PubMed Health⌕ Search

Biomedical subjects

G Andry

Publications and source records attributed to G Andry.

At least 37 records · Page 2Linked to original sources
PubMed1999

Late onset of tonsillar metastasis from breast cancer.

A 71-year-old woman non-smoker referred for repeated haemoptysis showed a tumoral lesion of the left tonsil. Pathological analysis of the biopsy showed characteristics compatible with a breast carcinoma metastasis, in which oestrogen and progesterone receptors were present. The patient had undergone mastectomy and had received adjuvant radiotherapy 24 years previously for a breast cancer with no complaints or signs of recurrence since. Investigations showed disseminated bone metastases but no other soft-tissue deposits. Anti-oestrogen therapy was applied. Only seven similar cases of tonsillar metastasis from breast cancer have been reported.

Adenocarcinoma↗
PubMed1999

[Adenopathy and eosinophilia].

The exercise topic is the persistence of adenopathies for many years in a young marocan boy who also presents with peripheral blood eosinophilia.

Adolescent↗
PubMed1998

Mutations of the beta2-microglobulin gene result in a lack of HLA class I molecules on melanoma cells of two patients immunized with MAGE peptides.

Mutations have been identified in the beta2-microglobulin gene of tumor cells of two metastatic melanoma patients who received immunizations with MAGE peptides. One mutation abolishes the start codon whereas the other introduces a premature stop codon. The second beta2-microglobulin allele of both tumors appears to be lost on the basis of sequence data and loss of microsatellite heterozygosity. The lack of beta2-microglobulin gene product results in the absence of HLA class I antigens on the surface of the tumor cells. This may explain why the tumors of both patients progressed despite the immunization treatment and shows the necessity of analyzing in depth the antigen presentation capability of the tumor cells for the interpretation of clinical trials involving anti-tumor vaccination.

Antigens, Neoplasm↗
PubMed1998

[Death from myocardial metastasis of thyroid cancers (insular, papillary with undifferentiated foyers)].

Two patients, both 70 years old, operated for differentiated thyroid cancer with foci of undifferentiated tumor (one papillary containing pseudosarcomatoid foci, the other with insular pattern containing undifferentiated foci) suddenly died. In both cases, for both of them metastatic involvement of the myocardium and endocardium. These original findings suggest that elderly patients suffering rom well differentiated thyroid cancer, containing undifferentiated foci, therefore suspected to have metastasized, would benefit from non-invasive cardiac work-up (sonogram) in order to plan their multidisciplinary treatment.

Aged↗
PubMed1997

A CASP-8 mutation recognized by cytolytic T lymphocytes on a human head and neck carcinoma.

Of the antigens recognized on human tumors by autologous cytolytic T lymphocytes, all those defined thus far have been identified on melanoma or renal cell carcinoma. We report here the identification of an antigen recognized by autologous cytolytic T lymphocytes on a human squamous cell carcinoma of the oral cavity. The antigen is encoded by a mutated form of the CASP-8 gene. This gene, also named FLICE or MACH, codes for protease caspase-8, which is required for induction of apoptosis through the Fas receptor and tumor necrosis factor receptor-1. The mutation, which was found in the tumor cells but not in the normal cells of the patient, modifies the stop codon and adds an Alu repeat to the coding region, thereby lengthening the protein by 88 amino acids. The ability of the altered protein to trigger apoptosis appears to be reduced relative to the normal caspase-8. The antigenic peptide is a nonamer presented by HLA-B*3503. The five last amino acids are encoded by the extension of the reading frame caused by the mutation. This, together with previous observations of CDK4 and beta-catenin mutations, suggests that a significant fraction of the point mutations generating a tumor antigen also play a role in the tumoral transformation or progression.

Aged↗
PubMed1997

[Belgian registry of thyroid cancer. Preliminary epidemiological characteristics revealed by a retrospective study (1988-1995). Belgian Thyroid Cancer Study Group].

