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Biomedical subjects

H Joyeux

Publications and source records attributed to H Joyeux.

At least 55 records · Page 3Linked to original sources
PubMed1988

Inhibition of cytochrome P-450p (P450IIIA1) gene expression during liver regeneration from two-thirds hepatectomy in the rat.

Regenerating liver from partial hepatectomy (HPX) is known to exhibit a strong and transient deficiency in both spectrally detectable microsomal cytochrome P-450 (P-450) and related monooxygenase activities. Male Wistar rats (250-300 g) were HPX or sham operated and liver was excised at different times after operation. The time course of accumulation of five different forms of P-450 (including P-450b/e, P-450c, P-450d, P-450p and P-450UT-A) was determined in the regenerating liver, by Western blots developed with specific antibodies. With the exception of P-450c, whose level was not affected, the accumulation of other forms strongly decreased during the first 24 hr after HPX. For P-450b/e and P-450d, 80% of initial level was restored at 96 hr, whereas for P-450p and P-450UT-A, two major forms in control rat liver, the accumulation was only 20-25% of the initial, 1 week after HPX. No significant decrease was observed in sham operated animals. Plasmid pDex 12 containing a cDNA insert coding for P-450p was used to further investigate the effects of HPX on P-450p mRNA level and gene transcription. Northern blot analysis of RNA from regenerating liver (cDNA insert of pDex 12 being used as a probe) demonstrated that P-450p mRNA level decreased strongly to a minimum 12 hr after operation. This was correlated with a strong and transient decrease in P-450p gene transcription determined from nuclear run on experiments, the time course of which, however, did not account for the early decrease in mRNA level. We conclude that P-450p deficiency in the regenerating liver results from a combination of transient inhibition of gene transcription and early increase of mRNA degradation. Time course and amplitude of the decrease in P-450 UT-A accumulation suggest an inhibition of gene transcription as observed with P-450p.

Animals↗
PubMed1988

[Home parenteral nutrition for adults. Results of a multicenter survey in France].

Home parenteral nutrition (HPN) is a growing therapy in North America and Europe. This first multicenter retrospective study of HPN in France has collected data on 81 patients sent home before December 31st, 1985. Intestinal failure, secondary to short bowel syndrome, small bowel stenosis or fistula, was the main indication for HPN. In 95 p. 100 of the cases, the clinical nutritional status during HPN was either normal or subnormal. The annual incidence of catheter change for technical complication was 0.78 and the mortality rate was 1.2 p. 100. Social rehabilitation was recovered during HPN in 60 p. 100 of patients. Thirty percent of the patients died of their primary disease during HPN but 43 p. 100 were off treatment, and 27 p. 100 were on HPN at the end of the study. The cost of HPN was reduced by 64 p. 100 in comparison with the cost of parenteral nutrition carried out in hospital.

Adult↗
PubMed1988

Colorectal carcinoma in patients younger than 40 years of age. Montpellier Cancer Institute experience with 78 patients.

During an 18-year period, 2600 patients were treated for colorectal carcinoma in the Montpellier Cancer Institute. Of the 93 patients younger than 40 years of age (3.6%), 78 records were retrospectively studied. The overall 5-year survival rate was 30%. Their survival was not significantly affected by the site of the primary tumor, the degree of tumor differentiation, or sex. The only significant parameter was Dukes' staging at presentation (P less than 0.0001). An analysis of sites of recurrence revealed the frequency of liver metastasis, ovarian metastasis in women, and local recurrence of rectal cancer. Although the high failure rate in these areas clearly justifies aggressive combined therapy, the high frequency of inaugural Stage D patients (27%) and their short mean survival time (5 months), underline the crucial importance of early detection. However, it is unfortunate that colorectal cancer screening in young patients is difficult because of the low rates of precancerous states (4%).

Adenocarcinoma↗
PubMed1988

[Cancer of the rectum: treatment by a radiosurgical combination of 328 patients. Mono- and multivariate analysis of prognostic factors].

