PubMed Health⌕ Search

Biomedical subjects

J Y Petit

Publications and source records attributed to J Y Petit.

At least 19 recordsLinked to original sources
PubMed1996

[Role of plastic surgery in the treatment of breast cancer].

The surgical treatment of breast cancer has changed dramatically since the last twenty years. Radical and super-radical mastectomy are almost no longer indicated except in certain cases of local recurrences. Breast saving procedures are the best indication for small tumors. And the psychological impact of the different treatments including radiotherapy and chemotherapy is considered as an important issue. Therefore, plastic surgeons are more and more frequently called upon to restore the breast appearance using some technique of breast reconstruction or to improve the bad results of a conservative treatment. Moreover, a good knowledge of the plastic surgery techniques allows a better exploration of the breast and large resections in case of fibrocystic diseases with extensive foci of microcalcifications. Such extensive explorations of the breast are more frequently indicated with the development of screening campaigns. When the mastectomy remains the best indication, it is mandatory to propose an immediate breast reconstruction. Insertion of a silicone implant is discussed in several countries, especially in France, although more and more studies are showing the inocuity of such material. A long experience at the Gustave-Roussy Institute of such material used for breast reconstruction showed us the inocuity of long term silicone exposure in patients treated for breast cancer. The conservative surgery should remove the tumor with a free margin of 1 to 2 or even 3 cm and the defect left is sometimes large enough to justify some local glandular mammoplasty in order to prevent from final mammary distorsion or local visible defect. Partial reconstructions could sometimes require more sophisticated techniques including musculo-cutaneous flaps or prosthesis implantation. Finally the integration of the plastic surgery in the surgical protocols of breast cancer treatment, requires a close collaboration between the plastic and the cancer teams. In certain cases, a special surgical training provides the surgeon with a double competence in oncology and in plastic surgery. With such breast surgeon competent both in oncology and plastic surgery, a patient can ask for an aesthetic operation without missing a complete cancer screening as well as she can be treated for a cancer with the best chance to obtain the best cosmetic result.

Breast Neoplasms↗
PubMed1995

Local relapse and contralateral tumor rates in patients with breast cancer treated with conservative surgery and radiotherapy (Institut Gustave Roussy 1970-1982). IGR Breast Cancer Group.

BACKGROUND: Breast conservation is now established treatment for patients with small breast cancers. The authors reviewed a large series of patients with long term follow-up who underwent conservative treatment. Clinical and pathologic factors were analyzed to identify patients at an increased risk of relapse in the breast (local relapse) or development of a contralateral tumor. METHODS: Seven hundred fifty-seven patients with unilateral invasive breast cancer (T0-2, N0-1, M0) were treated conservatively (wide local excision and radiotherapy) at the Institut Gustave-Roussy between 1970 and 1982. The median follow-up was 9 years. The risk of local relapse or development of a contralateral tumor (as first event) was studied by univariate analysis for the main clinical, pathologic, and treatment factors. Those found to be significant were entered into a Cox proportional regression analysis. RESULTS: Fifty-one patients relapsed in the treated breast (actuarial local relapse rates at 5 and 10 years were 5% and 8%, respectively) and 34 in the contralateral breast (actuarial contralateral tumor rates at 5 and 10 years were 3% and 6%, respectively). Multivariate analysis of the risk factors for local relapse showed that only age younger than 40 years (P < 0.02) or inadequate surgical excisioin (P < 0.02) were significant. No particular risk factors for contralateral tumor development were identified. CONCLUSIONS: Overall, for most patients, the risk of local relapse or of developing a contralateral tumor was low. A small number of young patients with inadequately excised tumors are at higher risk of local relapse, need more meticulous surgery, and may merit higher dose radiotherapy.

Actuarial Analysis↗
PubMed1995

Antiinflammatory mechanism of cordiachromene A action.

