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Biomedical subjects

B Roche

Publications and source records attributed to B Roche.

At least 73 records · Page 4Linked to original sources
PubMed1992

Preoperative radiation therapy and surgery in the treatment of "bulky" squamous cell carcinoma of the uterine cervix (stage Ib, IIa, and IIb operable tumors).

Forty-two women with "bulky" squamous cell carcinoma of the uterine cervix, larger than 5 cm, were treated between 1982 and 1988. The median follow-up was 5 years (from 37 to 106 months). The age range was from 25 to 77 years (mean: 49). There were 14 stage Ib, 5 stage IIa, and 23 stage IIb operable patients. Forty grays were delivered at mid-plane of the pelvis (23 fractions in 31 days) using the four-field technique (6-18 MV). External beam radiation therapy was followed by 20 Gy of intracavitary radiation therapy. Forty-eight days later total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) and bilateral pelvic lymphadenectomy were performed. The 3- and 5-year disease-free survival was 83 and 81%, respectively. The 5-year locoregional control rate was 83%. Thirteen patients suffered from mild to severe complications (31%) but there were only two long-term (5%) complications.

Brachytherapy↗
PubMed1992

Leiomyosarcoma of the pulmonary hilar vessels.

Leiomyosarcomas are uncommon tumors. They have a predilection for deep soft tissues, with a rare group arising in medium-sized or large veins, far less frequently in arteries. We report a case of a 63-year-old man, with an enlarging mass located in the left pulmonary hilar region which was discovered on a routine chest radiograph. Cytology of the sputum and bronchoscopic biopsies did not reveal any malignant cells. Over 5 months observation, there was a clear progression of the mass, and the patient finally underwent a left pneumonectomy which allowed the diagnosis of an intravascular leiomyosarcoma partially destroying major arteries and veins in the hilar region. A review of the literature reveals 67 cases of leiomyosarcoma involving the pulmonary artery. None of these cases had an associated venous pathology. The disease is found mainly in adult women. Clinical diagnosis is very difficult because most of the cases have no specific clinical signs; the major differential diagnosis is that of pulmonary thrombo-embolism. Prognosis depends on histological degree of the tumor and extent of the disease, metastases occur mainly in the liver, lung, and brain and less frequently in regional lymph nodes. Treatment is always surgical, chemotherapy is ineffective and the effectiveness of radiotherapy depends on the total dose of irradiation. Sarcomas of hilar blood vessels have a very poor prognosis with a one year survival estimated, from the onset of symptoms, at 20%.

Humans↗
PubMed1992

Splenic cysts in pediatric patients--a report on 8 cases and review of the literature.

8 cases of splenic cysts are reported: treatment was surgical in 4 large cysts (greater than 5 cm, 3 epidermoids and 1 pseudocyst), and non-operative in 4 small cysts (less than 5 cm, 3 post-traumatic pseudocysts and 1 congenital cyst, probably epidermoid). Follow-up was over a period of 3 months to 7 years. 3 among the 4 post-traumatic pseudocysts were followed up by ultrasound until resolution (3 months to 3 years), and 1 large pseudocyst was operated on due to rupture following benign trauma. 3 large cysts were epidermoid in origin, 1 was electively operated, and 2 were discovered and operated on because of complications (rupture, infection). Only one total splenectomy was performed; surgery preserved the spleen in all other cases; but 1 epidermoid cyst presents now with a recurrence. Based on this experience, we suggest frozen section of the cyst wall during surgery, to decide the type of partial splenectomy to be performed: total cystectomy or marsupialization.

Abscess↗
PubMed1992

Recent results of elective open cholecystectomy in a North American and a European center. Comparison of complications and risk factors.

Results of elective open cholecystectomy in 1252 patients treated in a North American and a European center were examined using a recent standardized classification of complications. Although there were significant differences between centers in population age, rate of concomitant disorders, and numbers of operators, the frequency and severity of complications were comparable. There were no deaths, but 12% and 14% of the patients developed complications in the two centers. About 6% of the patients developed grade I complications. Grade II complications were noted in 6% and 8%, and grade III in 0% and 0.3%. Using univariate and multivariate analysis, individual risk factors for developing complications were found to be different in the two centers. Two preoperative scoring systems, ASA and a simplified APACHE II, were predictive for complications in both centers, but did not account for all risk in these patients. Data from the two centers could not be combined because of significant interaction between risk factors and center. Elective open cholecystectomy is a safe procedure, particularly in terms of highly morbid complications and death. Generalization of risk factors identified in a particular center may be misleading because local conditions may significantly affect risk factors for complications. The data also demonstrate the advantages of a uniform way of reporting surgical complications, which may permit meaningful comparisons among centers.

Adolescent↗
PubMed1992

[Safety of cholecystectomy by laparotomy in elective situation and in emergency].

