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Biomedical subjects

J Briere

Publications and source records attributed to J Briere.

At least 73 records · Page 4Linked to original sources

Double intensive consolidation chemotherapy in adult acute myeloid leukemia.

Of 115 adult patients with de novo acute myeloid leukemia (AML), 87 (75.5%) achieved complete remission (CR) after induction treatment with zorubicin and conventional doses of cytarabine (Ara-C). Patients under age 45 years with histocompatibility locus antigen-identical sibling underwent bone marrow transplantation (BMT). The others were treated with two courses of intensive consolidation chemotherapy (ICC): course 1 with 4 days of high-dose Ara-C and 3 days of amsacrine (m-AMSA); course 2 with carmustine (BCNU), Ara-C, cyclophosphamide, and etoposide. Forty-two patients received both planned courses, 15 received only the first, and 13 patients could only support conventional maintenance therapy. Four patients died during consolidation. With a median follow-up of 60 months, the disease-free survival (DFS) after ICC at 5 years is 40.3% (+/- 6.5%), with no statistically significant difference between patients receiving one or two courses. The DFS for the 17 transplanted patients is comparable (P = .72) and is lower for the 13 excluded patients (23% +/- 11.5%, P = .046). Age did not influence the probability of remaining in CR. In univariate analysis, three parameters had a negative impact on the 5-year DFS: a high initial WBC count (52% for patients with less than 30 x 10(9) WBC/L v 12% for patients with greater than 30 x 10(9) WBC/L, P = .01), a long delay between induction treatment and course 1 (+/- 60 days; 63% v 29%, P = .01), and a long delay between course 1 and course 2 (+/- 60 days, 61.5% v 28.5%, P = .05). In multivariate analysis (Cox model), only the WBC count remained significant. This study confirms the value of intensive postremission chemotherapy, which can be compared in AML with allogeneic or autologous BMT. It also demonstrates the prognostic value of the initial WBC count. The optimal modalities of ICC remain to be defined by further studies.

Acute Disease↗

[Biological glue and obstruction of bronchial stumps. Experimental study. Sutureless bronchial closure of lobectomies in dogs].

From April, 1989 to January, 1990, we have been "inducing bronchial fistulae" in dogs by performing 10 lobectomies, 5 middle and 5 caudal, in both the right and the left lung. The bronchial stump was not sutured but closed by a "Tissucol-vicryl mesk" implant, which can be adapted to the size of the stump and is fully absorbed in the long term and replaced by a natural fibrous plug. The results seem to be fairly satisfactory: no dog died; all stumps--followed up a D10, D12... up to the 11th month--were obturated without complications, at least in these animals whose bronchi were normal and not infected. Bronchial fistulae still are a serious complication of lung resections, and while the smaller fistulae (2-3 mm) can be managed with biological glue delivered by simple endoscopy, severe fistulae--especially after pneumonectomy, above all in the right lung--often demand difficult, high-risk surgery. This points out to the interest of this small experimental series. Two conditions are essential to successfully implement this alternative procedure: 1) perfect sterilization of the excision pocket; a window is often required, which in addition has the advantage of facilitating the insertion and observation of the implant; 2) a high concentration of aprotinin (10,000 units) delaying the dissolution of the glue plug, thus allowing it to be integrated by the natural healing process.

Adhesives↗

Inhibitory effect of highly purified human platelet beta-thromboglobulin on in vitro human megakaryocyte colony formation.

The effect of highly purified human beta-thromboglobulin (beta TG), a glycoprotein present in platelet alpha granules, was tested on human bone marrow in vitro megakaryocyte (MK) colony formation. A concentration of 5 micrograms/ml of beta TG induced a 50% reduction in the number of MK colonies, and concentrations of 10 and 20 micrograms/ml completely inhibited MK growth. This inhibition was of importance for MKs because a higher concentration of beta TG (10 micrograms/ml) was needed to obtain a nonsignificant decrease in erythroblastic progenitors (erythroid burst-forming units, BFU-E), and no inhibition of granulocyte-macrophage colony-forming units (CFU-GM) was observed. beta TG acts mainly on maturation of MKs. These results indicate that beta TG could play a role in the physiological regulation of platelet production by MKs.

Blood Platelets↗

Differential adult symptomatology associated with three types of child abuse histories.

Using scales specifically developed for this purpose, the present study examined university women's retrospective reports of childhood sexual, physical, and psychological abuse as they related to three types of current psychosocial dysfunction. Multivariate analysis revealed that, as hypothesized, history of psychological abuse was uniquely associated with low self-esteem, physical abuse was linked to aggression toward others, and sexual abuse was specifically related to maladaptive sexual behavior. This analysis also indicated that although there were unique effects of each type of abuse, physical and emotional abuse were often present together--a combination associated with generalized psychosocial problems.

Adolescent↗

Childhood antecedents of antisocial behavior: parental alcoholism and physical abusiveness.

Hierarchical logistic regression was used to assess the independent and interactive effects of paternal alcoholism and physical child abuse on antisocial behavior in young adult men. Men with alcoholic fathers (N = 131) did not report or exhibit more antisocial behavior than comparison subjects (N = 70). Men with physical abuse histories, however, reported more aggressive and antisocial behaviors during a clinical interview and were rated by a clinical interviewer as more likely to act out aggression. Arrest records did not distinguish the groups. There was no evidence that paternal alcoholism and childhood victimization interacted to increase the risk of antisocial behavior.

Acting Out↗

University males' sexual interest in children: predicting potential indices of "pedophilia" in a nonforensic sample.

