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Simone Mathoulin-Pélissier

Publications and source records attributed to Simone Mathoulin-Pélissier.

12 recordsLinked to original sources

Could bipolar vessel sealers prevent bile leaks after hepatectomy?

BACKGROUND AND AIMS: The aim of this work was to test the feasibility of using a bipolar low thermal acting system inducing collagenic sealing but not protein coagulation to secure hepatic parenchyma cutting. MATERIALS AND METHODS: Thirty consecutive hepatectomies were carried out using kellyclasy plus ligatures and clips (controls), while the following 50 hepatectomies used kellyclasy plus bipolar vessels sealer (BVS). Blood loss, duration of hepatic pedicle clamping, length of hospital stay, and complications were recorded. RESULTS: There was no statistically significant difference in blood loss and duration of clamping between controls and BVS. Specific complications (9/21 in the control group vs 1/49 for the BVS group, p<0.00045) and length of hospital stay (14 days in the control group vs 11 days in the BVS group, p<0.014) were statistically lower in BVS group than in the controls, mainly due to prevention of bile duct leakages. CONCLUSIONS: Our data suggest that BVS may be particularly efficient to achieve bilistasis leading to the highest level of safety in performing hepatectomies. Further studies are now needed to confirm its superiority on the classical biliary ducts occlusion techniques.

Adult↗

Relationships between genetic polymorphisms and anticancer drug cytotoxicity vis-à-vis the NCI-60 panel.

INTRODUCTION: The National Cancer Institute (NCI)-60 panel consists of 60 human tumor cell lines initially established for screening thousands of molecules for antiproliferative activity. It has been powerful for deciphering the relationships between anticancer drug cytotoxicity and cell molecular characteristics. We tested its potential interest for establishing relationships between the polymorphism of genes involved in drug metabolism and transport or in DNA repair, and drug cytotoxicity extracted from NCI databases. METHODS: Using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) techniques, three frequent single nucleotide polymorphisms (SNPs) were analyzed: Lys751Gln in the Xeroderma pigmentosum complementation group D (XPD, ERCC2) gene, Asp1104His in the Xeroderma pigmentosum complementation group G (XPG, ERCC5) gene and Ile105Val in the glutathione S-transferase P1 (GSTP1) gene. RESULTS: The allelic frequencies of the variants were 33% for ERCC2, 23% for ERCC5 and 39% for GSTP1. The ERCC2 polymorphism appeared to be a strong determinant of the in vitro cytotoxicity of most anticancer agents, with lower half maximal inhibitory concentration (IC50) values in variant homozygous lines than in common homozygous or heterozygous cell lines. Unexpectedly, the cytotoxicity of taxanes appeared markedly dependent upon the ERCC2 genotype, with threefold lower mean IC50 values in variant homozygous cell lines. The ERCC5 genotype appeared to be important only for taxanes, with fourfold higher IC50 values in variant homozygous cell lines. The GSTP1 polymorphism was related to the cytotoxicity of several drug classes, especially topoisomerase inhibitors, antimetabolites and N7 alkylating agents. CONCLUSION: The NCI-60 panel is capable of providing clues and tracks for the establishment of clinically useful relationships between a given genotype and the cytotoxicity of an anticancer agent.

Antineoplastic Agents↗

Imputation of individual cancer cases to occupational causes.

