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Biomedical subjects

J Chevrant-Breton

Publications and source records attributed to J Chevrant-Breton.

At least 55 records · Page 3Linked to original sources

[Treatment of metastatic melanoma with dacarbazine recombinant interferon alfa 2A combination: results of multicentric study].

Fifty patients suffering from histologically proven metastatic melanoma were treated with a combination of DTIC (400 mg/m2 i.v. every 28 days) and recombinant alpha 2A interferon (Roferon-A) 10 x 10(6) U/m2 daily, administered intramuscularly or subcutaneously for 2 months followed by 7 x 10(6) U/m2 3 times a week. Treatment was carried out for a period of 12 months unless progressive disease was noted after 3 months. Among the 49 evaluable patients, 6 achieved a complete response (CR) and 4 a partial response (PR) (response rate, 20%) at 2 months, 8 CR and 3 PR (25%) and 8 CR and 2 PR (23%; 95% confidence limits, 13-40%) occurred at month 6 and 12 respectively These responses occurred notably in patients with cutaneous (3 cases) or lymph node metastases (4 cases), but 3 responses included visceral sites: lung (1 CR), liver (1CR and 1PR). Average response duration was 16.5 months (range 4-29 + months). The time required for objective response can be up to 6 months, which suggest that treatment should receive a reasonable trial period (at least 3 months). Clinical toxicity consisted mainly of a flu-like syndrome, anorexia and fever, and occurred in more than 50% of patients; hematologic and hepatic toxicities required a dose reduction in 54% of patients but in only one case did treatment have to be terminated because of this. Seventeen (35%) of the patients are still alive, 4 with metastases (follow-up period: 18-34 + months) and 13 without metastases (follow-up period: 13-32 + months). A combined regimen of r-IFN alpha 2A and dacarbazine is effective in treating patients with metastatic melanoma, with acceptable toxicities and a reasonable quality of life (out-patient treatment or district nurse care). The objective response rate (23% at 12 months) compares favourably with those of earlier trials using the same combination of drugs, and occurred not only in cutaneous and lymph node metastases but also in visceral metastases.

Adolescent↗

[Immunoscintigraphy of malignant melanoma].

This work is part of a multicentric European evaluation of the monoclonal antibody 225.28s targeted against malignant melanoma and its metastases. Twenty-eight patients (12 males, 16 females, mean age: 53 yrs), who had initially been treated by resection of the primary tumour, were included in the study. Twenty-three of the 26 metastases more than 1 cm in diameter were visualized by immunoscintigraphy. The sensitivity of the procedure (88%) is limited however by the small size of the lesions and their depth, as well as by background noise caused by circulating antibodies. Immunoscintigraphy enables non-invasive investigation of the whole body and can detect lesions that other conventional complementary explorations fail to identify.

Antibodies, Monoclonal↗

Eczematous dermatitis in relation to carbon ligamentoplasty.

Carbon biomedical devices are widely used in prosthetic surgery; their biocompatibility is excellent and cutaneous or mucosal adverse effects of carbon material remain exceptional. We describe a patient who developed an eczematous dermatitis on the right knee in the vicinity of a ligamentoplasty performed 2 months earlier. Patch testing with the carbon ligament was positive. Although the scattering of carbon material in the surrounding tissues is well known, cutaneous complications have, to our knowledge, never been reported.

Adult↗

[Antral vascular ectasia and scleroderma. Endoscopic, radiologic and anatomopathologic aspects of an uncommon association].

Diffuse gastric antral vascular ectasia (GAVE) is a new disease entity corresponding to peculiar acquired vascular malformations. In 1984 Jabbari et al. coined the term "Watermelon Stomach" for this lesion. We report here in a new case particular by its association with systemic sclerosis in a 66 year-old female. The diagnosis of GAVE was suggested upon endoscopic and angiographic findings. Atrophic fundic gastritis associated with achlorhydria and hypergastrinemia was also noted. Antrectomy was performed with success. Pathologic examination and morphometric analysis of the antrum specimen revealed the characteristic features of GAVE: 1) increase of the mean cross sectional area of mucosal vessel lumen and increase of the mean percentage of specimen area occupied by vessels; 2) presence of intravascular fibrin thrombi and 3) fibromuscular hyperplasia of the lamina propria.

