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Biomedical subjects

M Durand

Publications and source records attributed to M Durand.

At least 235 records · Page 13Linked to original sources
PubMed1981

[Combination treatment of localised breast cancers with a high risk of metastatic disease. The results of a prospective controlled study (author's transl)].

74 patients who had adenocarcinoma of the breast that was inoperable at the beginning because of local extension but without inflammation and without diagnosable metastases (T3b, T4, N1, 2 or 3, Mo) were submitted to a therapeutic regime which consisted consecutively of: 1) preliminary chemotherapy, 2) radiotherapy and/or extended radical surgery when there was any residual tumour, and 3) follow-up adjuvant chemotherapy. Two types of combinations of cytostatic drugs were used: adriamycin, vincristin and methotrexate (AVM) for 5-day cycles every 3 weeks, and cyclophosphamide, methotrexate and fluoro-uracil (CMF) in 14-day cycles every 4 weeks. Three to 5 cycles of AVM were used initially, then at first either AVM to a total of 550 mg/m2 adriamycin, or a series of CMF carried on for a year. Complete remission was obtained in 70% of the patients (52 out of 74) at the end of the local-regional treatment. The mean time of remission was 33 months and the mean time of overall survival was 43 months. The best results were obtained in younger women (under 65 years of age) with tumours that were less developed (T3b), and who could take all the adjuvant chemotherapy after they had complete remission. There was no relapse in 37 of the 48 patients in this group (77% of the cases). Overall the treatment was tolerated fairly well and there was no major complication at the time of radiotherapy or surgery. These results are comparable to those from other studies of a similar nature and show a real progress as compared with those that used to be obtained when only local and regional treatments were undertaken. A more thorough follow-up is however necessary since we can hope for improvements to increase the efficacy and tolerance of the treatments, but this form of treatment can here and now be considered as an important factor for improving the survival rate of these very high risk patients.

Aged↗
PubMed1981

[Palliative chemotherapy of adult soft tissue sarcomas with an association of cyclophosphamide-vincristine-adriamycine-dacarbazine (CYVADIC) (author's transl)].

From January 1976 to December 1979, 23 adults with advanced soft tissue sarcomas were treated with palliative chemotherapy associating cyclophosphamide, vincristine, adriamycin and dacarbazine (CYVADIC) according to two different schema administered successively. A higher than 50 per cent rate of tumoral response was observed in 52 per cent of cases with 13 per cent complete remissions. Median survival was 14 months in patients who responded to treatment, and 4 months in non-responders (p less than 0,01). Side effects were severe however, and it was necessary to discontinue treatment in 5 patients, and modify dosage in 9 other patients. The CYVADIC protocol is effective but requires some modifications to improve tolerance.

Adult↗
PubMed1981

[Contribution of drill-biopsies to pre-treatment investigation of breast adenocarcinomas (author's transl)].

The sensitivity of drill-biopsies (Rousseau's technique) was studied before using them routinely in pre-treatment investigation of breast adenocarcinomas. Results of histological examination, and estrogen (ER) and progesterone (PR) receptors levels obtained preoperatively by this technique, were compared with those from the corresponding mastectomy or tumourectomy specimens in 85 cases. Cytological examination of the various specimens, performed on prints, was used to compare their cellular density. Measurement of receptors included the determination of cytosolic and nuclear sites, and was performed by the single point dextran charcoal method. The limits of positivity established for ER and PR were 10 and 15 fM/mg protein respectively. The results showed sensitivity of 91.8 p. cent for pathology examinations; furthermore, the Scarff-Bloom-Richardson histoprognosis grading could be performed satisfactorily on drill-biopsy specimens. No significant difference was observed between the percentage of positivity for ER and PR from surgical and drill-biopsy specimens. Good correlation existed between values obtained from drill-biopsy and from surgery both for ER (r = 0.86, p less than 10(-5)) and PR (r = 0.86, p less than 10(-5)).

Adenocarcinoma↗
PubMed1980

[Treatment of Ewing's sarcoma by radiotherapy and adjuvant chemotherapy : results at 3 and 5 years (author's transl)].

The local treatment of Ewing's sarcoma by radiotherapy is classically linked to a very poor prognosis : 10 to 15% of 5 years survival, 75 to 95% of distant metastasis in 2 years. The combination of local radiotherapy to a systemic adjuvant chemotherapy have been recently shown to give a real benefit to this prognosis. The therapeutic trial of the EORTC and GETO, presented here allows us to hope a disease free survival at 5 years for 50% of our patients and a complete survival at 5 years for 56% of them.

Antineoplastic Agents↗
PubMed1980

Chemical control of respiratory frequency and tidal volume during sleep in preterm infants.