A survey was administered to 193 male undergraduate students regarding their sexual interest in children, as well as their responses to a number of questions theoretically relevant to pedophilia. In total, 21% of subjects reported sexual attraction to some small children, 9% described sexual fantasies involving children, 5% admitted to having masturbated to such fantasies, and 7% indicated some likelihood of having sex with a child if they could avoid detection and punishment. These sexual interests were associated with negative early sexual experiences, masturbation to pornography, self-reported likelihood of raping a woman, frequent sex partners, sexual conflicts, and attitudes supportive of sexual dominance over women. The data did not, however, support clinical theories regarding sexual repression or impulse-control problems among potential pedophiles.

Adult↗

Sexual abuse histories and sequelae in female psychiatric emergency room patients.

The charts of 100 nonpsychotic female patients in a psychiatric emergency room were reviewed to locate references to history of sexual molestation: 50 charts were selected at random from emergency room files, and 50 charts had been written by clinicians asked to query abuse history. A substantially higher rate of sexual abuse was found for patients who had been directly asked about sexual molestation (70%) than for the random sample (6%). Further analysis linked molestation history to suicidality, substance abuse, sexual difficulties, multiple psychiatric diagnoses, and axis II traits or disorders--especially borderline personality. Severe abuse and multiple abusers best predicted psychiatric sequelae.

Adult↗

Characteristics of megakaryocyte colony formation in normal individuals and in primary thrombocythemia: studies using an optimal cloning system.

Colony formation by megakaryocyte (MK) progenitors was studied in 36 normal individuals and in 26 patients with primary thrombocythemia (PT) using an improved plasma clot cloning system. MK colonies were identified by immunoperoxidase staining using a monoclonal antibody against human platelet glycoprotein IIb/IIIa complex. In normal individuals, a frequency of 194 +/- 23 MK colony-forming units (CFU-MK) per 5 X 10(5) bone marrow nonadherent mononuclear cells and 11 +/- 4 CFU-MK per 5 X 10(5) blood mononuclear cells was found. These CFU-MK grew as large (greater than 20 cells), mean (11-20 cells), small (3-10 cells), or mix-MK colonies (at least two MK) that comprised 15%, 23%, 62%, or 5% of all MK colonies in bone marrow and 0%, 8%, 92%, or 1% in peripheral blood, respectively. In PT, several abnormalities of MK colony formation were observed: 1) increased circulating CFU-MK numbers, 2) increased mix-MK colony formation, 3) spontaneous MK colony formation without phytohemagglutinin-stimulated leukocyte-conditioned medium and normal serum, 4) decreased proportion of larger MK colonies (greater than 11 cells) in PT bone marrow, and 5) failure of PT plasma or serum to stimulate MK colony formation by normal marrow cells in a normal fashion. These results indicate some of the characteristics of quantitative and qualitative abnormalities of in vitro megakaryocytopoiesis in PT.

Cells, Cultured↗

Symptomatology associated with childhood sexual victimization in a nonclinical adult sample.

The current study examined the incidence and long-term effects of sexual abuse in a nonclinical sample of adult women. Approximately 15% of 278 university women reported having had sexual contact with a significantly older person before age 15. On a modified version of the Hopkins Symptom Checklist, these women reported higher levels of dissociation, somatization, anxiety, and depression than did nonabused women. Abuse-related symptomatology was positively associated with the age of the abuser, the total number of abusers, use of force during victimization, parental incest, completed intercourse, and extended duration of time.

Adolescent↗

Multivariate correlates of childhood psychological and physical maltreatment among university women.

Little is known about the long-term effects of psychological or physical child abuse, despite recent advances in the related area of childhood sexual victimization. The present study used multivariate techniques to examine the relationship between four newly devised scales, measuring extent of psychological and physical maltreatment by mothers and fathers and a variety of current psychological symptoms in 251 university women. Results suggest two independent relationships: a global association between all four forms of maltreatment and almost all symptom variables and specific connections between paternal psychological and physical maltreatment, maternal physical maltreatment, and smaller subsets of symptoms. The data are interpreted as supporting an "ecological" perspective on abuse effects as well as demonstrating the value of multivariate methodologies in this area.

Adaptation, Psychological↗

Characteristics of circulating megakaryocyte progenitors (CFU-MK) in patients with primary myelofibrosis.

Characteristics of circulating CFU-MK and the effect of serum and plasma on CFU-MK growth were studied in 14 patients with primary myelofibrosis (MF) using short- and long-term culture methods. The number of CFU-MK in short-term cultures was significantly increased in the non-splenectomized patient group (p less than 0.01). Without added PHA-LCM and normal serum, spontaneous colony formation was found in 9 out of 10 patients. In long-term blood cultures from 6 MF patients, 3 untreated patients formed confluent adherent layers and produced in suspension an equal number or an even greater number of nucleated cells, megakaryocytes and CFU-MK than those obtained in long-term bone marrow culture from normal individuals. 2 splenectomized patients showed neither an increased numbers of CFU-MK nor the capacity to develop an adherent layer. The serum and plasma of MF patients failed to stimulate megakaryocyte colony formation by normal bone marrow in a normal fashion. These findings indicate a megakaryocytopoietic abnormality, and a central role of the spleen in extramedullary haematopoiesis in MF.

Blood Cell Count↗

Symptomatology in men who were molested as children: a comparison study.

Forty male and 40 female crisis center clients, evenly divided in terms of molestation history, were examined for possible long-term sequelae of sexual abuse. Although molestation during childhood was associated with previous suicide attempts and with elevated symptomatology on the Trauma Symptom Checklist, no differences between males and females were found on these variables.

Adjustment Disorders↗