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H Pujol

Publications and source records attributed to H Pujol.

At least 73 records · Page 4Linked to original sources
PubMed1991

[Giant fibroadenoma of the breast: reconstruction of the breast after resection using the dermal vault technique].

The authors report two cases of giant fibroadenoma of the breast and discuss the diagnostic and therapeutic problems and the value of the "dermal vault" technique. A giant fibroadenoma is a fibroadenoma with a diameter exceeding 6 centimeters. This benign tumor has an inflammatory growth during pregnancy. An exact histological diagnosis is necessary to differentiate GFA from sarcoma phyllodes. The reconstructive concern should not jeopardize the quality of the removal. The "dermal vault" technique seems to meet these requirements: diagnosis and removal are made through a posterior approach and symmetrization of the volumes is easily obtained on clamp. The new location of the NAC should be outlined while bearing in mind that a cutaneous retraction of the upper parts will systematically occur.

Adenofibroma↗
PubMed1990

The role of diet history and biologic assays in the study of "diet and breast cancer".

Nutritional factors related to breast cancer were investigated by means of a hospital-based case-control study in Milan (Italy) and Montpellier (France). Liposoluble vitamins, cholesterol and triglycerides were measured in blood samples taken from interviewed subjects (319 cases and 344 controls). In addition serum zinc and copper was assessed in the Italian samples and serum fatty acids and malonyl-di-aldehyde in the French samples. A significant difference was found between cases and controls in total fat and cholesterol intake in both populations, and in saturated fatty acid and mono-unsaturated fatty acid consumption in the French samples. No difference emerged in liposoluble vitamin consumption in both populations nor in zinc and copper consumption in the Italian samples. A statistically significant higher serum level of cholesterol and plasma level of vitamin E was observed in cases compared to controls in both populations. The difference in plasma vitamin E was confirmed after adjustment on total cholesterol and triglycerides. Similarly, zinc serum level was higher in Italian cases than in Italian controls, while malonyl-di-aldehyde was lower in French cases than French controls. A multivariate analysis was performed after classification of cases and controls according to quantile distribution of controls. Nutrient consumption and relevant blood markers were directly or partially correlated in both populations. All known risk factors plus age, serum total cholesterol and triglycerides were used as covariates. The odds ratio values for the highest quantiles are: Dietary cholesterol, OR = 1.9 (1.1-3.4); total dietary lipids, OR = 1.9 (1.0-3.4); plasma vitamin E, OR = 4.2 (1.9-9.0); serum zinc, OR = 12.2 (5.4-27.7); serum malonyl-di-aldehyde, OR = 0.56 (0.33-0.97).

Breast Neoplasms↗
PubMed1990

In situ evaluation of growth fraction determined by monoclonal antibody Ki-67 and ploidy in surgically resected non-small cell lung cancers.

Ploidy and growth fraction were analyzed by means of a computer-assisted image processor in surgically resected non-small cell lung cancer (NSCLC). This study was done in order (a) to evaluate the distribution of anti-Ki-67 immunostaining and (b) to correlate this distribution to ploidy status and pTNM stage of NSCLC. Thirty-two patients underwent a surgical resection for primary NSCLC following complete staging. Indirect immunoperoxidase reactions of monoclonal antibody Ki-67 were done on frozen tissue sections. Integrated optical density and index of stained nuclear surface were calculated by means of a computer-assisted image processor in 120 fields of each preparation in order to quantify the Ki-67 immunostaining. DNA content was determined by means of cytometry of Feulgen-stained cytological prints. The ploidy status was defined for each tumor by DNA index, percentage of hypodiploid cells, and type of DNA content histogram (near diploid, hyperdiploid, hypodiploid, and multiploid). Reproducibility of immunostaining quantitative analysis was demonstrated by iterative measurements of the same slide. Intratumoral heterogeneity of Ki-67 immunostaining induced integrated optical density variation assessed on six nonconsecutive tissue sections from at least two regions of the same tumor. This intratumoral variability was 15 times lower than integrated optical density variability between tumors. The Ki-67 immunostaining varied significantly according to the DNA content histogram type (P less than 0.05, Kruskal-Wallis test); most of the specimens with high Ki-67 immunostaining were multiploid or hypodiploid. Moreover, Ki-67 immunostaining correlated to the percentage of hypodiploid cells. Ki-67 immunostaining and ploidy status did not vary significantly according to the tumor-nodes-metastasis stage. We conclude that (a) quantitative analysis of Ki-67 immunostaining is a reliable evaluation of growth fraction in NSCLC if a large number of fields are analyzed to take into account intratumoral variability, (b) hypodiploidy and multiploidy are frequent abnormalities of DNA content, (c) Ki-67 immunostaining is significantly higher in hypodiploid and multiploid tumors. Thus, determination of growth fraction and ploidy in surgically resected NSCLC specimens may be considered as complementary prognostic parameters independent of the stage of the disease.

