[Simultaneous determination of serum levels of estradiol, prolactin, casein and immunoreactive neurophysins in pregnant and lactating women].
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Biomedical subjects
Publications and source records attributed to C Colin.
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Between 1966 and 1977, 142 breast cancers have been discovered in 85 250 women among 120,000 routine clinical examinations. Comparison between the information given by mammography alone compared with the panel of specialized techniques (cytology, thermography, mammography, echography) shows superiority for the latter. Complete breast check-ups have doubled the percentage of cancers discovered in the women that were examined (from 0,8% to 1,8%). A family history of breast cancer does not help in the discovery of cancer, except in cases of mammary changes noticed by the patient herself. However, these women have to be checked regularly, because the number of cancers diagnosed does not decrease at subsequent visits. The generalized practice of self-examination and of less mutilating treatment should encourage patients to consult earlier, as they have less fear that mutilating surgery will be performed.
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Murine mammary tumor virus main glycoprotein (gp47), prepared by diethylaminoethyl cellulose and hydroxyapatite chromatography of detergent-mercaptoethanol-KCI-disrupted virion, was used as labeled antigen in a highly specific and reproducible radioimmunoassay. Seven other (glyco) proteins of the virus were antigenically distinct from gp47. Serum and organs of unifected C57BL mice did not contain gp47, but sera of infected Swiss and RIII mice did contain the antigen. Despite the high content in the mammary gland, the level of gp47 in other organs was identical in male and female mice. The titer of gp47 in serum was high in tumor-bearing females, but it varied with the mouse strain. Anti-gp47 immunoglobulins could not be detected. The investigation included 314 human sera (107 normal, 65 benign mastopathy, 89 breast vancer, and 53 digestive cancer). None contained an antigen related to gp47. One of 20 human mammary cyst fluids was positive.
Fifty patients 70 years of age and older underwent coronary artery bypass surgery for disabling angina pectoris or congestive heart failure or both (two quadruple, 11 triple, 25 double grafts, 12 single). Twenty additional procedures were done (11 mitral valve replacements for papillary muscle dysfunction, six ventricular aneurysmectomies, four aortic valve replacements, and one repair of ventricular septal defect). Surgical mortality rate was 8 per cent (four patients). Total mortality rate was 14 per cent, after a mean follow-up of 17 months. Of 30 patients undergoing coronary artery bypass surgery alone, two died during surgery and none of follow-up. Age alone should not be a contraindication for coronary artery bypass surgery. Surgical risk is acceptable in older patients, and improvement can be expected in the majority of patients.
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Forty patients with a mean age of 65 years (range 44-76 years) were operated on; 30 of 40 patients (75%) had prior myocardial infarction. All had severe therapy-resistant congestive heart failure, 75% (30 of 40 patients) were symptomatic at rest, and 25% (10 of 40 patients) were symptomatic on minimal exertion. Cardiac index ranged from 1.24-2.84 L/min/m2 (mean 1.99). Left ventricular end-diastolic pressure ranged from 3-36 mm Hg (mean 18). All patients had significant mitral insufficiency and contractility was reduced markedly to moderately in 63% (25 of 40 patients). Significant coronary artery disease (obstruction greater than or equal to 75%) was present in all patients. All had mitral valve replacement, 30 had bypass surgery, and 7 left ventricular aneurysmectomy. Five died during surgery or before discharge (early mortality 12.5%). After a mean follow-up period of 16 months, another eight patients died, two with causes not related to the cardiovascular system (total mortality 32.5%). Of 20 patients with a cardiac index greater than or equal to 1.5 L/min/m2 and an ejection fraction greater than or equal to 0.40, 17 survived surgery and improved postoperatively. Mitral valve replacement for this group of patients is recommended.
Systematic senological examination which includes clinical, radiological, thermographic and cytological examination of 306 breast cancers and 776 benign breast conditions has led to the ability to demonstrate the value of classifying the information obtained by these examinations. The most significant results were obtained when cytological and rediological examinations were considered together. The combination of bloodless diagnosis is improved without having to resort to negative histological biopsies. This classification should also take into account the clinical examination and thermography, which is particularly useful in screening for diseases of the breasts. Mammary echography is still another method by which the precision of the diagnosis can be improved. Thermography, using liquid crystals, is a useful complement to a first clinical examination, but is not highly reliable.
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The results given by the P 32 test and thermography were compared in 92 cases of cancer of the breast, of which 7 appeared after oestrogens or androgens had been administered. After a hormone test of short duration it seemed that reliable results indicating hormone-dependent cancers would only be obtained with the thermographic test.
The pronostic classification based upon 8 radiographic signs (concerning malignant edema, tumor size and opacity aspect) allows to precise the clinical classification and is in good aggreement with the thermography classification of these cases. Localized or diffuse malignant edema is always of poor prognosis.
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