From 1973 to 1983, 328 patients have been treated for rectal carcinoma in the Centre Paul Lamarque by preoperative radiotherapy (40 Grays) followed by surgical excision. The average age was 64 years and the sex ratio was 2:1. Abdominoperineal resection was performed in 219 patients anterior resection in 99 patients and transanal resection in 10 patients. Overall 3 years survival was 82 p. 100 and 5 year survival was 73 p. 100. The five year local recurrence rate was 9.4 p. 100 with 3.5 p. 100 of patients having liver metastases. Monovariate analysis revealed that the local recurrence rate was influenced by tumor circumference (p = 0.005), tumor reduction after radiotherapy (p less than 0.001), histological type (p = 0.049), lymph node metastases and tumor infiltration (p = 0.001). Survival was influenced by lymph node metastases, tumor infiltration (p = 0.001) and histological type (p = 0.01). The multivariate analysis revealed that prognosis was influenced by lymph node metastases and tumor infiltration. The "down staging" induced by the radiotherapy did not modify the predictive value of these 2 prognostic parameters when compared to groups treated by surgery only.

Adult↗
PubMed1988

Endometrial cancer: a comparative analysis of the therapeutic results and causes of failure after treatment by radiation combined with surgery or radiation therapy alone.

The present study involved 215 endometrial carcinoma patients. Ninety-nine were treated by combined irradiation and surgery (preoperative external irradiation and intracavitary insertion followed by total hysterectomy and lymphadenectomy). Radiotherapy alone was used with 116 patients i.e. whole pelvis external irradiation and Heyman radium packing (40 patients) or afterloading techniques with Fletcher-Suit-Delclos applicators and cesium (76-patients). The 5-year NED survival rate was 78.7% in the combined therapy group and 44% in the exclusive radiotherapy group. The locoregional recurrence rates were 10% in the combined group and 28% in the exclusive radiotherapy group. These results are discussed in relation to data in the literature and to biases introduced due to patient selection in this nonrandomized study. Five-year survival rates, locoregional recurrence rates and sites of failures are analyzed according to the different treatments. Modifications of the external irradiation and intracavitary techniques allowed us to obtain better results and fewer complications.

Adenocarcinoma↗
PubMed1987

[Parenteral feeding at home. 100 cases].

Between 1979 and 1986, 100 patients underwent parenteral nutrition at home on account of malnutrition consecutive to digestive insufficiency or heavy anti-cancer chemotherapy. Parenteral feeding was performed through a buried catheter for a mean period of 74 days (range 30 to 430 days). The patients' nutritional status was improved, with a significant increase in weight, total plasma proteins and serum albumin (P less than 0.001). The principal complication observed was infection, and few patients (10.61%) were rehospitalized. Home parenteral nutrition may be regarded as "the artificial bowel" for chronic malnutrition patients. It increases the duration and quality of life without prolonging the time spent in hospital, and it reduces health expenses by 50 to 70%.

Adult↗
PubMed1987

Experimental model of extended repeated partial hepatectomy in the dog.

The model of extended repeated partial hepatectomy without vascular shunt in dogs is presented. It consisted of 65% initial hepatectomy and after liver regeneration (6-10 weeks) repeated hepatectomy. Finally, only the papillary process of the caudate lobe (PPC), which constitutes 5% of the initial hepatic mass, was left intact. The most important finding was an ability of PPC to reconstitute the liver mass which enabled survival without the vascular shunt. After repeated hepatectomy the need for artificial hepatic assistance (parenteral nutritional support with frozen plasma) was imperative to offset the effects of acute hepatic failure and to support PPC regeneration.

Animals↗
PubMed1986

Aggressive regional surgery for advanced ovarian carcinoma.