Cholecystectomy is the only effective treatment of gallbladder stones. A retrospective study was carried out on results of 658 cholecystectomies by laparotomy without choledochotomy performed between January 1987 and December 1989, to determine morbidity and mortality of elective and emergency surgery and by age. Operations for tumors of the gallbladder and choledolithiasis were not included in the analysis. During this period, cholecystectomy was performed electively in 387 cases and under emergency conditions in 261 patients. Mortality and post-operative morbidity were 0% and 14.7% respectively after elective surgery, increasing to 1.1% (Fisher = 0.0617) and 25.2 (p = 0.0004) respectively after emergency operations. This large increase in postoperative morbidity in urgent cases was due to an increase in systemic and not local complications, as a result of the higher proportion of emergency operations with advancing age. Since elective cholecystectomy is safe it can be proposed to patients with symptoms, including the elderly. It is difficult at present to compare results of cholecystectomy by laparotomy with those of laparoscopy since the average age of in the latter category is markedly lower and the number of acute cases still low. The principal advantage of celioscopy could be a long term reduction in systemic complications in emergency operations.

Adolescent↗
PubMed1992

[Nicardipine vs trinitrin for controlled hypotension in maxillo-facial surgery].

In this study we examined perioperative blood losses during maxillo-facial surgery comparing 2 techniques for controlled hypotension using nitroglycerin (NTG) and nicardipine (NICAR). 37 ASA I and II patients electively scheduled for rhinoseptoplasties under general anaesthesia were randomly divided into 2 groups. General anaesthesia was induced with intravenous thiopental and vecuronium following a neuroleptanalgesia consisting of fentanyl (0.053 +/- 0.004 microgram.kg-1.min-1) IV and droperidol (1.98 +/- 0.35 microgram.kg-1.min-1) IV given in bolus doses. The patients were intubated and ventilated (N2O in O2) to maintain normocarbia. Controlled hypotension to maintain a mean arterial pressure (MAP) between 50 and 55 mmHg was induced using an IV infusion of NTG 6 micrograms.kg-1.min-1 in group I and NICAR 10 micrograms.kg-1.min-1 over 10 minutes followed by an infusion at 4 mg.kg-1.min-1 for group II. Measurements of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), MAP using an automated blood-pressure cuff and end tidal carbon dioxide (ETCO2) were recorded prior to induction (PREIND), intraoperatively (PEROP) at 15, 30, 40 and 120 minutes post-induction, and at 15, 30 and 60 minutes postoperatively (POSTOP). Blood loss, graded as minimal or frank, was assessed by the surgeon during the operative period, post-extubation and 3 days postoperatively at dressing removal. The surgeon was unaware of the randomization schedule. Student's test was applied for statistical analysis of measured variables and Fisher's test for qualitative parameters. No statistically significant differences were noted between both groups with respect to demographic data, duration of surgery and total doses of anaesthetic agents (Table I).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Endothelin action in rat liver. Receptors, free Ca2+ oscillations, and activation of glycogenolysis.

High affinity binding sites for endothelin (ET) were identified on rat liver plasma membranes. Binding of 125I-ET-1 with its site was specific, saturable, and time dependent (kobs = 0.019 +/- 0.001 min-1), but dissociation of receptor-bound ligand was minimal. A single class of high affinity binding sites for 125I-ET-1 was identified with an apparent Kd of 32.4 +/- 9.8 pM and a Bmax of 1084 +/- 118 fmol/mg protein. ET-3 and big-ET-1 (1-38) (human) inhibited 125I-ET-1 binding with IC50 values of 1.85 +/- 1.03 nM and 43 +/- 6 nM, respectively. Aequorin measurements of cytosolic free Ca2+ in single, isolated rat hepatocytes showed that ET-1 at subnanomolar concentrations induced a series of repetitive, sustained Ca2+ transients. ET-1 had no effect on cAMP production. Finally, ET-1 caused a rapid and sustained stimulation of glycogenolysis in rat hepatocytes. A 1.8-fold maximal increase in glycogen phosphorylase alpha was observed at 1 pM ET-1, with an EC50 of 0.03 pM. Stimulation of the enzyme was specific for ET-1 since the order of potency of related peptides was similar to that in binding experiments (ET-1 greater than ET-3 greater than big ET-1). These data constitute the first demonstration of the presence of ET-1 binding sites in liver which is associated with a rise in cytosolic free Ca2+ and a potent glycogenolytic effect. We conclude that ET-1 behaves as a typical Ca2+ mobilizing hormone in liver.

Animals↗
PubMed1990

Glucagon-(19-29) exerts a biphasic action on the liver plasma membrane Ca2+ pump which is mediated by G proteins.

