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Alain Ruffion

Publications and source records attributed to Alain Ruffion.

30 records · Page 2Linked to original sources

[Spermatocytic seminoma. A clinicopathological and immunohistochemical study of 7 cases].

Spermatocytic seminoma is an uncommon tumor, representing less than 1% of the testicular tumors, occurring most often in old patients. We report 7 cases of this entity. The average age at presentation was 66 years. Tumors had a polymorphic appearance with small, intermediate and large cells, and "spireme" figures. They were pure, with no sarcomatous component. In all cases, the tumor was limited to the testis. In the peritumoral tissue, there was no intratubular germ cell proliferation, and no atrophic testis. Immunostaining was negative for all the classical antibodies tested (cytokeratins, PLAP, lymphoid markers), but all the cases expressed c-kit (100%). This membranous positivity was focal in 4 cases, very strong, and diffuse in the 3 others. Spermatocytic seminoma must be recognized, because its favorable evolution in absence of a sarcomatous component. Adequate treatment consists of orchidectomy alone. Positive staining for c-kit may be helpful for the diagnosis of spermatocytic seminoma.

Adult↗

Characterization of tumour necrosis factor-alpha-related apoptosis-inducing ligand and its receptors in the adult human testis.

Tumour necrosis factor-alpha-related apoptosis-inducing ligand (TRAIL) is a member of the tumour necrosis factor-alpha (TNF-alpha) family of cytokines which is known to induce apoptosis upon binding to its death domain-containing receptors, DR4/TRAIL-R1 and DR5/TRAIL-R2. Two additional TRAIL receptors, DcR1/TRAIL-R3 and DcR2/TRAIL-R4, lack functional death domains and act as decoy receptors for TRAIL. In this study, the presence of TRAIL and its receptors was investigated by immunohistochemistry in adult human testes. In addition, TRAIL and its receptors were studied in terms of protein and mRNA using western blot analysis and RT-PCR respectively. TRAIL and its receptors were immunodetected according to the different testicular cell types: TRAIL, DR5/TRAIL-R2 and DcR2/TRAIL-R4 were localized in Leydig cells, DR4/TRAIL-R1 was seen in peritubular and Sertoli cells whereas ligand and all receptors were detected in germ cells. Proteins and mRNA corresponding to TRAIL and its receptors were also identified in adult human testes. In conclusion, TRAIL and its receptors DR4/TRAIL-R1, DR5/TRAIL-R2, DcR1/TRAIL-R3 and DcR2/TRAIL-R4 are expressed in the human testis, and are predominantly localized in different germ cell types.

Adult↗

[Biopsy technique and biopsy schemes for a first series of prostatic biopsies].

OBJECTIVE: To define the modalities of prostatic biopsies in patients with suspected prostate cancer, particularly concerning prevention of complications, the number of biopsies and the biopsy schemes ensuring an optimal cancer detection rate, and recording of prognostic elements, all with an acceptable morbidity, METHOD: Review of the literature. RESULTS: Information before biopsy: A preliminary visit with oral and written information is necessary before any biopsy procedure in order to: describe the modalities of the procedure to improve the patient's cooperation, detect contraindications, guide preparation, explain the risks and elements of surveillance, and describe the management in the case of complications (level of evidence: IV-3). PREPARATION BEFORE BIOPSY: A single dose of prophylactic antibiotic is necessary before the examination. Longer antibiotic prophylaxis is necessary in patients with risk factors for infection (level of evidence: II). A rectal enema is recommended (level of evidence: III). Routine urine bacteriology and blood coagulation tests are unnecessary (level of evidence: II). In patients taking anticoagulants, this treatment must be stopped before the examination (level of evidence: IV-2). BIOPSY TECHNIQUE: Local anaesthesia with 1% lidocaine by ultrasound-guided injection into the periprostatic spaces is recommended to improve tolerability, when the number of biopsies is > 6 (level of evidence: II-2). General anaesthesia may be necessary in a minority of cases, for local anatomical reasons or when preferred by the patient. Prostatic aspiration biopsies should be performed via a transrectal approach with ultrasound guidance, especially in the absence of a palpable lesion (level of evidence: IV-1). The examination must start with digital rectal examination and complete analysis of the echostructure of the prostate to identify suspicious zones that will also be aspirated. Biopsy scheme as a function of stage: In the case of palpable or visible lesion (stage T2 or T3), at least six transrectal ultrasound-guided lateral sextant biopsies including the peripheral glandular zone at the base, in the middle and at the apex of each lobe as well as a biopsy in a suspicious zone are necessary for cancer detection and staging. Each biopsy must be identified or embedded separately to facilitate identification by the pathologist (level of evidence: IV-1). In the absence of palpable or visible lesion (stage T1a, b, c), another 6 sextant midlobar biopsies are recommended (12 biopsy plan). In the case of prostate volume < 40-50 cm3, the two midlobar biopsies of the apex may be eliminated (10 biopsy plan) (level of evidence: III-2). In the case of prostate volume > 40-50 cm3, anterior biopsies (4 additional biopsies, 16 biopsy scheme) including the glandular zone of benign hyperplasia are not routinely recommended (level of evidence: III-2). In stage T4, a biopsy in each lobe is sufficient for histological confirmation of the diagnosis. CONCLUSION: Complementary studies are necessary to validate the 12 biopsy or 16 biopsy plans, especially as a function of prostatic volume, clinical stage and biopsy sequence (first or second series).

