis was suspected because of delayed emission of meconium associated with an occlusion syndrome. It was confirmed by bone imaging, ultrasonography and magnetic resonance imaging. A colostomy was performed on day 7 then closed on day 43 after several rectal dilation were carried out. A presacral lipoma was operated on at 10 months. The 56 cases reported in the literature are reviewed.

Abnormalities, Multiple↗
PubMed1991

Prevalence and type of infertility in Gabon.

The prevalence and type of infertility based on the WHO criteria were determined in a rural and semi-rural population in south-eastern Gabon. The prevalence rate of infertility in the rural population was 5.7% for primary infertility and 20.0% for secondary infertility. In the semi-rural area, 3.0% suffered from primary infertility and 22.4% from secondary infertility. Pregnancy wastage and home delivery were risk factors for secondary infertility. An evaluation of the WHO criteria for fertility surveys was made.

Abortion, Spontaneous↗
PubMed1991

Seroprevalence of retroviral infection in women with different fertility statuses in Gabon, western equatorial Africa.

Seroprevalence of retroviral infection (HIV-1, HTLV-1) in women with different fertility statuses was studied in Gabon (Western Equatorial Africa). The overall prevalence rate of HIV-1 was 1.4% and of HTLV-1, 6.8%. In the primary infertile women the age-adjusted prevalence rate of HIV-1 was significantly higher than in the fertile women (9.3% versus 0.7%) and in secondary infertile women (9.3% versus 2.1%). There was no difference in sero-prevalence of HTLV-1 among women with different fertility statuses, but a steady increase with age was seen. Concomitant infection with HTLV-1 and HIV-1 was observed in two women. In Gabon primary infertile women could be considered a risk group for HIV-1 infection.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Papillary--cystic tumor of the pancreas. Apropos of 1 case with histological, immunohistochemistry and ultrastructural study].

The authors report the clinical and histological features of a case of papillary and cystic tumour of the pancreas in a 34 year old man. The solid and papillary tumour architecture associated with pseudocystic areas and a richly vascular stroma gave this tumour an original histological appearance. The study of the immunochemical and ultrastructural features of the tumour cells suggested an acinar differentiation.

Adult↗
PubMed1990

Combination therapy with flutamide and medical (LHRH agonist) or surgical castration in advanced prostate cancer: 7-year clinical experience.

Three hundred and sixty-three patients with clinical stage D2 prostate cancer who had not received previous endocrine therapy or chemotherapy were treated with the combination therapy using the pure antiandrogen Flutamide and the LHRH agonist [D-Trp6,des-Gly-NH2(10)]LHRH ethylamide (or orchiectomy) for an average of 771 days (24-2607 days). Only 31 of the 308 evaluable patients (10.1%) did not show an objective positive response at the start of the combination therapy compared with an average of 18% in five recent studies using monotherapy. The median survival achieved using monotherapy is approximately 24 months while, in the present study, it is increased to 41.2 months, thus giving an additional 17 months of survival with the combination therapy. It should be mentioned that at the time of relapse, combination therapy is continued and, in addition, further blockade of adrenal androgen secretion is achieved with aminoglutethimide and hydrocortisone. While our studies showing the advantages of combination therapy with pure antiandrogen in advanced prostate cancer have been confirmed by independent large-scale randomized studies, our preliminary data clearly suggest the interest of downstaging early stage prostate cancer by temporary combination therapy prior to radical prostatectomy.

Adenocarcinoma↗
PubMed1990

Treatment of hirsutism with the pure antiandrogen flutamide.

The effectiveness of the antiandrogen flutamide in combination with an oral contraceptive was studied in 20 patients with moderate to severe hirsutism. Eight patients had no previous therapy, whereas 12 had failed to respond to oral contraceptives, spironolactone, or dexamethasone therapy. Treatment with the antiandrogen flutamide (250 mg twice daily) and an oral contraceptive (Ortho 1/35) resulted in a particularly rapid and marked decrease in the total hirsutism score, which reached the normal range at 7 months. Seborrhea, acne, and hair loss score were also rapidly corrected. Treatment was associated with a decrease in plasma luteinizing hormone, progesterone, and estradiol levels. Plasma sex hormone-binding globulin levels were initially low in 18 to 20 patients but increased significantly during therapy. No clinically significant side effects were observed.

