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Biomedical subjects

E Coste

Publications and source records attributed to E Coste.

At least 19 recordsLinked to original sources
PubMed2005

[Treatment of anemia and bone metastasis in metastatic non-small-cell lung cancer. A French survey].

Use of erythropoietin (EPO) for chemotherapy-induced anemia and biphosphonates (BP) for bone metastasis has increased steadily. However, there are no guidelines on their use in many situations such as non small cell lung carcinoma (NSCLC), which frequently alters quality of life markedly. Therefore, a multicentric survey was designed to assess the treatment of anemia and bone metastasis in chemotherapy-treated patients with non-small-cell lung carcinoma. Nine representative centers of the oncology working party of the French respiratory society (Groupe d'Oncologie de la Société de Pneumologie de Langue Française) participated. Inclusion criteria were stage IV NSCLC and at least one course of chemotherapy in the last 3 months. A total of 148 and 50 patients (pts) were included in the anemia and bone metastasis surveys, respectively. Anemia was present in 60.8% of patients, and was not treated in 75%; 15 patients received EPO (10.1%). Independent predictors of EPO use were presence of anemia-related symptoms, hemoglobin level, age and center: the rate of prescription in patients with anemia varied from 13 to 73% between centers. BP were administered in 38% of patients with bone metastasis. Independent predictors of BP use were calcium serum level, pain, and center with a rate of prescription ranging from 0 to 80% between centers. This study reveals that, in France, most patients with anemia are not treated, EPO being seldom prescribed. The use of both EPO and BP is highly variable between centers. Guidelines on the use of these supportive treatments could help improve the care for lung cancer patients receiving chemotherapy.

Anemia↗
PubMed2004

[Bronchial presentation of stage IVB Hodgkins disease].

INTRODUCTION: Bronchial localisation of Hodgkins disease has been described only rarely and it is exceptional as the presenting feature. More frequently the clinical presentation is extrinsic bronchial compression. OBSERVATION: Mr B.C., 34 years old, had a past history of cured alcoholism and abuse of cannabis and buprenorphine. In February 2001 he presented with generalised pruritus, weight loss of 8 kg in one year, a 1 cm node above the right clavicle, hypereosinophilia, and CT evidence of non-obstructive mediastinal adenopathy and interstitial lesions in the right lower lobe. Five months later he was admitted to hospital with a febrile illness. The right supraclavicular node had disappeared but there was gross mediastinal adenopathy, associated with a right perihilar soft tIssue mass encircling the upper, middle and lower lobe bronchi and multiple peripheral parenchymal nodules. Bronchoscopy revealed complete stenosis of the right upper lobe bronchus and bronchial histology confirmed Hodgkins disease. CONCLUSIONS: Bronchoscopy is an effective investigation for the detection of endobronchial Hodgkins disease, often overlooked because parenchymal abnormalities are attributed to extrinsic compression. In order to determine the disease stage more precisely we advise immediate bronchoscopy when there is suspicion that Hodgkins disease may be the cause of clinical.

Adult↗
PubMed2002

Phase II randomized multicenter study evaluating a treatment regimen alternating docetaxel and cisplatin-vinorelbine with a cisplatin-vinorelbine control group in patients with stage IV non-small-cell lung cancer: GFPC 97.01 study.

