... Isabelle Caro a, Xavier Boulenc a Monique Rousset b Viviane Meunier a Martine Bourri6 a, Bernand Julian a, Henri Joyeux c, Claude Roques a ... Cell culture Parental Caco-2 cells, originating from a hu-man colorectal carcinoma (Fogh et... more
... Isabelle Caro a, Xavier Boulenc a Monique Rousset b Viviane Meunier a Martine Bourri6 a, Bernand Julian a, Henri Joyeux c, Claude Roques a ... Cell culture Parental Caco-2 cells, originating from a hu-man colorectal carcinoma (Fogh et al., 1977), were obtained from Dr J. Fogh ...
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To assist radiologists and physicians in diagnosing, and in treatment planning and evaluating in liver oncology, we have developed a fast and accurate segmentation of the liver and its lesions within CT-scan exams. The first step of our... more
To assist radiologists and physicians in diagnosing, and in treatment planning and evaluating in liver oncology, we have developed a fast and accurate segmentation of the liver and its lesions within CT-scan exams. The first step of our method is to reduce spatial resolution of CT images. This will have two effects: obtain near isotropic 3D data space and drastically decrease computational time for further processing. On a second step a 3D non-linear `edge- preserving' smoothing filtering is performed throughout the entire exam. On a third step the 3D regions coming out from the second step are homogeneous enough to allow a quite simple segmentation process, based on morphological operations, under supervisor control, ending up with accurate 3D regions of interest (ROI) of the liver and all the hepatic tumors. On a fourth step the ROIs are eventually set back into the original images, features like volume and location are immediately computed and displayed. The segmentation we ...
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Subclavian vein cannulation, although a major progress in temporary vascular access, was associated with a significant morbidity and mortality. A safer alternative technique would therefore be welcome. For the last 2 years, we developed a... more
Subclavian vein cannulation, although a major progress in temporary vascular access, was associated with a significant morbidity and mortality. A safer alternative technique would therefore be welcome. For the last 2 years, we developed a new approach consisting in internal jugular vein cannulation (IJVC) with 2 silicone rubber catheters with a long-term proved biocompatibility. 138 pairs of cannulae were inserted in 129 uremics patients. Mean duration of use was 54 days (1 day to 17 months). More than 3,000 high-performance HD sessions were performed. IJVC handling and care was easily managed by nurses. Low incidence of complications was observed: 2 thrombosis episodes, 3 skin infection with 2 septicemiae, 1 air embolism, 1 anaphylactoid reaction. No death was related to the technique itself. IJVC offers a new method of percutaneous central vein cannulation, providing a safe and reliable temporary vascular access immediately usable for all kinds of extracorporeal treatment.
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A home enteral nutrition (HEN) system was introduced to deliver a day's ration of an "all-in-one" sterile and modular formula from a large container. The nutrient formula consisted of... more
A home enteral nutrition (HEN) system was introduced to deliver a day's ration of an "all-in-one" sterile and modular formula from a large container. The nutrient formula consisted of carbohydrate, protein, and lipid modules sterilized separately, in an autoclave at 120 degrees C, then mixed and supplemented with minerals and trace elements. Vitamins were given the patients through a feeding tube before connecting the nutrient container. The system was used to feed 12 malnourished patients (10 men and two women) with cancer (carcinoma of esophagus or tongue) or without cancer (esophageal perforation). All patients had normal gastrointestinal function but could not take in more than 500 kcal/day orally, because of their primary disease or the treatment for it (surgery in four patients; and radiotherapy, associated in some cases with chemotherapy, in eight). HEN duration ranged from 30 to 435 days at a daily cost of approximately US $15 to $20. Statistical analysis (Student's t-test for paired data) showed significant body weight gain (p less than 0.05) and significant increases in serum levels of albumin, transthyretin (p less than 0.05, respectively), and transferrin (p less than 0.01). Increases of serum total protein level were not statistically significant (p less than 0.09). The nutrient formula was well tolerated and there were no HEN-related rehospitalizations. Seventy-five % (nine of the patients) considered that HEN had improved their quality of life. The daily savings per patient, compared to the cost of treatment in a hospital, was about $260/day.(ABSTRACT TRUNCATED AT 250 WORDS)
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A single injection of 5 mg of 7, 12-dimethylbenzanthracene (DMBA) resulted in a high incidence of lingual fibrosarcoma in 67 Wistar rats. No metastases were found. We studied the influence of age and sex on the incidence, latency of... more
A single injection of 5 mg of 7, 12-dimethylbenzanthracene (DMBA) resulted in a high incidence of lingual fibrosarcoma in 67 Wistar rats. No metastases were found. We studied the influence of age and sex on the incidence, latency of tumors, loss of weight and the spontaneous survival of animals. The method described offers an experimental model for the study of cachexia resulting from upper digestive and respiratory tract cancer.
