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Biomedical subjects

G Andry

Publications and source records attributed to G Andry.

At least 55 records · Page 3Linked to original sources
PubMed1990

[Magnetic resonance imaging (MRI) of cervico-facial tumors].

Magnetic Resonance Imaging (MRI) gives substantial advantages for the study of tumoral extension in the anatomically complex cervico-facial region. The multiplanar approach permits a better analysis of the anatomical relationships of the tumor, including relationships with the vascular structures, without the need for injecting a contrast medium. The method is able to accurately differentiate tissues and is very sensitive for detecting tumoral tissue. Lesions poorly visible with CT, with poor contrast enhancement or lying in a muscular environment, are well demonstrated. Some difficulties remain for obtaining from patient a complete immobility for a long examination. We think MRI gives a substantial benefit for the diagnostic work-up of cervico-facial tumours, and could be the first imaging technique in this area, particularly if further shortening of the examination time is gained with fast imaging methods and if availability of MRI installations is improved.

Head and Neck Neoplasms↗
PubMed1989

Adenosine triphosphate, bradykinin, and thyrotropin-releasing hormone regulate the intracellular Ca2+ concentration and the 45Ca2+ efflux of human thyrocytes in primary culture.

The hormonal stimulation of phospholipase C and the consequent activation of the Ca2+-phosphatidylinositol cascade in eukaryotic cells is associated with modifications of the [Ca2+]i (intracellular Ca2+ concentration) which modulates cellular functions. In this study, these modifications were investigated in primary cultures of human thyroid cells. The mean apparent basal [Ca2+]i of human thyrocytes measured using the intracellularly trapped fluorescent indicator Quin-2 was found to be 89 +/- 16 nM (n = 49). ATP and, to a lesser extent, ADP, but not AMP or adenosine, elicited a concentration-dependent biphasic rise in human thyrocytes [Ca2+]i and increased their 45Ca2+ efflux. The first transient phase of the [Ca2+]i rise induced by ATP was resistant to extracellular Ca2+ depletion, whereas the second sustained phase was abolished in these conditions. This suggests that although the first phase of this response involves a release of Ca2+ from intracellular stores, the second phase requires extracellular Ca2+ influx. The response of human thyrocytes to analogs of ATP is compatible with a P2-purinergic effect of ATP on these cells. Bradykinin and TRH affected the human thyrocyte [Ca2+]i and 45Ca2+ efflux similarly to ATP. The human thyrocyte [Ca2+]i and the 45Ca2+ efflux were not modified by carbachol, a nonhydrolyzable analog of acetylcholine. The present results suggest the presence of P2-purinergic receptors to ATP and of receptors to TRH and bradykinin on human follicular thyroid cells. They also confirm that the Ca2+-phosphatidylinositol cascade is present in these cells and suggest that this cascade is modulated by ATP, TRH, and bradykinin. As this cascade is involved in the regulation of protein iodination, and therefore of thyroid hormones synthesis, these agents might have an important role in the regulation of the thyroid function.

Adenine Nucleotides↗
PubMed1989

Relation between estrogen receptor concentration and clinical and histological factors: their relative prognostic importance after radical mastectomy for primary breast cancer.

After modified radical mastectomy, 490 primary breast cancer patients were followed for a median of 75 months. Bloom grade was measured in 340 patients and ER status in 341. Follow-up of these patients has yielded the following results: (a) The value of traditional indices has been reaffirmed. (Cox's multivariate analysis identified, in order of decreasing importance, the number of invaded lymph nodes, the initial tumor size and the histological grade. Other variables were found to be of lesser importance and were correlated with the three main indices.) (b) The value of ER status disappeared after more than 3 years of follow-up. (c) ER positive patients fared better after recurrence. This was interpreted as being a consequence of their responsiveness to hormonal treatment.

Adult↗
PubMed1989

Neoadjuvant chemotherapy with cisplatin, methotrexate, bleomycin and vincristine (CABO) in patients with stage III and IV squamous cell carcinoma of the head and neck.

Forty-six patients with Stage III-IV previously untreated squamous cell carcinoma of the head and neck were treated with neoadjuvant chemotherapy with cisplatin, methotrexate, bleomycin and vincristine. The overall response rate was 70%, with a 9% complete response rate. The most frequent side effects were myelosuppression, nausea and vomiting, alopecia, neurotoxicity and stomatitis. Definitive local therapy consisted of surgery alone in 13 cases, surgery plus radiation in another 13, and radiotherapy alone in 14. Six patients, four of whom died, received no definitive local therapy and two were lost to follow-up. The median disease-free survival time was 10.5 months, and the most frequent cause of failure was local regional relapse (85%). Median survival time was 13 months and there were eight long-term survivals (median 48 months). Response to chemotherapy was independent of all analysed prognostic factors. Disease-free survival and survival were significantly influenced by the presence or absence of lymph nodes. Our results do not support the routine use of neoadjuvant chemotherapy with cisplatin, methotrexate, bleomycin, and vincristine in patients with advanced cell carcinoma of the head and neck.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

Locoregional recurrences after 649 modified radical mastectomies: incidence and significance.