During a given sleep state, respiration changes from periodic to regular and vice-versa. Because such spontaneous changes occur without changes in electro-encephalogram (EEG), electro-oculogram (EOG), electro-cardiogram (ECG) or body movements, we hypothesized that they are induced by chemical stimuli such as CO2. To test this hypothesis we examined 12 preterm infants in whom spontaneous changes in respiratory pattern were allowed to occur within the same sleep state, and infants in whom such changes were induced by inhalation of 0.3% to 1.2% CO2. Using a nosepiece and a screen flowmeter we measured the respiratory pattern, VE, f, VT, TI, TE, Ttot, VT/TI, TI/Ttot and PACO2. In REM sleep, spontaneous changes from periodic to regular were associated with increase in VE from 0.466 (mean) to 0.530 L/min (P less than 0.5) and CO2 induced changes accompanied by an increase in VE from 0.416 to 0.571 L/min (P less than 0.05). Similarly in N-REM sleep, VE increased from 0.385 to 0.445 L/min (P less than 0.05) during CO2 induced changes, and from 0.420 to 0.454 L/min (P less than 0.05) during CO2 induced changes, and from 0.420 to 0.454 L/min (P less than 0.05) during CO2 induced changes. Increased VE produced both spontaneously or by CO2 administration was associated with decreased VT, decreased Ttot, decreased VT/TI and slight increase in PACO2. We suggest that changes in respiratory pattern occurring within the same sleep state are chemically mediated.

Carbon Dioxide↗
PubMed1980

Interaction of lac repressor with alternating poly d (A-T) and poly d (G-C). Circular dichroism studies.

The binding of lac repressor to poly d(A-T) and d(G-C) has been studied using circular dichroism. The results indicate that the binding induces the same conformational change of both polynucleotides and perturbs the same number of nucleic acid bases (28 bases). It is shown that in 0.1 M phosphate buffer the CD measurement can be used to determine the binding constant of lac repressor to poly d(A-T). Competition experiments performed at various salt concentrations show that the stronger interaction of lac repressor for poly d(A-T) than for poly d(G-C) is based on difference in the dissociation rate of the complexes whereas the association rate for both polymers are similar.

Binding Sites↗
PubMed1980

Electron microprobe analysis of zinc incorporation into rumen protozoa.

With the aid of electron microprobe analysis on ciliate spreads, we detected zinc in ciliates and its accumulation in the endoplasm. A correlation was found between the amount of zinc accumulation and its concentration in the medium. By the same microprobe analysis of of ultrathin sections, we determined semiquantitatively the zinc accumulation in the intracytoplasmic granules and its presence in macronuclei and in intra- and extracellular bacteria.

Animals↗
PubMed1980

Hodgkin's disease, clinical stages I and II. Results of radical irradiation with or without chemotherapy.

From 1965 to 1976, 170 patients with Hodgkin's disease, clinical stages I or II, were treated with radical irradiation. A first group of 42 patients was treated with irradiation alone, a second group of 24 patients received one course of chemotherapy followed by irradiation, and a third group of 104 patients was treated with a sandwich regimen including chemotherapy + irradiation + chemotherapy. Although the treatment were not randomized, the comparison of the results shows a striking improvement in the group submitted to the C + R + C regimen: in this group the plateau of disease-free survival was 90 per cent. This result was obtained after treatment for about 3 months without surgical staging or maintenance chemotherapy. However, this treatment may favor some complications,. mainly the development of a second malignancy; these risks may be decreased by reducing the treatment in patients with good prognosis.

Adult↗
PubMed1980

[Chemotherapy in cervical cancer. Assessment of 267 palliative treatments and current trends (author's transl)].

Over the last 10 years 267 treatments with cervical cancer have been treated with chemotherapy in 4 anticancer centers. The analysis of these results shows: 1) 9 per cent of the treatments were discontinued because of clinical and hematological intolerance reactions; these intolerance reactions were responsible for 1 per cent of the therapeutic deaths; 2) an effect on the functional symptoms in 52 per cent of the patients with multiple drug regimens; 3) an objective global response in 18 per cent of the patients treated with single drug therapy (3 regressions greater than 50% out of 6 cases treated with cis-platinum) and in 22 per cent of the patients treated with various associations. Comparison of these results to recent data in the literature confirms: 1) the hope of improving objective results by developing more rational protocols of association, since, for the moment more active drugs are not available; 2) a much more marked chemotherapeutic action on lesions which have not been previously irradiated (statistically significant differences in response). Chemoresistance in cervical cancers may not be as frequent or as insurmountable as generally believed. The role of chemotherapy may be visualized from: 1) the palliative point of view, for efficacy while reducing toxicity); 2) induction sequence in curative treatment programs for advanced local forms with unfavorable prognosis (logical and attractive orientation of therapeutic studies); 3) the point of view of adjuvant treatment which remains to be defined. Rigorous studies are required to assess whether chemotherapy can give eventual long term improvement in high risk cervical cancers.

