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Biomedical subjects

L Barrelet

Publications and source records attributed to L Barrelet.

At least 37 records · Page 2Linked to original sources
PubMed1988

Proliferative and cytolytic potentials of purified human tumor-infiltrating T lymphocytes. Impaired response to mitogen-driven stimulation despite T-cell receptor expression.

Using limiting dilution analysis (LDA) we have previously shown that in most instances, the frequency (F) of proliferative T lymphocyte precursors (PTL-P) was strikingly reduced in tumor-infiltrating lymphocytes (TIL). In this study involving 19 cases, we show that the impaired clonogenic potential of CD2+ TILs is primarily caused by an intrinsic defect rather than to suppressor T cells or to a direct effect of the tumor cells usually present in the culture system. This was demonstrated by experiments in which the F of PTL-Ps was quantitated both in highly purified CD2+ TILs (using a cell-sorter) and in non-purified TIL suspensions (still containing tumor cells), which originated from the same biopsy specimen. The F of PTL-Ps was virtually identical in either sorted or nonsorted suspensions and the data from LDA were always consistent with the single-hit Poisson model, indicating that no suppressor cells interfered with growth of CD2+ TIL. Stimulation of sorted CD2+ TIL in low-density cultures by either phytohemagglutinin or anti-CD3-monoclonal antibody (MAb) indicated that the antigen-dependent activation pathway was impaired, although structurally intact T-cell receptor (TCR) complexes were apparently expressed, as assessed by immunofluorescence. The depressed proliferative response of CD2+ TIL could not be reversed in vitro when phorbol-esters were used in combination with ionomycin, which bypass the TCR. Nevertheless, 180 clones obtained from 8 cases were analyzed for their cytolytic activity. The majority mediated specific lytic activity (against unknown antigens), as assessed by lectin-dependent cell cytotoxicity, whereas only 6% of them manifested lymphokine-activated killing on appropriate targets.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1988

Family expressed emotion and outcome of schizophrenics: a study in a French cultural environment.

This is the first attempt in a french cultural environment to relate family characteristics and expressed emotion to clinical course of schizophrenics. patients were studied during a two year period after their first or second hospital stay. Critical comments on subcategory of classical expressed emotion is associated with relapse, rehospitalization and work capacity but not with a broad measure of social activity.

Cultural Characteristics↗
PubMed1987

[Costs of psychiatric treatment: a comparative approach to 3 categories of patients].

Based on methodology similar to that used in international studies, the calculation of costs was carried out for three cohorts of patients: schizophrenics, other psychotics and non-psychotics, taking into account the parameters of sex, age, professional employment/unemployment. Attention is paid particularly to: the preponderance of indirect costs over direct costs, the much higher level of costs for psychotic patients and amongst these above all of schizophrenics, and significant differences in this last group with regard to sex and age. As far as direct costs are concerned, no substitution of hospital costs by outpatient costs is noted; on the contrary, the cumulative effect of these two constituent parts is marked among the three cohorts no matter what parameters of analysis of data are used.

Adult↗
PubMed1987

[Model of crisis intervention: theoretical actuality and clinical usefulness].

The efficiency of the crisis intervention model has been reviewed for its usefulness as it appears in the recent literature. On the practical level this has been done on a crisis ward, the Brief Therapy Center CTB (= Centre de thérapies brèves) in Carouge; but also the theoretical level has been taken into account. This model has been in the center of the deinstitutionalization during the seventies and eighties. Through its application, essentially admissions to hospital treatment could be prevented, as we can see it from the case report statistics. Furthermore the study of these case report statistics reminds us of the fact that even patients with serious psychiatric illnesses like schizophrenias show "crises" in their evolution which might be approached by this intervention model.

Crisis Intervention↗
PubMed1987

Combination of mitomycin, vindesine, and cisplatin in the treatment of head and neck squamous cell carcinoma.

Thirty patients with squamous cell carcinoma of the head and neck were treated with a combination of mitomycin (10 mg/m2, Day 1), vindesine (3 mg/m2, Days 1 and 8), and cisplatin (60 mg/m2, Day 1), repeated every 28 days. Seven patients were previously treated by surgery, radiotherapy, or chemotherapy, and 23 had untreated advanced tumors. Objective responses were seen in 17 of 27 evaluable patients (63%), with three (11%) complete remissions. Moderate myelosuppression was the main toxic effect. Considering the advanced tumor staging (54% N3 tumors), this chemotherapeutic regimen appears as effective as other cisplatin-based chemotherapies.