The aim of a cancer registry is to study the incidence of cancer in a well-determined population and to allow epidemiological research to the setting up of diagnosis and therapeutic strategies. The Belgian Thyroid Cancer Study Group (BTCSG) was founded in 1990. In the present study we report data collected from 1988 to 1995 in 397 patients with a differentiated (papillary and follicular) thyroid carcinoma living in the french-speaking area of Belgium. The sex ratio female/male is 3.5 and the median ages at the diagnosis, is similar (45 yrs, 12-82) in both sexes. Seven cases of thyroid cancer were registered in young patients less than 18 yrs old. Thyroid carcinoma were associated with multinodular goiter in more than 50% cases. Cancer was bilateral in 17%. Papillary histological type accounts for 84% in our series while its diagnosis was established in 45% at early clinical stages (TO-T1). These observations could probably be related with 1) broader indications and more aggressive options for the surgical removal of diffuse multinodular goiter, 2) more sophisticated pathologic examinations that might have led to the detection of a greater incidence of occult carcinomas, incidentally discovered. Lymph nodes metastases were present at the time of diagnosis in 20%, especially in young patients. The risk for local and/or lateral recurrence or distant metastases is significantly related to the size of the tumor, histologically verified lymph node metastases and the values of the EORTC prognostic index (> or = 50) that additionally takes into account the differentiation of the tumor. Considering our short median follow-up time of 25 months, it is currently too early to define if the controversial attitude about the extent of surgery (total thyroidectomy plus I131 or individualized surgery) can also negatively influence the risk for recurrence. In our series, eight patients died of thyroid cancer.

Adolescent↗
PubMed1997

[Invasive differentiated thyroid cancers: discussion of therapeutics, multidisciplinary approach].

Although well differentiated treated thyroid cancers have generally an indolent course, some of those tumors present with an aggressive pattern, invading locoregional structures in the neck (mainly in the central compartment of the neck). Patients are usually older than 50 years. Initial treatment should imply large resections including the pharynx, a portion of the esophagus and sometimes the larynx, reconstruction may be necessary, with the use of flaps (free or pedicled). Those major operations have to be balanced with the quality of life and the length of expected survival, especially for older people whose adaptation to this pattern of survival may be an overwhelming situation (informed consent of the patient is necessary, a detailed information about the expected results is mandatory). Recent studies at the Mayo Clinic and at the Memorial Sloan Kettering Cancer Center have shown that intraluminal invasion of the esophagus or of the trachea are indicators of a poor prognosis. Multivariate studies have demonstrated that the age of the patient at presentation remains the predominant prognostic factor: for patients younger than 45 years, safe margins of excision allow a similar survival to that of patients without extrathyroidal extension. Whereas, after stratification for age, for older patients, the survival seems not to be affected by the size of the tumor or by the uncompleteness of the resection, this may be explained, at least partially, by the poor prognosis of the disease in those older patients. External beam radiation seems to be useful for patients for whom resection with close margins or shave-excision are performed. Two recent publications show that external radiation improves the survival of patients for whom complete resection of the tumor was not possible.

Adenocarcinoma, Follicular↗
PubMed1996

Antiemetic effect of subhypnotic doses of propofol after thyroidectomy.

Postoperative nausea and vomiting (PONV) are unpleasant, often underestimated side effects of anaesthesia and surgery, not devoid of medical complications. Prevention with antiemetics is only partially effective. Propofol has been shown recently to possess antiemetic properties in several situations. In this prospective, randomized, controlled trial, we have compared the antiemetic efficacy of subhypnotic doses of propofol, with Intralipid as placebo, after thyroidectomy. We studied 64 patients of both sexes, aged 22-71 yr, ASA I or II, undergoing thyroidectomy. After premedication with a benzodiazepine, balanced anaesthesia was produced with isoflurane and nitrous oxide in oxygen, and supplementary analgesia with fentanyl i.v. as required. Postoperative analgesia was provided with non-opioids, and piritramide 0.25 mg kg-1 i.m. on demand. Patients were allocated randomly and blindly to receive a 20-h infusion of either propofol or 10% Intralipid 0.1 ml kg-1 h-1. Intralipid, the excipient of propofol, was chosen as placebo as it is devoid of antiemetic effects. Sedation scores, respiratory and cardiovascular variables, and incidence of PONV were assessed every 4 h for 24 h. Pulse oximetry and ECG were monitored continuously. Both groups were comparable in characteristics, surgical and anaesthesia procedures, amount of opioids given during and after operation, and total amount of the study drug infused after operation. Occurrence of PONV was similar before the start (propofol 41%, Intralipid 50%) and after completion (propofol 0.64%, Intralipid 1.6%) of infusion and decreased with time in both groups during the infusion. However, symptoms were reduced to nil with propofol but persisted and were more severe with Intralipid during infusion (P < or = 0.01). The overall incidence of PONV during infusion was 10% (three of 32 patients) in the propofol group and 65% (21 of 32 patients) in the Intralipid group. Cardiovascular and respiratory variables, and SpO2 were unaltered, and sedation decreased similarly with time in both groups. We conclude that propofol, given at subhypnotic doses, effectively reduced the incidence of PONV without untoward sedative or cardiovascular effects.