BACKGROUND: The potential absence of cross-resistance between cisplatin and docetaxel in non-small-cell lung cancer (NSCLC) suggests that alternating regimens of cisplatin-based chemotherapy and docetaxel might increase the activity of chemotherapy in stage IV NSCLC. PATIENTS AND METHODS: Randomized, multicenter, non-comparative phase II study in patients with stage IV NSCLC (Eastern Cooperative Oncology Group performance status of 0-2). Patients randomized to alternating treatment group (A) received docetaxel 100 mg/m2 on days (D) 1 and 43 alternating with cisplatin 100 mg/m2 on D22 and vinorelbine 30 mg/m2 on D22, D29 and D36. Those randomized to the control group (B) received cisplatin 80 mg/m2 on D1, D22 and D43 and vinorelbine 30 mg/m2 once a week from D1 to D57. Treatment was continued for a further 6 weeks in the event of objective response or stabilization. RESULTS: Seventy patients were enrolled (group A: 38, group B: 32). More premature treatment discontinuations due to toxicity were observed in group A (median number of cycles: 3) than in group B (median number of cycles: 5). The intention-to-treat objective response rate was 10.8% [95% confidence interval (CI) 0.8% to 20.8%] in group A compared with 25% (95% CI 10% to 40%) in group B, the median time to treatment failure being 10.2 weeks and 17.3 weeks, respectively. The median survival and 1-year survival were 29.1 weeks and 39% in group A compared with 41.6 weeks and 42% in group B. Febrile neutropenia occurred in 5.9 and 4.9% of the cycles in group A and group B, respectively. Non-hematological toxicity was moderate in the two groups. CONCLUSIONS: The addition of docetaxel alternating with cisplatin-vinorelbine did not enhance the activity of this combination. The development of sequential regimens might be a more promising way of exploiting the absence of cross-resistance between these two drugs.

Adult↗
PubMed2001

3D reconstruction of the encapsulating contour of arteriovenous malformations for radiosurgery using digital subtraction angiography.

PURPOSE: Treatment planning for radiosurgery depends on the precise definition of radiation target volumes. For vascular pathologies such as arteriovenous malformations (AVM), the most usual technique remains standard X-ray projection imaging, most often carried out under stereotactic conditions. To further benefit from the advantages of two-dimensional digital subtraction angiography (DSA), the authors have developed a method for determining the three-dimensional shape of arteriovenous malformations from two views. METHODS AND MATERIALS: After correction of image intensifier distortion and calibration of both views, the 3D shape of the AVM was determined from two DSA projections using epipolarity geometry. The AVM-encapsulating contour was modeled by triangulation of a stack of almost parallel ellipses. The method was technically validated using artificial targets in a skull phantom. Clinical validation was carried out on 10 patients who were examined using both conventional angiography under stereotactic conditions (SX-ray) and DSA. RESULTS: There was excellent agreement between the artificial target volumes measured with SX-ray and with DSA. The correspondence between AVM volumes found for patients was not as good as with the phantom. CONCLUSIONS: The different image characteristics of the two modalities lead to some differences in AVM estimations. However, the results were sufficiently satisfactory to justify routine use of this AVM modeling technique for radiosurgery planning.

Angiography, Digital Subtraction↗
PubMed2000

Accurate localization of needle entry point in interventional MRI.

In interventional magnetic resonance imaging (MRI), the systems designed to help the surgeon during biopsy must provide accurate knowledge of the positions of the target and also the entry point of the needle on the skin of the patient. In some cases, this needle entry point can be outside the B(0) homogeneity area, where the distortions may be larger than a few millimeters. In that case, major correction for geometric deformation must be performed. Moreover, the use of markers to highlight the needle entry point is inaccurate. The aim of this study was to establish a three-dimensional coordinate correction according to the position of the entry point of the needle. We also describe a 2-degree of freedom electromechanical device that is used to determine the needle entry point on the patient's skin with a laser spot.

Biopsy, Needle↗
PubMed2000

De novo adhesions with extraperitoneal endosurgical para-aortic lymphadenectomy versus transperitoneal laparoscopic para-aortic lymphadenectomy: a randomized experimental study.

OBJECTIVE: The objective of this study was to compare the risk of adhesion formation and the site of postoperative adhesions after transperitoneal versus extraperitoneal laparoscopic para-aortic lymphadenectomy. STUDY DESIGN: A prospective study was conducted on 66 pigs, randomly allocated to 2 groups of 33 animals that underwent transperitoneal versus extraperitoneal laparoscopic para-aortic lymphadenectomy. RESULTS: No statistically significant difference was observed between the 2 techniques in terms of operating time, number of lymph nodes removed, and intraoperative and postoperative morbidity. More lymphoceles were observed in the extraperitoneal laparoscopy group (P =.0002). The overall adhesion rates were 76% in the transperitoneal group and 43.33% in the extraperitoneal group (P =.04). The adhesion score specific to the operative site was lower in the extraperitoneal group (P =.0005). A stereolocalization study showed that almost all adhesions after transperitoneal laparoscopy were situated in the para-aortic external irradiation field, whereas adhesions after extraperitoneal laparoscopy were predominantly situated outside this field. CONCLUSION: Extraperitoneal laparoscopy generates significantly fewer adhesions in the para-aortic irradiation field.