A continuous series of 649 patients, treated by modified radical mastectomy for primary breast carcinoma, is analyzed after a median follow-up of 92 months. 'True isolated' locoregional recurrences (LR), defined as LR not preceded or followed by distant metastases within 6 weeks, appeared with a cumulative actuarial incidence rate of 6%, 14% and 19% after 1, 5 and 7 years respectively, whereas the respective figures for distant metastases (M1) were 10%, 37% and 48%. The main initial parameters, predicting both the LR-free and the M1-free interval, are presented by statistical analyses in the following order of importance: number of invaded lymph nodes in the axilla, tumor size (T) and histological grading of differentiation. The same factors also predicted the imminence of M1 once LR had occurred, as well as survival after LR. A higher incidence of M1 after LR was also correlated with estrogen-receptor negative tumors and with those LR occurring within one year after mastectomy. LR occurred at the chest wall (65%), in the sub-clavicular fossa (16%) and the axilla (6%); the remaining 13% occurred in two of the sites. There was a trend towards longer survival after chest wall recurrence than after LR recurrence at another site. Axillothoracic irradiations postmastectomy gave a lower rate of LR in 227 patients than did a regimen of 12 months adjuvant chemotherapy with irradiation restricted to the internal mammary lymph nodes in 120 subsequent patients: 17 vs 25% at 5 years (P = 0.03 when adjusted by initial nodal involvement and T-size). Total excision of LR (repeated if new LR occurred) gave better rates of local ultimate control and survival than other kinds of treatments, with or without adjuvant local or systemic therapy. LR is not always a sign of imminent generalized disease. Actuarial 5-year survival after LR is 26.2% overall whereas, if only 'true isolated' LR are considered, the survival is 37%.

Breast Neoplasms↗
PubMed1989

Vertical hemipharyngolaryngectomy: reconstruction with the radial forearm free flap.

A considerable body of literature defines techniques to restore glottic function after partial laryngectomy. The authors of this paper describe a new original technique for glottic and hypopharyngeal reconstruction after vertical hemipharyngolaryngectomy. Using a radial forearm free flap including the tendon of the palmaris longus and a sensitive branch of the radial nerve, they were able to reconstruct the missing vocal cord and a pyriform fossa. This procedure permits an extended resection without the usual phonatory or swallowing inconveniences. There is no contraindication for postoperative radiotherapy. The technique and preliminary functional results are reported.

Forearm↗
PubMed1989

Free and pedicled flaps for head and neck reconstruction in radically irradiated fields: 6 years' experience at the Jules Bordet Institute.

From 1982 to 1988, 127 flaps were performed after ablative surgery for head and neck squamous cell carcinoma: 86 pedicled pectoralis major island and 41 free flaps of different types. One hundred and four were evaluable for this retrospective study: 66 after definitive radiotherapy (6000-8000 cGy) and surgery for recurrent or persistent disease and 38 after elective surgery for Stage III and IV tumors without previous irradiation. Wound healing, hospital stay, survival rate and complications are compared between irradiated and nonirradiated areas. The indications, advantages and disadvantages of each type of flap are reviewed according to the main goals of our treatment: i.e. local disease control, restoration of function, cosmetic appearance and short hospital stay.

Adult↗
PubMed1989

Human medullary thyroid carcinoma: cell cultures and xenotransplants in nude mice. Immunocytochemistry and calcitonin secretion.

Occult primary and recurrent medullary thyroid carcinomas (MTC) detected only by elevated calcitonin levels in the peripheral blood, generally after pentagastrin-test stimulation, are difficult to localize. Some new imaging procedures with radionuclide tracers or radiolabelled monoclonal antibodies against carcinoembryonic antigen seem to bring some potentially therapeutic benefits. We report our results with cell cultures and xenotransplants of human MTC with the intention of establishing reproducible models in vitro and in vivo. Cell cultures secrete calcitonin at up to 1200 pg/ml for periods ranging from 3 to 13 weeks. Immunocytochemistry detects cytoplasmic granules positive for calcitonin in polygonal epithelioid cells with dendritic processes. Xenotransplants in nude mice fare better in the subcutaneous axilla than in the subrenal capsule assay. In the former location the tumor-take is good and calcitonin is detected in the blood of the tumor-bearing animals, at levels ranging from 286 to more than 20,000 pg/ml. These models would be potentially usable as targets for radionuclide tracers and/or radiolabelled monoclonal antibodies.

Animals↗
PubMed1989

Concomitant osteitis fibrosa cystica and ameloblastoma of the mandible.

