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Biomedical subjects

H Pujol

Publications and source records attributed to H Pujol.

At least 109 records · Page 6Linked to original sources
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

[Muscular tumors of the esophagus. Apropos of 9 cases and review of the literature].

Between 1970 and 1983, nine cases of tumors of esophageal muscle and connective tissue were treated at the Centre Paul Lamarque. Leiomyoma (LM) (6 cases in this series) represented 0.8% of esophageal tumors reported from among 1,200 patients, while leiomyosarcoma (LMS) (3 cases in this series) were observed in 0.25%. LM is usually detected fortuitously and is asymptomatic, LMS provoking dysphagia of the "foreign body" type contrasting with the "monstrosity" of the radiologic image. Endoscopy and biopsy is justified only when LMS in suspected, since it could interfere with enucleation. Treatment is surgical, by enucleation without mucosal effraction for LM and esophageal resection for LMS. Adjuvant therapy has failed to provide evidence of efficacy.

Adult↗
PubMed1985

[Cancer of the endometrium: analysis of the comparative results and causes of failure in radiosurgical treatment and physical agents alone. 215 cases treated between 1968 and 1978].

Two groups of patients (215 cases) with endometrial cancer were treated between 1968 and 1978 either by a combination of radiotherapy and surgery or by radiotherapy alone. In the first group (99 cases) with a mean age of 59 years, results were very favorable for stage T1 and T2 (49/60, 82%) which confirm other results in the literature. The combination of radiotherapy and surgery comprising external irradiation and intracavitary irradiation prior to total hysterectomy did not appear to increase the number of complications to the urinary or digestive tracts. The second group (116 cases) comprised patients treated exclusively by radiotherapy due to the presence of metastatic disease (74 cases) or excessive local-regional extension (37 cases). The cure rate at 5 years appeared satisfactory for stage T1 (35/54, 65%). The differing results between combined radiotherapy and surgery with methods using radiotherapy alone should be partially corrected to take into account the older average age of the second group (69 years). Failures due to the appearance of metastases were approximately similar in both groups (near 6%); on the other hand, local-regional recurrences were more frequent when radiotherapy alone was used, which accounts for the differing results between the two groups. In the second period (1972 to 1978), the group treated exclusively with radiotherapy benefited from a technique used with cervical cancer: external irradiation followed by intracavitary irradiation with a Fletcher-Suit applicator with results similar to those treated in the first period with intracavitary irradiation.(ABSTRACT TRUNCATED AT 250 WORDS)

Endometrium↗
PubMed1985

[Epithelial tumors of the ovary. Therapeutic results apropos of 165 cases of stage II and III tumors].

A report on the treatment of 165 epithelial tumours of the ovary (60 of which were stage II and 105 were stage III) by medical means after surgery. The results are far better in stage II cases for the length of survival without disease and the 5 year survival rate when surgical excision was complete (40 months and 43%) as compared with the disease-free interval and survival when surgical excision was incomplete (14 months and 27%) (p less than 0.05). There was a significant difference (p less than 0.05) in favour of pelvic and total abdominal irradiation as compared with other added therapeutic measures: 41 months as a median of disease-free interval and 60% survival at 5 years for patients who had pelvic and total abdominal irradiation combined with chemotherapy as against 26 months and 38% survival for patients who had only pelvic irradiation with chemotherapy. In the 105 stage III cases the median interval of disease-free survival and the survival at 5 years are quite different (p less than 0.01) for the 57 cases who had complete surgical excision (30 months and 17.5%) as compared with those who only had incomplete surgical treatment (1.4 months and 2%). There was no significant difference in the disease-free interval and the 5 year survival rate according to the different post-surgical therapeutic measures, whether these were chemotherapy alone or pelvic irradiation or pelvic and abdominal irradiation. These results are compared with those of other treatments following surgery of tumours of the ovary (a historical comparison and random trials).

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1984

Immunohistochemical detection of the estrogen-regulated 52,000 mol wt protein in primary breast cancers but not in normal breast and uterus.

An estrogen regulated glycoprotein of molecular weight 52,000 is released by metastatic human breast cancer cells in culture. In order to detect this protein directly in human tissues, several high affinity monoclonal antibodies were produced against the 52,000 mol wt protein. Frozen sections of human breast cancer samples were stained by the peroxidase-anti-peroxidase method using these antibodies. In 20 of 25 samples, specific immunoperoxidase staining was observed in the cytoplasm of epithelial cells with six monoclonal antibodies to the 52,000 mol wt protein. The 5 samples that were not stained contained no detectable estrogen receptor. Epithelial cells were not stained in 6 normal mammary glands collected during reduction mammoplasties and in 9 normal uteri, whether tissues were collected during the follicular or luteal phase. The demonstration that the 52,000 mol wt estrogen regulated protein is present in the cytoplasm of some primary breast cancers but absent in normal mammary tissue and uterus indicates its possible use as a tumor marker.

