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Biomedical subjects

J Lacour

Publications and source records attributed to J Lacour.

At least 37 records · Page 2Linked to original sources

Enhancement of natural killer cell activity and 2-5A synthetase in operable breast cancer patients treated with polyadenylic; polyuridylic acid.

Treatment of operable breast cancer patients with a single injection of 60 mg poly(A); poly(U) (polyadenylic, polyuridylic acid) resulted in an enhancement of natural killer (NK) cell cytotoxicity against human myeloid K562 target cells. Furthermore, the level of 2-5A synthetase in peripheral blood lymphocytes of such patients was increased after the treatment. Both of these effects, measured 24 and 48 hours after the injection of poly(A); poly(U), were statistically significant compared to their respective levels before the treatment. These events, therefore, may be used as markers to monitor the immediate response of patients toward treatment with this synthetic double-stranded RNA.

2',5'-Oligoadenylate Synthetase↗

Polyadenylic.polyuridylic acid in the cotreatment of cancer.

The biological properties of polyadenylic . polyuridylic acid (Poly(A) . Poly(U] are discussed and the application to the treatment of cancer in various animal models is described. Pharmacokinetic properties are presented and the results of clinical application to humans with specific reference to adjuvant treatment of breast cancer are examined in some detail. Given these results and the total lack of toxicity or of secondary effects of Poly(A) . Poly(U) it appears that further development and application of this polynucleotide complex are certainly justified in terms of clinical use in cancer and perhaps in viral pathologies.

2',5'-Oligoadenylate Synthetase↗

Clinical trials using polyadenylic-polyuridylic acid as an adjuvant to surgery in treating different human tumors.

The results of a randomized trial of polyadenylic-polyuridylic [poly(A).poly(U)] acid given as adjuvant treatment for operable breast cancer were reviewed after a mean follow-up period of 87 months. The overall survival was significantly improved in patients given the adjuvant (155 cases) as compared with the controls (145 cases). A significant benefit was observed in patients with invaded axillary nodes; the best results were obtained in the group of patients with up to three nodes involved, who showed a significant increase in both overall and relapse-free survival. The biological response modifications observed after treatment with poly(A).poly(U), namely, production of interferon and increase of natural killer cell activity, are described and their possible role in the mechanism of action of the complex is discussed. The results of a Phase I clinical tolerance study of the duplex in cancer patients will be reported. The aims and protocols of new clinical trials with adjuvant poly(A).poly(U) in different types of tumors will be presented.

Breast Neoplasms↗

Conservative treatment versus mastectomy in breast cancer tumors with macroscopic diameter of 20 millimeters or less. The experience of the Institut Gustave-Roussy.

A clinical trial was conducted at the Institut Gustave Roussy between October 1972 and December 1980 to compare mastectomy with local excision plus Cobalt-irradiation, in patients with breast cancer tumors of 20 mm in diameter or less at macroscopic examination. Low-axillary dissection and extemporaneous histologic examination were carried out for all patients. If one or more positive nodes were found, complete axillary dissection was performed. The study included 179 patients. No significant difference was detected in either overall or relapse-free survival between the two groups, although the conservatively treated group showed slightly better results. The results of conservative treatment were esthetically satisfactory in 92% of the cases. The trial included a second randomization for the patients with positive axillary nodes to assess the value of nodal area irradiation; 72 patients were studied in this part of the trial. No significant differences were found between the two groups after adjustment for the number of positive axillary nodes, although the no-nodal irradiation group showed better results and less complications than the nodal irradiation group.

Axilla↗

Adjuvant treatment with polyadenylic-polyuridylic acid in operable breast cancer: updated results of a randomised trial.

The results of a randomised trial of polyadenylic-polyuridylic acid given as adjuvant treatment for operable breast cancer were reviewed after a mean follow up period of 87 months. Of the 300 patients included in the original trial, 145 had been allocated to conventional treatment alone and served as controls. At the time of review the overall survival of the group given polyadenylic-polyuridylic acid was significantly improved (p less than 0.05) as compared with that of the controls given conventional treatment alone. Significant benefit (p less than 0.02) was also observed among patients with evidence of disease in lymph nodes, the best results occurring in those with up to three invaded nodes, who showed a significant increase in both overall and relapse free survival. No evidence of toxicity was recorded. These findings confirm the value of polyadenylic-polyuridylic acid as adjuvant treatment for operable breast cancer. Results in an experimental model and in patients receiving the adjuvant suggested a possible role of interferon and natural killer (NK) cells in the mechanism of action.

Breast Neoplasms↗

Radical mastectomy versus radical mastectomy plus internal mammary dissection. Ten year results of an international cooperative trial in breast cancer.

A multicentric randomized trial evaluated the interest of internal mammary dissection on operable breast cancer patients. One thousand four hundred and fifty-three patients were included in the study and were followed for ten years. There is no difference in survival or in relapse-free survival between the two groups. There were significantly more local recurrences in the group without internal mammary dissection, but these recurrences occurred mainly on patients who developed metastases. A great difference between centers was observed in the number of nodes examined and there is therefore a difference in the prognostic value of the number of nodes invaded.

Breast Neoplasms↗

Medullary thyroid carcinoma: prognostic factors and treatment.