The mechanism of antiinflammatory action of cordiachromene A, isolated from the chloromethylenic extract of the ascidian Aplidium antillense or chemically synthesized, was studied using different in vivo and in vitro inhibition tests on enzymes of the cyclooxygenase cascade. Cordiachromene A inhibits prostacyclin synthesis and arachidonic acid metabolism but not phospholipase A2 and peroxidase. The mechanism of action, already known to be stereospecific, operates by cyclooxygenase inhibition.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1995

Influence of alkyl chain lengths in dialkylglycerophosphocholines towards phospholipase A2 inhibition in macrophages.

Rat peritoneal macrophages were cultured with a specific and potent phospholipase A2 activator A 23187, with 1-stearoyl-2-[3H]arachidonoyl-sn-GPC as source of [3H] arachidonic acid, and with a dialkyl-GPC, at 2, 10 or 20 microM. Four dialkyl-GPCs were prepared by chemical synthesis. Position 2 of rac-glycerol was alkylated with an alkane chain of 8 carbons and position 1 was alkylated with various alkane chains (8, 10, 12, or 16 carbons). [3H] arachidonic acid was split, then recovered with cell nonesterified fatty acids and nonphosphorous glycerolipids after endocellular phospholipase A2 activity. It was also recovered with fatty acids and eicosanoids isolated from culture medium. Inhibition of fatty acid release and eicosanoid synthesis depended on mixed chain dialkyl-GPC structures. The highest inhibitory effect on arachidonic acid release was reached with 1-decyl-2octyl-GPC and was practically as high in culture medium (IC50 at 5 microM) as in cells (IC50 at 4 microM). 1,2-di-octyl-GPC and 1-dodecyl-2-octyl-GPC had weaker inhibitory effects (but higher in culture medium than in cells). The asymmetrical 1-hexadecyl-2-octyl-GPC poorly affected enzyme activity.

Animals↗
PubMed1995

New antiinflammatory compounds that inhibit tumor necrosis factor production: probable interaction with protein kinase C activation.

We have previously described a family of benzamide derivatives that showed antiinflammatory activity in vivo on carragenin-induced paw edema and experimental cerebral edema. Those compounds inhibited eicosanoids production from activated macrophages (M phi) without inhibiting cyclooxygenase. To further investigate their antiinflammatory activity and compare it to that of classical cyclooxygenase inhibitors, we analyzed their effect on the production of a major proinflammatory cytokine, tumor necrosis factor (TNF-alpha), by in vitro-activated peritoneal macrophages. We show that, in marked contrast with ibuprofen, flurbiprofen and indomethacin which all significantly enhanced TNF production, the two benzamide derivatives tested, JM34 and JM42, significantly inhibited TNF-alpha production by zymosan or lipopolysaccharide-activated M phi. Those compounds did not interfere with the calcium-dependent pathway because they did not affect TNF production of either mice peritoneal M phi or human T cell clones induced by the calcium ionophore A23187 alone. More likely, these benzamide derivatives acted mainly at the level of the protein kinase C (PKC) pathway because: 1) After treatment of M phi with PKC inhibitors which significantly inhibited TNF production, our compounds showed no additional inhibition. 2) Our compounds significantly inhibited TNF production of M phi stimulated with the phorbol ester phorbol di-butyrate alone or in combination with A23187. 3) After depletion of PKC by prolonged phorbol di-butyrate treatment of M phi, inhibition of TNF production by our compounds was markedly decreased.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

[Role of immediate reduction mammaplasty and mammapexy in the conservative treatment of breast cancers].

For some years, breast cancer surgery has become increasingly conservative, in order to preserve the aesthetic aspect of the treated breast and global harmony of the bosom. Unfortunately, conservative treatment is followed by 20% to 30% of unsatisfactory cosmetic results. Some studies have defined the various factors associated with an increased failure rate in terms of cosmetic results. These are related to the surgical technique, patient characteristics, or tumor specificities. In these cases with a poor aesthetic prognosis, the authors propose, following the initial tumorectomy, esther breast reduction or mammaexy, in order to reshape the volume of the breast as symmetrically as possible. In a series of 21 female patients operated at the Institut Gustave-Roussy between 1988 and 1991, the authors describe the aesthetic and carcinologic advantages of this method, and define its main indications. Although the aesthetic aspect of the operated breast was considered tube excellent in 33% of cases and good in 67% of cases, the global harmony of the breasts was excellent or good in 76% of cases. The 24 moderate or poor results were due to asymmetry of shape or volume, which is easy to improve by a secondary contralateral breast reduction.