Adult↗
PubMed1995

Parotid surgery.

Explore the source record for details and available documents.

Humans↗
PubMed1995

Aggressive basal cell carcinoma of head and neck areas.

Among skin cancers, basal cell carcinoma (BCC) is considered as a relatively indolent disease. Sometimes, these carcinomas have an unusual clinical behaviour, with extreme aggressiveness. Based on reports of eight cases of aggressive BCC of the head and neck areas, and after a review of the literature, we define three criteria of aggressiveness: (1) initial diameter greater than 1 cm, (2) more than two recurrences despite all tentative conclusions of adequate treatment, or (3) extension into any extracutaneous structure.

Adult↗
PubMed1993

Elevated CEA in breast cancer patients with overlooked medullary thyroid carcinoma.

After mastectomy and radiation for breast cancer, two patients were found to have persistent elevated CEA in their serum. This finding was erroneously attributed to occult metastases for the first patient and to local recurrence for the second. Overlooked medullary thyroid carcinoma (MTC) was the causal disease in both patients. A review of the literature stresses the frequency of CEA elevation in serum of MTC patients. A thorough search for any possible cause of elevated levels of CEA is advocated, particularly by thyroid sonogram with a needle aspiration biopsy when a nodule is discovered and by calcitonin assay in the serum.

Adenocarcinoma, Mucinous↗
PubMed1993

Postoperative irradiation for thyroid cancer.

The place of external irradiation for thyroid cancers remains controversial. Between 1974 and 1989, 94 patients with a differentiated thyroid cancer were seen in our department for additional treatment (radioiodine with or without external radiation) after a surgical resection. 56 patients were treated with radioiodine alone and 38 patients had an additional course of external radiation. Survival was identical for the two groups but the local relapse rates were 21% and 3% respectively. So, in this retrospective study, the addition of external radiation appears to improve the local control especially in the case of an incomplete surgical resection or extracapsular tumor extension. This benefit was achieved without severe radiation-induced late effects.

Adolescent↗
PubMed1993

Wound dressing in major head and neck cancer surgery: a prospective randomized study of gauze dressing vs sterile vaseline ointment.

A total of 207 patients were randomized in a prospective comparative study of standard gauze dressing vs sterile vaseline ointment. 179 patients were evaluable. All patients received antimicrobial prophylaxis. The two groups (86 standard and 93 vaseline) were comparable as far as age (mean, 57 yr; range, 21-84), genders (155 males/24 females), weight (mean, 66 kg; range, 40-69), type of surgery, previous or concomitant anticancer treatment. Severity of surgery was identical, as was the severity of cancer, in the two groups. Wound infection within 20 days of surgery occurred in 31.2% (29/93) of the vaseline group and 24.4% (21/86) in the standard group (NSS). Bacteremia occurred in three patients from the vaseline group and in four patients from the standard group. Bronchopneumonia occurred in 10 patients from the vaseline group and 14 patients in the standard group. The spectrum of microorganisms recovered was similar in the two groups. The need for antimicrobial treatment (empiric or for documented infections) within 20 days after surgery was 34.4% (32/93) in the vaseline group and 36.0% (31/86) in the standard group. The median delay to infection (range in days) in the vaseline group was 9 (5-15) for wound and 6 (1-12) for bronchopneumonia. For the standard group the corresponding delays were 8 (4-15) and 7 (2-19). Vaseline dressing was not associated with an increased risk of infection as compared to the standard gauze dressing.

Adult↗
PubMed1992

Antimicrobial prophylaxis for major head and neck surgery in cancer patients: sulbactam-ampicillin versus clindamycin-amikacin.