A patient with a multiloculated cystic lesion of the mandible, and clinical as well as biological features of hyperparathyroidism is presented. This association suggesting the diagnosis of brown tumor was actually due to an ameloblastoma of the mandible. Such a concomitant association of an ameloblastoma with symptomatic hyperparathyroidism has never been reported to our knowledge.

Adenoma↗
PubMed1988

Papillary and follicular thyroid carcinoma. Individualization of the treatment according to the prognosis of the disease.

A retrospective study of a continuous series of 152 patients is presented: the patients were treated between 1 January 1955 and 31 December 1981 for a papillary or a follicular thyroid carcinoma. The prognostic index, proposed by the EORTC Thyroid Cancer Cooperative Group in 1979, was calculated for each patient. According to the survival curves and recurrences after treatment, the study shows a clear-cut difference in prognosis if the prognostic index is below 50 or is equal to or above 50. This observation supports the proposal of minimal treatment for less aggressive tumors and extensive treatment for the high risk patients. The actual treatment plan is: (1) total lobectomy when the tumor is unilateral and the prognostic index below 50, but total thyroidectomy in the other cases; (2) lymph node surgery only in cases of node involvement. Instead of a radical neck dissection, a more conservative procedure should be performed, removing the lymphatic chains and preserving the sterno-cleidomastoid muscle, the internal jugular vein and the spinal accessory nerve; (3) no postoperative radioiodine for low risk patients with complete removal of the tumor; (4) postoperative thyroid hormone at doses suppressing secretion of TSH for all patients.

Adolescent↗
PubMed1988

Antimicrobial prophylaxis for major head and neck surgery in cancer patients.

A total of 113 patients were randomly allocated to receive either ticarcillin plus clavulanic acid (total dose, 20.8 g) or clindamycin (total dose, 2.4 g) plus amikacin (total dose, 1 g) as perioperative antimicrobial prophylaxis for major head and neck surgery. The two groups were similar in age, prior antineoplastic treatment (surgery, chemotherapy, and radiotherapy) or tracheostomy, and the various types of surgery including radical neck dissection. The wound infection rate was 10% in the group of patients receiving clindamycin plus amikacin and 36% in the group receiving ticarcillin plus clavulanic acid (P less than 0.05). Initiation of systemic antibiotic therapy within 15 days of surgery was necessary for 20 and 45% of these patients, respectively (P less than 0.05). The distribution of microorganisms causing wound infections was comparable in both groups, except for anaerobes, which were isolated predominantly from patients who had received ticarcillin plus clavulanic acid.

Adult↗
PubMed1986

Cholesonographic characteristics of cystic duct metastasis causing acute acalculous cholecystitis: case report.

A variety of epithelial malignancies are capable of metastasizing to the bile ducts and gall bladder in a fashion distinct from concurrent spread to the liver. Ultrasonography has proved useful in evaluating obstructive jaundice in this setting and, in the case described, accurately diagnosed acute acalculous cholecystitis caused by a solitary metastasis from carcinoma of the breast to the cystic duct. Exploratory laparotomy confirmed the accuracy of this preoperative diagnosis.

Adenocarcinoma↗
PubMed1980

Regulation of cyclic nucleotide and prostaglandin formation in normal human thyroid tissue and in autonomous nodules.

We have investigated the regulation of the human throid gland based on controls discovered in the dog thyroid gland. TSH and thyroid-stimulating immunoglobulin enhanced cAMP accumulation, which supports the validity of the Sutherland model for the action of TSH on the human thyroid. Iodide inhibited TSH- and thyroid-stimulating immunoglobulin-activated cAMP accumulation and this effect was reduced by methimazole, showing that, in this tissue, iodide, through an oxidized derivative, depresses the TSH-cAMP system. Contrary to the hypothesis of a short feedback loop of thyroid hormone, no thyroid effect of T3 or T4 was found. Adrenergic agents (norepinephrine and isoproterenol) enhanced cAMP accumulation; this effect was inhibited by dl-propranolol but not by d-propranolol or phentolamine. This suggests a positive control of the thyroid cAMP system by beta-adrenergic receptors. Histamine also increased cAMP accumulation. However, the role of these controls is unknown. Acetylcholine, by a muscarinic type effect, enhanced cGMP accumulation and prostaglandin E2 and prostaglandin F2 alpha release. These effects were mimicked by ionophore A23187 and abolished in a calcium-deprived medium, which suggests that they are secondary to a raised Ca++ influx. The results are summarized in a general working model of human thyroid regulation. These biochemical controls have been compared in normal tissue and autonomous nodules. No evidence of increased sensitivity to TSH of the nodular tissue was found. On the other hand, this tissue was less sensitive to acetylcholine (cGMP accumulation) and more sensitive to norepinephrine (cAMP accumulation).

4-(3-Butoxy-4-methoxybenzyl)-2-imidazolidinone↗