OBJECTIVES: Many potential occupational causes of cancer have been documented. Imputation of an individual cancer to occupational or other causes is, however, difficult. A method based on the Bayes theorem is proposed for assessing causal relationships at the individual level. METHODS: Causality assessment, dealing with four types of persons defined by exposure and the occurrence of cancer, was linked with imputation, only dealing with persons who have cancer and were exposed. Imputation was then formulated using the Bayes theorem, relating epidemiologic information regarding causes, a patient's exposure history, and the posterior odds that the cancer was caused by a suspected occupational exposure. Data needed to apply a Bayesian method were defined in terms of relative risks, proportion of people exposed in populations, and the frequency of a positive relevant characteristic for persons without cancer. A relevant characteristic was defined using a formal consensus between experts. The method was then illustrated with cases of mesothelioma and lung cancer in possible relation to asbestos. RESULTS: Experts defined the relevant characteristics as being qualification of occupational exposure, intensity of exposure, latency, disease characteristics, and presence of causal agent in the body. Application to mesothelioma and lung cancer cases illustrated the potential usefulness of the method. CONCLUSIONS: The importance of occupational exposure in the formulation of imputation underscores the need for available and reliable data sources on occupational exposures. The proposed method could become a powerful tool for the expert assessment of causes of cancer cases, provided data become available in individual files and the literature.

Aged↗

Immunohistochemically detected lymph node metastases from breast carcinoma: practical considerations about the new American Joint Committee on Cancer classification.

BACKGROUND: The authors applied the sixth edition of the American Joint Committee on Cancer (AJCC) classification system to their previously published group of patients with breast carcinoma who had immunohistochemically detected lymph node metastases. METHODS: The original lymph node-negative slides from 218 patients, including 129 patients with infiltrating duct carcinoma (IDC) and 89 patients with infiltrating lobular carcinoma (ILC), were reviewed and then destained to perform immunohistochemistry. Each tumor cell deposit was measured. Single tumor cells could not counted or measured (because the distance separating the most distant cells could be > 2.0 mm), but they were separated into Class 1 (sparse) and Class 2 (numerous). According to the AJCC classification, isolated tumor cells (ITCs) should be classified as pN0(i+) when they measure < or = 0.2 mm and pN1mi when they measure < or = 2.0 mm but > 0.2 mm. RESULTS: ITCs were found in 13 IDCs (10%) and in 37 ILCs (41%) and corresponded in IDCs to a single deposit of a few tumor cells that measured < or = 0.2 mm (associated with a single tumor cell in 3 tumors) and were classified as pN0(i+). In ILCs, ITCs corresponded to single tumor cells with an irregular distribution throughout the entire lymph node section (24 ITCs and 13 ITCs in Class 1 and Class 2, respectively) and were difficult to classify. CONCLUSIONS: The results suggest that there are 2 categories of pN0(i+): measurable tumor cell deposits < or = 0.2 mm, which were found exclusively in IDCs; and nonmeasurable ITCs, which were found in ILCs and rarely in IDCs. The new classification is difficult to apply to ITCs that are detected by immunohistochemistry in ILCs.

Breast Neoplasms↗

Epidemiology of HIV-associated cryptococcosis in France (1985-2001): comparison of the pre- and post-HAART eras.

OBJECTIVE: To analyse the epidemiological evolution of cryptococcosis in France after the introduction of highly active antiretroviral therapy (HAART). DESIGN: Retrospective study of cryptococcosis cases recorded at the National Reference Center for Mycoses in France since 1985. METHODS: Using the national surveillance data, we reviewed 1644 cases of HIV-associated cryptococcosis diagnosed in France (population, 59 million) between 1985 and 2001 and compared them to 335 cases recorded in HIV-negative patients. RESULTS: The total number of cryptococcosis cases evolved in parallel to that recorded for HIV-infected patients. Changes occurring after HAART introduction were analysed. A negative binomial regression model established a 46% decrease of the incidence of cryptococcosis during the post-HAART era (1997-2001, n = 292) compared to the pre-HAART era (1985-1996, n = 1352). According to multivariate analysis, African origin, older age, heterosexual HIV contamination, no previous AIDS-defining illness, and no previous HIV infection diagnosis were variables independently associated with an increased risk of cryptococcosis during the post-HAART era. During the same period, the characteristics of the HIV-negative population did not change. CONCLUSIONS: Our analysis of the national surveillance identified demographic factors associated with an increased risk of cryptococcosis in the post-HAART era suggesting that failure to consult and considering oneself not at risk were determinant in the current epidemiology of HIV-related cryptococcosis in France.