Research Interests: Dentistry, Weight Loss, Female, Animals, Male, and 4 moreFibrosarcoma, Rats, Cachexia, and Chi Square Distribution
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Objective. – Healthy and pathological hepatic volumetry can be of great interest in Liver pathology and treatment. We studied the hepatic segmentation in order to verify if it is possible to estimate the volume of one lobe, when the... more
Objective. – Healthy and pathological hepatic volumetry can be of great interest in Liver pathology and treatment. We studied the hepatic segmentation in order to verify if it is possible to estimate the volume of one lobe, when the volume of the other lobe or the total liver is known.Patients and Methods. – We studied 50 normal hepatic angiotomographies. For each exam and using the Couinaud classification, we measured the total hepatic volume, the right lobe, the left lobe and the caudate lobe volumes. We used a software called “Hepato” developed in order to quantify automatically CTScan images of the liver. We performed a linear regression analysis (least squares method) and calculated the determination coefficient to study the correlation between the different volumes.Results. – The mean total hepatic volume was 1497 cm3. We obtained for the right lobe 1231 cm3, 226 cm3 for left lobe, and 39 cm3 for the caudate lobe. Moreover there was a weak correlation between these volumes.Conclusion. – Exact volume estimation of an hepatic lobe in one patient can not be obtained from the total hepatic volume. However, theses volumes can only be measured from three-dimensional images. Since classical image editing tools are time request, it becomes impossible to utilize them in a clinical routine to get the different volumes of the Liver. Thus, a software dedicated for liver parenchyma recognition is necessary.
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Temporary and immediately usable vascular access is a vital need in treating uremic patients. Subclavian vein cannulation, although a major progress, has been associated with significant morbidity and mortality. Accordingly, for the last... more
Temporary and immediately usable vascular access is a vital need in treating uremic patients. Subclavian vein cannulation, although a major progress, has been associated with significant morbidity and mortality. Accordingly, for the last 2.5 years the authors have been developing an alternative technique consisting of internal jugular vein cannulation (IJVC) with two silicone rubber catheters with a long-term, proved biocompatibility. One hundred sixty-five pairs of cannulas were inserted in 153 patients. Mean duration of use was 57 days (1 day to 17 months). More than 3,000 high-performance hemodialysis sessions were performed. IJVC handling and care were easily managed by nurses. A low incidence of complications was observed: two thrombosis episodes, four skin infections with three septicemia, one air embolism, and one anaphylactoid reaction. No death was related to the technique itself. IJVC offers a new, safe, and reliable temporary vascular access immediately usable for all kinds of extracorporeal treatment.
