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Biomedical subjects

J Lansac

Publications and source records attributed to J Lansac.

At least 163 records · Page 9Linked to original sources
PubMed1990

Preoperative or postoperative brachytherapy for patients with endometrial carcinoma stage I and II.

In endometrial carcinoma, vaginal vault brachytherapy is performed to improve the local control rate and to decrease vaginal recurrences. To assess the best chronology of this brachytherapy compared to surgery, we have retrospectively analyzed results of treatment of patients treated either with preoperative brachytherapy (60 Gy) and then radical hysterectomy with bilateral salpingo oophorectomy (RH-BSO) (Group 1), or with RH-BSO and then postoperative brachytherapy (60 Gy) (Group 2). There were one hundred twenty-one patients in Group 1 and 63 in Group 2. The mean age was 61.8 years in Group 1 and 64.3 in Group 2. In Group 1, 73% of the patients were Stage I, and 77.6% were in Group 2. The two groups were comparable for histological grading and depth of tumoral invasion into the myometrium. Brachytherapy was delivered with one uterine and two vaginal sources in Group 1 and with three vaginal sources in Group 2. Doses to the reference volume and to reference points were calculated according to ICRU recommendations. Brachytherapy data were similar in the two groups except reference volume, which was smaller in Group 2. Local control rate was 87% in Group 1 and 91% in Group 2. Distant metastasis occurred in 12% of patients in Group 1 and 9% in Group 2. The 5-year actuarial survival rate was 84% in Group 1 and 89% in Group 2. Regarding stage, histological grading, and depth of tumoral invasion, no differences were observed between the two therapeutic groups. The only prognostic factor in the entire population was Stage. The 5-year actuarial survival rate was 91% for Stage I patients and 69% for Stage II (p value less than 0.03). The late severe complication rate was 14% in Group 1 and 7.9% in Group 2, a difference which was not statistically significant. We concluded that since no differences were observed between the two techniques, vaginal brachytherapy should be performed postoperatively when surgery is the first treatment (Stage I or II, grade 1 or 2, and no deep tumoral invasion into the myometrium).

Brachytherapy↗
PubMed1990

Papillary tumour of the vagina resembling transitional cell carcinoma.

A case of a peculiar papillary neoplasia of the vagina resembling a urothelial tumour is presented. Four vaginal tumours were excised from a 76-year-old woman. Five years before this patient had undergone a uretero-nephrectomy for a non-invasive papillary transitional cell carcinoma of the renal pelvis. The four vaginal tumours demonstrated gross and microscopic similarities to low-grade papillary transitional cell carcinoma of the urinary tract. This observation indicates that multicentric, non-invasive, papillary tumours may affect the whole uro-genital area. The vaginal wall was not overlaid by a normal squamous epithelium, but by a peculiar "transitional-like" epithelium. Variegated endocrine cells were documented within this lining, using immunohistochemical and ultrastructural techniques. The eventuality of a histogenetic link between the tumour and the adjacent epithelial lining remains unresolved.

Aged↗
PubMed1990

Lymphadenectomy in the management of endometrial carcinoma stage I and II. Retrospective study of 155 cases.

In our institution endometrial carcinomas Stage I and II were treated with initial uterovaginal brachytherapy 60 Gy followed by modified radical hysterectomy with pelvic lymphadenectomy. We have studied the results in order to assess the value of lymphadenectomy in the treatment strategy. Between 1976 and 1986, 155 patients were treated (107 Stage I, 48 Stage II mean age 60.2 years). Twenty-six patients also received postoperative pelvic external beam irradiation on account of lymph node involvement and/or deep tumour invasion into the myometrium. Fourteen patients (9%) had lymph node involvement. External iliac lymph nodes were involved in 78.5% of these cases. Lymph node involvement rate was higher for stage II, grade 3 tumours and when there was deep tumour invasion of the myometrium. The rate of local (pelvic) treatment failure was 12% for node-negative patients and 36% for node-positive patients and the 5-year actuarial survival rates for the two groups were 83% and 41% respectively. As a consequence of our interpretation of the findings and influenced by the high complication rate which we attribute to lymphadenectomy and the information given by other prognostic indicators, we have changed to a policy of carrying out pelvic external radiotherapy for all Stage II, grade 2 or 3 cases and those with deep myometrial invasion. Lymphadenectomy is not performed in these cases. For patients with Stage I grade 1 tumours without deep tumour invasion only external iliac node sampling is performed. If this shows tumour, external irradiation is given in addition to vaginal vault brachytherapy.

Adenocarcinoma↗
PubMed1990

Effects of freezing-thawing on the spermatozoon nucleus: a comparative chromatin cytophotometric study in the porcine and human species.