Between January 1975 and December 1983 in the Cancer Institute, Montpellier, France, regional surgery (RS) was performed on 18 Stage III and 3 Stage IV patients (International Federation of Gynecology and Obstetrics [FIGO]) with histologically proven cystadenocarcinoma of the ovary. All patients were placed into one of three nonrandomized groups: Group A (9 patients), RS at first-look surgery; Group B (7 patients), RS at second-look surgery; and Group C (5 patients), RS at third-look surgery. Group A was given adjuvant chemotherapy, whereas Group B and C patients underwent nonregional surgery at first- or second-look operation, and received chemotherapy supplemented in some Group C cases by radiotherapy before RS. The adjuvant chemotherapy consisted of: cyclophosphamide plus Alkeran (mephalan) plus 5-fluorouracil (the first 7 patients) and Adriamycin (doxorubicin) plus cisplatin plus hexamethylmelamine (14 additional patients). RS consisted of basic procedures--abdominal hysterectomy; bilateral salpingo-oophorectomy; omentectomy--and specific procedures--abdominal and pelvic peritonectomy; either total or partial colectomy; jejunoilectomy, leaving at least 150 cm of the jejunum; and retroperitoneal lymph node dissection aimed at maximal cytoreduction of tumor mass. There was no operative mortality. The overall postoperative morbidity was 33.3% (seven patients) due to wound sepsis. The survival from the beginning of treatment (absolute survival [AS]) and survival after RS (RSS) were compared. In Group A (AS = RSS) the probability of survival at 112 months (6/9 patients are still alive) was 0.52. In Groups B and C the median survival times (AS and RSS) were 37 and 17 months and 18 and 1 month, respectively. The difference in AS among the three groups of patients was not statistically significant (log-rank test), whereas the RSS was statistically significant between Group A versus Groups B, C, and Groups B and C combined (P less than 0.05).

Adult↗
PubMed1986

Total parenteral nutrition needs in different types of short bowel syndrome.

Thirty-nine patients with short bowel syndrome after extensive small bowel resection, with or without associated partial or total colectomy, received continuous total parenteral nutrition followed by discontinuous parenteral nutrition. Home parenteral nutrition was introduced in 16 of these patients; in eight it was permanent. The assessment of nutritional status included body weight; standard urinary and blood studies; albumin, prealbumin, and transferrin serum levels; and both urinary and fecal nitrogen. A statistically significant correlation (P less than 0.001) was observed between the length of the remaining small bowel and the necessary duration of nutritional support. Multivariate analysis allowed us to classify patients into three groups as a function of remaining gut length and the duration of required nutritional support. This study should help to define the best nutritional support protocol for patients with various short bowel syndromes in order to ensure the best possible intestinal adaptation and to improve their quality of life.

Adult↗
PubMed1986

Calcium absorption following small bowel resection in man. Evidence for an adaptive response.

Seventeen patients who had undergone extensive small bowel resection were studied for calcium absorption (FACa) and plasma vitamin D metabolites. FACa was measured by a double radio-tracer technique and expressed as percentage of total oral dose. FACa was decreased compared with controls (34%, range: 3-46 v 65%, range: 57-73, P less than 0.01). A positive correlation (r = 0.49, P = 0.05) was found between FACa and the remaining length of small bowel (SBL). As wide variations in both SBL and duration after surgery were observed among the seventeen investigated patients, we were led to individualize less heterogeneous subgroups of patients. Better correlations were found when the patients were divided into two subgroups according to whether the time interval between the resection and the investigation was shorter (r = 0.75, n = 11, P less than 0.02) or longer (r = 0.89, n = 6, P = 0.05) than 2 years. In thirteen patients who had a SBL shorter than 100 cm, a positive correlation was observed between FACa and the time interval after surgery (months): r = 0.65, P less than 0.05. Plasma 1,25 (OH)2D was markedly reduced in the whole group (31 pmol l-1, range: 8-108) compared with controls (103 pmol-1, range: 59-134, P less than 0.01). The present study shows that in extensively small bowel resected patients, calcium absorption is reduced, the alteration being dependent both on the length of the remnant small bowel and on the time after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Internal jugular vein cannulation with two silicone rubber catheters: a new and safe temporary vascular access for hemodialysis. Thirty months' experience.

Temporary and immediately usable vascular access is a vital need in treating uremic patients. Subclavian vein cannulation, although a major progress, has been associated with significant morbidity and mortality. Accordingly, for the last 2.5 years the authors have been developing an alternative technique consisting of internal jugular vein cannulation (IJVC) with two silicone rubber catheters with a long-term, proved biocompatibility. One hundred sixty-five pairs of cannulas were inserted in 153 patients. Mean duration of use was 57 days (1 day to 17 months). More than 3,000 high-performance hemodialysis sessions were performed. IJVC handling and care were easily managed by nurses. A low incidence of complications was observed: two thrombosis episodes, four skin infections with three septicemia, one air embolism, and one anaphylactoid reaction. No death was related to the technique itself. IJVC offers a new, safe, and reliable temporary vascular access immediately usable for all kinds of extracorporeal treatment.

Aged↗