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Biomedical subjects

R Renaud

Publications and source records attributed to R Renaud.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Breast osteosarcoma. Review of the literature and presentation of two cases].

Two cases of primary osteosarcoma of the breast are reported. The Authors emphasize the overwhelming role of chimiotherapy in the treatment of this rare condition, not dissimilarly from recent advances in the management of osseous osteosarcoma. There was no evidence of recurrent or metastatic disease at respectively 38 and 49 months of follow-up. A review of the literature, including 150 published cases, reveals that therapeutic policies quite diverge yet.

Aged↗
PubMed1991

[Functional and urodynamic results of Burch's colpopexy. A series of 173 cases].

The authors describe their experience with modified Burch retropubic urethropexy with a mean follow-up of 4 1/2 years; they clinically assessed 173 women. 114 of these had urodynamic studies. The long term objective success of this operative procedure, with a success rate of 95% in genuine stress incontinence and of 96% in correction of the cystocele, justify its use to cure urine loss in women with primary stress incontinence or after failure of a previous operation. The results do not get worse with a long term follow-up. The mechanism of action consists in improving the abdominal pressure transmission ration (+29%) with only a little decrease of the post-operative mean maximal urethral closure pressure (-8,8 cm H2O). The most challenging complication encountered was bladder instability (22.5%); post-operative retrocele or enterocele occurred in 15% of cases. The other side effects were dysuria, pubic pain and trachelocele. The rate of failure is nearly 5% mainly due to insufficient correction of the abdominal pressure transmission ration, or post-operative bladder instability or low urethral closure pressure.

Adult↗
PubMed1990

Female urinary incontinence: comparative value of history and urodynamic investigations.

In order to identify the role of urodynamic investigation in relation to urinary symptoms, the authors assessed the diagnostic value of history and of urodynamic investigation in female urinary incontinence. 154 patients presenting with urinary incontinence were investigated prospectively, by standardised history and investigation of bladder stability and investigation of bladder stability and of cervico-urethral closure function. Clinical and urodynamic diagnostic conclusions were compared. Urodynamic results were highly discordant in the presence of clinical 'erethism', whilst agreement was more marked in the case of stress incontinence. Urodynamic investigation may be indicated after failure of medical treatment in the case of 'dysfunction'. By contrast, it is essential in stress incontinence in order to identify the mechanism or detect subclinical 'dysfunction'.

Female↗
PubMed1990

[Tamoxifen and endometrial adenocarcinoma].

The authors report a case of endometrial carcinoma treated with tamoxifen introduced after normal initial uterine curettage. Based on recent experimental and clinical data, the importance of a gynecological follow-up in anti-estrogen therapy is emphasized.

Adenocarcinoma↗
PubMed1989

Partial characterization of steroid sulfohydrolase and steroid sulfotransferase activities in purified porcine Leydig cells.

Subcellular fractions of purified pig Leydig cells from 7 different animals have been investigated with respect to their abilities to catalyze the sulfation of several steroids and the hydrolysis of the sulfated forms of these same steroids. Considerable estrone sulfate sulfohydrolase of pH optimum 7.5 and high apparent Km was found to be concentrated in the 105,000 g pellet but no evidence was obtained, in any subcellular fraction, for the presence of any activity toward the 3-sulfate of pregnenolone, dehydroepiandrosterone (DHA) or delta 5-androstene-3 beta,17 beta-diol (androstenediol). Cytosolic sulfotransferase activity toward estrone, pregnenolone, DHA and androstenediol was present in each animal. The activity toward these 4 substrates was eluted from a gel filtration column as a single peak of apparent molecular weight 43 KDa. Upon chromatofocusing, a sharp estrogen sulfotransferase peak of apparent pI 6.1 and pH optimum 9.5, was clearly separated from the neutral steroid sulfotransferase which eluted over a more acidic pH range in a manner suggestive of the presence of several isozymes. This latter, which exhibited a wide pH optimum range between 6 and 8.5, was most active toward androstenediol, and least active toward pregnenolone. The estrogen sulfotransferase exhibited Michaelis-Menten kinetics (apparent Km = 4 microM). The neutral steroid sulfotransferase activity increased in velocity with increasing androstenediol or DHA concentration up to 1 microM beyond which considerable substrate inhibition occurred. It appears from these data that neutral steroid sulfates synthesized in the pig Leydig cell are not subject to enzymic desulfation in the same cells.

