PubMed Health⌕ Search

Biomedical subjects

M Julien

Publications and source records attributed to M Julien.

At least 19 recordsLinked to original sources
PubMed1992

[Liver transplantation associated with combined adjuvant treatment in hepatocellular carcinoma. Feasibility and preliminary results].

Combined adjuvant therapy was prospectively assessed in 7 patients receiving orthotopic liver transplantation for hepatocellular carcinoma complicating cirrhosis. The protocol included hepatic arterial chemotherapy while waiting for transplant, immediate preoperative liver irradiation, and early postoperative chemotherapy. There were no postoperative deaths, and morbidity included mainly hematologic toxicity of chemotherapy. Two patients died of tumor recurrence 6 and 14 months after transplant. The remaining 5 patients are alive and free of disease with a follow-up of 7 to 26 months. These results show the feasibility of aggressive adjuvant therapy in patients transplanted for hepatocellular carcinoma and suggest a possible effect of such a protocol on the prevention of tumor recurrence.

Adult↗
PubMed1992

Expression of intermediate filament proteins in TPA-induced MPC-11 and HL-60 cells.

Under normal culture conditions, the tumor cell lines MPC-11 and HL-60 exhibit high rates of proliferation and show a peculiar expression of intermediate filament proteins as they appear to synthesize only lamin B. A 48-h exposure of murine plasmacytomas MPC-11 to the phorbol ester TPA reduces their growth and induces vimentin synthesis without affecting the composition of their nuclear lamina. When applied to human leukemic promyelocytes HL-60, such treatment promotes their maturation into macrophage-like cells: their proliferative ability is suppressed, a differentiated phenotype is developed, and their content in intermediate filament proteins now includes vimentin and a full complement of lamins A, B, and C. In the present study, a kinetic analysis of vimentin and lamin A/C expression in relation to proliferation and differentiation has been performed in these two cellular systems. Proliferation rates of MPC-11 and HL-60 populations were evaluated by monitoring cell growth and measuring thymidine incorporation. Maturation of HL-60 cells was assessed by Giemsa staining and percentage of adherent cells. Expression of vimentin and lamins A/C was analyzed using immunofluorescence and immunoblotting techniques. Our data show that there is a relationship between the level of vimentin expression and the extent of growth inhibition in both systems. They also suggest that the expression of lamins A/C during the TPA-induced maturation of HL-60 promyelocytes might be part of the processes which lock these cells into the macrophage pathway.

Animals↗
PubMed1992

Cellular reaction to the Vascugraft polyesterurethane vascular prosthesis: in vivo studies in rats.

The biocompatibility of Vascugraft, a polyesterurethane vascular prosthesis manufactured by Braun-Melsungen AG, was assessed by immunofluorescence and histological studies. Discs, 1 cm2, of Vascugraft prosthesis were implanted into the peritoneal cavity of rats. Results were compared with Impra, GORE-TEX and Mitrathane prostheses and a control group. Animals were killed at 1, 2, 6, 9 and 12 wk. Total T cells, T helper cells, T suppressor cells and activated T lymphocytes expressing Interleukin-2 receptors were quantified by a cytofluorometric technique in the peripheral blood of rats. For each period of implantation, all vascular prostheses showed no significant change in the percentage of total T cells, T subsets and T cells expressing Interleukin-2 receptors when compared to the control group. Histological examination of the tissue reaction surrounding the Vascugraft revealed a mild inflammatory reaction, similar to the one observed with both polytetrafluoroethylene grafts. However, the rate and the degree of encapsulation were different between grafts. The Vascugraft prosthesis was well encapsulated 2 wk after implantation, whereas inhibition of fibroblastic proliferation into the graft wall and surrounding both polytetrafluoroethylene grafts was observed for each period of implantation. The Mitrathane prosthesis exhibited a moderate inflammatory response, characterized by a high level of activation on fibroblasts compared to other grafts.

Animals↗
PubMed1992

Hepatic arterial infusion of floxuridine in patients with liver metastases from colorectal carcinoma: long-term results of a prospective randomized trial.