Animals↗
PubMed2000

[Comparison of transperitoneal versus extraperitoneal laparoscopic para-aortic lymphadenectomy: randomized experimental study].

OBJECTIVES: The objective of this study was to compare the risk of adhesion formation and the site of postoperative adhesions after transperitoneal versus extraperitoneal laparoscopic paraaortic lymphadenectomy. MATERIAL AND METHOD: A prospective randomized trial was conducted on 66 pigs, submitted to transperitoneal (n = 33) or extraperitoneal (n = 33) laparoscopic paraaortic lymphadenectomy. The efficacy and the intra and postoperative morbidity (adhesion score taking into account the number of adhesions and the surface area involved) of each approach were compared. The site of postoperative adhesions in relation to a simulated external irradiation field was determined by a stereo-localization system (Syslav) on 20 pigs. RESULTS: No statistically significant difference was observed between the two techniques in terms of operating time, number of lymph nodes removed, and intra and postoperative morbidity except for lymphoceles and adhesions. No case of lymphocele was observed in the transperitoneal group versus 13 cases (43.33%) in the extraperitoneal group (P = 0.0002). Final total adhesion score was 76% (n = 22) in the transperitoneal group versus 63.33% (n = 19) in the extraperitoneal group. Adhesion score specific to the operative site was 76% (n = 21) in the transperitoneal group versus 43.33% (n = 13) in the extraperitoneal group (P = 0.04). A statistically significant difference was observed between the two approaches in terms of final total adhesion score (P = 0.008) or adhesion score specific to the operative site (P = 0.0005). The stereolocalization study showed that almost all adhesions were situated in the paraaortic external irradiation field after transperitoneal laparoscopy, while adhesions were predominantly situated outside this field after extraperitoneal laparoscopy. CONCLUSIONS: Extraperitoneal laparoscopy generates significantly fewer adhesions in the paraaortic irradiation field and should have a risk of radiation enteritis less important than transperitoneal laparoscopy.

Animals↗
PubMed1999

3D reconstruction of the cerebral arterial network from stereotactic DSA.

The authors present an automatic algorithm for 3D reconstruction of cerebral blood vessels by digital subtracted angiography. The patient is localized by a stereotactic method. The reconstruction algorithm includes two steps: first vessel extraction then 2D matching and reconstruction. Accurate vessel skeletons are generated by a combination of mathematical morphological algorithms and adaptive filters. The 3D reconstruction algorithm is based on the reconstruction of vessels center lines. For that purpose, three different projections of the vascular network are used. Reconstruction is computed segment by segment (a curved line between two nodes). For each segment point, the algorithm defines all epipolar solutions on the other views. These epipolar solutions are sorted and pooled by 2D continuity and 3D proximity criteria resulting in a 3D graph. Optimal 3D segment is defined by a recursive algorithm that looks up the better path in the 3D graph. The algorithms have been implemented on a Compatible-PC computer in C language. More than 95% of static copper phantom was reconstructed in 5 min and with 1 mm 3D accuracy. 70% of arteries (from carotid to the seventh node) of a true patient arterial network were reconstructed is less than 30 min.

Algorithms↗
PubMed1999

Automatic quality assessment protocol for MRI equipment.

The authors have developed a protocol and software for the quality assessment of MRI equipment with a commercial test object. Automatic image analysis consists of detecting surfaces and objects, defining regions of interest, acquiring reference point coordinates and establishing gray level profiles. Signal-to-noise ratio, image uniformity, geometrical distortion, slice thickness, slice profile, and spatial resolution are checked. The results are periodically analyzed to evaluate possible drifts with time. The measurements are performed weekly on three MRI scanners made by the Siemens Company (VISION 1.5T, EXPERT 1.0T, and OPEN 0.2T). The results obtained for the three scanners over approximately 3.5 years are presented, analyzed, and compared.