AIDS-Related Opportunistic Infections↗

Determinants of allogeneic transfusion among patients who had an autologous blood procedure, France.

Autologous transfusion techniques have been proposed to decrease viral contamination related to allogeneic transfusion. Epidemiological studies looking at the actual effect of such policy are scarce. The aim of this study was to assess factors associated to the transfusion of additional allogeneic units among autologous blood recipients in France. We used a subgroup of data of RECEPT, a representative study of transfusion in French hospitals, and described blood recipients and components during the first 24 hours following a transfusion in 175 teaching and non teaching hospitals. We analysed data regarding patients included in the original study, who received autologous blood transfusion (376 patients). Almost one fifth of patients transfused with autologous blood was exposed to additional allogeneic transfusion. Patients undergoing cardiovascular surgery and who were transfused with blood salvage received allogeneic transfusion more frequently than patients undergoing orthopaedic surgery. Further implication of epidemiologists in studies of transfusion or other health technologies could help better formulate policies purported at decreasing risks.

Blood Transfusion↗

[Management of cancer patients by general practitioners. Results of a survey among 422 physicians in Aquitaine].

OBJECTIVE: To have a better knowledge on the role of the general practitioner in the management of cancer patients, their opinion on communications with the specialists and their training in oncology. METHOD: In March 2000, a questionnaire was sent to a random sample of 730 general practitioners in the Aquitaine area. RESULTS: We obtained 440 answers (60%). The general practitioners declared taking care of a mean of 16 cancer patients among their clientele and seeing 5 new cases every year. Two thirds of them decided on the orientation of their patients, case by case. Nearly 70% of the practitioners reported difficulties, notably psychological, in the case of relapses or during the terminal phase. The majority (94%) considered the quality of the information provided by the specialists as correct or good. Globally, the practitioners would prefer to be more involved in the treatment of their cancer patients and 82% would accept to ensure the follow-up of the patients in remission. CONCLUSION: The expectations of the general practitioners defined in this study merit reflection for the development of treatment networks in order to improve their organisation and the collaboration between general practitioners and specialists.

Adult↗

Breast ductal carcinoma in situ with microinvasion: a definition supported by a long-term study of 1248 serially sectioned ductal carcinomas.

BACKGROUND: The significance of microinvasion is still debated and clinical management is controversial. The authors defined ductal carcinoma in situ with microinvasion (DCIS-MI) as DCIS with infiltration of the periductal stroma by a few tumor cells, singly (type 1) or in clusters (type 2). With this definition, the authors attempted to evaluate the clinical significance of microinvasion. METHODS: The authors compared the clinical, pathologic features, and survival (median follow-up, 7.3 years) of 1248 patients with, respectively, DCIS (722 patients), DCIS-MI with microinvasion type 1 and type 2 (243 patients), and invasive ductal carcinoma in situ with a predominant DCIS component greater than or equal to 80% of the tumor (IDC-DCIS, 283 patients). RESULTS: Microinvasion was associated with DCIS histologic type, grade, and extent (respectively, P < 10(-8), P < 10(-3), P < 10(-4)). Axillary lymph node metastases were observed in a few patients with DCIS and DCIS-MI type 1 (respectively, 1.4% and none), in 10.1% with DCIS-MI type 2 and in 27.6% with IDC-DCIS. Metastasis free and overall survival probabilities were significantly different between three groups in the following order from best to worst prognosis: 1) the group comprising DCIS and DCIS-MI type 1, 2) the DCIS-MI type 2 group, and 3) the IDC-DCIS group. CONCLUSIONS: The authors' results suggest there are two types of DCIS-MI: 1) type 1 that behaves like DCIS and should be managed as such; 2) type 2 that is less pejorative than IDC-DCIS but is more so than type 1.

Adult↗