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Biomedical subjects

M Durand

Publications and source records attributed to M Durand.

At least 217 records · Page 12Linked to original sources
PubMed1982

[Chemotherapy in advanced malignant melanoma. Results of a controlled trial comparing a combination of dacarbazine (DTIC) and detorubicin with dacarbazine alone].

51 patients with malignant melanomas who had not previously received chemotherapy were studied in a phase III trial. They were all advanced cases, either in relapse or showing metastatic spread and with one or several measurable tumor sites. They were judged to be too advanced for surgery or radiotherapy. They were split at random into two groups. Both groups received DTIC (250 mg/m2, IV, over 4 days every three weeks) and one group received detorubicin (120 mg/m2, IV every three weeks) as well. Detorubicin is a new anthracyclin drug which has shown promise in the treatment of these tumors in a previous trial. The combination of the two drugs produced better results than dacarbazine alone. Eight 50% regressions were obtained out of 22 cases studied (36%) with the combination, as opposed to 4 out of 26 (15%) with the single drug. The average length of response was also longer for the combination, i.e. 6 months opposed to 5 for the single drug. The differences were not, however, statistically significant (X2 = 2.09). Toxic reactions were also more frequent with the combination therapy (65%) than with DTIC alone (40%) (X2 = 0.42), as well as more serious because of the myocardial toxicity of the anthracyclin drug. This trial showed that a combination of dacarbazine with detorubicin improves the therapeutic outcome. Whether this represents a real benefit will need statistical confirmation from trials of combinations using other anthracyclins.

Adult↗
PubMed1982

[Treatment of inflammatory breast cancer. Controlled study of a combination therapy program].

The authors report 27 cases of inflammatory carcinoma of the breast (T3-T4, M0) and propose: induction chemotherapy (adriamycin, vincristin, methotrexate) conventional local and regional radiotherapy, sometimes complementary surgical exeresis, and a complement of consolidation chemotherapy (cyclophosphamid, methotrexate, fluoro-uracil or adriamycin, vincristin, and methotrexate). In these forms, where the prognosis is very bad, this therapeutic regimen may improve considerably the median remission and survival rates. But important therapeutic progress remains.

Adenocarcinoma↗
PubMed1982

Maintenance immunotherapy with BCG in non-Hodgkin's malignant lymphomas: a progress report of randomized trial.

Ninety-eight patients with non-Hodgkin's malignant lymphoma were first put into complete remission by a combination of chemotherapy and radiotherapy, and then received one course of chemotherapy as reinforcement. They were then randomized to receive either maintenance BCG therapy or no other treatment. Ninety-three patients were available for this analysis. There was a significant difference (P = 0.021) in relapse-free survival times between the two groups of patients. This difference is particularly significant in male patients, in patients ages 50-65 years, in all histologic classes, in patients treated after an initial relapse, and in clinical stages I and II. There was also a difference in crude survival, but the difference was not significant.

Aged↗
PubMed1982

Pharmacokinetics of adriamycin in patients with breast cancer: correlation between pharmacokinetic parameters and clinical short-term response.

The pharmacokinetics of adriamycin was evaluated in the plasma of 12 patients with breast cancer after injection of an i.v. bolus. The patients were suffering from a locally advanced tumor, were free of metastases and had received no prior treatment. They received a chemotherapy consisting in adriamycin (50 mg/m2) on day 1, vincristine (1 mg/m2) on day 2 and methotrexate (6 mg/m2) on days 3, 4 and 5. The response to chemotherapy was assessed as the percentage of reduction of the palpable tumoral mass. Plasma samples were collected at various times after injection of the drug. Adriamycin and its metabolites were extracted using an original column purification technique and were evaluated by high-performance liquid chromatography with fluorometric detection. Pharmacokinetic parameters were calculated with a computer program based upon an algorithm of non-linear function minimization. The three successive half-lives presented little individual variations and were 4.75 min, 0.822 hr and 18.9 hr. On the other hand, the A, B and C parameters were highly scattered. The total plasma clearance of the parent drug ranged from 28.3 to 98.7 1/hr. A highly significant correlation was observed between parameter A and the short-term clinical response. Moreover, a mild correlation exists between the half-life of the 1st phase and the short-term clinical response. We can therefore assume that the efficacy of the drug may be dependent upon its distribution in the organism. Such a relationship may allow the development of new protocols of chemotherapy in order to obtain an optimal distribution of the drug in every patient.

Adult↗
PubMed1982

Ventilatory response to 100% and 15% O2 during wakefulness and sleep in preterm infants.