Adenocarcinoma↗
PubMed1990

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

At the present time endometrial carcinoma is considered to be among the most frequent of gynecological tumors and its incidence is now reaching that of cervix carcinoma. In this paper, we present the results of two series of treatment for endometrial carcinoma, one using the combination of surgery and radiation, the second one using radiation treatment alone. Indeed, due to our recruitment criteria between 1968 and 1978 at the Montpellier Cancer Institute, the proportion of patients treated exclusively by physical agents was more or less equal to those receiving combined treatment. In many cases, either because of the poor condition of the patient, or due to local involvement, irradiation alone was used. The report of the results explain the therapeutic failures and show by means of two sequential series how techniques have been developed. Previously treated patients were excluded (44 cases).

Adenocarcinoma↗
PubMed1990

Cathepsin D assay in primary breast cancer and lymph nodes: relationship with c-myc, c-erb-B-2 and int-2 oncogene amplification and node invasiveness.

In breast cancer, axillary lymph node invasiveness is the major prognostic factor in predicting relapse and metastasis. Nevertheless, since 30% of node-negative tumors also relapse, it is necessary to develop other independent prognostic factors. Oncogene amplification and the level of cathepsin D (cath-D), an acidic lysosomal protease produced and secreted in excess by breast cancer cells, have been proposed as additional prognostic factors. We have compared the cytosolic cath-D level and the amplification of three oncogenes: c-myc, neu-erb-B-2 and int-2 in 140 primary breast carcinomas and 64 axillary lymph nodes collected in 1987 and 1988 at the Cancer Center of Montpellier (Centre Paul Lamarque). None of the patients had previously received hormonal or chemotherapy. The cath-D concentration was measured with an immunoradiometric assay using monoclonal antibodies. DNA purified from the same samples was analyzed by a standard Southern blotting technique to estimate oncogene amplification. No correlation was found between the level of cath-D in the tumor and node invasiveness. Using a cut-off level of 60 pmol/mg protein, the status of cath-D was not correlated with neu-erb-B-2 and int-2 amplification and only correlated with c-myc amplification (P = 0.011). Both c-myc and cath-D are associated with cell proliferation, induced by estrogens in ER+ breast cancer, and constitutively produced in ER- breast cancer. The level of cath-D was significantly higher in the invaded lymph nodes (P = 0.04) than in the histologically non-invaded ones. Nevertheless, some non-invaded lymph nodes contained a high level of cath-D, as confirmed by immunoperoxidase staining. In conclusion, in breast cancer, a high cytosolic cath-D concentration is more frequent in tumors with c-myc amplification but is dissociated from neu-erb-B-2 or int-2 amplification, suggesting that the determination of these three markers will have an additional prognostic value.

Axilla↗
PubMed1990

Tumorectomy and radiation therapy in early breast cancer: a report on 392 patients.

Three hundred ninety-two breast cancer patients (231 with stage I and 161 with stage II disease) were treated with tumorectomy followed by radiation therapy. The overall actuarial survival rate was 86.5% at 5 years and 78.0% at 10 years. The 5-year disease-free survival rate was 70.2%. Survival rates depended on locoregional tumor extension. Patients with stage I tumors had a survival rate of 92.0% at 5 years and 84.0% at 10 years; patients with stage II tumors had a survival rate of 82.0% at 5 years and 75.0% at 10 years. The percentage of patients with local recurrences was 13.0% for all patients (10.8% for stage I and 16.1% for stage II patients). The percentage of patients with lymph node recurrences was 1.5% for all patients (1.3% for stage I and 1.9% for stage II patients). The percentage of patients with distant metastases was 11.2% for all patients (7.8% for stage I and 16.1% for stage II patients). Locoregional control rates compared favorably with those in the literature. Breast preservation rates at 5 years were 85.0% for stage I and 80.9% for stage II patients. Cosmetic results were judged good by physicians in 80% of patients and by 90% of the patients themselves. Complication rates were very low.

Adenocarcinoma↗
PubMed1990

pH monitoring for 24 hours of gastroesophageal reflux and gastric function after intrathoracic gastroplasty after esophagectomy.

Gastroesophageal reflux is the main complaint after intrathoracic gastroplasty for carcinoma of the esophagus. Eighteen patients who underwent intrathoracic gastroplasty were studied by 24 hour pH monitoring. Two groups of patients were separately evaluated according to the surgical procedure performed--group 1, nine patients with tubulized stomach and gastroesophageal anastomosis at the apex of the thorax, and group 2, nine patients without tubulized stomach and with low gastroesophageal anastomosis. Gastroesophageal reflux and gastric function were analyzed. Gastroesophageal reflux was clinically present in 36 per cent of patients. During the 24 hour pH monitoring period, the percentage of time that the esophageal electrode showed a pH value of less than 4 was shorter for group 1 than for group 2 (13.3 +/- 11.3 versus 32.7 +/- 21.7), indicating less gastroesophageal reflux. Gastric secretion was also studied with 24 hour pH monitoring. Gastric secretion was reduced after gastroplasty, compared with a control group. Gastric secretion was identical between groups 1 and 2. Tubulization did not impair gastric secretion. Findings from this study show that good functional results can be achieved after intrathoracic gastroplasty if the anastomosis is performed on the neck or at the apex of the thorax. This technique can reduce gastroesophageal reflux without an antireflux procedure.

