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Biomedical subjects

B Brun

Publications and source records attributed to B Brun.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Can tumors of the breast larger than 3 centimeters be treated conservatively?].

Unlike small breast cancers, which are now treated conservatively by primary tumorectomy, the most important lesions (T2 and T3) as usually treated tumorectomy, the most important lesions (T2 and T3) as usually treated by mastectomy. However, in patients with these large lesions attempts may be made at conserving the breast with reliable oncological safety and good cosmetic results. Depending on clinical presentation, one or the other of two therapeutic approaches may be considered. The most common treatment is preoperative radiotherapy of 45 Gy which, in more than 50 p. 100 of the cases results in a tumoral regression that is sufficient for secondary tumorectomy to be performed. In some patients, the first-line treatment consists of wide tumoral excision as part of a reductive mammaplasty, followed by radiation.

Breast Neoplasms↗
PubMed1990

[Teratospermia and the fertilizing capacity of semen in the lemur].

As in fertile men, Lemur fulvus mayottensis spermatozoa are pleiomorphic. Percentage of structural defects of semen varies in breeding and nonbreeding seasons. Spermatozoa exhibit acrosomal and flagella abnormalities. These primates could serve as a useful model for teratospermia study, especially because this seasonal variation.

Acrosome↗
PubMed1990

[Arterial stenosis after radiotherapy].

Published reports of arterial stenosis following radiotherapy are reviewed. In oncological practice, this complication is rare but experimental studies have demonstrated the role of irradiation in producing arterial lesions. The histological specificity and the mechanisms of radiation and related arterial lesions are discussed. Atherosclerosis risk factors and chemotherapy could have a synergic role on artery stenosis. Cases reported of arterial stenosis after radiotherapy include subclavicular artery after breast cancer, carotid artery after head and neck cancer, coronary artery and abdominal aorta or its trunks after pelvic and abdominal irradiation. The radiotherapy parameters described are not unusual. Therapeutical modalities and their indications are presented.

Adult↗
PubMed1989

Echocardiography and cerebral computed tomography in chronic atrial fibrillation.

Chronic atrial fibrillation (CAF) may be complicated by asymptomatic small silent cerebral infarctions as well as by stroke. The echocardiographic findings in 29 patients with CAF and 29 controls in sinus rhythm are presented. The cerebral computed tomography (CT) findings in these patients were previously published and significantly more small low-density lesions, probably reflecting previous infarctions, were found in patients with CAF than in controls. The aim of the present study was to evaluate if patients with such cerebral lesions had characteristic echocardiographic abnormalities with special reference to patients with CAF. No significant differences could be detected between the groups with and without cerebral lesions regarding the occurrence of valvular heart disease, left ventricular dysfunction, end-diastolic diameter of the left ventricle, left atrial dimension and left ventricular fractional shortening. Only seven patients with CAF (24%) compared with 21 in sinus rhythm (72%) had normal echocardiograms (P less than 0.001). In conclusion, echocardiography gave no guidance to why some patients developed cerebral low-density areas on CT.

Aged↗
PubMed1989

Cerebral ventricular enlargement relates to neuropsychological measures in unselected AIDS patients.

In a cross-sectional study of unselected Danish AIDS patients various linear measures of cerebral ventricular size obtained by computed tomography were compared with results of neuropsychological test performances. Third ventricular width as well as right and left septum-caudate distances were enlarged in the patients (P less than 0.01). Of 20 patients 15 had at least one abnormal ventricular measurement. Although only one patient was demented, ventricular size correlated inversely with neuropsychological function (r = -0.61, P less than 0.02). The correlation between ventricular size and variation of the reaction time was even closer (r = 0.74, P less than 0.01). It is concluded that neuroradiological signs of central atrophy often occur in AIDS patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Cerebral computed tomography in paroxysmal atrial fibrillation.

Atrial fibrillation (AF) is associated with an increased risk of stroke. In patients with chronic AF, without clinically known cerebrovascular disease, computed tomography (CT) has revealed a high frequency of abnormal low-density areas suggesting old asymptomatic infarcts. To investigate the frequency of such lesions in paroxysmal AF, 30 patients with paroxysmal AF and 30 controls matched in sinus rhythm, without history of cerebrovascular disease, were CT scanned. Four patients with paroxysmal AF (13%) and 3 controls (10%) had abnormal CT scans with areas of low density with sharp demarcation from surrounding tissue. The abnormal areas probably reflected small, clinically silent infarcts. There were no differences between paroxysmal AF and controls in number and size of abnormal areas with apparent tissue loss. In contrast to chronic AF, the risk of such lesions in paroxysmal AF does not seem to be increased compared with matched sinus rhythm controls. This is in agreement with the clinical experience of a low risk of stroke in paroxysmal AF.

Adult↗
PubMed1989

Hemodilution increases cerebral blood flow in acute ischemic stroke.