Adult↗
PubMed1995

[Diagnosis of local breast cancer recurrences by magnetic resonance imaging].

The aim of this study is to determine the diagnostic value of magnetic resonance imaging in the diagnosis of local recurrence of breast cancer. From 1991 to 1994, 61 women were studied prospectively using magnetic resonance imaging. All examinations were made on a 1.5 Testa machine with T1 weighted images and after gadolium-dota injection and dynamic images (T1 weighted sequences every 47 seconds during injection of a gadolinium-dota bolus). All the pre-injection, images in the dynamic series were subtracted from the images after injection. A surgical biopsy was obtained in 39 patients yielding a diagnosis of local recurrence (n = 28) or a benign lesion (n = 11). Among the 28 local recurrences, pathology examination reported invasive cancer in 22 and intra-ductal carcinoma in 6. In 22 patients with normal magnetic resonance imaging, follow-up examinations were performed every 6 months. There were no local recurrences within a delay of 6 to 36 months. Twenty-six of the 28 patients with a local recurrence, cystosteatonecrosis and surgery scar tissue less than 6 months old showed contrast uptake 1 min and 34 s after gadolinium injection during the dynamic sequence. This product uptake yielded nodular images within the invasive carcinomas and linear images in the intraductal cancers. In all cases, it is easier to visualize this contrast uptake in subtraction images. In conclusion, magnetic resonance imaging is a simple reliable method for the diagnosis of local recurrence of breast cancer.

Adult↗
PubMed1994

Chest wall reconstruction following resection of large primary malignant tumors.

Reconstructive procedures following radical resection of large primary malignant chest wall tumors (PMCWT) continue to evolve. Between 1982 and 1993, 32 consecutive patients (18 males/14 females) with a median age of 47 years (range, 12-77) underwent radical resection for large (median 10 +/- 5.4 cm) PMCWTs arising either from the bone (n = 15) or soft tissues (n = 17) of the chest wall. Nine (28%) had previous surgical resection before referral. Sixteen (50%) required extensive skin excision. Twelve sternectomies (5 total and 7 partial) and 20 lateral chest wall resections were performed. In this latter group, 16 patients (80%) had at least three ribs resected. Resection extended to the lung (10 wedge resections, 2 lobectomies and 1 pneumonectomy) in 13 patients, diaphragm in 3, abdominal wall in 2, brachiocephalic and subclavian vessels in 5, superior vena cava in 1 and upper limb in 1. Stability of the chest wall was obtained with prosthetic material in 27 patients, including Marlex (n = 21), polytetrafluoroethylene (PTFE) (n = 4) and polyglactin (n = 2) meshes. After sternectomy, six patients had a methyl methacrylate mesh reinforcement while soft tissue reconstruction was carried out using the pectoralis major muscle (PM), either alone with skin advancement (n = 8) or as a myocutaneous flap in three males (unilateral n = 2, bilateral n = 1) and by a latissimus dorsi (LD) myocutaneous flap in one female. Muscle transposition was used to reconstruct defects of the lateral chest wall and included 10 LD, 6 PM and 2 serratus anterior (SA) muscles, with associated advancement of the diaphragm in two cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Can breast reconstruction with gel-filled silicone implants increase the risk of death and second primary cancer in patients treated by mastectomy for breast cancer?

An increased risk of cancer and autoimmune disease associated with gel-filled silicone implants has been suggested recently, but these possible detrimental effects have not been adequately studied in patients with breast cancer. In order to evaluate these effects, we have studied 146 patients with breast cancer treated by mastectomy at the Gustave Roussy Cancer Institute between 1965 and 1983 and who received a gel-filled silicone implant for immediate or delayed breast reconstruction between 1976 and 1984. These patients were compared with 146 matched controls with breast cancer who were treated in the same center by mastectomy without breast reconstruction and were matched for age at diagnosis (within 10 years), year of diagnosis (within 3 years), stage, histologic type of the tumor, histopathologic grade, and nodal status. The relative risks of death, relapse, and second primary cancer were estimated by means of the Cox proportional hazards model stratified on age at diagnosis. The risks of distant metastasis and death due to breast cancer were significantly lower in the breast reconstruction group than in the control group. The risks of local recurrence, second breast cancer, and second primary cancer in another site than the breast were not significantly different between the two groups of patients. Our results do not support the hypothesis of a detrimental effect of gel-filled silicone implants either in the course of breast cancer or in the risk of death due to other diseases.

