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Biomedical subjects

A Rey

Publications and source records attributed to A Rey.

At least 19 recordsLinked to original sources
PubMed1992

Preoperative care of infants with nephroblastoma. The International Society of Pediatric Oncology 6 experience.

The International Society of Pediatric Oncology (SIOP) recommends preoperative treatment in the management of eligible patients with Wilms' tumor. Until 1980, children younger than 12 months of age (infants) at diagnosis had been excluded from the SIOP trials. SIOP 6, conducted from 1980 to 1987, was the first SIOP study to include infants older than 6 months of age. This retrospective analysis of 145 infants registered to SIOP 6 demonstrates that in infants older than 6 months and having favorable histology (FH), a two-drug preoperative chemotherapy (CT) regimen of 4 weeks significantly ameliorated stage distribution as determined at delayed surgery but did not affect a good outcome. However, the CT dose utilized in SIOP 6 resulted in an unacceptable toxicity in this age group, and SIOP 9, the new SIOP study of Wilms' tumor, recommends a reduced dose of CT in infants. Preoperative CT is not recommended in infants younger than 6 months of age. Specifically, the high incidence (29%) of mesoblastic nephroma in this age group does not justify such an approach. Histopathologic diagnosis should be obtained in these patients before any treatment.

Age Factors↗
PubMed1992

A phase II trial of early intensive chemotherapy with autologous bone marrow transplantation in the treatment of poor prognosis non seminomatous germ cell tumors.

Twenty-eight patients with poor prognosis, advanced metastatic non seminomatous germ cell tumors (NSGCT) were treated with early high dose chemotherapy and autologous bone marrow transplantation (ABMT) rescue. The primary tumor was testicular in 19 patients and extragonadal in nine patients. For 19 patients with a testicular primary, the median probability of complete remission (CR) was 0.05 according to our prognostic mathematical model based on pretreatment levels of serum HCG and AFP. The same prognostic model was used for extragonadal primaries. Treatment consisted of two cycles of a modified double dose of cisplatin, vinblastine, bleomycin, VP-16 regimen (mPVeBV) followed by a high dose cisplatin-etoposide-cyclophosphamide regimen (PEC) followed by ABMT. Of the 28 patients, 17 (61%) achieved CR, one of which was surgical CR (sCR), five died of rapidly progressive disease early during the first cycle of mPVeBV, two had treatment-related deaths, three did not respond and one patient refused treatment. Of the 17 patients initially in CR, three relapsed after 4, 4 and 7 months respectively and have subsequently died. Two other patients died while still in CR: one committed suicide and one died of an infectious complication due to transfusion-related AIDS. Twelve patients are alive in CR after a median follow-up of 66 months (range 7-72 months). The non parametric 3-year survival rate is 40%. To demonstrate the effect of intensive chemotherapy with ABMT, a randomized multicenter French study was set up to evaluate the PVeBV regimen with or without high dose treatment and ABMT in poor risk NSGCT patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

[Spontaneous sphenoidal rhinorrhea].

We describe the case of a woman, who presents a spontaneous rhinorrhea. The metrizamid computerized tomographic cisternography proves the precise anatomic location of the dural osseous defect, in the left sphenoidal sinus. Transsphenoidal approach terminated the leakage in a single procedure, without shunt.

Cerebrospinal Fluid Rhinorrhea↗
PubMed1991

M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for advanced carcinoma of the bladder. The French Federation of Cancer Centers experience.

70 patients with advanced transitional cell carcinoma of the bladder received methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC). Complete responses (CR) were obtained in 13 of the 67 (19%) evaluable patients and partial responses (PR) in 25 patients for an objective response rate of 57% (95% CI 45-69%). Of the 54 patients who have had a minimum follow-up of 2 years, 8 patients (15%) are disease-free or have stable residual disease. Median survival of the 70 patients was 13 months. Toxicity was acceptable with no drug-related deaths. Because of myelosuppression, only 15 patients (21%) received treatment without delays in drug administration or modifications from the planned schedule. Our results confirm that this regimen is effective, with some patients being long-term survivors.