Adenocarcinoma↗
PubMed1980

[Long term hemodynamic results following complete cure of Fallot's tetralogy].

Cardiac catheterisation was carried out on an unselected series of 148 patients who had undergone complete correction of Fallot's tetralogy after an average postoperative period of si and a half years (range 2 to 20 years). 4% residual significant interventricular shunts (Qp/Qs > 1.3), 11% residual stenosis on the infundibulo-pulmonary tract (gradient greater than or equal to 10 mmHg) and 60% pulmonary incompetence was found. These findings do not reflect the excellent clinical results. All patients had normal lives: 89% remain asymptomatic since their operation and symptoms in the other patients are limited to moderate dyspnoea on effort or to arrhythmias which are usually periodic. A synthesis of the clinical and haemodynamic data shows that only a quarter of patients may be considered to be cured, that although the surgical results in 2/3 patients are not perfect, they are satisfactory, and that the results of complete correction in the remaining 12% are poor. The results do not appear to be related to the age at which correction was performed or to previous palliative surgery. On the other hand, the long-term haemodynamic results were related to the surgical method of infundibulo-pulmonary repair. Systolic right ventricular pressures of over 60 mmHg recorded at the end of operation in 33 patients, had returned to normal in 76% cases. These results suggest that the indications for prosthetic remodeling of the infundibulo-pulmonary tract should be increased, although this does not always prevent residual stenosis.

Adolescent↗
PubMed1980

[Non-Hodgkin's malignant lymphomas. Clinico-pathological data and course in 370 patients (author's transl)].

Three hundred and seventy non-Hodgkin's malignant lymphomas were seen at the Fondation Bergoniéé between 1965 and 1978 and classified according to the Kiel classification. Pretherapeutic data and evolution allow to recognize three distinct pathologic groups: 1) a first type of lymphosarcoma, so-called "low grade malignancy", is observed only in adults and old patients; the disease is often disseminated, the evolution is slow and the prognosis favorable; 2) a second type, so-called "lymphoblastosarcoma", is only one observed in young patients, the evolution is fast with frequent leukemic transformation and this group is thus very close to acute lymphoid leukemia; 3) a third type, so-called "immunoblastosarcoma", is observed only in old patients; the evolution is fast but without major spread; for these two latter groups, the prognosis is unfavorable. This highly significant and clearcut distinction may be a help for scheduling treatment according to each group of patients.

Humans↗
PubMed1980

[Combination chemotherapy of anaplastic carcinoma with adriamycin, vincristine, methotrexate and cyclophosphamide (author's transl)].

Taking into account the evolutive features of anaplastic cancers, the authors used four-drug combination chemotherapy with adriamycin, vincristine, methotrexate and cyclophosphamide applied to 55 patients. Treatment was administered in courses of 3 weeks at 15-day intervals and consisted of 3 days of treatment/week, repeated every 15 days. On the whole the treatment was well tolerated; however, the use of adriamycin was restricted because of its cumulative toxicity. Immediate objective responses were observed in 48 patients (87% of the cases) with 32 tumor regressions < 50 per cent (58%), 14 of which were complete remissions. The effects were most distinctive in distant lymph node metastases (78%). In the majority of cases the effects were of brief duration. Whether or not radiotherapy was associated, the overall course of the disease was not significantly influenced. The authors point out that patients responding to this protocol did not achieve the median survival, whereas the median survival was 17 months for an identical period of observation with varied treatments used priorly. The authors conclude that this chemotherapeutic protocol needs to be reinforced and readjusted in order to improve long term results.

Adult↗
PubMed1979

[A comparative study of two similar groups of 364 children treated for rheumatic fever according to identical protocols (1955--1961, 1965--1972) (author's transl)].

From 1955 through 1972, all children admitted to two after-care centers for rheumatic fever were examined by the same physicians with the same diagnostic criteria and treated according to the same rules. A comparaison between two groups of children who were examined ten years apart has confirmed the changes which took place in the course of rheumatic fever during this period. The incidence of recidives recorded at admission has dropped considerably. Multiple recidives, too, have grown rarer. The incidence of the forms with cardiopathy at admission has dropped. This is, for the most part, due to the reduction in the number of recidives. The severity of cardiopathies has abated, too, and this goes irrespective of the number of previous attacks. The results of treatment in children with cardiopathy are identical in both groups. Treatment methods have not changed from the beginning to the ending of the study; there is a good ground for thinking that the advances observed are due principally to the secondary prevention and related, therefore, to improvements in the health education level, which leads to a recidive prevention better done than in the past.

Adolescent↗