Breast Neoplasms↗
PubMed1994

Locally advanced breast cancer: contrast-enhanced subtraction MR imaging of response to preoperative chemotherapy.

PURPOSE: To determine the value of contrast material-enhanced subtraction magnetic resonance (MR) imaging in assessment of response to chemotherapy in locally advanced breast cancer. MATERIALS AND METHODS: Eighteen women treated with chemotherapy because of locally advanced breast cancer underwent preoperative MR examination including both routine and dynamic MR sequences after injection of gadolinium tetraazacyclododecanetetraacetic acid. Any early contrast enhancement, concomitant with early vascular enhancement during the dynamic MR study, was considered pathologic. RESULTS: Dynamic MR studies showed early contrast enhancement in all women with residual tumor except one with nodular residual tumor. Histopathologic analysis and dynamic MR images of contrast-enhanced lesions correlated well, but in one patient, intraductal extension was not seen on MR images, and in another, additional isolated tumor cells were seen in the histologic specimen. Subtraction images always facilitated visualization of vascular and pathologic contrast enhancement. CONCLUSION: Dynamic MR contrast-enhanced subtraction studies are useful in assessment of residual tumor after chemotherapy.

Adult↗
PubMed1994

[Anatomopathological problems of mastopathies at risk].

As breast cancer screening programmes gain momentum, there is a parallel increase in histological problems mainly related to the identification of an increasing number of "borderline" breast lesions. The results of recent studies are often inconsistent, and bear witness to the lack of a consensus regarding the interpretation of both ductal and lobular epithelial hyperplasia. The authors insist on the need for an adequate number of samples and an irreproachable histologic technique which is indispensible if the morphologic subtleties, currently the only valid factors permitting the diagnosis, are to be appraised. The role of the pathologist is therefore crucial in the management of specimens which are entrusted to him and in helping the clinician to tailor treatment to fit each individual patient.

Breast↗
PubMed1994

Effect of octadecylmethylglycerophosphocholine and hexadecylmethylglycerol on arachidonic acylation or release in macrophages.

1-O-Octadecyl-2-O-methyl-sn-glycero-3-phosphocholine (ET-18-O-CH3) and 1-O-hexadecyl-2-O-methyl-sn-glycerol (hexadecylmethylglycerol) are dialkylglycerolipids poorly split by the lipolytic enzymes which can activate macrophages in culture. This study concerned the incorporation of [3H]arachidonate into glycerolipids of rat peritoneal macrophages and its subsequent release. Cells cultured with ET-18-O-CH3 or hexadecylmethylglycerol were labelled according to two procedures: (1) Cells were incubated first with dialkylglycerolipid and then with the tritiated arachidonate: hexadecylmethylglycerol was practically inactive. ET-18-O-CH3 inhibited acylation of arachidonate in cell glycerophospholipids (50%) and triglycerides (60%) during de novo glycerolipid synthesis, resulting in increased fatty acid radioactivity in cells. Both dialkylglycerolipids induced the release of tritiated eicosanoids and fatty acids in the medium. (2) Cells previously labelled with [3H]arachidonate were incubated with dialkylglycerolipid. Prelabelled glycerophospholipids and triglycerides were only slightly affected by ET-18-O-CH3 which was nonetheless more efficient than hexadecylmethylglycerol in decreasing cell triglyceride (50%) and glycerophospholipid (10%) synthesis. Both induced the release of eicosanoids and fatty acids into the medium. It is concluded that these agents, particularly ET-18-O-CH3, allowed moderate but significant amounts of eicosanoids and fatty acids to be maintained in the medium.

Acetylation↗