Biopsy, Needle↗

[Contribution of fluorescence immunocytochemistry (uCyt+TM) in the postoperative surveillance of bladder cancer].

OBJECTIVE: To assess 1) the value of fluorescence immunocytochemistry (uCyt+ test, DiagnoCure Inc., Quebec) in the detection of recurrent bladder tumour after transurethral resection (TUR) and 2) the predictive value of a positive uCyt+ test in patients with negative cystoscopy. MATERIAL AND METHODS: This study was based on 132 patients with a mean follow-up of 21.9 weeks after TUR. The initial tumours were pTa G1-2 in 66.7% of cases, and G3 in 28.8% of cases. Cystoscopy, urine cytology (UC) and uCyt+ test data were collected on the day of the first control visit (D0), and the patients were then reviewed at 6 and 12 months. All lesions detected on cystoscopy were biopsed. RESULTS: The mean sensitivity of UC was 47.4% and the mean sensitivity of uCyt+ was 73.7% (84.2% in combination). In patients with negative cystoscopy on D0, a positive uCyt+ test has no predictive value at 6 months. At 12 months, 20.0% of patients with positive UC had relapsed, versus 16.7% of patients with negative UC (p = ns). On the other hand, at 12 months, 50.0% of patients with negative cystoscopy but positive uCyt+ test had relapsed, versus 16.4% of patients with a negative uCyt+ test (p < 0.01). CONCLUSIONS: The uCyt+ test allows assessment of the risk of recurrence at I year, while UC alone only has a diagnostic value. These results raise the possibility of combining the tests in order to decrease the frequency of follow-up cystoscopy.

Adult↗

[Endocrine therapy for localized or locally advanced prostate cancer].

The place of endocrine therapy, either alone or in combination with radiotherapy and surgery, remains highly controversial in the treatment of non-metastatic prostate cancer. The authors review the results of isolated endocrine therapy or associated with local therapy. At the present time, there are few arguments in favour of the use of endocrine therapy in the following situations: isolated treatment of localized or locally advanced cancer prior to radical prostatectomy, after radical prostatectomy. Current data suggest a benefit of endocrine therapy in combination with radiotherapy in patients with high-grade localized or locally advanced cancer.

Androgen Antagonists↗

[Prostatic cancer].

Explore the source record for details and available documents.

Antineoplastic Agents↗

The survival effect of prolactin on PC3 prostate cancer cells.

OBJECTIVES: Recent studies suggest a paracrine/autocrine loop involving prolactin (PRL) within the human prostate. The aims of this study were to determine the effects of PRL on the growth and survival of prostate cancer cells and the intracellular signalling mechanisms underlying such effects. METHODS: The effect of PRL on proliferation of LNCaP, PC3 and DU145 was assessed by Coulter counting. The effect of PRL on TRAIL-, staurosporine- and flavopiridol-induced apoptosis was assessed by Timelapse microscopy and Annexin V binding. The status of the PRL receptor (PRL-R) and Akt/PKB (protein kinase B) activity were assessed by Western blotting. RESULTS: All three cell lines expressed both the short and long forms of the PRL receptor. Although, no significant effect of PRL on the proliferation of these cells was found, PRL partially inhibited TRAIL-induced apoptosis in PC3 cells. PRL also enhanced the phosphorylation of Akt/PKB in these cells. CONCLUSIONS: PRL had no significant effect on the proliferation of PC3, DU145 and LNCaP, but inhibited TRAIL-induced apoptosis in PC3 cells, possibly via enhanced Akt/PKB phosphorylation in PC3 cells. Further investigations are underway to determine the survival effect of PRL on the other two prostate cancer cell line.

Apoptosis↗

[Hormonal therapy in metastatic prostatic cancer].

For more than sixty years, the treatment of advanced prostate cancer has been based on androgen deprivation. Despite this long follow-up, the optimal treatment regimen is still a subject of controversy. Treatments inducing chemical castration have been greatly improved over recent years with the appearance of LH-RH analogues, non-steroidal antiandrogens and finally, more recently, LH-RH antagonists and Gn-RH agonists. The modalities of endocrine therapy have also evolved: early or late, total, intermittent or even targeted to the prostate by the use of non-steroidal antiandrogens alone. In this article, the authors review the results of each of these various treatment options in order to place them in perspective with the real benefit that can be expected in terms of quality of life and survival in patients with metastatic disease.

Gonadotropin-Releasing Hormone↗

[Two indications for bilateral neuromodulation].

The authors report two cases of patients presenting with complex voiding disorders treated successfully by bilateral neuromodulation. In the first patient, bilateral neuromodulation (left S2 and right S3) was indicated after failure of a first trial of conventional neuromodulation. In the second case, a complementary electrode in addition to the S3 electrode was placed at S1 to treat nerve root pain associated with urinary symptoms. The preoperative and postoperative findings are reported together with the course and possible explanations for the success of this treatment modality.

Adult↗