PURPOSE: A multicentric randomized study that compared patients who received intrahepatic arterial infusion (HAI) to a group of patients who did not receive HAI (control group) was performed for unresectable hepatic metastases from primary colorectal carcinoma. PATIENTS AND METHODS: One hundred sixty-six patients were assigned randomly to HAI of floxuridine (5 fluoro-2'deoxyuridine [FUDR]) 0.3 mg/kg/d for 14 days every 4 weeks or to the control group; this latter group, depending on the investigator's choice, was either under observation or received systemic fluorouracil (5-FU). The same regimen of systemic 5-FU also was administered to the HAI group in the event of extrahepatic progression. No crossover from the control group to the HAI group was permitted. The mean duration of follow-up was 54 months (range, 31 to 72), and 163 patients were analyzed. RESULTS: A significant improvement was observed in the survival rate for the 81 patients assigned to HAI group (P less than .02) with a 1-year survival rate of 64% versus 44% in the control group (82 patients). The 2-year survival rate was 23% versus 13%. The median survival was 15 months versus 11 months for the HAI group and the control group, respectively. Survival was better for patients with a less than 30% liver involvement, and for those treated in more specialized centers. The hepatotoxic effects of HAI were observed in 47 patients (chemical hepatitis [n = 28], and biliary sclerosis [n = 19]). The 1-year rate of sclerosing cholangitis was equal to 25%. Gastrointestinal toxicity was infrequent and consisted of gastritis or diarrhea. CONCLUSIONS: Therapy with HAI of FUDR improves the survival of patients with liver metastases over colorectal carcinoma. However, the methods that are used to diminish the toxicity of HAI and efficient systemic chemotherapy, such as a combination of 5-FU and leucovorin, are required to prevent extrahepatic metastases.

Colorectal Neoplasms↗
PubMed1992

The effects of speech and language therapy for a case of dysarthria associated with Parkinson's disease.

We report the results of a single-subject multiple baseline across behaviours experiment of a 74-year-old woman presenting with Parkinson's disease. Her speech was typical of a hypokinetic dysarthria. The main features of her dysarthric speech were: a restriction in the modulation of fundamental frequency, an inappropriate pitch level and a rate disturbance. Three measures of prosody were operationally defined as follows: (1) linguistic modulation of fundamental frequency, (2) mean fundamental frequency and (3) rate. Treatment focused on ameliorating these aspects employing a multiple baseline design. Measures during and post-therapy documented improvement for each of these three aspects of prosody. Independent judges were also more capable of understanding her speech and her speech prosody after therapy. Upon follow-up measures 10 weeks later, most of the improvement was maintained.

Aged↗
PubMed1992

Polyadenylic-polyuridylic acid as an adjuvant in resectable colorectal carcinoma: a 6 1/2 year follow-up analysis of a multicentric double blind randomized trial.

In a double blind study, patients with operable carcinoma of the colon and the upper rectum, who have undergone a macroscopically complete resection of their tumor, were randomized to receive either (i) polyadenylic-polyuridylic acid (AU), one i.v. injection of 60 mg (in 50 ml of solution) once a week for 6 weeks, or (ii) a placebo (P) one i.v. injection of 50 ml of a saline solution with the same schedule. From January 1983 to December 1986, 288 patients were enrolled: 145 in AU group and 143 in P group. The main clinical and pathological characteristics were equally distributed throughout the two groups. There was a significant difference (P < 0.02) in the overall survival (OS) between the two groups, in favor of the P group. The 5-year OS rate was 68% (SD = 4%) in the AU group versus 81% (SD = 3%) in the P group. Thus, AU as a single adjuvant, appears to be ineffective and therefore has no indication in the treatment of colorectal carcinoma.

Aged↗
PubMed1991

Conservative treatment for breast cancer: long-term results (15 years).