Seventy-five patients with medullary thyroid carcinoma (MTC) have been treated at Institut Gustave-Roussy from 1932 to 1979. Of these, 13 patients had distant metastases and received palliative treatment, their median survival was 3 years. Sixty-two patients with MTC limited to the neck received curative treatment; 6 had exclusive external radiotherapy for inoperable disease and 56 were surgically treated: 23 by total thyroidectomy and 33 by partial thyroidectomy. After surgery 29 patients received external radiotherapy for cervical lymph node involvement (25/29) and/or incomplete surgical resection (12/27). The survival rate was 69% at 5 years and 48% at 10 years. It was lower in patients with distant metastases at presentation (p less than 10(-5)), with tumoral infiltration of the posterior tissue planes (p less than 0.025) and in patients in whom surgical excision had not been satisfactory (p less than 0.01). It was not correlated with cervical lymph node involvement probably because those patients with lymph node involvement had been irradiated. The 29 patients who received post-operative cervical radiotherapy had initially more extensive local disease (p less than 0.05) than the 27 patients treated by surgery alone, nevertheless their survival was slightly higher. No difference in survival rate was observed between patients treated by total thyroidectomy or partial thyroidectomy, among whom only 4 local recurrences occurred. Three of the 6 patients treated with external radiotherapy alone experienced long survival (4, 7 and 10 years) and a fourth is still in clinical remission 4 years after treatment. The effectiveness of chemotherapy in patients with metastases was poor, only one patient out of 6 had a partial remission following a treatment by adriamycin. In the familial form and multiple endocrine neoplasia type II, total thyroidectomy appears to be indicated. In the sporadic cases, partial thyroidectomy is usually sufficient. External radiotherapy is effective in MTC and seems to be able to eradicate small foci of residual tumor; it is indicated when surgical excision is impossible or incomplete.

Adolescent↗

Serial transmission of hepatitis B like non-A, non-B hepatitis and associated markers to chimpanzees successfully immunized against HBV.

In order to demonstrate that the HBV like strain of NANB hepatitis bred true as non-B together with its associated markers, 2 chimpanzees with high titer anti-HBs (45 and 125 AUSAB RU respectively) immunized with the Pasteur HB vaccine received 1 ml IV of a NANB inoculum. Two neighbour captive animal served as controls. The inoculum was the serum of a leukemic patient in remission for over 3 years with NANB chronic active hepatitis which serum contained HBV like particles and was found positive for NANBe Ag and anti-NANBc whereas in the liver typical numerous "SHIMIZU" dense soft edge aggregated intranuclear structures were demonstrated by electron microscopy. After 4 weeks portal inflammation and hepatocyte necrosis with significant aminotransferase elevation lasting for over 10 weeks developed in the 2 infected chimpanzees. No change in anti-HBs titer was seen and HBs, HBc, HBe Ag and/or AB could neither be detected in serum by RIA nor in liver by immunofluorescence during the 6 month follow up period. By contrast NANBc Ag became clearly demonstrable by immunofluorescence in the liver nuclei together with anti-NANBc in the serum after the 6th week and both persisted for over 4 months. Double unit structures similar to those of NANB/F strain were demonstrable in the cytoplasm at the acute phase. None of these changes was seen in the two control animals. Inoculation of the acute phase serum in the 2 previous control animals was again followed by the same sequence of events. Hybridization studies with HBV DNA of liver biopsies of infected chimps were negative.

Animals↗

[Food consumption of children eating lunch in school restaurants].

In order to study the dietary intakes of children having lunch at school, 150 children were observed: 60 aged 5-6 years, 60 aged 9-10 years and 30, aged 5-13 years, attending 5 different schools (4 in town, 1 in the country). The estimation of spontaneous ingesta was made according to the weighing method. Energizing rations, the percentages of caloric intakes, the amounts of total, animal and vegetal lipids, of total carbohydrates and pure carbohydrates, of total, animal and vegetal proteins were estimated for each meal and each child. The analysis of these ingesta suggests that the dietary habits of children at school is a major factor of nutritional lack of balance, much more important than that related with the quality of the proposed food.

Adolescent↗

[Value of serum thyroglobulin assays in cancers of the thyroid].

Serum thyroglobulin (Tg) assays provide no clue as to the nature of a cold thyroid nodule, but they provide guidelines for isotope exploration tests in differenciated epitheliomas. Undetectable Tg levels during hormonal treatment make these tests unnecessary, while measurable levels in the absence of residual thyroid tissue should encourage investigations for metastases, and the higher these levels the more thorough the investigation. When thyroid residues are present Tg levels are usually within the normal range for a healthy population (2.5-28 ng/ml) and no conclusion can be drawn. The destruction of thyroid residues with Iodine 131 in poor prognosis patients facilitates monitoring by means of Tg assays.

Bone Neoplasms↗

Delayed regional lymph node dissection in stage I melanoma of the skin of the lower extremities.

Results of a prospective randomized clinical trial conducted by the WHO Collaborating Centers for the Evaluation of Methods of Diagnosis and Treatment of Melanoma are reported. Five-hundred-fifty-three Stage I patients whose limbs were affected entered the study; 267 were submitted to wide excision and immediate node dissection and 286 had wide excision and node dissection at the time clinically positive nodes were detected. Survival curves of the two treatment groups could be superimposed. No subsets of patients benefitted from immediate node dissection. The authors conclude that delayed node dissection is as effective as the immediate dissection in Stage I melanoma of the extremities if the patient can be checked every three months. If the quarterly follow-up is not guaranteed, immediate node dissection is advisable, at least for melanomas thicker than 2 mm.

Adolescent↗