Image Processing, Computer-Assisted↗
PubMed1999

Chronic constrictive pericarditis induced by long-term bromocriptine therapy: report of two cases.

OBJECTIVE: To report two cases of chronic constrictive pericarditis that appear to be related to the intake of bromocriptine for Parkinson's disease. CASE SUMMARY: Two white men (aged 63 and 69 y) were treated with bromocriptine for four (40 mg/d) and two years (30 mg/d), respectively, with a cumulative dose intake of 58.4 and 21.9 g, respectively. The patients experienced dyspnea with bilateral lower-limb edema and pleural effusion, suggesting right cardiac dysfunction. Echocardiography, computed tomography, and cardiac catheterization results were compatible with a diagnosis of constrictive pericarditis, so pericardectomy was performed on both patients. The anatomic pathology examination showed a fibrous pericardium; cultures were sterile. In the first case, pleural effusion recurred seven months after the pericarditis; bromocriptine was suspected and treatment was discontinued. In the second case, just prior to the pericardectomy, an episode of mental confusion occurred and prompted the cessation of bromocriptine therapy. DISCUSSION: To the best of our knowledge, only one case of constrictive pericarditis induced by bromocriptine therapy has previously been described in the literature. CONCLUSIONS: Our cases call attention to a possible association between bromocriptine use in patients who have Parkinson's disease and constrictive pericarditis.

Aged↗
PubMed1997

Assessment of image intensifier and distortion for DSA localization studies.

The authors present methods of correcting pincushion and S distortions of an image intensifier, and of measuring the geometrical parameters of the imaging device used for localization from digital subtraction angiography brain studies. Pincushion and S distortions of the image intensifier are corrected by a calibration grid. A test pattern is used to study effectiveness of the corrections. Intrinsic geometrical parameters (source-to-image distance, centre of X-ray projection) of the apparatus are measured by the use of a calibration phantom. Short-range and long-range time drift of the distortion, as well as influence of the parameters of image acquisition on the accuracy of the localization results, are considered. The results obtained successfully demonstrate the accuracy of the correction, provided that the apparatus is warm.

Angiography, Digital Subtraction↗
PubMed1997

[Determination of target volume for dosimetric planning in stereotactic radiosurgery].

Stereotactic radiosurgery needs an accurate determination of the target volumes to be irradiated and of sensitive volumes to be spared: position, external boundaries, internal volume. These parameters can be obtained by using either projection imaging (radiographs, digital angiography), or tomographic imaging (magnetic resonance imaging, computerized tomography). The authors describe the methods used in these different imaging modalities and the problems encountered in target determination. Methods of validations are described. Results obtained on phantoms and on actual target volume are given and discussed.

Humans↗
PubMed1995

A frameless stereotaxic localisation system using MRI, CT and DSA.

The authors present a method of stereotaxic localisation using magnetic resonance imaging (MRI) computerized tomography (CT) and digital subtracted angiography (DSA) which does not require localisation frams fixed to the patient's skull, but uses only four cranial landmarks corresponding to the holders of the neurosurgical stereotaxic frame. The method presents no major constraints in routine examinations. The geometrical distortions of the imaging devices are corrected. Three-dimensional localisation is performed using sagittal and axial slices in MRI, axial slices in CT and only two associated frontaly and lateral views in DSA. The images data are transferred to a PC-based system. By locating the landmarks on the images, the transformation matrixes can be computed to obtain the 3D coordinates of a target in the stereotaxic space and in any imaging modality. The results obtained show the precision of the corrections and the millimetre accuracy of pin-point target localisation.

Angiography, Digital Subtraction↗
PubMed1993

Ultrasonic signs of pneumothorax: preliminary work.

