Biomedical subjects
Publications and source records attributed to J Rousseau.
A child aged 4 1/2 years was found to have secondarily infected retained secretions in the vagina from a vaginal membrane. The authors underline the value of intravenous urography coupled with rectal insufflation, which is essential in order to confirm the diagnosis of colpos and to eliminate any associated urinary malformation.
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The authors studied the urinary complications following 721 operations performed between 1960 and 1974 for cervix uterin carcinoma. The surgical method was the one used at the Fondation Curie according to the protocol of treatment. They have noted that: --first, the surgical act as primary treatment (672 cases) was innocuous, as this series showed only 0,6% of the severe complications; in contrast, when the surgery is performed for a recurrence after a total dose irradiation, the severe complications raised to 8%; --secondly, the uretero-hydronephroses following this type of surgery are relatively frequent on the systematic urograms, but most of them are quite asymptomatic and without later sequelae only 0,3% of them required a surgical treatment. The authors analyse the factors influencing the ureteral stenoses, especially the extent of lymphadenectomy and the associated external irradiation. They studied too the ureteral stenoses due to a local recurrence.
Incubation of 20 alpha-hydroperoxycholesterol (I) and its 20 beta-isomer, 20 beta-hydroperoxy-20 isocholesterol (II) with adrenocortical mitochondrial preparations in the absence of molecular oxygen, in normal and 18O-enriched water, gave 20 alpha, 22R-dihydroxycholesterol (III) from I and 20 beta,21-dihydroxy-20-iso-cholesterol (IV) from II. Mass spectral analysis of the persilylated glycol products III and IV showed no uptake of 18O, indicating that the oxygen atoms of the C20-, C22- and C21-hydroxyl groups originated from the 20-hydroperoxy atomic oxygen complex is the intermediate in the enzymic oxidative reactions of cholesterol side-chain cleavage.
Primary vaginal cancer are infrequent and amount to 2 or 3 per cent of the gynecological cancers. Their diagnosis is difficult, because many other cancers metastasize in the vagina. The primary vaginal cancer arise mostly after climateric. Adjuvant causes would be a total hysterectomy in the past, prolapsus, prolonged use a pessary or a previous irradiation. The squamous-cell carcinomas, by far the most frequent (91%), are mostly situated in the upper third of the vagina on the anterior and posterior walls. Surgery, being difficult and mutilating is rarely indicated. So the treatment is mainly radiotherapic: external irradiation and intracavitary curietherapy. The radiation techniques are a little different according to the site of the lesion in the lower third or not. The upper lesion can be treated like a cervix cancer. The lower ones are more difficult to handle; for curietherapy, one must use molded apparatus, loaded with Iridium wire, adapted to each special case. The therapeutic results are rather poor:43 per cent for the 5-year cure rate and 36 per cent for the 10-year cure rate: less than for the cervix uteri. The upper lesions have a better prognosis than the lower ones. Results should be improved with an earlier diagnosis, a more accurate radiotherapy and a more precise dosimetry. The non-squamous-cell cancers (adenocarcinomas, sarcomas, mallignant melanomas) are generally rather radio-resistant. They are rare and their prognosis is very poor.
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Trypsin and pronase treatment of purified human neutral bronchial mucins released small fragments from the C-terminal end of these molecules and resulted in slight increases in their sedimentation coefficient presumably reflecting conformational changes. The antigenic determinant of neutral bronchial mucins which appears to be located on this C-terminal fragment is destroyed by pronase or by treatments such as periodate oxidation or galactose oxidase-bromine oxidation which modify the carbohydrate moieties. Thus, both amino acid and carbohydrate residues are involved in the structure of the antigenic determinant.
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This study deals with 524 cases of uterine cervix (except stade IV cases) completely treated at the Foundation Curie with esclusive radiotherapy from from 1962 to 1968. The irradiation techniques, as well as the doses given to the tumor and to the critical organs are stated. The various sequelae and complications are described, according to the class and severity. The cases are divided into two groups: 257 cured patients and 267 dead patients. For the cured patients, half of them (49%) had no trouble at all. Among the 130 remaning cases, 16% presented with mild troubles, 23% with moderate sequelae, 9% with marked complications and 3% with severe complications leading to an infirmity. The rectal troubles are frequent (55% of all the troubles) in 40% of the patients; though rarely, they can be severe (6% of the cases). They appear relatively early. The bladder troubles rank second (37% of all the troubles) in 20% of the patients; never severe and without any renal effect, they are more delayed than the former. The skin and soft tissues troubles are only a few (5%) for 5% of the patients. They are mostly mild and moderate. One skin necrosis was noted due for a large part to the very poor general conditions of the patient. The bone troubles are always classified here as marked or severe; they are rare (2,6%) in 2,3% of the patients. Their treatment is satisfactory. One single case of bilateral femur neck fracture gave a permanent infirmity. We have noted no nervous trouble, nor urinary trouble other than the bladder ones, nor bowel troubles aprt from a mild and transient sigmoiditis. The genital troubles noted in 21% of the patients are mostly vaginal adhesion in women over 60 years of age. The sexual troubles, very difficult to analyse, have not been studied here. The treatments of these various troubles have generally been simple, not very compelling, and effective. Only eight patients with severe complications (3%) underwent important therapeutics (fecal diversion, none surgery) and kept an infirmity. One patient (0,4%) died during the post-operative course. For the dead patients, the study is less significant, because of the neoplastic evolution and of the rather short survival. This fact explains that 20% only of the patients (versus 51%) presented with 106 troubles (versus 304). The rectal troubles remain frequent 33%) of the cases), though the bladder troubles, more delayed, are very less numerous (1,8% of the patients). The bone complications are similar in number and quality (2,2% of the patients).
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The concept of a possible biogenetic intramolecular relationship between several pairs of hydroxylated positions of corticosteroids, in particular between positions 17alpha and 21, has been proposed by us some time ago. We now present evidence that to a certain extent such a relationship can indeed exist. 18O-labelled 17alpha-hydroperoxyprogesterone was incubated under ordinary oxygen atmosphere with the microsomal fractions of bovine adrenal cortex. Following extensive purifications by thin-layer chromatography, we have isolated a metabolite with mobility characteristics corresponding to those of authentic 17,21-dihydroxy-4-pregnene-3,20-dione (cortexolone). According to its mass spectrum, this metabolite has a molecular weight of 350, i.e. 4 atomic mass units higher than the molecular weight of non-labelled cortexolone. No conversion of 17alpha-hydroperoxyprogesterone to cortexolone was observed with a previously heat-inactivated preparation. The presence of 4 additional mass units in the cortexolone metabolite means that the latter has preserved two 18O-labels in the molecule, one at position 17alpha and the other one at position 21. This can only be explained by a rearrangement reaction of the hydroperoxide group in such a way that it is accompanied by a C-17alpha to C-21 hydroxyl transfer. In the inverse case, when non-labelled 17alpha-hydroperoxyprogesterone was incubated under 99% 18O2-atmosphere, non-labelled cortexolone of molecular weight 346 was also found.
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