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Biomedical subjects

J M Simon

Publications and source records attributed to J M Simon.

At least 19 recordsLinked to original sources
PubMed1992

Time factors in breast carcinoma: influence of delay between external irradiation and brachytherapy.

From 1971 to 1983, 398 (33 T1, 309 T2, 56 T3) biopsy-proven breast adenocarcinomas were treated conservatively at Hôpital Henri Mondor by an initial course of external irradiation (45 Gy, 25 fractions, 5 weeks) followed by interstitial iridium-192 implant for a further 37 Gy to the tumor. The mean interval between external irradiation and brachytherapy was 5.9 weeks (S.D. 1.7, range 1-18). Seventy-seven local failures were observed at 10-148 months (median 34.5). The actuarial probabilities (S.E.) of local control at 5 and 10 years were 0.86 (0.02) and 0.74 (0.03), respectively. The follow-up for patients free of local recurrence was 4-205 months (median 95). Multivariate analysis showed an increasing probability of local failure with longer interval between external irradiation and brachytherapy (Relative Risk [R.R.] 1.23 [95% confidence limits: 1.07, 1.41] per week, p = 0.005), and a lower risk of failure in case of complete tumor regression after external irradiation (R.R. 0.47 [0.25, 0.90], p = 0.022), and higher brachytherapy dose rate (R.R. 0.13 [0.02, 1.02] per Gy/h, p = 0.053). No influence of tumor size and total dose (possibly because only limited variations in total dose were observed), or histological grading (not performed in 140 [35%] patients) was found. Because of the lack of dose-control relationship, quantification of the effects of delay between external irradiation and brachytherapy (in terms of compensatory dose) and of dose rate (Incomplete Repair Model) was not possible.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1992

Regulation of membrane phospholipid metabolism in heart cell culture.

We have isolated, from newborn rats, heart cultures enriched in contractile muscle cells (M) and cultures of fibroblast-like cells (F). M cultures respond to simulated ischemia by an arrest of beating activity, by a decrease in beta oxydation rate, ATP and phosphocreatine content and by a loss of membrane phospholipids associated with neutral lipids accumulation. F cells in contrast do not respond to oxygen deprivation. Firstly, we observed that cocultures of M and F cells respond to oxygen deprivation by an arrest of beating activity and a decrease in cellular ATP content, but failed to exhibit any significant loss of membrane phospholipids. Secondly, we demonstrated that culture medium conditioned by F cells is able to inhibit the reaction of M cells to simulated ischemia thus suggesting that fibroblasts produce a diffusible factor able to block phospholipase activation. Heat treatment and trypsinisation failed to abolish this activity, indicating that the phospholipase inhibitory factor is probably not a polypeptide.

Animals↗
PubMed1991

Effect of dose rate on local control and complications in definitive irradiation of T1-2 squamous cell carcinomas of mobile tongue and floor of mouth with interstitial iridium-192.

From 1971 to 1988, 134 T1 and 145 T2 biopsy-proven squamous cell carcinomas of mobile tongue and floor of mouth were definitively managed by iridium-192. Implantations were performed using either guide gutters or afterloading plastic catheters. The prescribed dose at the reference isodose (85% of the basal dose rate, Paris system) was 60-70 Gy. Total dose was not adjusted to dose rate or tumor volume. Results of the 279 implants have been analysed to look for a possible influence of dose rate on local control and necrosis. Follow-up patients free of local recurrence is 1-180 months with average of 51 months. The 279 tumors were divided in four groups according to dose and dose rate: greater than or equal to 62.5 Gy and greater than or equal to 0.5 Gy/h (n = 130), greater than or equal to 62.5 Gy and less than 0.5 Gy/h (n = 36), less than 62.5 Gy and greater than or equal to 0.5 Gy/h (n = 81), less than 62.5 Gy and less than 0.5 Gy/h (n = 32). The four groups were comparable according to age, sex, tumor diameter and macroscopic aspect. At 5 years, the estimated local control (Kaplan Meier) was 93, 87, 79 and 52%, respectively (dose adjusted to dose rate: p less than 0.001, dose rate adjusted to dose: p less than 0.01, Log-rank); the necrosis rate was 44, 24, 37 and 5%, respectively (dose adjusted to dose rate: p = 0.08, dose rate adjusted to dose: p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗
PubMed1991

Influence of dose rate on local control of breast carcinoma treated by external beam irradiation plus iridium 192 implant.