We measured cerebral blood flow in 10 consecutive, but selected, patients with acute ischemic stroke (less than 48 hours after onset) before and after hemodilution. Cerebral blood flow was measured by xenon-133 inhalation and emission tomography, and only patients with focal hypoperfusion in clinically relevant areas were included. Hemodilution was done according to the hematocrit level: for a hematocrit greater than or equal to 42%, 500 ml whole blood was drawn and replaced by the same volume of dextran 40; for a hematocrit between 37% and 42%, only 250 ml whole blood was drawn and replaced by 500 cc of dextran 40. Mean hematocrit was reduced by 16%, from 46 +/- 5% (SD) to 39 +/- 5% (SD) (p less than 0.001). Cerebral blood flow increased in both hemispheres by an average of 20.9% (p less than 0.001). Regional cerebral blood flow increased in the ischemic areas in all cases, on an average of 21.4 +/- 12.0% (SD) (p less than 0.001). In three patients, a significant redistribution of flow in favor of the hypoperfused areas was observed, and in six patients, the fractional cerebral blood flow increase in the hypoperfused areas was of the same magnitude as in the remainder of the brain. In the last patient, cerebral blood flow increased relatively less in the ischemic areas. Our findings show that cerebral blood flow increases in the ischemic areas after hemodilution therapy in stroke patients. The marked regional cerebral blood flow increase seen in some patients could imply an improved oxygen delivery to the ischemic tissue.

Acute Disease↗
PubMed1989

[Efficacy and toxicity of intrapleural mitoxantrone: apropos of 18 cases of pleural metastases of breast cancer].

Mitoxantrone, an anthracenedione, has been shown to be as effective as doxorubicin, but with less local or systemic toxicity, when used for the treatment of advanced breast cancer. As the high molecular weight and hydrophilic property of this drug let us predict a slow intracavity resorption, we tested its use in the treatment of malignant effusions refractory to systemic chemotherapy. 18 women, 43 to 83 years old, with cytologically demonstrated metastatic pleural effusions, and with prominent clinical symptoms, were included in the study. All these patients were refractory to hormonotherapy and combination chemotherapy (previous regimens included anthracyclines in 17 patients but none had received systemic mitoxantrone). No previous local treatment had been attempted. During the study period, no other treatment has been given. Mitoxantrone (6 mg/m2) has been administrated after effusion aspiration. A complete response was seen in 8 patients, a partial response in 5, and no change in the 5 others but one had received only one injection on account of a transitory shock immediately after. No others side effects were reported (fever, local pain, alopecia, vomiting). No patient had evidence of myelosuppression. These results suggest that intracavity injection of mitoxantrone is feasible and generally safe in most patients. Some efficiency has been seen in previously heavily treated patients refractory to systemic chemotherapy. Local administration of mitoxantrone deserves further investigation.

Adult↗
PubMed1988

[Can the indications of conservative radiosurgical combination in the treatment of breast cancer be extended?].

In the hope that women with breast cancer unsuitable for primary tumorectomy would benefit from a conservative treatment, we tried to reduce the lesional volume by an initial irradiation of 45 Gy administered in 25 fractions over 35 days. This treatment was applied to 111 patients (69 T2; 42 T3). In 44 cases (40 per cent), tumoral regression enabled a secondary tumorectomy to be performed. In 16 cases (14 per cent), the tumour totally disappeared, and an additional irradiation by endocurietherapy in intermediate dosage could be given. In 51 patients (46 per cent), the tumoral response was poor and the patients underwent, depending on their wishes, either mammectomy (9 cases; 8 per cent) or high-dose endocurietherapy (42 cases; 38 per cent). Analysis of tumoral regression according to size, histological type and mammographic image provided for a better identification of good responders. The cosmetic and oncological results of this preliminary study are satisfactory, with a 95 per cent local control at 5 years after secondary tumorectomy.

Adenocarcinoma↗
PubMed1988

Treatment of inflammatory breast cancer with combination chemotherapy and mastectomy versus breast conservation.

Twenty-six consecutive patients with nonmetastatic inflammatory breast cancer (IBC), were treated in a single institution using the same protocol, and all were followed for at least 48 months. The first phase of treatment consisted of two monthly cycles of combination chemotherapy with Adriamycin (Adria Laboratories, Columbus, OH), vincristine, cyclophosphamide and 5-fluorouracil. Local treatment was then undertaken using in all cases a cobalt 60 beam to deliver 45 Gy to the entire mammary gland and lymph-draining areas. Local treatment was completed either by mastectomy, or by conservation of the breast and interstitial irradiation of the primary tumor site. Chemotherapy was resumed after completion of local treatment for a total of 6 cycles. Metastatic disease occurred in 19 of 26 patients from 8 to 55 months; five patients are alive and free of disease from 48 to 81 months. Failure to control local disease or local recurrences was noted in two of ten patients undergoing mastectomy, and in seven of 13 patients with conservation of the breast. While this difference is not statistically significant we concluded that methods of breast conservation which limit the high dose volume to the tumor site do not assure local control in IBC. The median disease-free survival and overall survival of 12 and 31 months, respectively, are not satisfactory. Better systemic treatment is needed.

Adult↗