We have recently shown that nanomolar concentrations of glucagon-(19-29), which can derive from native glucagon by proteolytic cleavage of the dibasic doublet Arg17-Arg18, inhibit the Ca2+ pump in liver plasma membrane vesicles independently of adenylyl cyclase activation (Mallat, A., Pavoine, C., Dufour, M., Lotersztajn, S., Bataille, D., and Pecker, F. (1987) Nature 325, 620-622). We report here that the regulation of the Ca2+ pump by glucagon-(19-29) is dependent on guanine nucleotides. In the presence of 10 microM guanosine 5'-3-O-(thio) triphosphate (GTP gamma S) or 75 microM GTP, glucagon-(19-29) caused a biphasic regulation of the Ca2+ pump. ATP-dependent Ca2+ transport was inhibited in the presence of 10 pM to 1 nM glucagon-(19-29), while higher concentrations of the peptide (1-100 nM) reversed the inhibition caused by lower ones. GTP gamma S alone, at high concentrations (100 microM), reproduced the inhibitory effect of glucagon-(19-29) and induced a 40% inhibition of the basal activity of the Ca2+ pump which was reversed by low concentrations of glucagon-(19-29) (10 pM to 1 nM). Treatment of rats with cholera toxin resulted in a 70% increase in the basal activity of the Ca2+ pump, a loss of sensitivity to GTP gamma S and to the biphasic regulation by glucagon-(19-29). Treatment with pertussis toxin did not affect the response of the Ca2+ pump to GTP gamma S and glucagon-(19-29). We conclude that glucagon-(19-29) can exert a biphasic effect on the Ca2+ pump which is mediated by G protein(s) sensitive to cholera toxin.

Adenylate Cyclase Toxin↗
PubMed1990

Delayed anterior decompression in patients with spinal cord and cauda equina injuries of the thoracolumbar spine.

Forty-nine patients with complete and incomplete injuries of the spinal cord or cauda equina who had undergone anterior decompression at a minimum of 3 months after injury were examined. Follow-up was from 12 months to 19 years. Postoperative neurologic improvement occurred in 46.5% of patients with incomplete injuries. If the surgery was performed less than 2 years after injury, neurologic improvement occurred in 68% with an improvement in Frankel grade of 32%. Bladder function improved in 27% of patients and if operated on less than 2 years after injury improvement occurred in 43%. Conus medullaris decompression resulted in a 50% improvement. There was an 83% improvement in the pattern of pain after decompression. Of 23 patients with preoperative spasticity, 10 improved but 6 were worse after surgery.

Adult↗
PubMed1988

[Chronic pancreatitis: natural history and development in relation to alcoholism].

42 cases of chronic pancreatitis treated between 1976 and 1986, presenting 0.2% of all patients seen at the surgical clinic in the same period, have been reviewed. 37 patients (88%) were alcoholics and the prevalence of males was 83%. -Study of dietary habits showed a very high alcohol intake of 135.3 g alcohol per day, contrasting with the control group's alcohol consumption of 44.9 g per day. Alcohol intake calculated per life of patient with chronic pancreatitis represented 850.4 kg, whereas the control group consumed 344.1 kg (beer and wine). -Patients with chronic pancreatitis had started excessive alcohol consumption at an average age of 18 +/- 2 years and continued for an average of 18.0 +/- 1 years. These data correspond to zone A, i.e. Southern Europe. The evolution was analyzed with regard to persistence or cessation of alcoholism. Repeated attacks of chronic pancreatitis were seen in both groups. Patients abstaining from alcohol had only one attack during an average period of 10 years. Painful recurrences after surgery seem to be more frequent with persistent alcoholism (4 out of 5 patients), whereas in 15 patients without alcoholism they were observed only 3 times. -This shows that alcoholism remains the main factor in the natural history and evolution of chronic pancreatitis.

Adult↗
PubMed1984

Backscatter electron imaging of cells from effusions.

Cells from body cavity effusions from 35 patients were examined by scanning electron microscopy using both secondary electron imaging and backscatter electron imaging (BEI). This technique allows simultaneous viewing of the same cell for histological identification and for surface configuration. Mesothelial cells, macrophages, lymphocytes, neutrophils and malignant cells could be identified by their nuclear details and their surface features. Mesothelial cells had either smooth surfaces or blebs with few microvilli. Lymphocytes and neutrophils had similar surface features but could be easily identified by BEI. Macrophages had lamellar cytoplasm. Malignant cells were usually large and occurred singly or more frequently in groups. Their irregular chromatin pattern was easily recognized by BEI and was clearly different from mesothelial cells. This technique uses micropore filters to collect the cells. It is a rapid and simple procedure which offers advantages over previously described techniques using glass coverslips.

Exudates and Transudates↗
PubMed1976

Microsomal cytochromes of Candida tropicalis grown on alkanes.

A comparison of methods used in isolating microsomes and in measuring microsomal cytochrome P-450 demonstrated that separation following protoplast lysis gave the best results. By this latter technique a high amount of cytochrome P-450 (0.2-0.3 nmol/mg) was recovered but cytochrome P-420, considered as the denatured form, was absent. The alkanes specifically induce cytochromes P-450 and b5 localized on the microsomes. The denaturation in vivo of cytochrome P-450 into cytochrome P-420 even occurs during storage at 1 degree C. This degradation is increased during preparation of subcellular fractions if no preventive measures are taken.

Alkanes↗