From 1971 to 1983, 20 T1, 267 T2, and 53 T3 biopsy-proven adenocarcinomas of breast were definitively managed by radiotherapy. The breast and regional nodes received 45 Gy of 60Co irradiation in 25 fractions over 5 weeks (45 Gy/25/5 wks). Electrons were used to deliver a further 15 Gy/7/1.5 weeks to the internal mammary chain and 25 Gy/11/2.5 weeks to the lower axilla. The primary tumor was boosted by Iridium 192 implant for a further 37 Gy prescribed at 85% of the basal dose rate (Paris system). Rigid needles were secured by templates in single plane (58/398) or double plane (340/398) geometry. Results of the 340 two-plane implants have been analyzed to look for a possible influence of dose rate on local control. Follow-up for patients free of local recurrence is 4-204 months (median: 92 months). The 340 tumors were divided into three groups according to dose rate: 0.32-0.49 Gy/hr (n = 95), 0.50-0.59 Gy/hr (n = 120), and 0.60-0.90 Gy/hr (n = 125). The three groups are statistically comparable according to age, tumor size, mean 60Co dose, mean Iridium dose, overall treatment time, and follow-up. The local failure rate in the three groups is 27% (26/95), 20% (24/120), and 13% (16/125) (p less than 0.03, Chi square). At 15 years the estimated local control (Kaplan Meier) is 60%, 72%, and 84% (p less than 0.02, Logrank), respectively. This analysis indicates that there is a significant effect of dose rate on local control for carcinoma of the breast treated by combined external beam (45 Gy) plus Iridium 192 implantation (37 Gy). To maximize local control the authors recommend an implant dose rate of greater than or equal to 0.6 Gy/hr.

Adenocarcinoma↗
PubMed1990

Humor and its relationship to perceived health, life satisfaction, and morale in older adults.

The purpose of this investigation was to examine the relationship between the use of humor as a coping strategy and health indicators as measured by perceived health, life satisfaction, and morale in older adults. A packet of questionnaires was administered to a nonrandom sample of 73 noninstitutionalized adults over age 55. Of the independent variables of situational humor, coping humor, residence, gender, age, living arrangements, and socioeconomic status (SES), none are significant predictors of perceived health at the .017 alpha level, whereas the variable of living arrangements is predictive of life satisfaction. Furthermore, coping humor and socioeconomic status are predictive of morale in older adults. This study adds to the knowledge of humor as a coping strategy as well as a developmental concept in older adults. Implications for nursing practice and research are discussed.

Adaptation, Psychological↗
PubMed1990

[Breast recurrence after conservative treatment of cancers of the breast: predictive factors and prognostic significance].

The prognostic significance of local relapse after conservative treatment of early stage breast cancer has been controversial. To determine the prognostic value of breast relapse occurrence and the factors predisposing to local failure, we analysed the results obtained in a series of 324 patients conservatively treated for breast invasive carcinomas of 2 cm or less. All patients were treated by tumorectomy and axillary dissection, radiation therapy, and adjuvant medical treatment in 85 of 109 patients with involved nodes. The overall 5-yr survival rate was 91.5%. The actuarial 5-yr local control rate was 91.9%. Local relapses occurred in 25 patients. In these patients, the overall 5-yr survival rate was significantly decreased as compared to that of patients without local relapse (76.9% versus 93.4%, P less than 0.001). Recurrence in the breast within 2 yr of initial treatment of severely affected the risk of metastasis occurrence as compared to later relapses (metastasis-free survival rate of 14.3% versus 63.9% at 3-yr from local relapse, P less than 0.01). Local relapse occurred more frequently in premenopausal patients, in patients with low bodymass index, and in patients with small breast size. Local control was not significantly affected by age, tumor size or node involvement. We conclude that the occurrence of a breast relapse after a local conservative treatment has a negative significance and is predictive of a high risk of distant metastasis development, especially when local relapse occurred within 2 yr of initial treatment. There is a need to determine individual factors that could allow discrimination of patients with a high probability of local relapse and subsequent metastasis.