Freezing-thawing effects on the nuclei of porcine and human spermatozoa were studied by determining native DNA percentage from fluorescence after acridine orange (AO) staining and by analyzing chromatin structure by a quantitative microspectrophotometric study of Feulgen-DNA complexes before and after freezing. The study of boar spermatozoa revealed no alteration in native DNA percentage after freezing. However, native DNA percentage decreased significantly in human spermatozoa. Feulgen-DNA content and sperm nuclear surface area decreased in both species after freezing. These results prompted us to hypothesize an overcondensation of sperm chromatin after freezing-thawing. This overcondensation may be related to the lower conception rates obtained with human and porcine semen after cryostorage via defective decondensation.

Animals↗
PubMed1990

Ultrastructural changes in membranes and acrosome of human sperm during cryopreservation.

Functional ultrastructural changes in human sperm heads were evaluated following semen dilution in cryoprotective medium (with and without seminal plasma) as well as freezing/thawing. Plasma membranes were as much altered by dilution as by freezing/thawing when compared with fresh samples. The most striking effect on acrosome noted during freezing/thawing was a dramatic decline in percentage of intact spermatozoa. Acrosomal changes seemed to be less important in the fractions without seminal plasma. These deleterious effects were very demonstrable using transmission electron microscopy (TEM), rather than conventional staining. TEM is useful in obtaining more detailed information on membrane and acrosome integrity until a specific procedure to evaluate functional/physical integrity can be found. Cryopreservation in the absence of seminal plasma can be used for intrauterine insemination in AIH, AID programs with frozen semen.

Acrosome↗
PubMed1990

[Cytokeratins and exocervical malpighian epithelium. Particular distribution of several cytokeratins].

The purpose of this study was to determine tissue distribution of certain cytokeratins along the ectocervical lining. A series of 20 cases was investigated by immunocytochemical labelling with specific antibodies against cytokeratins 19, 18, 8, 7, 10. Monoclonal antibodies were used on frozen sections. Distribution of keratin or alteration in expression was correlated with morphologic changes. All specimens were lined by a normal stratified squamous epithelium which was devoid of argyrophilic cells. Low molecular weight cytokeratins 8, 18, 19 (normally expressed in simple epithelia) were consistently and exclusively expressed through out the basal cell layer of the ectocervical lining. Some other particular immunostainings have been noted. A peculiar staining pattern was observed around some stromal papillae. Development of papillae was accompanied by the expression of cytokeratin 10 (which is commonly detected in skin), and by a reduction in the level of expression of simple epithelial cytokeratins. In addition, in the middle zone, anticytokeratin 10 revealed a mosaic of positive and negative cells even in light microscopically non keratinizing squamous epithelium, with differences of expression from case to case.

Cervix Uteri↗
PubMed1990

[A misleading breast tumor: a granular cell tumor of the breast].

Granular cell tumours are rare benign neoplasms, that occur infrequently in the vulva or the breast. Two cases of the tumour occurring in the breast observed personally are reported. Emphasis is laid on the clinical radiological and macroscopic aspects of this tumour that can mimic carcinoma of the breast. It is best to carry out frozen section histological examination because this is the only way to make a correct diagnosis. Positive immunohistological staining for S-100 protein which is also found in Schwann cells shows that it may be of neural origin for such lesions. The ultrastructure suggests the same origin. The only treatment should be wide local excision with the frozen section making it possible to avoid more radical surgery. Long term observation should be carried out when the excision is near the tumour because there is a high risk of recurrence if that occurs.

Adult↗
PubMed1990

[Breast recurrence after conservative treatment of cancers of the breast: predictive factors and prognostic significance].

The prognostic significance of local relapse after conservative treatment of early stage breast cancer has been controversial. To determine the prognostic value of breast relapse occurrence and the factors predisposing to local failure, we analysed the results obtained in a series of 324 patients conservatively treated for breast invasive carcinomas of 2 cm or less. All patients were treated by tumorectomy and axillary dissection, radiation therapy, and adjuvant medical treatment in 85 of 109 patients with involved nodes. The overall 5-yr survival rate was 91.5%. The actuarial 5-yr local control rate was 91.9%. Local relapses occurred in 25 patients. In these patients, the overall 5-yr survival rate was significantly decreased as compared to that of patients without local relapse (76.9% versus 93.4%, P less than 0.001). Recurrence in the breast within 2 yr of initial treatment of severely affected the risk of metastasis occurrence as compared to later relapses (metastasis-free survival rate of 14.3% versus 63.9% at 3-yr from local relapse, P less than 0.01). Local relapse occurred more frequently in premenopausal patients, in patients with low bodymass index, and in patients with small breast size. Local control was not significantly affected by age, tumor size or node involvement. We conclude that the occurrence of a breast relapse after a local conservative treatment has a negative significance and is predictive of a high risk of distant metastasis development, especially when local relapse occurred within 2 yr of initial treatment. There is a need to determine individual factors that could allow discrimination of patients with a high probability of local relapse and subsequent metastasis.