To examine the ventilatory response to 100% and 15% O2 during wakefulness and sleep, we studied eleven preterm infants birthweight 1770 +/- 102 g; gestational age 32 +/- 1 weeks; postnatal age 31 +/- 5 days) on two occasions each. Wakefulness (W) was present around feeding time and was defined by open eyes for more than 2 min plus presence of purposeful movements. Rapid eye movement (REM) and non-rapid eye movement (N-REM) sleep were defined using electroencephalogram (EEG), electrooculogram (EOG), electrocardiogram (ECG), and body movements. During 100% O2 breathing, immediate (30 s) decreases of 28, 39 and 37% followed by late (5 min) increases in ventilation (Ve) of 42, 49 and 27% were observed during W, REM and N-REM sleep (P greater than 0.05 between states). PaCO2 decreased significantly towards the end of 5 min of breathing 100% O2 in W, REM and N-REM sleep (P greater than 0.05). Average duration of apnea following sudden administration of 100% O2 was 8.5, 11.1 and 8.8 s during W, REM and N-REM sleep (P greater than 0.05 between states). During inhalation of 15% O2, there was a late decrease in ventilation of 19 and 23% during wakefulness and REM sleep, and a sustained increase in Ve of 17% during N-REM sleep (P less than 0.05). PaCO2 at the end of hypoxia (5 min) was significantly decreased in N-REM sleep only (P less than 0.05). We suggest that (i) peripheral chemoreceptor activity is qualitatively intact during W and sleep, as reflected by (a) the immediate changes in Ve during inhalation of high and low O2, and (b) apnea following administration of 100% O2. (ii) The late decrease in ventilation with hypoxia is absent in N-REM sleep.

Electroencephalography↗
PubMed1982

Cranial blood volume changes during mechanical ventilation and spontaneous breathing in newborn infants.

We derived a noninvasive method to compare changes in cranial blood volume during mechanical ventilation with changes occurring during spontaneous breathing in newborn infants. In ten infants receiving mechanical ventilation, cranial blood volume increased during inspiration by a mean of 8.3%. We found a consistent relationship between clinical estimation of lung compliance and the amount of cranial volume expansion. During spontaneous breathing in ten infants cranial blood volume decreased during inspiration by a mean of 5.8%. The findings indicate the need for careful monitoring during periods of rapid changes in lung compliance.

Blood Volume↗
PubMed1982

Non-Hodgkin's malignant lymphomas: treatment of localized relapses with chemo + radio + BCG-therapy.

16 patients with relapsing non-Hodgkin's malignant lymphomas considered as clinical stage I or II were treated by an association of chemo + radiotherapy and thereafter by maintenance BCG therapy. 5 of them were included in a randomized trial and have a significantly different disease-free survival from patients receiving the same treatment but without BCG. 11 were systematically treated by BCG and they also have a fairly good disease-free survival. Such a treatment appears to be of value in treating these patients and even probably of curing some of them.

Adult↗
PubMed1982

[Effect of diets low in phosphorus and high in dietary calcium on phosphatemia and phosphorus and calcium levels in rumen contents of sheep].

Four semi-purified diets with different calcium (Ca) and phosphorus (P) contents were given to adult sheep at a level of 1 kg daily plus 100 g of straw. The phosphorus was supplied as dicalcium phosphate, almost insoluble in rumen fluid. In the preliminary period, all the animals (16) were fed the test diet (NCa-NP) containing 8.4 g of Ca and 3.3. g of P. In the experimental period (table 3) two trials were carried out. In trial 1, two groups of 5 sheep each were given for 5 weeks a diet low in P (1 g/kg) and either low (2 g/kg) (diet BCa-BP) or high (10 g/kg) (diet HtCa-BP) in calcium. In trial 2, which lasted for 19 weeks, the HtCa-BP diet was compared to a high Ca (10 g/kg) normal P (3.3 g/kg) diet (diet HtCa-NP); two groups of 2 sheep each were fed both these diets every 3 hours, and one group (HtCa-BP) was fed twice daily. The concentration of ultrafilterable inorganic Ca (CaiU) in the rumen contents was related to the Ca level of the diet (tables 4, 5). However, individual variations were high and CaiU concentrations were negatively correlated to rumen pH (fig. 7). When diets adequate in P were fed, ruminal concentrations of ultrafilterable P (PiU) were rather high (400-490 mg/l), showing the importance of endogenous P supply in the rumen. With an adequate P supply, a high Ca intake had no effect on either plasma or ruminal PiU. When low P diets were fed, there was a steady decrease in plasma Pi from 6 to 3.5 mg P/100 ml and in ruminal PiU from 500 mg/l to values lower than 300 mg/l up to 5-6 experimental weeks. These decreases were greatest with high Ca intake (HtCa-BP diet) (figs. 2, 3), some animals being markedly affected (ruminal PiU values lower than 20 mg/l). However, the decreases in ruminal PiU were less pronounced with frequent feeding than with feeding twice a day. Considering all the results obtained, ruminal PiU concentrations were positively correlated with plasma Pi concentrations (r = + 0.77; n = 75) (fig. 8). Therefore, high Ca intake can enhance the response to P deficiency and reduce further plasma Pi concentrations and levels of available P in the rumen. Microbial P requirements may not be satisfied in such conditions, which would reduce ruminal microbial digestion in some animals.