Antibodies, Monoclonal↗
PubMed1983

Release of estrogen-induced glycoprotein with a molecular weight of 52,000 by breast cancer cells in primary culture.

In an attempt to find estrogen-specific responses in breast cancer, we have established primary cell culture from metastatic pleural effusions of breast cancer and have analyzed the proteins labeled by [35S]methionine and released into the culture medium using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. We show that the synthesis of a Mr 52,000 glycoprotein which is released by metastatic breast cancer cells in primary cultures is stimulated by estradiol in four of six patients. This protein is similar to the Mr 52,000 protein of MCF7 cells on the basis of its mobility in one- and two-dimensional gel electrophoresis [the molecular weight of this protein was originally found to be 46,000; it is closer to 52,000 using labeled proteins from New England Nuclear as molecular weight markers], its immunoprecipitation by antisera raised against the Mr 52,000 protein, and its binding to concanavalin A. We conclude that, similar to some breast cancer cell lines, some metastatic breast cancers synthesize a Mr 52,000 glycoprotein which is regulated by estrogens and exported from the cells into the medium. This study also shows that some primary cultures established from metastatic breast cancer remain responsive to estradiol in vitro for the synthesis of specific proteins. More clinical studies are needed to prove the interest of the Mr 52,000 secreted protein as an additional marker of the hormone responsiveness of breast cancer.

Breast Neoplasms↗
PubMed1982

Follow-up results from a randomized trial for T3 and T4 breast cancer patients: previous BCG immunotherapy improves response to chemotherapy in the relapse patient.

Following locoregional treatment, patients were randomized into three groups: The first groups received no complementary treatment; the second group received adjuvant chemotherapy (vincristine, cyclophosphamide, and 5-fluorouracil once a month for 12 months); and the third group was treated by immunotherapy (150 mg BCG once a week for 1 year). Sixty-two of the 82 patients studied were menopausal. No significant difference was observed between the three groups. All patients were followed-up for at least 18 months. The disease-free interval difference between the chemotherapy group and the control and immunotherapy groups is not significant. But it should be noted that only 21.8% of the control group did not relapse compared to 57% in the chemotherapy group. BCG immunotherapy in such patients must be considered ineffective. However, our results suggest that patients first treated with BCG respond better to chemotherapy than patients not receiving any previous therapy.

Breast Neoplasms↗
PubMed1982

Osseous metastases in the hand. A general review of three cases.

Osseous metastases in the hand are rare. The authors report 3 cases, bringing the total number of reported cases up to 106. They affect mainly men; their clinical features are local swelling and pain frequently ascribed to a trauma. The diagnosis is often mistaken, many patients being initially treated for a distal felon. Distal phalanx is the main involved area, with irregular osteolysis and cortical destruction. The etiology is quite different from that of metastases to other bones: bronchopulmonary cancer is by far the most frequent with 46% of cases, followed by breast cancer (15%). Other types of cancer are much less frequently involved. The evolution is sombre; average life expectancy is 3 1/2 months. Treatment may involve, as needed, distal digital amputation on antalgic radiotherapy.

Aged↗
PubMed1982

[Contribution of artificial feeding to the prevention of fistulae, anastomotic breakdowns, and eviscerations. Applications to diffuse postoperative peritonitis in eight cases (author's transl)].

Based on the study of 8 cases diffuse post-operative peritonitis, the authors demonstrate in an exemplary manner the benefit derived through artificial nutritive support which permits, in certain well-defined cases, one-step digestive sutures and allows high-quality anastomotic and parietal healing. This new therapeutic attitude should not be generalized; it remains as yet very special, requiring specific metabolic safety measures. Only surgical teams in total control of the metabolic and nutritive problems accompanying heavy visceral surgery are in a position to apply this new concept.

Adult↗
PubMed1981

[Therapeutic failures in early stages of Hodgkin's disease : causes and prevention (author's transl)].

A retrospective study of 65 patients with Hodgkin's disease (clinical stage I: 11 cases; stage II: 54 cases) included an analysis of the causes of therapy failure. Twenty-five of the 65 patients had been treated by regional irradiation (thoracic mantle or inverted Y field) restricted to only one side of the diaphragm; 27 patients had received the same irradiation followed by chemotherapy (MOPP). The subjects were irradiated on both sides of the diaphragm; 3 of these had received the same radiotherapy followed by chemotherapy (MOPP). Relapses in the irradiated fields were rare. Relapses in the areas bordering the irradiated fields were definitely the result of faulty delivery. Better evaluation of the precise extent of the disease, particularly by laparotomy, would lead to improved initial treatment (radio- or chemotherapy). The availability of improved irradiation techniques and a better choice of indications, particularly concerning the timing for chemotherapy, should result in maximal reduction of therapeutic failures in the early stages of Hodgkin's disease.

Antineoplastic Agents↗