Adult↗
PubMed1991

[Study of high doses of carboplatin as a first choice in the therapy of advanced ovarian cancers].

Thirty female patients with ovarian cancer of poor prognosis were included in a chemotherapy trial using high dose IV carboplatin--800 mg/m2 every 5 weeks. The subjects had three to six cycles prior to second laparotomy. Twenty-eight patients were assessable. There was no neurological, auditory or renal toxicity. Limiting toxicity was haematological, the mean neutrophil count was less than 650 mm3 and the mean platelet count less than 30,000/mm3. No death occurred from toxicity. The clinical response rate was 67%, and the surgical response rate 53.5%, with 15% complete histological responses. Survival at 18 months is 36%. A trial concerning 36 patients treated with an association of carboplatin at the same dose combined with cyclophosphamide has just been completed and the results are being analyzed.

Adenocarcinoma↗
PubMed1990

[Schistosomiasis of the spinal cord. Contribution of magnetic resonance imaging].

The authors report a case of spinal cord schistosomiasis presenting as myelitis, with rapidly developing deficit, signs of severe cerebrospinal fluid inflammation, normal myelography and computerized tomography. The patient's country of origin suggested schistosomiasis, and the diagnosis was confirmed by serology and rectal biopsy which showed eggs of Schistosoma mansoni. Magnetic resonance imaging was helpful as it confirmed the absence of spinal cord compression and showed a lesion of the conus medullaris, this region being the most frequent site of schistosomial myelitis.

Adult↗
PubMed1990

Spina bifida: a chick embryo experimental model.

Neural Tube Defects (NTD) can be induced in the chick embryo with relative ease in order to provide an experimental tool for investigation of such disabling malformations. Domestic hen (Gallus gallus) eggs were incubated at 37.5 degrees C and 80% humidity for 24 h. At that moment, 5 ml of albumen were aspirated by sterile puncture of the shell, and the incubation was resumed. The embryos were recovered and studied at the 8th, 10th and 14th days. Almost half (45%) of the 602 treated embryos survived and 73 of them (12%) had various malformations. Thirty-six (6%) suffered NTD of which 30 were open myelomeningocele, 2 meningocele and 4 encephalocele. The anatomy of the defects was astonishingly similar to that of the human malformation. Whether these experimental NTD are induced by mechanical or nutritional modifications of the internal environment of the egg is unknown, but the similarity of the lesion with those in humans make them suitable for further investigation of these issues. We believe that this relatively simple and inexpensive model is a suitable tool for research on spina bifida.

Animals↗
PubMed1990

Treatment of malignant gliomas with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy: a phase II study.

Forty patients with malignant supratentorial gliomas were treated with surgery, intra-arterial infusions of 1-(2-hydroxyethyl)chloroethylnitrosourea, and radiation therapy. The median duration of survival was 12 months; it differed according to the histological subtype (over 30 months for patients with anaplastic astrocytomas or anaplastic oligodendroglioma and 10.5 months for glioblastoma; P = 0.0025). Serious complications of monocular blindness and leukoencephalopathy were observed in four patients (10%).

Adolescent↗
PubMed1990

Embolization with particles in thoracic intramedullary arteriovenous malformations: long-term angiographic and clinical results.

To evaluate the long-term results of endovascular treatment with particles in the management of thoracic intramedullary arteriovenous malformations (AVMs), the authors retrospectively reviewed the angiographic and clinical findings in 35 patients. Follow-up was 1-15 years (mean, 6 years) in 28 patients and 6-10 months (mean, 7 months) in seven. A total of 158 embolization procedures were performed in 35 patients. Revascularization occurred frequently, necessitating multiple endovascular sessions. Long-term clinical evaluation showed clinical improvement, compared with the initial status before treatment, in 63% of the patients. Clinical aggravation due to embolization was observed in seven patients (20%) after 12 of the 158 endovascular sessions (8%). These results are better than those reported after surgery and indicate that embolization with particles is an efficient and safe tool in the treatment of thoracic intramedullary AVMs.