A total of 99 patients with head and neck cancer who were to undergo surgery were randomized in a prospective comparative study of sulbactam-ampicillin (1:2 ratio; four doses of 3 g of ampicillin and 1.5 g of sulbactam intravenously [i.v.] every 6 h) versus clindamycin (four doses of 600 mg i.v. every 6 h)-amikacin (two doses of 500 mg i.v. every 12 h) as prophylaxis starting at the induction of anesthesia. The two groups of evaluable patients (43 in the clindamycin-amikacin treatment group and 42 in the sulbactam-ampicillin treatment group) were comparable as far as age (mean, 57 years; range, 21 to 84 years), sex ratio (71 males, 28 females), weight (mean, 66 kg; range, 40 to 69 kg), indication for surgery (first surgery, 48 patients; recurrence, 37 patients), previous anticancer treatment (surgery, radiation therapy, chemotherapy), type of surgery, and stage of cancer. The overall infection rate (wound, bacteremia, and bronchopneumonia) within 20 days after surgery was 20 patients in each group. Wound infections occurred in 14 (33%) sulbactam-ampicillin-treated patients and 9 (21%) clindamycin-amikacin-treated patients (P = 0.19; not significant). The rates of bacteremia were 2 and 4%, respectively. The rates of bronchopneumonia were 14.3 and 23.2%, respectively (P was not significant). Most infections were polymicrobial, but strict anaerobes were recovered only from patients who received sulbactam-ampicillin. Antimicrobial treatment was required within 20 days after surgery for 42% of the sulbactam-ampicillin-treated patients and 44% of the clindamycin-amikacin-treated patients. By comparison with previous studies, we observed a decreased efficacy of antimicrobial prophylaxis in patients with head and neck cancer undergoing surgery because of the increased proportion of patients who were at very high risk for infection (extensive excision and plastic reconstruction in patients with recurrent stage III and IV cancers) and because of the longer duration of surgery.

Adult↗
PubMed1991

ATP, bradykinin, TRH and TSH activate the Ca(2+)-phosphatidylinositol cascade of human thyrocytes in primary culture.

We have recently shown that adenosine triphosphate (ATP), bradykinin and thyrotropin-releasing hormone (THR) increase the ([Ca2+]i) of human thyrocytes in primary culture. We show here that these agents also stimulate the generation of [3H]-inositol monophosphate (IP1), inositol bisphosphate (IP2) and inositol trisphosphate (IP3). The stimulation of IP3 generation followed two distinct kinetics: it was sustained when the cells were triggered with ATP and transient when the response was elicited by TRH or bradykinin. In addition, we have shown that under the appropriate experimental conditions, high thyroid-stimulating hormone (TSH) concentrations were also able to stimulate human thyrocyte IP1, IP2 and IP3 accumulation and to increase their [Ca2+]i. These data suggest that ATP, bradykinin, TRH and high TSH concentrations activate the Ca(2+)-phosphatidylinositol cascade of human thyrocytes. Since this cascade plays a crucial role in the control of protein iodination, ATP, TRH and bradykinin could be important regulators of thyroid hormone synthesis in human thyrocytes.

Adenosine Triphosphate↗
PubMed1991

Wide vertical hemipharyngolaryngectomy with immediate glottic and pharyngeal reconstruction using a radial forearm free flap: preliminary results.

We propose a new technique of wide vertical hemipharyngolaryngectomy which combines resection of laterally localized extended pharyngolaryngeal tumors with immediate microsurgical reconstruction using a radial forearm free flap, including the tendon of the palmaris longus. It eliminates the limitations of resections, which are usually performed to avoid closure difficulties of the resulting defect. In addition, the new technique avoids the use of tumor-neighboring structures for closure, fulfilling the oncological principles of surgery performed in this region. Our preliminary results show good restored deglutition and phonation. Postoperative irradiation does not seem to affect these results.

Forearm↗
PubMed1991

[Tumors of the submaxillary gland].

The tumors of the submaxillary gland are rare. The authors are reviewing 23 cases gathered from three Departments over ten years. The tumors of the submaxillary gland are malignant in as many as 50% of all cases! When the lesion is benign, pleiomorphic adenoma is the most frequent possibility. The authors emphasize the necessity of early and complete surgical treatment, requiring at least total submaxillectomy in case of benign tumor. Cervical mode dissection will be considered if the tumor is malignant.

Adenoma, Pleomorphic↗