Adult↗
PubMed1990

[Predisposing factors for local recurrence after conservative treatment of breast cancer].

The factors predisposing to local relapse after conservative treatment of early stage breast cancer are controversial. To determine these factors, we analysed the results obtained in a series of 512 patients consecutively treated for invasive breast carcinomas by conservative surgery and radiotherapy. All patients were treated by tumorectomy and axillary dissection, radiation therapy of 45 Gy to the whole breast with a boost of 15 Gy to the tumor area, and adjuvant medical treatment for 168 out of 187 patients. The overall 5-year and 10-year survival rates were respectively 92.5% and 79.9%. The actuarial 5-year and 10-year local control rates were respectively 91.2% and 83.6%. Local relapses occurred in 35 patients. Local relapse occurred more frequently in premenopausal patients, in patients less than 50 years-old as compared to older patients, in patients with low body-mass index (BMI), and in patients with small breast size. Local control was not significantly affected by tumor size or node involvement. With multivariate analysis, the only factor influencing local control was the body-mass index: the actuarial risk of local relapse was increased by 5.7 in patients with a BMI less than or equal to 22 as compared to patients with a BMI greater than 22 (p less than 0.02). We concluded that although certain clinical factors such as age, menopausal status, breast size and body-mass index have an influence on local control, these factors are not sufficiently discriminant to question the indication of conservative treatment. There is a need to individualize factors that could allow a better discrimination of patients with a high probability of local relapse.

Adult↗
PubMed1990

[Endocrine cells and Malpighian epithelium. Merkel-type cells? Immunohistochemical and ultrastructural study].

This study was devoted to a peculiar population of argyrophilic cells present among various stratified squamous epithelia. The purpose of the study was to determine the distribution and the nature of these argyrophilic cells, and to reappraise their degree of analogy with the Merkel cells of epidermis. Examples of squamous epithelia from skin, exocervix, anal canal and dermoid cyst of ovary were investigated using histochemical, immunohistochemical and ultrastructural techniques. Melanin-containing cells as well as peculiar argyrophilic cells were revealed in each series of specimens. These peculiar argyrophilic cells expressed EMA, chromogranin A and NCL-5D3 (cytokeratins 19, 18, 8) immunoreactivities. By contrast, they were serotonin negative. An intense staining for EMA was observed. These cells were obviously endocrine cells. Ultrastructural studies confirmed the presence of endocrine cells within the anal canal and the exocervix; moreover, in anal canal, some of these cells appeared to have contacts with a nerve terminal. Through the epidermis, these cells can only correspond to Merkel cells, because of their chromogranin positivity. Throughout other squamous epithelia, this population of endocrine cells (serotonin negative) bear some analogies with Merkel cells of epidermis. Their distribution, morphology, EMA immunoreactivity and ultrastructural appearance were reminiscent of those of the Merkel cells. They could be named Merkel-type cells. Additional studies, using other characteristic or specific markers of Merkel cells, are clearly required to determine the exact degree of analogy between these types of cells. Merkel-type cells could be largely distributed through stratified squamous epithelia from various tissues. They can be easily visualized by their strong EMA immunoreactivity and must be distinguished from Paget cells.

Endocrine Glands↗
PubMed1990

[Epithelial cancer of the ovary in adults: prognostic and therapeutic study of 95 cases].

The authors report 95 cases of ovarian carcinoma treated between 1st January 1975 and December 1986 in the department of gynecology and radiotherapy of hospital Bretonneau in Tours. The overall actuarial 5-year survival was 37.5%, for stage I 100%, stage II 51%, stage III 36%, stage IV 5%, grade I 88%, grade II 51%, grade III 18%. The authors stress the prognostic importance of histologic grade and the bad prognosis of small cell ovarian carcinoma with hypercalcemia. The authors propose a therapeutic attitude based on the results and a review of the literature.

Actuarial Analysis↗
PubMed1990

[Outcome of 470 pregnancies after artificial insemination with frozen sperm].

UNLABELLED: This article describes the outcome of the pregnancies conceived after AID with frozen semen in the Tours CECOS Centre between January 1st 1988 and December 31st 1986. There were 487 (including multiple pregnancies). These have been compared with a control group and with the national study conducted by INSERM in 1981. The study of the literature allows comparisons. The rate of pregnancies not resulting in a living child is not significantly different from the control series (abortions 11.4%, ectopic pregnancies 1% and in utero fetal deaths 0.4%). Pregnancies that continued: the rate of multiple pregnancies was higher (2.7%). There were more cases of bleeding (6.8% compared with 2.4%), more hypertensions (13.3% compared with 11.6%) and the same rate of premature labour (9.4%) as in the control group. The Caesarean section rate (22% as against 6%) was higher. The rate of forcepts delivery was lower (9.2% as against 12.8%). Concerning the children we found more premature babies (15.8% versus 5.6%) but no difference in the sex ratio, their height-weight as against their term, their Apgar score, morbidity or number or type of malformations (3.4%). IN CONCLUSION: the quality of the children is about the same with the proviso that the group is too small to conclude about the incidence of chromosomal abnormalities.