Adult↗
PubMed1990

Effect of combined androgen blockade with an LHRH agonist and flutamide in one severe case of male exhibitionism.

A severe exhibitionist has been treated with the combination of an LHRH agonist and the antiandrogen flutamide in order to maximize androgen blocking and to control his severe deviant behaviour. The results obtained show that the androgen blockade ended his exhibitionistic behaviour and markedly decreased his sexual fantasies and activities, especially masturbation, without significant side effects.

Administration, Oral↗
PubMed1990

Steroid fatty acid esters in adrenals and plasma: effects of ACTH.

The presence and production of 5-ene-steroid fatty acid esters (SFA) has been previously reported in bovine adrenals. A study was conducted, using a series of chromatographic procedures and radioimmunoassays, to determine the levels of SFA in adrenals from man, cattle, dog, rat and guinea-pig, and to assess, in both rats and guinea-pigs, the effect of ACTH on SFA production by adrenals and their subsequent secretion into the circulation. The effects of ACTH on plasma SFA and non-conjugated steroid levels were also investigated in human subjects. Our data indicated that adrenal pregnenolone fatty acid ester (PREG-FA) levels were below 40% of PREG levels in cattle, dog, rat and guinea-pig while, in man, PREG-FA levels were threefold those of PREG. A large proportion of dehydroepiandrosterone (DHEA) and 5-androstene-3 beta, 17 beta-diol were present as fatty acid ester derivatives in the adrenals of all species, with the exception of cattle. In both rats and guinea-pigs, administration of ACTH caused a sharp increase in adrenal PREG of approximately threefold which lasted for 6 h, while the concentration of adrenal PREG-FA was slightly increased for a short time. In plasma, however, a marked rise in PREG-FA occurred, while the changes in PREG levels were much lower than those of its acylated counterpart. In man, PREG and DHEA concentrations were rapidly stimulated two-fold in the first 30 min following the administration of ACTH, while PREG-FA and DHEA-FA levels were increased by approximately 2.5-fold (P less than 0.01) at 120 and 180 min.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Glands↗
PubMed1990

Hormonal and biochemical changes during treatment of endometriosis with the luteinizing hormone-releasing hormone (LH-RH) agonist [D-Trp6,des-Gly-NH2(10)]LH-RH ethylamide.

The effect of medical oophorectomy induced by treatment with the luteinizing hormone-releasing hormone (LH-RH) agonist [D-Trp6,des-Gly-NH2(10)]LH-RH ethylamide was studied in 34 patients with laparoscopically proven endometriosis. Tamoxifen was administered during the 1st month of therapy to prevent flare-up of the disease during the estrogen surge. Fifteen women had a decrease of their laparoscopy scores translated into an improvement in the stage of disease, whereas in 12 others, the decrease in their scores was not enough to allow a change of disease stage. The 2nd laparoscopy was not performed in 7 women. Medical oophorectomy, after daily injection of the LH-RH agonist (LH-RH-a), was accompanied by low levels of circulating estradiol. The serum concentration of all delta 4-3-ketosteroids was significantly decreased during medical oophorectomy, whereas the level of circulating delta 5-3 beta-hydroxysteroids was not altered except for pregnenolone. The present data indicate that medical oophorectomy induced by an LH-RH-a in association with tamoxifen is a very efficient and well tolerated therapy in endometriosis.

Adrenal Cortex Hormones↗
PubMed1990

Complete response to combination therapy with an LHRH agonist and flutamide in metastatic male breast cancer: a case report.

Twelve months after modified radical mastectomy with axillary dissection (4 out of 13 nodes found positive) in a 66-year old man, bone scintigraphy showed multiple bone metastases. Treatment was started with the combined administration of an LHRH agonist and the pure antiandrogen Flutamide. Six and a half months later, bone scintigraphy was normal while serum testosterone was reduced to 10% of control and the serum concentration of the adrenal steroids was decreased by 23 to 45%. Following relapse of the disease at 12 months, more complete blockade of adrenal steroid secretion was achieved with aminoglutethimide and hydrocortisone. Stability of the disease was then observed up to the last evaluation performed in January 1990 (5 years of stable disease). Since the adrenal steroids are converted into active androgens and estrogens in peripheral tissues, including the breast, the combined therapy has the advantage of reducing the source of potentially active estrogens and androgens while blocking the action of androgens in target tissues. No side-effects other than those due to hypoandrogenicity, namely hot flushes and loss of libido and potency were observed. This well-tolerated treatment achieves complete medical castration, partial medical adrenalectomy, and neutralization of peripheral androgen action.