Adult↗
PubMed1989

Relationship between vitamin E and polyunsaturated fatty acids in breast cancer. Nutritional and metabolic aspects.

Intake of vitamin E, total lipids, total cholesterol, and fatty acids were analyzed with the blood levels of vitamin E, total cholesterol, triglycerides, and the serum distribution of fatty acids in a hospital-based population of 120 patients and 109 controls. In regard to nutritional intake, the only significant differences involve saturated and monounsaturated fatty acid consumption, which is more elevated in postmenopausal patients than in postmenopausal controls. Vitamin E and total cholesterol blood levels are significantly higher in patients than in controls, where the difference is that vitamin E is independent from cholesterol level in premenopausal women only. Fatty acid serum distribution is comparable in both samples, with the exception of arachidonic acid, which is significantly lower in premenopausal patients than in premenopausal controls. Two multivariate regression analyses of the plasma vitamin E levels of patients and controls were done with menopausal status and nutrients as independent variables for the first analysis, and with menopausal status and all blood analytes for the second one. The regression coefficients for total cholesterol and triglycerides are statistically significant for both samples, whereas a positive association between vitamin E plasma level and sunflower oil consumption and between vitamin E plasma level and serum linoleic acid distribution is significant for patients only. Furthermore, the multiple regression shows that, when adjusted for analyte variables, plasma vitamin E levels are higher in premenopausal than in postmenopausal patients. In addition, plasma lipid peroxidation, evaluated by malondialdehyde measurement, is shown to be significantly lower in patients than in controls. Malondialdehyde level is associated with a significant lower odds ratio (OR) after multivariate tertile analysis (OR for the highest tertile: 0.51; 95% CI: 0.29-0.89). Together, these findings are consistent with a picture of lower lipid peroxidation in patients than in controls.

Adult↗
PubMed1989

Alcohol consumption in a case-control study of breast cancer in southern France.

The effect of alcohol consumption on breast cancer risk was investigated in a hospital-based, case-control study of 808 patients (349 cases and 459 controls) in Montpellier (France). Semi-quantified diet history including beverage consumption as well as relevant medical and personal characteristics were assessed by interview. A dose-rate relationship for total alcohol consumption was found with unadjusted odds ratios ranging from 1.8 (95% CI 1.2-2.8) for 1 to 2 drinks per week to 3.5 (95% CI 2.0-6.1) for more than 17 drinks per week, in comparison with less than 1 drink per week. Confounding by known or suspected determinants of breast cancer, smoking, use of oral contraceptives, lipid and vitamin consumption was looked into. Significant interactions were found with level of education and lipid consumption, with a higher risk for alcohol in women having had less schooling or consuming less fat. Adjustment with respect to the other risk factors did not modify the relationship. There was a significant risk increase both for wine and stronger drinks. Along with several other studies, our results give support to the hypothesis that alcohol is a risk factor in breast carcinogenesis.

Alcohol Drinking↗
PubMed1989

Tamoxifen treatment increases the concentration of 52K-cathepsin D and its precursor in breast cancer tissue.

The pro-cathepsin D of Mr 52,000 is regulated by estrogens via the estrogen receptor (RE) and is secreted by breast cancer cells in vitro. In an attempt to predict the hormone responsiveness of breast cancer in vivo, we have assayed total 52K cathepsin D and its precursor in the primary breast cancer cytosol of 36 patients treated before surgery with 30 mg of tamoxifen daily for 1 to 5 weeks (average, 3 weeks). Compared to a similar control population, total 52K cathepsin D was increased by tamoxifen (P = 0.02) but less so than its precursor (P less than 0.001). Furthermore, 45% of the RE-positive tumors from tamoxifen-treated patients had a higher cathepsin D precursor concentration than the same type of tumor from control patients, or than RE-negative tumors from tamoxifen-treated patients. This 3-week challenge test was probably too short to avoid partial estrogenic activity of tamoxifen (flare) and the authors infer that longer time of treatment would decrease rather than increase the concentration of cathepsin D in the RE-responsive tumors. However, two cancers from patients with relapses after prolonged tamoxifen treatment (greater than 6 months) also had high concentrations of 52K cathepsin D and its precursor. The authors conclude that the concentration of cathepsin D and its precursor in breast cancer cytosol can be increased by short-term tamoxifen treatment, suggesting that these tumors are estrogen responsive.

Adult↗
PubMed1989

[Prevention of cisplatin nephrotoxicity in cancer: adjusting the dosage with a computerized chrono-pump].

Platinum and its derivates are particularly efficient in treatment of ovarian and testis carcinomas. Nevertheless, the high nephrotoxicity of these drugs limits their use. It is known that nephrotoxicity appears when platinum plasmatic concentrations are higher than 1.5 mg/l. Moreover, the wide variability between patients and between cures, emphasizes the difficulties of utilization. Using a computerized pump and a program for individual dosage regimen, an efficient prevention of plasmatic overdosages have been realised and nephrotoxicity accidents have been avoided.

Aged↗