Adult↗
PubMed1990

[Predisposing factors for local recurrence after conservative treatment of breast cancer].

The factors predisposing to local relapse after conservative treatment of early stage breast cancer are controversial. To determine these factors, we analysed the results obtained in a series of 512 patients consecutively treated for invasive breast carcinomas by conservative surgery and radiotherapy. All patients were treated by tumorectomy and axillary dissection, radiation therapy of 45 Gy to the whole breast with a boost of 15 Gy to the tumor area, and adjuvant medical treatment for 168 out of 187 patients. The overall 5-year and 10-year survival rates were respectively 92.5% and 79.9%. The actuarial 5-year and 10-year local control rates were respectively 91.2% and 83.6%. Local relapses occurred in 35 patients. Local relapse occurred more frequently in premenopausal patients, in patients less than 50 years-old as compared to older patients, in patients with low body-mass index (BMI), and in patients with small breast size. Local control was not significantly affected by tumor size or node involvement. With multivariate analysis, the only factor influencing local control was the body-mass index: the actuarial risk of local relapse was increased by 5.7 in patients with a BMI less than or equal to 22 as compared to patients with a BMI greater than 22 (p less than 0.02). We concluded that although certain clinical factors such as age, menopausal status, breast size and body-mass index have an influence on local control, these factors are not sufficiently discriminant to question the indication of conservative treatment. There is a need to individualize factors that could allow a better discrimination of patients with a high probability of local relapse.

Adult↗
PubMed1990

Identifying clinical nursing research priorities.

This paper describes a project conducted by a nursing research committee to identify and prioritize nursing research questions or topics that are most significant to the welfare of patients at a Southern university hospital. Ninety-seven nurses representing clinical staff, administration, and education were invited to participate in three rounds using the Delphi survey technique. Group consensus was reached on priority areas for nursing research at this particular institution. The purpose of this article is to outline the process of developing the project and discuss recommendations resulting from the survey.

Clinical Nursing Research↗
PubMed1990

Thyroid dysfunction in elderly hospitalized patients. Effect of age and severity of illness.

To investigate the relative effects of aging and severity of illness on thyroid function as well as the prevalence of thyroid dysfunction in the elderly, we performed thyroid function testing on 190 hospitalized patients 60 years of age or older. Abnormalities of thyroid test results were frequent, and only 27% of patients had normal values for all thyroid function studies. The largest number of patients (125) had a low serum T3 level. Regression analysis showed that severity of illness was a stronger predictor of the T3 level than was age. Our results confirm previous observations that clinical thyroid disease in the hospitalized elderly is not uncommon and often goes unrecognized. Our results also demonstrate for the first time that low concentrations of T3 correlate with a quantitative measure of the severity of illness but only marginally with aging.

Age Factors↗
PubMed1989

Percutaneous transtracheal catheter ventilation (PTCV) in complete airway obstruction--a canine model.