Research Interests:
Research Interests:
Glutamine is a nonessential neutral amino acid that is widely consumed by the intestinal tract in catabolic states. We have followed up the plasma amino acid profile after extensive small-bowel resection in dogs receiving total parenteral... more
Glutamine is a nonessential neutral amino acid that is widely consumed by the intestinal tract in catabolic states. We have followed up the plasma amino acid profile after extensive small-bowel resection in dogs receiving total parenteral nutrition (TPN) with or without glutamine (GLN) or N-acetylglutamine (aGLN) supplementation. Animals were divided into four groups according to the type of surgery (enterectomy or transection) and nutrition (TPN, TPN with aGLN, or TPN with GLN). Plasma GLN levels decreased in group I (enterectomy and TPN) on day 2 (p = .03) and significantly increased on postoperative days in groups III (enterectomy and TPN with aGLN) and IV (enterectomy and TPN with GLN). A significant increase of plasma GLN was observed in groups III and IV compared with group I on days 6 and 8 (p = .03 and p = .01). Plasma alanine decreased in groups with bowel resection, whereas no change was observed in the control group (transection) and the decrease of plasma alanine was significantly less pronounced in groups III and IV compared with group I. The increase of crypt depth and villous height was more pronounced in groups III and IV. These results suggest that GLN is a required substrate for mucosal growth and function, which could improve the intestinal adaptation encountered after enterectomy.
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The expression of several forms of cytochrome P450 including P450 1A2, 2D6, 2E1, and 3A was investigated in human hepatocytes maintained in primary culture for 96 h in the absence or presence of 50 sM of various imidazole derivatives.... more
The expression of several forms of cytochrome P450 including P450 1A2, 2D6, 2E1, and 3A was investigated in human hepatocytes maintained in primary culture for 96 h in the absence or presence of 50 sM of various imidazole derivatives. These included ketoconazole, clotrimazole, miconazole, fluconazole, sec- nidazole and metronidazole. In addition, the typical in- ducers rifampicin and 3-naphthoflavone were used
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Research Interests:
In 90%-hepatectomized rats, the plasma testosterone level (0.34 +/- 0.07 ng.ml, mean +/- SEM) is significantly lower (P less than 0.001) than in sham operated male rats (1.7 +/- 0.26 ng.ml, mean +/- SEM). In dogs, after 90% hepatectomy,... more
In 90%-hepatectomized rats, the plasma testosterone level (0.34 +/- 0.07 ng.ml, mean +/- SEM) is significantly lower (P less than 0.001) than in sham operated male rats (1.7 +/- 0.26 ng.ml, mean +/- SEM). In dogs, after 90% hepatectomy, the mean plasma testosterone concentration fell to 1/10 of the plasma testosterone level measured in sham operated animals either 24 or 72 h after surgery. In hepatectomized men, plasma testosterone is markedly decreased in contrast to what is observed after duodeno-pancreatectomy performed under the same conditions of anesthesia. These results suggest that 90% hepatectomy severely alters the Leydig cell function.
Research Interests: Kinetics, Dogs, Humans, Testosterone, Animals, and 6 moreCorticosterone, Male, Middle Aged, Rats, Leydig cells, and Steroid
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Ambulatory total parenteral nutrition (TPN) at home was used in 85 patients within a 6-yr period. Indications include severe malabsorption, fistulas, anorexia nervosa, and malignancies. The median duration of home TPN (HPN) was 67 days... more
Ambulatory total parenteral nutrition (TPN) at home was used in 85 patients within a 6-yr period. Indications include severe malabsorption, fistulas, anorexia nervosa, and malignancies. The median duration of home TPN (HPN) was 67 days (range: 30-4,155 days). HPN duration for patients with benign diseases was longer [357.12 days (range: 30-4,155 days)] than for cancer patients [93.54 days (range: 30-421 days)]. Under HPN, patients gained a good nutritional status with an increase of total protein (p less than 0.001) and serum albumin levels (p less than 0.001). Weight gain was also significant (p less than 0.001). The rehospitalization rate was low (7.8%), but it was higher when HPN lasted for more than 3 months (10.87% +/- 1.58%) compared with short-term HPN (5.69% +/- 1.25%). Metabolic complications were unusual, and rehospitalization was related to the oncological treatment and/or infectious complications. Therefore, ambulatory HPN is a nutritional support that can significantly improve the life of patients with alimentary failure. Moreover, HPN allows significant cost savings compared to the alternative of prolonged hospitalization.
