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C Bouchet

Publications and source records attributed to C Bouchet.

At least 37 records · Page 2Linked to original sources
PubMed1995

[Comparison of 3 quality of life instruments in the longitudinal study of rheumatoid arthritis].

Quality of life measures take into account the patient's perception of health. Many generic or specific instruments are available. The psychometric properties of such measures should allow for adequately testing the hypothesis of an investigation. We studied the properties of three quality of life measures: the Health Assessment Questionnaire (HAQ) specific for rheumatic diseases, the Nottingham Health Profile (NHP)--a generic measure--and the General Health Questionnaire (GHQ) which measures psychological dimensions. They were applied in a one year cohort study of 111 French rheumatoid arthritis patients set up for determining prognosis factors of quality of life. Criterion validity was established on high correlation between Ritchie index and physical dimensions (r = 0.29 to 0.58, p < 0.01). Internal consistency was good with Cronbach's alpha coefficients over 0.8 for all dimensions. Reproducibility was studied for physical dimensions with Intra-class Correlation Coefficient (ICC) for patients clinically unchanged. It was excellent for the HAQ (ICC = 0.89), good for the NHP (ICC = 0.57 to 0.73) but weak for the GHQ (ICC = 0.13 for somatic dimension). After one year follow-up, a significant change in quality of life could only be evidenced by the HAQ (Standardized Response Mean = 0.4, p < 0.05) in patients with clinical significant change. So among the three instruments, the HAQ should be preferred for longitudinal studies, possibly supplemented with a generic instrument that investigates more dimensions of quality of life.

Adult↗
PubMed1995

Comparative study of four extraction procedures for urokinase type plasminogen activator and plasminogen activator inhibitor-1 in breast cancer tissues.

The urokinase type plasminogen activator (u-PA) and the plasminogen activator inhibitor-1 (PAI-1) are among the best second-generation prognostic tissue factors in breast cancer. However, different extraction procedures and assay kits are used in different laboratories. A total of 79 breast tumour tissues stored in liquid nitrogen were analysed in this study. We compared u-PA and PAI-1 levels determined with the American Diagnostics (AD) kit after various extraction procedures. The median cytosolic extraction yield in the presence of 0.4 mol/l KCl, calculated relative to extraction in the presence of 10 ml/l Triton X100 when adapted to standard laboratory working hours (incubation for 2 h instead of 12 h) was 74.4% for u-PA and 85.8% for PAI-1. In addition, the correlations were acceptable. Cytosolic extracts prepared with KCl could permit optimal u-PA and PAI-1 assays while also enabling hormone receptors to be determined with the same specimens. Further studies with clinical data are now necessary to determine the prognostic relevance of this extraction procedure.

Breast Neoplasms↗
PubMed1994

Prognostic value of urokinase-type plasminogen activator (uPA) and plasminogen activator inhibitors PAI-1 and PAI-2 in breast carcinomas.

It is now clearly established that proteolytic enzymes, including plasminogen activator (uPA), play an important role in breaking down the extracellular matrix, which is considered to be a step in metastasis formation. Plasminogen activators are controlled at various levels. Two inhibitors, PAI-1 and PAI-2, have been identified, the latter being more specific for uPA. In attempts to determine their prognostic value, it is essential to investigate the relative importance of these parameters and their interactions. We used an immunoenzymatic method to assay uPA, PAI-1 and PAI-2 antigens in cytosols prepared from 314 primary breast tumours. The patients were followed up for a minimum of 6 years and all relevant clinical and laboratory findings were recorded. Univariate analysis confirmed the poor outcome of patients whose tumours contained large amounts of uPA and PAI-1. In addition, low levels of PAI-2 correlated with shorter disease-free survival in the overall population (P = 0.02), post-menopausal women (P = 0.02) and women without lymph node involvement (P = 0.02). Multivariate analysis in the 'main effects' Cox model identified node involvement, macroscopic tumour size and PAI-2 as significant variables. The 'interactive' model, taking into account interactions between uPA and its two inhibitors, identified a first subgroup with a very poor prognosis associating either high levels of PAI-1 with low levels of PAI-2 in the overall population and the women with no node involvement or high levels of uPA with low levels of PAI-2 in the group of menopausal women. We conclude that PAI-1 provides the same prognostic information as uPA, and does not appear to play a role as an inhibitor. In contrast, PAI-2 increases the prognostic value of uPA, particularly in post-menopausal women, and PAI-1 in patients with no node involvement.