Animals↗
PubMed1982

[Axillary lymph nodes in breast cancer. Comparison of standard histological analytical technics and macroscopic serial sections].

Lymph nodes in breast cancer have been examined by two histological techniques in 324 patients who underwent axillary node dissection. A routine pathologic examination consisted in the examination of only one pathological section while in the other, the lymph nodes were macroscopically serially sectioned. With the latter, an increase of 18.8 per cent in the number of detected metastases was noted. However this increase can be considered of prognostic and therapeutic importance only in 8.6 per cent of cases: half corresponding to those cases in which more than the initial threshold number of three lymph nodes were found, the other half corresponding to those cases in which one lymph node was found while the initial examination was negative. In the latter case, the increase of lymph node involvement was mainly due to "clandestine" metastases, i.e. lymphatic embolisation of micrometastases.

Adenocarcinoma↗
PubMed1982

[Effect of cobalt and vitamin B 12 on growth and survival of rumen ciliates in vitro as a function of bacterial population].

The effect of inorganic cobalt or organic cobalt in the form of vitamin B12 was studied on the growth of rumen ciliates in the presence of normal bacterial population and in the presence of reduced bacterial population. It was stated that concentration from 0.1 to 1 cobalt microgram/ml and 0.12 to 0.24 vitamin B12 microgram/ml stimulated growth of rumen ciliates. At rates 10 to 20 times weaker, cobalt in the form of vitamin B12 was more active than cobalt in inorganic form. With reduced bacterial population (10(3) B/ml) protozoa died within a few days but their survival was prolonged by adding cobalt, this effect being more pronounced with vitamin B12 than with inorganic cobalt. The growth of ciliates treated with antibiotics was stimulated by addition of bacteria, and this effect was more pronounced when the bacteria had been preincubated with cobalt. Incorporation of cobalt into rumen ciliates was studied using electron microprobe analysis. Cobalt was present in all the ciliate but essentially accumulated as granules in the endoplasm inside or outside the vacuoles. With reduced bacterial population, cobalt was also incorporated into the ciliates whatever the Co concentration. Indeed, ciliates seemed to need bacteria in order to use the organic cobalt for growth.

Animals↗
PubMed1982

[Prognosis of lymphosarcomas. Multivariate analysis in a series of 334 patients].

In this retrospective study, we analysed prognostic factors of 334 previously untreated patients with non Hodgkin's malignant lymphoma. The importance of the different prognostic variables was first studied with survival curves. Next, using a "segmentation" method and a logistic regression analysis, we studied the factors influencing the complete remission rate which is the most important prognostic factor. For the "low-grade" lymphosarcomas, with the segmentation method, we obtained five patients groups for which the complete remission rates varied between 7 and 95.5 per cent according to clinical staging, age and mediastinal involvement. For the "high-grade" lymphosarcomas, we obtained four patients groups in which the complete remission rates varied between 8.7 and 84.7 per cent according to mediastinal and sub-diaphragmatic involvement and clinical staging. Lastly, the Cox model was used in order to determine the best variable combination capable of predicting the survival of patients with clinical stages I or II. These variables were pathological grading, complete initial remission, clinical staging and BCG immunotherapy. With scores deduced from the Cox model, we were able to determine three prognostic groups for which the survivals at 3 years were very significantly different (7 to 89%).

Adolescent↗
PubMed1982

[Senile cardiac amyloidosis: study of possible relationship between amyloid and atheromatous processes in 923 cases (author's transl)].

Amyloid diseases include a widely dispersed group of conditions. A part from secondary, primary, and familial amyloid diseases, and those due to endocrine tumours of the APUD system, there is a tendency to isolate a group of senile amyloid diseases affecting mainly the heart. A study in a series of 923 elderly subjects demonstrated a negative correlation between amyloid disease and atheromatosis. As certain secondary amyloid diseases, particularly those secondary to myeloma, are, inversely, sometimes associated with rapidly developing atherosclerosis, this suggests the need for further studies to define the relationship between the two processes.

Aged↗
PubMed1982

[High dose metoclopramide during cancer chemotherapy. Phase II study in 80 consecutive patients].