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Research Interests:
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Research Interests:
Massive resections of the intestine including the ileocecal valve are associated with a high mortality. This model of short bowel in the dog consists of an extensive small-bowel resection (remaining jejunum 25 cm) associated with... more
Massive resections of the intestine including the ileocecal valve are associated with a high mortality. This model of short bowel in the dog consists of an extensive small-bowel resection (remaining jejunum 25 cm) associated with colectomy. Small-bowel adaptation is evidenced by increases of crypt depth (p = 0.02) and villus height (p = 0.001) in animals fed per os. Plasma glutamine levels decrease after surgery, while there is a significant decrease of plasma alanine levels (p less than 0.001). This model should allow to pursue investigations on the importance of glutamine as an essential fuel for intestinal mucosa regeneration.
Research Interests: Dogs, Intestinal Mucosa, Female, Animals, Male, and 3 moreClinical Sciences, Amino Acids, and Glutamine
The model of extended repeated partial hepatectomy without vascular shunt in dogs is presented. It consisted of 65% initial hepatectomy and after liver regeneration (6-10 weeks) repeated hepatectomy. Finally, only the papillary process of... more
The model of extended repeated partial hepatectomy without vascular shunt in dogs is presented. It consisted of 65% initial hepatectomy and after liver regeneration (6-10 weeks) repeated hepatectomy. Finally, only the papillary process of the caudate lobe (PPC), which constitutes 5% of the initial hepatic mass, was left intact. The most important finding was an ability of PPC to reconstitute the liver mass which enabled survival without the vascular shunt. After repeated hepatectomy the need for artificial hepatic assistance (parenteral nutritional support with frozen plasma) was imperative to offset the effects of acute hepatic failure and to support PPC regeneration.
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Autologous hepatocellular transplantation using reflux into the spleen via the venous tributaries was compared in 65% hepatectomized dogs to direct injection into the splenic pulp. Transplantation into the spleen via the inferior terminal... more
Autologous hepatocellular transplantation using reflux into the spleen via the venous tributaries was compared in 65% hepatectomized dogs to direct injection into the splenic pulp. Transplantation into the spleen via the inferior terminal polar splenic vein led to a better survival rate (50 vs. 0%). Hepatocytes embolization to the intrahepatic portal vein system was observed. Although hepatocyte transplantation into the spleen can be accomplished either by direct punction of the spleen or by retrograde injection into a splenic vein, the second method decreases the frequency of cell embolization.
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Research Interests:
Research Interests: High Pressure, Dogs, Animals, Clinical Sciences, Pressure, and 3 moreClinical Data, Colostomy, and Colon
Research Interests: Calcium, Humans, Digestive and Liver Diseases, Female, Male, and 15 moreStatistical Significance, Clinical Sciences, Intestinal absorption, Aged, Middle Aged, Digestive System, Adult, Time Factors, Gastrointestinal Tract, Xylose, Calcium Absorption, Parenteral Nutrition, Organic Compound, Small Intestine, and Postoperative Period
Thirty-nine patients with short bowel syndrome after extensive small bowel resection, with or without associated partial or total colectomy, received continuous total parenteral nutrition followed by discontinuous parenteral nutrition.... more
Thirty-nine patients with short bowel syndrome after extensive small bowel resection, with or without associated partial or total colectomy, received continuous total parenteral nutrition followed by discontinuous parenteral nutrition. Home parenteral nutrition was introduced in 16 of these patients; in eight it was permanent. The assessment of nutritional status included body weight; standard urinary and blood studies; albumin, prealbumin, and transferrin serum levels; and both urinary and fecal nitrogen. A statistically significant correlation (P less than 0.001) was observed between the length of the remaining small bowel and the necessary duration of nutritional support. Multivariate analysis allowed us to classify patients into three groups as a function of remaining gut length and the duration of required nutritional support. This study should help to define the best nutritional support protocol for patients with various short bowel syndromes in order to ensure the best possible intestinal adaptation and to improve their quality of life.