Adult↗
PubMed1994

[Prognostic value of urokinase-type plasminogen activator and 2 inhibitors PAI-1 and PAI-2 in breast cancer].

It is now clearly established that proteolytic enzymes, and in particular plasminogen activator (uPA), play an important role in breaking down the extracellular matrix, which is considered to be a step in metastasis formation. Plasminogen activators are controlled at various levels. Two inhibitors, PAI-1 and PAI-2, have been identified, the latter being more specific for uPA. In attempts to determine their prognostic value, it is essential to investigate the relative importance of these parameters and their interactions. We used an immunoenzymatic method to assay uPA, PAI-1 and PAI-2 antigens in cytosols prepared from 314 primary breast tumors. The patients were followed up for a minimum of six years and all relevant clinical and laboratory findings had been recorded. Univariate analysis confirmed the poor outcome of patients whose tumors contained large amounts of uPA and PAI-1. In addition, low levels of PAI-2 correlated with shorter disease-free survival in the overall population (P = 0.02), post-menopausal women (P = 0.02) and women without lymph node involvement (P = 0.02). Multivariate analysis using the "Main Effects" Cox model identified node involvement, macroscopic tumor size and PAI-2 as significant variables. The "interactive" Cox model, taking into account interactions between uPA and its two inhibitors, identified a first subgroup with a very poor prognosis associating either high levels of PAI-1 with low levels of PAI-2 in the overall population as well as following stratification for axillary node negative disease, or high levels of uPA with low levels of PAI-2 in the group of menopausal women. We conclude that PAI-1 provides the same prognostic informations as uPA, and does not appear to play its role as an inhibitor. In contrast, PAI-2 increased the prognostic value of both uPA, particularly in post-menopausal women, as well as PAI-1 in a subgroup of axillary node negative patients.

Adult↗
PubMed1992

[A comparative study of CPK during spinal surgery in the knee-chest position. Apropos of 93 patients].

A number of severe rhabdomyolysis with acute renal failure have been reported following spine surgery in knee chest position. CPK were measured postoperatively in 93 patients (A group), comparatively with two groups in which respectively neurosurgery without any muscle stretching (B group) and abdominal surgery with aid of retractors (C group) were performed. CPK were significantly and similarly increased in A and C groups only. This postoperative increase of CPK appears to be related more to the muscle stretching than to the posture itself. Intraoperative low blood pressure and an operating time longer than 4 hrs contribute probably to rhabdomyolysis. No renal failure was observed in our series. Low limb vascular insufficiency is the main contra-indication of knee chest position. Postoperative diuresis surveillance is mandatory in all cases, CPK analysis is not.

Adult↗
PubMed1991

Relationship between cathepsin D, urokinase, and plasminogen activator inhibitors in malignant vs benign breast tumours.

The concentrations of cathepsin D (Cath D), urokinase (uPA) and two plasminogen activator inhibitors (PAI-1 and PAI-2) were analysed in the cytosols of 130 human mammary tumours (43 benign tumours and 87 primary and unilateral breast carcinomas). uPA, PAI-1 and PAI-2 levels were measured by antigenic immunoassays and Cath D by immunoradiometric assay. The median levels of the four parameters were significantly higher in the malignant tumours than in the benign ones. Cath D and uPA increases were 4-fold and 5-fold respectively. PAI-1 and PAI-2 increases were much more important, 74-fold and 29-fold respectively. In malignant tumours, median levels of Cath D and uPA did not vary according to classical prognostic factors (histologic grade, presence or absence of axillary lymph nodes, steroid receptors, UICC stage, tumour size, age, and menopausal status). However, PAI-1 decreased in ER+ and PR+ tumours and PAI-2 increased in menopausal women's tumours. When Cath D, uPA, PAI-1 and PAI-2 levels in malignant tumours were compared, positive correlations were found for all combinations. The implication of plasminogen activator inhibitors in the phenomenon was surprising and merits further investigation using tools other than global antigen measurements in tumours.