From 1961 to 1974, 245 patients with unilateral "operable" breast cancer (25% T1, 56% T2, 19% T3) were treated with breast conservation and irradiation at the Gustave Roussy Institute (1961-1969) or at the Henri Mondor Hospital (1970-1974). The minimum follow-up is 15 years. Most patients with T greater than 3 cm underwent radiation therapy with the tumor in place, while the greater part of patients with T less than 3 cm received radiation therapy after tumorectomy. The breast and draining lymph node areas received widefield telecobalt irradiation to 45 Gy. The dose to the tumor site was boosted using iridium-192 implantation. Additional irradiation was given to the internal mammary and lower axillary nodes using an electron beam. The 15 years NED survival rate was 63%, 51% and 26% for T1, T2 and T3 tumors, respectively. The NED survival for T less than or equal to 1 cm was 86%. The local recurrence rate was 8, 12 and 19% for T1, T2 and T3 tumors, respectively. Of the patients with local recurrence, 85% underwent surgical salvage. Complications were rare. Cosmetic results were satisfactory in most patients including the T3 group. The proportion of breasts conserved among patients living NED at 15 years, was 97, 88 and 93% for T1, T2 and T3 tumors, respectively. In 1980, after almost 20 years experience using breast conserving techniques, we modified our treatment policies in close collaboration with our surgical team, hel cbye extending the indications for tumorectomy and associating routine surgical exploration of the lower axilla.

Breast Neoplasms↗
PubMed1991

External irradiation prior to conservative surgery for breast cancer treatment.

From 1981 to 1987, 138 patients with breast cancer unsuitable for primary tumorectomy received initial external radiotherapy (45 Gy/25f/35d) in order to reduce the tumor volume so that secondary limited surgery could be performed. There were 81 T2 and 57 T3. Fifty-seven percent of the patients had a tumor larger than 4.5 cm. After completion of the radiotherapy, 22 patients (16%) showed no more evidence of a tumor either clinically or radiologically and received a boost of 25 Gy. In 52 cases (38%) the tumor regression allowed for secondary tumorectomy followed by a boost of 20 Gy. Sixty-four patients (46%) showed either little or no tumor regression: radical surgery was performed in 14 cases (10%) and high dose boost curietherapy (37 Gy) in the 50 (36%) remaining patients who refused mastectomy. Breast conservation in good condition was thus obtained in 74 patients (54%). Sufficient tumor regression to allow secondary tumorectomy was more often observed in T2 than in T3, in poorly differentiated tumors or mucinous type, and in tumor with well defined mammographic aspects. Actuarial 5-year local control and disease-free survival rates after limited surgery were, respectively, 90% and 73%. No particular complications were observed after secondary tumorectomy. This therapeutic approach is encouraging in patients with large T2 and T3 breast tumors, but a longer follow-up is required to assess definitive conclusions.

Breast Neoplasms↗
PubMed1990

[Can tumors of the breast larger than 3 centimeters be treated conservatively?].

Unlike small breast cancers, which are now treated conservatively by primary tumorectomy, the most important lesions (T2 and T3) as usually treated tumorectomy, the most important lesions (T2 and T3) as usually treated by mastectomy. However, in patients with these large lesions attempts may be made at conserving the breast with reliable oncological safety and good cosmetic results. Depending on clinical presentation, one or the other of two therapeutic approaches may be considered. The most common treatment is preoperative radiotherapy of 45 Gy which, in more than 50 p. 100 of the cases results in a tumoral regression that is sufficient for secondary tumorectomy to be performed. In some patients, the first-line treatment consists of wide tumoral excision as part of a reductive mammaplasty, followed by radiation.

Breast Neoplasms↗
PubMed1990

Conservative management of tumors of the rectum by radiotherapy and local excision.

Twenty-five patients with invasive adenocarcinoma of the rectum were treated by preoperative external irradiation (35 Gy), local excision, and peroperative placement of a plastic tube loop in the tumor bed for perioperative brachytherapy (20 or 25 Gy). Patients treated were too frail for radical resection (14 patients) or had refused a permanent colostomy (11 patients). With a mean follow-up of 40.5 months, there have been 5 patients with local relapse, 3 of whom had salvage abdominoperineal resections: 2 have no evidence of disease and 1 has developed distant metastatic disease. The 20 patients with local control have normally functioning sphincters; 1 has developed distant metastatic disease. This combined approach was designed to expand the curative role of local resection in carcinoma of the rectum. The surgical techniques are thoroughly described and the potential role and indications of this approach are discussed.

Adenocarcinoma↗
PubMed1990

[Postoperative pyoderma gangrenosum and cancer of the breast. Apropos of a case].