From november 1981 to january 1982, 80 consecutive patients received high dose metoclopramide, adjoined to different cancer chemotherapy regimens containing cisplatine, dacarbazine, actinomycin D or mithramycin. Nineteen of them (23,75%) had no chemotherapy induced nausea or vomiting, 30 (37,5%) had nausea alone or vomited only once, and 17 (21,3%) had 3 to 5 episodes of vomiting. The overall efficacy of high-dose metoclopramide was 83,7 per cent. It has been seen whatever the chemotherapeutic agents used, and was inchanged for the following courses in 33 of 37 patients who received 2 to 4 courses. In 25 out of 33 patients who had already received the same chemotherapy without high dose metoclopramide, the digestive tolerance have been improved by the antiemetic treatment. Toxicity of high dose metoclopramide had been encountered in 17 (21,5%) of the patients and necessited this treatment to be stopped in 10. There were mainly extrapyramidal syndroms, diarrhea and drownsiness. The toxicity of high dose metoclopramide was of concern mainly in patients younger than 30, and/or when dosage escalation have been attempted.

Adolescent↗
PubMed1981

Effect of periodic or regular respiratory pattern on the ventilatory response to low inhaled CO2 in preterm infants during sleep.

We wanted to know whether the ventilatory response to low concentrations of CO2 is measurable in the absence of change in alveolar PCO2, is sleep state dependent, and is dictated by the resting respiratory pattern. Therefore, we gave 11 preterm infants (birth weight, 1,565 +/- 122 g; gestational age, 32 +/- 1 wk; postnatal age, 28 +/- 5 days) 0.5 to 1.5% CO2 after a control period of breathing 21% O2. They were studied on 2 or 3 occasions, the aim being to have 5 infants in each of 2 categories, periodic to regular breathing, and regular to regular breathing, after administration of CO2 in both sleep states (n = 20). In both sleep states, when low CO2 increased ventilation, alveolar PCO2 also increased. The increase in ventilation was primarily due to an increase in breathing frequency if breathing was periodic, and to an increase in tidal volume if breathing was regular. This response was not affected by sleep state. We conclude that changes in respiratory pattern with low inhaled CO2 are fundamentally dependent on whether the baseline respiration is periodic or regular.

Carbon Dioxide↗
PubMed1981

Effect of feeding on the chemical control of breathing in the newborn infant.

To examine the influence of feeding on the chemical control of breathing in neonates, we studied the ventilatory response to 3% CO2 in air in nine bottle fed (BOT) and eight breast fed (BR) term infants during feeding while the infants were alert. Control responses were obtained either before or after feeding, VE, respiratory frequency, tidal volume, inspiratory time, expiratory time, and sum of inspiratory and expiratory time, VT/Ti/Ttot, PACO2 and slope (S) of CO2 response (liter/min/kg/mmHg) were determined. During 3% CO2 while resting BR had a lower VE, VT, VT/Ti than BOT and S in BR was 40% of BOT (P less than 0.05). During feeding and CO2 when compared to resting and CO2 there was no difference in either BR or BOT in VT/Ti but Ti/Ttot decreased in both groups. During feeding, S in BOT was reduced from 0.049 +/- 0.012 (mean +/- S.E.) to 0.013 +/- 0.002 (74% reduction) and in BR from 0.020 +/- 0.002 to 0.009 +/- 0.002 (55%). Thus, behavioral activity (either BR or BOT) markedly depresses the ventilatory response to chemical stimuli (CO2). This modification is primarily related to changes in "effective" respiratory timing (Ti/Ttot) rather than mean inspiratory flow (VT/Vi).

Bottle Feeding↗
PubMed1981

[Chemotherapy associating mitomycin C, thiotepa and vindesine in advanced breast cancers. Study of 100 cases (author's transl)].

One hundred patients suffering from advanced breast cancers and resisting to one (15) or several (85) drugs previously administered have been treated by an association of mitomycin C, thiotepa and vindesine, given every 3 weeks. Toxic effects were frequently observed and it was necessary to stop the treatment in more than 25 p. cent of the patients. Hemorrhagic complications due to thrombopenia (50 p. cent of cases) were severe in few cases and were responsible for the death of 2 patients. An overall objective response has been obtained in 41 cases and a regression in more than 50 p. cent of the lesions with a median duration of 7.5 months has been observed in 15 cases. The most striking effects have been noted in lymph nodes and skin involvement with an appreciable effect on the functional (subjective) and painful syndrome in 60 p. cent of cases. Difficulties in applying this chemotherapy to patients who had already been heavily treated explain a toxicity which would probably be reduced by an earlier application of the treatment. The quality of the results obtained (here) with these patients incite to study the effect of this association primarily to improve the long-term prognosis of localized or already disseminated breast cancers.

Adenocarcinoma↗