Breast Diseases↗
PubMed1990

[Surgery of intracerebral arteriovenous malformations: the anesthesiologist's point of view. Report of 50 cases].

This retrospective study was undertaken in order to analyse the application of the grading scheme of Spetzler and Martin to a series of 50 excised arteriovenous malformations. The frequency distribution of scores was as follows score II, 21 cases; score III, 18 cases; score IV, 7 cases and score V, 4 cases. Neurological deficit (54%), intracerebral hematoma (34%), intraventricular (12%) and subarachnoid hemorrhage (24%), epileptic seizure (26%), difficulty of surgery duration (8.1 h +/- 2.8), per-operative bleeding and coagulation abnormalities (14%), post-operative morbidity (early postoperative neurological status, duration of controlled ventilation and stay in Intensive Care Unit) and outcome were taken as target variables. Youth has a favorable influence on outcome: 100% of patients less than 30 years have a good outcome, whereas 88% of the 30 to 50 years old group and 67% of the patients older than 50 years have a similar favorable recovery. According to these factors, the clinical grading scale of Spetzler and Martin seems to provide a good pre-operative evaluation of surgical risks.

Adolescent↗
PubMed1989

[Effects of an intravenous injection of nicardipine on cerebral blood flow in subarachnoid hemorrhage caused by intracranial aneurysm].

Fifteen patients with ruptured intracranial aneurysm have been operated before undergoing post surgery xenon inhalation for cerebral blood flow valuation: first measurement has been performed as CBF reference; 2nd measurement has been done after 0.1 mg.kg-1 I.V. bolus of nicardipine; sides effects are mainly due to BP fall 2/15 and some consequent neurological distress have been noticed (2/15); results should be carefully interpreted. Significant CBF increase have been measured after nicardipine injection, specially in brain area correlated to low CBF before injection (the lower the CBF, the higher the increase of local flow). The study prompt us to check the effect of nicardipine on patient (with CBF measurement after nicardipine test) before giving the treatment. Problems remain to be solved with further studies and not yet established: correlation between hemodynamics changes and clinical status and also which time of disease evolution is the best to be treated.

Adult↗
PubMed1986

[Aneurysm of the popliteal vein. A rare cause of recurrent pulmonary embolism].

Popliteal vein aneurysm, a rarely observed, apparently benign lesion may nevertheless be the cause of disabling pulmonary emboli. Two personal cases and 13 reported in the literature are reviewed. Detected during phlebography of lower limbs during investigation of a pulmonary embolus, the aneurysm, of a sacciform shape, was located above the interline of the knee and often contained a thrombus: this site of onset facing the calf "venous pump" makes it an "experimental" emboligenic focus. The pulmonary embolus is a serious affection since it is repetitive: a pulmonary scan showed dissemination in the two fields of the hypovascularized zones. Identification of an acute or chronic cor pulmonale was a routine finding and a paradoxical embolus in the arterial territory was observed twice. Local surgery (venous repair or exclusion of the aneurysm) can be performed in association with anticoagulant therapy, but partial interruption of inferior vena cava appears to be the safer method of avoiding a recurrent embolus, which may be fatal.

Adult↗
PubMed1986

[Complications related to the seated position of the aged patient in neurosurgery].

The advantages of the sitting position for neurosurgery of the posterior fossa are evident and universally admitted. However, respiratory and haemodynamic consequences make this position uncommon and even exceptional for the old patient whose existing physiological cardiovascular and pulmonary disturbances may result in greater risks. In this study, the complications observed during and after surgery in twenty-two patients over 65 years are analysed. These patients underwent functional neurosurgical procedures in sitting position. According to the results, old age does not appear to be an absolute contra-indication of the sitting position for this type of surgery.

Aged↗