Pyoderma gangrenosum (PG) consists of extensive necrotic ulceration with bluish and purplish red margins. This disease is often associated with ulcerative colitis, systemic, hematologic or rheumatic diseases. However post-surgical idiopathic PG can occur. One post-mastectomy case is reported. PG can first be suspected on clinical appearance and the lack of a specific etiology. PG is a diagnosis of exclusion that is made only after other possibilities have been ruled out. The treatment is surgical excision and systemic corticosteroids.

Adult↗
PubMed1989

[A new conservative approach in the treatment of cancer of the rectum].

Between 1980 and 1987, 25 patients with cancer of the middle or lower rectum were treated with preoperative radiotherapy (35 Gy over 3 weeks) followed, a few weeks later, by "tumorectomy". During surgery, a guiding tube was positioned on the tumoral bed for a localized overdose of curietherapy. The superimpression was 20 Gy for submucosal lesions (7 patients) and 25 Gy for lesions that had invaded the muscle coat (8 cases) or reached the serous coat (10 cases). During a mean follow-up period of 40.5 months, there were 5 recurrences and they all appeared before 18 months had elapsed since the end of treatment. Two of these 5 patients are alive and without metastasis 1 year after a secondary abdominoperineal rectal amputation. The 20 patients who showed no recurrence have normal sphincter function and 19 of them are now alive without evidence of malignancy. In cancer of the middle or lower rectum this conservative approach seems to be suitable for patients who cannot benefit from radical surgery or refuse abdominoperineal rectal amputation.

Adult↗
PubMed1989

Acute mononeuropathy with angiotropic lymphoma.

Angiotropic lymphoma can present as a vascular disease in the central nervous system. The patient described in this report had a sudden pain in the region of the right superficial peroneal nerve and a nerve biopsy showed tumoral cells in the lumen of most small blood vessels. This pathology, first described in the skin as malignant angioendotheliomatosis, can be compared with the occurrence of multiple emboli in the vasa nervorum. In recent cases, tumoral markers have evidenced a lymphomatous origin, generally of the B type.

Acute Disease↗
PubMed1989

Factors affecting the birth and death of mutual-help groups: the role of national affiliation, professional involvement, and member focal problem.

Examined the predictive relationship of three variables to the birth and death of mutual-help groups for a statewide New Jersey sample of 3,152 groups over a 2-year period. The three variables studied were group affiliation with a national mutual-help organization, local professional involvement in group activities, and group members' type of focal problem. Log-linear logit analysis revealed that the best-fitting model included Affiliation Status x Professional Involvement, and Affiliation Status x Focal Problem interactions. Among unaffiliated groups, professional involvement was related to lower group mortality, while among affiliated groups it was related to higher group mortality. Unaffiliated behavior control groups had higher odds for mortality and for birth than either unaffiliated life stress groups or unaffiliated medical groups. Among main effect findings, unaffiliated groups had consistently higher odds for birth than affiliated groups. The implications for research and action are discussed.

Humans↗
PubMed1989

A new combined approach in the conservative management of rectal cancer.

Between 1980 and 1987, 25 patients with rectal cancer were treated with a combination of preoperative external irradiation of 35 Gy in 15 fractions over 3 weeks which was followed, 6 to 8 weeks later, by a tumorectomy and peroperative placement of a plastic tube loop for post-operative interstitial therapy by iridium-192. This boost dose was 20 Gy (Paris System) for submucosal lesions (seven patients) and 25 Gy for intramural (eight patients) and extramural (ten patients) lesions. With a mean follow-up of 40.5 months, there have been five local recurrences, the latest occurring 16 months post-tumorectomy. Two of these five patients are alive and disease-free 1 year post salvage abdominoperineal resection. The 20 patients with local control have preserved a full functional sphincter and 19 of them are disease-free; there were few complications. This sphincter preserving combined approach seems promising for patients with tumors of the middle and lower rectum who cannot undergo major surgery and for selected patients who refuse abdominoperineal resection.

Adenocarcinoma↗
PubMed1989

[Extracorporeal lithotripsy in the treatment of biliary calculi].

The authors present their experience from February 1988 with biliary lithotripsy in 125 patients. They review the protocol inclusion criteria and the various forms of complementary medical treatment. From this group, 30% of the patients underwent cholecystectomy, 45% received medical treatment and only 25% did not eventually require complementary medical therapy.

Cholelithiasis↗