Adult↗
PubMed1986

[Primary germinal tumor of the mediastinum: study of a case evolving over 7 years].

Mediastinal seminoma is a rare malignant germ cell neoplasm histologically identical to the more common gonadal germinoma. The case reported here illustrates typical findings for presentation and response to primary therapy in mediastinal seminoma. The tumor was located in the anterior mediastinum and appeared as a well-defined lobulated mass. However, the patient's subsequent course was unusual in the multiplicity of sites of disseminated disease, and in that all were apparently controlled by local irradiation and chemotherapy. Primary treatment used was surgery and radiotherapy of the mediastinum. The patient developed bony metastases 2 years after, and these lesions were treated with radiotherapy followed by chemotherapy. Four years after, a new mediastinal mass began to enlarge with metastases in the lungs and the bone. This recurrence was controlled by chemotherapy only. Mediastinal germ cell tumors is thought by some observers to represent related aberrations of embryologic development with subsequent malignant changes. These tumors usually occur in young men and most patients are symptomatic (dyspnea), but some others present without symptoms and are diagnosed from a routine chest X-ray. The relatively high proportion of lungs and bony metastases may reflect an increased tendency to vascular spread from the great vessels. Combination chemotherapy with cis-platinum, bleomycin and vinblastine will induce complete remission in 70% of patients with disseminated germ cell tumors. New active agents such as VP-16 and carboplatin appear to be the most active drugs next cis-platinum for these tumors.

Adult↗
PubMed1986

The predictive value of estrogen and progesterone receptors' concentrations on the clinical behavior of breast cancer in women. Clinical correlation on 547 patients.

The aims of this study were as follows: to confirm that the presence of estrogen (ER) and progesterone (PgR) receptors is an indicator of clinical behavior of human breast cancer independent of other known prognostic factors; to seek clinical correlates of those receptor values that best predict the overall disease evolution; and to determine the relative prognostic importance of PgR versus ER. The clinical records of 547 patients, the follow-up of some extending to 6 years, were analyzed in retrospect. Patients were placed into one of four disease stages and also in three groups according to the degree of axillary node involvement. In each group the prognostic value of receptors for patient survival, disease-free interval and, in case of metastasis or local recurrence, the response to endocrine treatment or chemotherapy were studied. The break point in the spectrum of receptor concentrations with regard to survival, disease-free interval, and response to treatment was greater than or equal to 20 for ER+, greater than or equal to 15 for PgR+, and less than 5 for both ER- and PgR- reported in fmol/mg protein. Survival and disease-free interval showed positive correlations with ER and PgR (P less than 0.001-less than 0.0003). When disease stage or node involvement were considered, these correlations were found essentially in Stage II and node involvement in more than three nodes, where patients had longer survival and disease-free interval if ER and PgR were positive (P less than 0.05-less than 0.0003). Estrogen receptor was a more sensitive prognostic indicator than PgR, and the combination ER+/PgR+ showed a correlation equivalent to ER+/PgR-. The correct prediction percentages of the response of patients to endocrine treatment were 77% if ER+, 69% if PgR+, and 79% if both ER+ and PgR+. However, the correct prediction percentage of the response to chemotherapy was of 50%. These results show that ER and PgR are prognostic factors for survival and disease-free interval mainly on patients at Stage II and node involvement of greater than three, with ER demonstrating a better predictive value than PgR. The measurement of these receptors provides a prognostic index for response to endocrine therapy but is without value in predicting the response to chemotherapy.

Actuarial Analysis↗
PubMed1985

A clinical trial of aminoglutethimide in advanced postmenopausal breast carcinoma: low response in patients previously treated with medroxyprogesterone.

In an attempt to define the influence of prior hormonal treatments upon aminoglutethimide activity in advanced cancer of the breast, 42 heavily pretreated postmenopausal patients received aminoglutethimide, 4 X 250 mg daily, with hydrocortisone or cortisone. Twenty-six received high doses of medroxyprogesterone before entering this study. There was no significant difference in patients' characteristics with or without medroxyprogesterone pretreatment. A comparison of patients with and without prior medroxyprogesterone shows a significant difference in the response rate to aminoglutethimide-hydrocortisone (4 vs 32%, P = 0.02). In patients pretreated with tamoxifen but not with medroxyprogesterone the response rate to aminoglutethimide was 36%. These results suggest that aminoglutethimide has a low activity in breast cancer patients previously exposed to medroxyprogesterone, an agent with glucocorticoid-like activity inducing adrenal suppression.