Aged↗
PubMed1990

[Cellular kinetics of cerebral glioma: study of the proliferative activity using monoclonal antibody Ki 67. Apropos of 60 cases].

The monoclonal antibody Ki 67 is able to detect a nuclear antigen expressed by proliferating cells during the cellular cycle (phase G1, G2, S and M). It is used as a marker of the proliferative activity of 60 cerebral gliomas including 41 biopsied under stereotaxic conditions. The immunocytochemical study performed with the peroxidase antiperoxidase technique on crushed and smeared fresh tumors, permit to define a nuclear marking index for each tumor. The index Ki 67 is correlated with the degree of tumor malignancy. The maximum values are found in astrocytomas IV (20%) and malignant ependymomas (18%), with a mean index at 11% in the 25 high-grade gliomas and 1.7% in low-grade gliomas. The minimum values are observed in pilocytic astrocytomas and low-grade oligodendrogliomas. Marked variations of the index Ki 67 are found in homogeneous tumor classes regrouping tumors of identical nature and grade: grade IV astrocytomas (5 to 20%), grade III astrocytomas (8 to 18%). These marking differences reflect the heterogeneous nature of the proliferative activity of morphologically similar gliomas. The nuclear marking index with antibody Ki 67 complements the findings of the standard histological examination of cerebral gliomas. This is an additional diagnostic mean to evaluate the proliferative potential and the prognosis of these tumors.

Antibodies, Monoclonal↗
PubMed1989

Pre- and peroperative diagnosis of metastatic pheochromocytoma in multiple endocrine neoplasia type 2a.

A 37-year-old woman with a multiple endocrine neoplasia type 2a underwent bilateral adrenalectomy and total thyroidectomy with parathyroidectomy in 1977. The left-sided pheochromocytoma was considered to be malignant. Seven yr after the initial operation, an enhanced urinary excretion-ratio of N-methyladrenaline/adrenalin suggested the possible presence of either persistent or metastatic pheochromocytoma Iodine-123-labeled metaiodobenzylguanidine scintigraphy (I-123 MIBG) showed a hot spot in the right lung. However, repeated chest-X-rays and computed tomographic scanning of the thorax remained negative. Anatomical localization of the lesion was finally obtained with magnetic resonance imaging. The surgical removal of the small pheochromocytoma was guided by the gamma-ray emission of I-123 MIBG administered iv before the operation. This case report illustrates the usefulness of new analytical methods and of new imaging techniques in the diagnosis and management of metastatic pheochromocytoma.

Adult↗
PubMed1989

Hypogonadism and ecdysteroid production in Loa loa and Mansonella perstans filariasis.

Possible endocrinological repercussions of infection with Loa loa and Mansonella perstans filariae were studied in Gabonese subjects. Microfilaremic males were compared with amicrofilaremic controls. In the infected group 13/105 subjects (12%) presented only abnormally low serum levels of testosterone (less than 4 ng/ml), 25/105 (24%) only abnormally high serum levels of gonadotrophins, FSH (greater than 15 mIU/ml) and LH (greater than 20 mIU/ml), and 22/105 (21%) presented anomalies in both testosterone and gonadotrophin levels. One out of 68 control subjects had 3.6 ng/ml seric testosterone and all had normal levels of gonadotrophins. Ecdysteroids were detected (greater than 0.025 ng/ml) in the serum of 87/97 (90%) microfilaremic subjects (GM 0.123 ng/ml) compared to 12/64 (19%) controls (GM 0.030 ng/ml). Ecdysteroids were detected in the urine of all subjects, infected (GM 8.468 ng/ml) as well as control (GM 1.245 ng/ml). The hormonal perturbations were correlated with the levels of Loa loa microfilaremia but not with those of serum and urinary ecdysteroids. These results demonstrate that microfilaremic subjects often show endocrinal signs of hypogonadism and present appreciable levels of ecdysteroids in serum and urine. A direct role for parasitic ecdysteroids in hypogonadism remains to be demonstrated.

Adult↗