Percutaneous transtracheal catheter ventilation (PTCV) may be used as an alternative airway when contraindications to endotracheal intubation exist. A canine model tested the efficacy of low-flow oxygen delivery, coupled with commonly available intravenous catheters, for PTCV in a large animal model. Previous studies at this institution demonstrated the feasibility of this technique in a small animal model (feline). Eighteen mongrel dogs were anesthetized, intubated, and ventilated for 30 min with a volume ventilator. The endotracheal tube was then removed, the trachea cross-clamped, and PTCV was instituted and continued for 60 minutes. Arterial blood gas analysis was performed every 5-15 min during the experimental period. Oxygen flow rates of 3, 5, and 7 L/min were paired with catheter sizes of 10 and 12 gauge (g) creating six experimental groups (three animals in each group). Data demonstrate that PTCV provided adequate oxygenation (pO2 greater than 450 mm Hg) and ventilation (pCO2 less than 85 mm Hg) with flow rates of 5 and 7 L/min with both catheter sizes. Satisfactory oxygenation (pO2 greater than 250 mm Hg) could be obtained with the 3 L/min flow rate with both catheter sizes, but ventilation was inadequate (PCO2 greater than 200 mm Hg). Using readily available materials and low-flow oxygen rates this PTCV technique was shown to be safe and effective in oxygenating and ventilating this canine model with complete airway obstruction.

Airway Obstruction↗
PubMed1988

Humour and the older adult: implications for nursing.

This correlational descriptive study examined the relationship between the uses of humour and health outcomes as measured by perceived health, life satisfaction, and morale in older adults. The sample of this pilot study consisted of 24 volunteers from a senior citizen community centre who are ambulatory adults over 61 years old. Subjects were administered questionnaires which consisted of a demographic data sheet, the Situational Humour Response Questionnaire, Coping Humour Scale, Current Health Subscale, Life Satisfaction Index, and the Affect Balance Scale. The findings revealed significant (P less than 0.05) positive relationships between situational humour and perceived health (r = 0.43), and situational humour and morale (r = 0.38). Furthermore, there was a significant negative relationship between coping humour and perceived health (r = -0.46). These findings suggest that humour may be one phenomenon which influences the older adult's perception of perceived health, life satisfaction and morale and may assist in successful ageing. These preliminary findings support the need for further research to examine these relationships with a larger study.

Adaptation, Psychological↗
PubMed1987

Family composition, socioeconomic status, and adolescent substance use.

The hypothesis that deprivation in the form of parental absence and economic hardship causes youth substance use was tested in a study population consisting of two hundred sixty-two adolescents, ages 13 through 17, and one parent of each. No correlation between family composition and youth substance use was found. Two measures of socioeconomic status, family income and parents' subject rating, also revealed no correlation with youths' substance use behavior. However, when father's occupation was used to evaluate this relationship, significantly more abstainers were shown to have fathers who are professionals, and significantly more users had fathers occupying managerial or foreman-level positions; a possible explanation for this result is that occupation may somehow be related to parental style. The common sense assumption that parental absence and economic hardship are directly responsible for youth substance use is unsupported by our data.

Adolescent↗
PubMed1987

Labeling index and labeling distribution in the colonic crypts: a contribution to definition of patients at high risk for colorectal cancer.

The labeling index (LI), representing the percentage of S-phase cells, was measured in the healthy colorectal mucosa of subjects without a personal or familial history of neoplasm as well as in persons with a positive history, and was compared to the LI in benign or malignant lesions in a total of 128 subjects. In the healthy mucosa, LI was lowest in control subjects; it rose progressively in patients with a personal history of adenoma, patients with non colorectal cancer, and colorectal cancer patients respectively. There was a significant increase in LI from healthy mucosa to adenoma to carcinoma. The pattern of labeling in the crypts was studied in 56 subjects with different familial and personal histories. Limitation of labeling to the deepest part of the crypts was observed in control subjects and to a lesser extent in the healthy mucosa of patients with adenoma. An upward shift of the proliferative zone was observed in patients with a personal or familial history of cancer; adenomatous lesions had an inverse labeling distribution: labeling decreased from the luminal aspect towards the deep segments. High LI values and a shift of the proliferative zone towards the surface of the crypt may identify individuals at high risk for cancer of the colon and rectum.

Adenoma↗