Aged↗

Hereditary epidermolytic palmoplantar keratoderma associated with breast and ovarian cancer in a large kindred.

We report a large kindred in which palmoplantar keratoderma occurred in association with breast or ovarian cancer or both. This kindred consisted of 61 members of four generations. Thirty-five individuals had palmoplantar keratoderma, including eight women who also had breast or ovarian cancer or both. Five of the six women with breast cancer and both the women with ovarian cancer have died. The proband presented with a yellowish, uniform hyperkeratosis surrounded by a red border covering the entire surface of the palms and soles. Light microscopic examination showed features of epidermolytic hyperkeratosis, and ultrastructural examination revealed the typical markers for this entity, cytolysis and clumps of keratin filaments. This kindred is the first, to our knowledge, to have an association of epidermolytic hyperkeratosis and internal malignancy.

Adult↗

A chronic, infantile, neurological, cutaneous and articular (CINCA) syndrome. A specific entity analysed in 30 patients.

We have studied the clinical presentation and course of a chronic inflammatory disease occurring in childhood and observed in 30 patients. The first symptoms were generally present at birth, except in a few patients where they were first noticed in early infancy. All the patients had the association of three main symptoms: neurological, cutaneous and articular. The skin rash was the first symptom observed in all the patients and looked like a chronic non pruritic urticaria varying during the day. The articular manifestations involved knees, ankles and feet, elbows, wrists and hands unaffecting the other joints. They could be mild giving arthritis during flare-ups or severe with major radiological modifications affecting the epiphysis, metaphysis and growth cartilage. The neurological manifestations were characterized by a chronic meningitis and symptoms indicating meningeal irritation: headaches, seizures, spasticity of legs. Most patients had a cerebral atrophy and a low IQ. Sensory organ involvement occurred progressively during the follow-up: ocular inflammation with optic atrophy, deafness and hoarseness. Common morphological features characterized these patients with short stature, head enlargement, saddle back nose and short and thick extremities with clubbing of fingers. The course was that of a chronic inflammatory disease with numerous flare-ups associating fever, splenomegaly and adenomegaly. Except for a high level of eosinophils in blood, CSF and tissues, the biology was non specific and only exhibited features of inflammation. Except for two families, the disease was sporadic. A high frequency of prematurity with features resembling a foetal infection was observed but no proof of a possible causal virus has so far been found so that etiology remains unknown.

Adolescent↗

[Etiologic and epidemiologic questions posed by erythema chronicum migrans and Lyme disease. Apropos of 4 cases at the Regional Hospital Center, Rennes].

The authors give 4 observations, made in Rennes (France), of 3 cases contracted in France and 1 in Canada, cases they think to be related, for 3 at least, to the infectious entity described by American authors under the name of Lyme disease. If 1 of these cases was limited to an erythema chronicum migrans, the 3 others showed a beginning evolution towards a classical Lyme disease. In 2 of these 3 last cases, the infection was perhaps cut short by a quickly applied therapy by antibiotics. They discuss the different hypotheses about the negative Borrelia serologic reactions in 3 of the 4 cases. A possible arboviral aetiology is evocked. In only one of the 4 cases, a tick-bite can be asserted, the role in the the transmission of this kind of arthropods being strictly excluded in 2 of the 3 other cases (transmission likely by a mosquito and by a biting fly (tabanid?)). The authors put the question of the possibility of transmission, for erythema chronicum migrans and Lyme disease, by arthropods other than ticks.

Adult↗

Multiple glomus tumors associated with multiple neoplasias.

We report the case of a 60-year-old man who presented with a lentigo maligna melanoma, which led to the discovery of a malignant endobronchial tumor and who had noticed the appearance of disseminated multiple glomus tumors about 10 years before. The late onset of this form of benign vascular tumor raises the question whether multiple glomus tumors may have been, in this case, a cutaneous marker of the development of underlying malignancy.

Biopsy↗