Adult↗
PubMed1984

[Unproven methods in oncology].

As in some other chronic diseases (rheumatism, multiple sclerosis, etc.), unproven methods of diagnosis and treatment have long been current in cancer. Since 1960 the American Cancer Society has published an abundant literature on these "unproven methods", which serves as a basis for a historical review: some substances (Krebiozen, Laetrile) have enjoyed tremendous if shortlived success. The present trend is back to nature and "mild medicine". The proponents of this so-called natural medicine are often disciples of a pseudoscientific religion using irrational arguments. Direct attacks on these erroneous theories and their public refutation fail to convince the adepts, who trust in these methods and are not amenable to a scientific approach. Study of their psychological motivations reveals that in fact they seek something more reassuring than plain medical explanation which is aware of its limits. They feel reassured by theories which often bear some resemblance to the old popular medicine. To protect patients against these dangerous methods and all the disillusionment they entail, the Swiss Society of Oncology and the Swiss Cancer League have decided to gather information and draw up a descriptive list of the commonest unproven methods in Switzerland (our File No. 2, "Total anti-cancer cure", is given as an example). The files are published in French, German and English and are available to physicians, nursing teams, and also patients who wish to have more objective information on these methods.

Complementary Therapies↗
PubMed1984

Combination chemotherapy for non-small cell lung cancer with doxorubicin and mitomycin or cisplatin and etoposide.

The combinations of doxorubicin (40 mg/m2 iv every 3 weeks) and mitomycin (12 mg/m2 iv every 6 weeks) or cisplatin (80 mg/m2 iv every 3 weeks X 3, then every 6 weeks) and etoposide (80 mg/m2 iv on Days 1-3 every 3 weeks X 3, then every 6 weeks) were evaluated in a randomized phase II trial in 77 patients with measurable or evaluable non-small cell lung cancer. No patient had been pretreated with prior chemotherapy. The overall response rate for the doxorubicin and mitomycin regimen was 11% and for the cisplatin and etoposide regimen was 23%. Responses lasted a median of 5.5 months. Median survival was 7.0 months for the doxorubicin and mitomycin regimen and 8.0 months for the cisplatin and etoposide regimen. One treatment-related death was observed after doxorubicin and mitomycin in a patient who had received radiation therapy immediately prior to study entry. Otherwise, the hematologic toxicity of both chemotherapy regimens was moderate, with only six patients (10%) having World Health Organization grade 3 toxicity and no patients having World Health Organization grade 4 toxicity. However, subjective tolerance gastrointestinal upset) of the cisplatin and etoposide combination was poor.

Adenocarcinoma↗
PubMed1983

[Clinical characteristics and evaluation of risk in the graft versus host reaction following transfusion].

Graft versus host disease (GVHD) is a well recognized entity following bone marrow transplantation. Similar syndromes have been described after blood product transfusions, notably in patients with primary immunodeficiency syndromes and in patients with malignancies associated with immune deficiency or under immunosuppressive treatment. Review of the literature shows that posttransfusion GVHD is characterized by maculopapular skin rash, gastro-intestinal symptoms, liver disease, severe pancytopenia and, in some cases, hepatosplenomegaly and lymphadenopathy. The time to onset and the duration of the disease are short (10 days) and the mortality approaches 90%. The clinical features of this rare disorder are presented in the hope that, with increased awareness of this complication, clinicians will take preventive measures in patients at risk because no satisfactory therapy yet exists.

Graft vs Host Disease↗
PubMed1983

Placental site trophoblastic tumor (trophoblastic pseudotumor) of the uterus with metastases and fatal outcome. Clinical and autopsy observations of a case.

A 41-year-old woman who 5 years earlier had a hysterectomy for a placental site trophoblastic tumor (formerly called trophoblastic pseudotumor) was readmitted to the hospital with pelvic recurrence and multiple lung metastases. Despite an initial decrease in the size of the lung metastases and concomitant lowering of the serum values of human chorionic gonadotropin (beta-HCG) from 2,200 to 40 ng/ml, combined chemotherapy became ineffective. The patient died 4 months later with widespread metastases. The clinical course and the autopsy findings of this case are reported and compared with the two similar cases reported in the literature.

Adult↗