Abortion, Spontaneous↗
PubMed1990

[Artificial insemination with donor sperm. A model for the study of human reproduction].

From the experience of the CECOS French Federation concerning artificial insemination with the donor's semen (AID), a certain number of facts about the natural fecundation of couples can be deduced. The study of healthy donors constitutes and interesting biological observatory as regards the norms of the semen characteristics, the epidemiology of sexually transmissible diseases, the epidemiology of genetic abnormalities. The study of the AID results indicates that the best day for fecundation ranges between D - 3 and D + 1 (D0 being the last lowest point on the temperature curve), the rate of success varies according to the quality of the cervical mucus, the age of the woman, the length of treatment, but also to the quality of the semen (numeration, mobility, teratospermia). These results vary also in inverse ratio to the quality of the husband's semen, thus showing that the sterility problem is well a problem of the couple.

Adult↗
PubMed1990

[Pure primary retroperitoneal seminoma in a woman. Apropos of a case].

The authors report a case of a stage IV retroperitoneal seminoma in a patient of 43 years of age diagnosed after histological examination of a biopsy specimen from the left sub clavicular lymph mode showed metastatic seminomatosis. After complete assessment including and abdominal and pelvic ultrasound, a CT scan of the abdomen and pelvis, an intravenous urogram, a lymphogram and serial estimations of tumour markers (alpha feta protein and beta HCG) a laparotomy was carried out. This made it possible to take a retroperitoneal biopsy as well as to carry out a total hysterectomy without conservation of the ovaries. From all this we concluded that we were dealing with a straightforward very large retroperitoneal seminoma. The treatment was continued with large doses of chemotherapy using Vinblastin, Cisplatin and Bleomycin (V.C.B.). She received 5 treatments of this and then had radiotherapy. The authors report this first case described in the literature (because they found no other in women) and what made them decide on the therapy.

Adult↗
PubMed1989

Presence of PAF-acether in human breast carcinoma: relation to axillary lymph node metastasis.

PAF-acether (PAF; formerly platelet-activating factor), a potent lipid mediator of inflammation, is involved in multiple cellular functions. To evaluate the role of PAF in human cancer, we obtained specimens from patients with localized breast carcinoma and assayed them for PAF. PAF was found in almost all carcinoma, although it was not detected in most of the matched, nontumor breast tissue samples. Intratumor PAF level was elevated when axillary lymph node involvement was low. Greater axillary extension (two or more positive lymph nodes) was associated with a decreased intratumor PAF level. These findings, along with the independence of other prognostic factors, indicate that PAF is a tumor marker of axillary lymph node involvement.

Axilla↗
PubMed1989

Endocrine cells in human Bartholin's glands. An immunohistochemical and ultrastructural analysis.

Endocrine cells were investigated in human Bartholin's glands by use of histochemical, immunohistochemical and ultrastructural methods. Endocrine cells represent normal constituents of these glands, being mainly distributed throughout the transitional epithelium of the major excretory duct; however, single elements are dispersed among the acinar lobules. Serotonin-, calcitonin-, katacalcin-, bombesin- and alpha-hCG-immunoreactive cells were recognized, with serotonin-immunoreactive cells predominating. Co-expression of calcitonin, katacalcin or alpha-hCG with serotonin was observed in single endocrine cells. At the ultrastructural level, these cells are richly granulated and show typical neuroendocrine features. Bartholin's glands display an endocrine profile quite similar to that of other cloacal-derived tissues.

Antibodies↗
PubMed1989

Artificial procreation with frozen donor semen: experience of the French Federation CECOS.

The French Federation CECOS (Centre d'Etude et de Conservation du Sperme Humain) sperm banks collate the results of its 20 centres and provides annual reports on their activity. Since its creation in 1973, approximately 17,000 pregnancies have been obtained using frozen donor semen either for artificial insemination by donor (AID) or for in-vitro fertilization. The recruitment of the donors was very strict, only 62% of the 6810 donor candidates were accepted. The overall mean success rate per cycle for all women who began AID was approximately 8%, and the theoretical cumulative success rate was 48% at six cycles and 66% at 12 cycles. The population of recipient patients was very heterogeneous, including fertile, sub-fertile and infertile women. Some of these female factors have been analysed.

Cryopreservation↗