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Research Interests: Nutrition and Dietetics, Gastroenterology, Adolescent, Multivariate Analysis, Clinical Nutrition, and 16 moreHumans, Chronic Disease, Female, Male, Clinical Sciences, Aged, Middle Aged, Intestinal Obstruction, Adult, Survival Rate, Prognosis, Age Factors, Parenteral Nutrition, Neurosciences, Mortality rate, and Factorization Method
During an 18-year period, 2600 patients were treated for colorectal carcinoma in the Montpellier Cancer Institute. Of the 93 patients younger than 40 years of age (3.6%), 78 records were retrospectively studied. The overall 5-year... more
During an 18-year period, 2600 patients were treated for colorectal carcinoma in the Montpellier Cancer Institute. Of the 93 patients younger than 40 years of age (3.6%), 78 records were retrospectively studied. The overall 5-year survival rate was 30%. Their survival was not significantly affected by the site of the primary tumor, the degree of tumor differentiation, or sex. The only significant parameter was Dukes' staging at presentation (P less than 0.0001). An analysis of sites of recurrence revealed the frequency of liver metastasis, ovarian metastasis in women, and local recurrence of rectal cancer. Although the high failure rate in these areas clearly justifies aggressive combined therapy, the high frequency of inaugural Stage D patients (27%) and their short mean survival time (5 months), underline the crucial importance of early detection. However, it is unfortunate that colorectal cancer screening in young patients is difficult because of the low rates of precancerous states (4%).
Research Interests: Cancer, France, Humans, Female, Male, and 5 moreAdult, Retrospective Studies, Age Factors, Adenocarcinoma, and 5-FLUOROURACIL
Thirty-seven patients with low rectal carcinoma were treated by transanal resection between January 1979 and December 1988. Adjuvant radiotherapy was used in eight patients before operation, in 13 after operation and six patients had both... more
Thirty-seven patients with low rectal carcinoma were treated by transanal resection between January 1979 and December 1988. Adjuvant radiotherapy was used in eight patients before operation, in 13 after operation and six patients had both preoperative and postoperative radiotherapy. The selection criteria for transanal resection were low, superficial tumours treated conservatively with curative intent (group 1, 18 patients) or patients medically unfit for (12) or refusing (seven) abdominoperineal resection (APR) (group 2, 19 patients). In group 1, the local recurrence rate was 11 per cent with an overall 5-year survival rate of 100 per cent. In group 2, the local recurrence rate was 53 per cent with an overall 5-year survival rate of 35 per cent. There was no postoperative mortality and minimal morbidity. Salvage of local failure was by APR in six patients. The survival rate after local recurrence was 70 per cent at 1 year and 30 per cent at 5 years. Transanal resection can be proposed as a curative procedure for selected low, small, minimally infiltrating and well differentiated adenocarcinomas. Local control might be improved by postoperative radiotherapy for Astler-Coller stage B1 tumours or those above 3 cm in diameter. Further trials should examine the results of high-dose (60 Gy) preoperative radiotherapy so that transanal resection might be employed for favourable post-irradiation stage (0 or A) lesions. This new strategy will benefit from a better evaluation of tumour response after primary radiotherapy and an improved assessment of histological excision margins.
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... 23. R. Curi-Pedrosa, M. Daujat, L. Pichard, JC Ourlin, P. Clair, L. Gervot, P. Lesca, J. Domergue, H. Joyeux, G. Fourtanier and P. Maurel. J. Pharmacol. Exp. Ther. 269 (1994), pp. 384392. View Record in Scopus | Cited By in Scopus... more
... 23. R. Curi-Pedrosa, M. Daujat, L. Pichard, JC Ourlin, P. Clair, L. Gervot, P. Lesca, J. Domergue, H. Joyeux, G. Fourtanier and P. Maurel. J. Pharmacol. Exp. Ther. 269 (1994), pp. 384392. View Record in Scopus | Cited By in Scopus (113). 24. V. Rogiers. ...