Adult↗
PubMed1990

[Needle biopsy of pancreatic masses].

We report the results of 66 ultrasound or CT guided needle aspirations in 59 patients with pancreatic masses, from 1983 to 1987. Cytologic and histologic samples were obtained in 45 cases. Histologic samples, formed by minute tissue fragments, were paraffin embedded for standard sections (minibiopsy). Sensitivity, specificity and overall accuracy of the series as a whole were 88, 100 and 89.8%, respectively. We discuss the clinical usefulness of the technique; isolated cytologic and histologic results are compared and the minibiopsy contribution to the cytologic diagnosis is discussed.

Adult↗
PubMed1989

Histopathological classification of childhood rhabdomyosarcoma: a report from the International Society of Pediatric Oncology pathology panel.

Five hundred thirteen soft tissue tumours of childhood referred to the International Society of Pediatric Oncology (SIOP) Rhabdomyosarcoma study have been reviewed. The period covered was from January 1975 to December 1983. Three hundred thirty-nine neoplasms were regarded as embryonal rhabdomyosarcoma. The histological diagnosis of all referred tumours is given, and a classification of rhabdomyosarcomas developed during the course of the study is described. The relationship between histological subtypes and aspects of clinical behaviour is presented. The classification is thought to be helpful in diagnosis and also in assessment of the likelihood of recurrence and/or metastasis of childhood rhabdomyosarcoma.

Adolescent↗
PubMed1989

Rhabdomyosarcoma in infants under one year of age: experience of the Institut Gustave-Roussy.

Forty-three infants under 1 year of age (median 4 months) with rhabdomyosarcoma (RMS), representing 11% of all childhood RMS seen over the same period, were treated and followed between 1955 and 1984 at our institute. Compared to the 340 older children (1-16 years of age), there were no significant differences in male/female ratio, primary site, or clinical stage, but there was a higher frequency of alveolar and poorly differentiated histologic subtypes in infants aged under 1 year (P = 0.05 and P less than 0.001, respectively) and increased frequency of botryoid RMS in older children (P less than 0.02). Although children older than 1 year of age had a significantly higher complete remission rate (83% vs. 51%, P less than 0.001), their 5 year overall survival (43%) was no different from that of infants under 1 year of age (35%). In the older group there was no survival difference between alveolar (38%) and nonalveolar (44%) histologic subtypes, but in infants younger than 1 year, alveolar subtype had a significantly poorer prognosis (13% vs. 47%, P = 0.01). Management of patients at this age group is difficult and major advances are needed to increase survival rates with a minimum of morbidity.

Adolescent↗
PubMed1989

Spinal dural arteriovenous malformations with perimedullary drainage. Indications and results of surgery in 30 cases.

70 patients were treated for spinal dural arteriovenous fistula in the same centre, during a period of 10 years. Conus medullaris and cauda equina syndromes were observed in all patients as the clinical stereotyped presentation. Diagnosis was based on myelography in the first instance and then on angiography. 40 patients were treated by intravascular neuroradiological embolization, whereas the other 30 were operated on. Surgery was proposed because embolization was contraindicated (7 cases of hazardous catheterisation) of inefficient (23 cases = 38%). The results of the operative series are presented, and compared with those of embolization. Improvement was observed in 50% of the 20 patients with follow up, but a complete recovery to an asymptomatic state was never obtained. For the other patients (47%) complete stabilization of the disease could be obtained, whereas in one of the patients (3%), who was operated upon because of failure of embolization, surgery was also completely ineffectual. The long-term results of patients treated surgically are comparable with those patients efficiently embolized. 5 patients of the operative series were submitted to MRI before and after surgery: the results and the place of MRI are discussed.

Adult↗