Ultrasonography is considered to have limited application in respiratory diseases because air reflects sound waves. Twenty-four patients with radiologically confirmed pneumothorax and 100 healthy subjects underwent sonography. In all normal subjects, the hyperechoic pulmonary interface showed respiratory motions termed the "gliding sign" with some comet-tail artifacts. Sonographic signs were shown in all pneumothoraces: disappearance of the gliding sign and no comet tails. The extent of collapse cannot be evaluated, but it is possible to determine its area in partial pneumothorax (N = 5). The follow-up (N = 8) showed the reappearance of the gliding sign. Ultrasonography may be helpful in diagnosing pneumothorax in certain cases.

Adolescent↗
PubMed1993

Identification of a neuron-specific promoter of human aromatic L-amino acid decarboxylase gene.

We have cloned the 5' region of human aromatic L-amino acid decarboxylase (AADC) gene in a cosmid and an overlapping lambda clone, and sequenced the first five exons. A 61 base pair (bp) non-coding, first exon containing for the 5' end of a human pheochromocytoma AADC cDNA was localized 16 kb upstream of exon 2, in which translation is initiated. The transcription start site was localized by RNAse mapping, primer extension and reverse transcription-PCR. The non-conventional cap site was preceded by a modified TATA box at position -29. A strong promoter was characterized in the 560 bp region upstream of the cap site by linkage to the reporter gene LacZ, and transfection in human neuroblastoma SK-N-BE and SK-N-BE-K2 cells. Using a series of constructs bearing a varying length of 5' flanking region, three positive regulatory elements have been localized in the -560 to -394, -244 to -200 and -147 to -1 regions. Negative regulatory elements were localized in the -9000 to -560 and -394 to -316 regions. Surprisingly, constructs comprising all or the major part of intron 1 were inactive, suggesting the presence of a silencer in the first intron, or incorrect splicing events. The construct containing 560 bp of 5' flanking sequence did not express in human cholinergic neuroepithelioma cells MC-I-XC, and in three non-neuronal cell lines which displayed high AADC activities: human pancreatic carcinoma cells AsPC-1, rat insulinoma cells RINm5F and mouse anterior pituitary cells AtT20. These data suggest that we have identified a neuron-specific AADC promoter. An extensive search for a second promoter responsible for AADC gene expression in non-neuronal cells only gave negative results.

Amino Acid Sequence↗
PubMed1993

Frameless method of stereotaxic localization with DSA.

PURPOSE: To improve a method of stereotaxic localization with digital subtraction angiography that does not require use of a localization frame fixed to the patient's skull during examination. MATERIALS AND METHODS: An independent, low-cost, stereotaxic computing system was devised. Software programs used magnetic resonance images, computed tomographic scans, and digitized radiographs of plastic bone implants with head landmarks to establish reference trihedrons in each imaging system, transpose target coordinates from one system to another, adjust surgical instruments, help plan radiation surgery, and compute and display isodose curves. RESULTS: The geometric distortions of the image intensifier were corrected. Distortion problems of the conic projection were solved, and three-dimensional localization was achieved with only two associated front and lateral views. Accuracy to within 1 mm was achieved for the three coordinates. CONCLUSION: This frameless stereotaxic localization technique is highly accurate and reliable. The system allows maximum automation of examination procedures.

Angiography, Digital Subtraction↗
PubMed1993

Peripheral pulmonary lesions: ultrasonic features and ultrasonically guided fine needle aspiration biopsy.

When transthoracic biopsy is required for diagnosing lung diseases, radiographic procedures are the methods of choice, sonographic application being still limited. Sixty-four consecutive patients with pulmonary lesions adjacent to the chest wall underwent sonography. Findings showed hypoechoic homogeneous lesions (56 cases) with posterior regular margin (57 cases). Increasing echoes deep to the mass and sonographic interruption of hyperechoic surface were seen in all patients. In two cases, chest wall invasion had been diagnosed. Histologic diagnosis was made in 55 of the 64 patients (85.9%). Two pneumothoraces occurred. Sonography is a useful, accurate, and safe technique for diagnosing selected pulmonary lesions.

Adult↗