Androstenediols↗
PubMed1989

[Use of erythrocytapheresis in a pregnant woman with sickle cell anemia].

A case is reported of a 23 yr old pregnant woman from Zaire in whom homozygous sickle-cell disease was discovered at her first obstetrical visit at 25 week amenorrhea. She had had two previous pregnancies: the first one had been voluntarily interrupted; the second one went to term, but the child, born in a state of apparent death, died on the third day. Despite severe normocytic anaemia (5 mmol.l-1 haemoglobin, 2.9 T.l-1 erythrocytes, 0.25 haematocrit, 93 fl mean globular volume), she was symptomless. The diagnosis was confirmed by haemoglobin electrophoresis: 0 haemoglobin A (HbA) and 0.854 haemoglobin S (HbS). Because foetal growth and maturation appeared satisfactory, no procedure to increase the HbA/HbS ratio was used before the 37th week of amenorrhea. At that time, erythrocytapheresis was carried out using a discontinuous flow cell separator. Eight phenotyped red cell packs without leukocytes (removed by filtration) were transfused; at the end of the procedure, there was 0.67 HbA and 0.25 HbS. At 39 week amenorrhea, haemoglobin electrophoresis gave 0.43 HbA and 0.47 HbS. No further treatment was therefore given. At the 40th week, she gave birth to a healthy girl, Apgar score 10 at 1 min. She was given two further red cell packs at start of labour, because her haemoglobin level had fallen to 6.4 mmol.l-1. In the immediate postpartum, her HbS level was 0.38. The aims, advantages and disadvantages of the different techniques available for the treatment of homozygous sickle-cell anaemia in pregnancy are discussed.

Adult↗
PubMed1989

[Results of cisplatin-based polychemotherapy and analysis of prognostic factors in ovarian cancer. Apropos of 106 cases].

One hundred and six patients with stage Ic to IV ovarian carcinoma were treated by a protocol consisting of optimal debulking surgery followed by 9 cycles of CHAP chemotherapy. Clinical response was confirmed by a second-look procedure. Sixty-nine patients (65%) responded with 54 histological complete remissions (50.8%). Nineteen patients did not receive any complementary treatment due to a negative reaction, or prolonged neutropenia. Seven patients received maintenance chemotherapy, 10 an abdominal radiotherapy, 22 intraperitoneal chemotherapy and 11 autologous bone marrow transplantation. The 5-year survival rate was 32.5% and disease-free survival rate was 39.7%. Prognostic-factor analysis showed that age, initial staging, residual disease and cytological grading were significant. The authors propose a classification based on the risk of relapse, and different therapeutic indications for improving response rate and patient survival.

Adult↗
PubMed1988

[Specific expression of human pS2 gene in breast cancer].

The hormone-dependence of some human breast cancers is well recognized. However, the molecular mechanisms responsible for the growth stimulation of these cancers by oestrogens are still poorly understood. With the hope of elucidating these mechanisms, we have recently cloned and studied the structure-function relationship of the human oestrogen and progestin receptors, and also undertaken a study aimed at characterizing genes whose expression is controlled by oestrogens in hormone-dependent breast cancers. We review here our findings concerning one of these genes and its expression products, the pS2 gene. We discuss also whether a systematic determination of pS2 gene expression in breast cancer biopsies could be useful to establish a new biochemical classification of these cancers which may be useful to improve the diagnosis of hormone-dependent cancers.

Amino Acid Sequence↗
PubMed1987

Specific expression of the pS2 gene in subclasses of breast cancers in comparison with expression of the estrogen and progesterone receptors and the oncogene ERBB2.

The expression of the pS2 gene, which is induced by estrogen in the breast cancer cell line MCF-7, has been investigated in breast cancers by using pS2 mRNA determination in tumor specimens and immunocytochemistry to identify pS2 protein in paraffin-embedded sections. Using these assays we show that determination of pS2 gene expression allows the definition of subclasses of estrogen-receptor-containing breast cancers that may be used to more precisely identify estrogen-dependent tumors. Tumor specimens have also been analyzed for the presence of mRNAs for the estrogen receptor and for the ERBB2 oncogene. No evidence for the presence of truncated forms of estrogen-receptor mRNA has been found, and overexpression of the ERBB2 oncogene did not correlate with the steroid receptor status or pS2 gene expression.

Breast Neoplasms↗
PubMed1987

[Basic principles of a breast cancer detection program].

The results of different programmes for screening carried out at present in foreign countries give sufficient proof of the value of screening for cancer of the breast in asymptomatic women of over 50 years of age. There is a significant reduction in mortality between 30 and 70%, according to different studies. Women who were screened had their cancers diagnosed at an earlier stage of the illness than those who were not screened whatever the ages of the women were. These results give a basis for planning screening in France. However, controlled pilot studies should still be carried out to widen screening in a country. These studies should in particular look at technical methods, evaluate the quality of the information that is obtained and the acceptability by women, as well as the training of radiologists and the qualities of the methods used. Finally, each programme should be controlled by the Public Authorities who will be paying for it.

Adult↗
PubMed1987

[Ovarian pregnancy. Apropos of 32 cases].

Ovarian pregnancies usually are diagnosed by the trophoblast which has gone into the ovarian tissue being found histologically. These pregnancies usually suggest haemorrhage from the corpus luteum or a rupture of ovarian cysts. The average age at which they appear is 29, just as it is the age for tubal pregnancies, but they do differ because there are few signs of infection and of infertility, and there are more multipara and women who are wearing an IUD. Two-thirds of ovarian pregnancies are on the peritoneal surface or in the hilum, away from the corpus luteum, and one-third are situated on the scar of the follicular ostium and have later infiltrated into the follicle. Most of these cases can be explained by reflux of the oocyte into the peritoneum.

Adult↗
PubMed1987

[Oligohydramnios. Diagnosis. Etiology. Prognosis].

We have studied 68 cases of severe oligohydramnios and compared them with the published literature on the aetiology, pathology, diagnosis, complications and prognosis. The principal aetiological features have been malformations of the fetal urinary tracts, intra-uterine growth retardation, high maternal blood pressure, nicotine poisoning and prolonged pregnancy. The perinatal mortality and morbidity, as well as the caesarean section rate, are raised because of the complications, such as the tetrad of oligohydramnios, prematurity, fetal distress in labour and post-maturity. When oligohydramnios is the sole presenting feature the prognosis for the fetus is better.

Adult↗
PubMed1987

[Hormone therapy and chemotherapy of endometrial cancer].

It is correct to add hormone or chemotherapy in advanced metastatic disease of endometrial carcinoma and in recurrences. Large doses of hormone treatment have to be given. These are progestagens and the success rate with them, no matter which product is used, is approximately 30%. The use is limited by high blood pressure and the risks of vascular complications and metabolic upsets. Tamoxifen seems to the better tolerated and gives similar results. The response to hormone treatment depends on how sensitive the tumor is to the hormones. It is better when it has large numbers of progesterone receptors and it is of low grade. When the tumour is resistant to hormones, chemotherapy with cytotoxic drugs should be used. These drugs are adriamycine and mono or combined chemotherapy, but there is no protocol as yet that is better than any other. The debate about whether to use adjuvant treatment in stage I or II cases is open. It must be considered when the prognosis seems to be bad or there seem to be large risks of recurrences.

Antineoplastic Agents↗
PubMed1987

[Hormone dependence and steroid receptors in adenocarcinomas of the endometrium].

The degree of hormone-dependence of endometrial cancers may be evaluated by the presence and the rate of estradiol and mostly progesterone receptors in an endometrial fragment. The most differentiated tumors have a high receptor content, while anaplastic cancers are most of the time without them. They must be systematically determined regardless of other prognostic factors enabling to evaluate the prognosis and guide the treatment. It is presently facilitated by the method of immunochemical titration on histological section, available for estrogen receptors, disclosing the spatial and functional distribution of hormono-dependent cells.

Cell Nucleus↗