Indications for hepatic ultrasonography in breast cancer staging and follow-up.

Retrospective analysis of the medical records of 6649 breast cancer patients seen over an 11-year period found 438 patients (6.6%) with liver metastases (LM) and 432 patients (6.5%) with benign liver lesions (BLL). Liver ultrasonography (LUS) and liver function tests had been performed for all patients. LM were the first manifestation of metastatic spread in 20.1% of the 438 patients; median survival was related to the presence (6.7 mo.) or absence (12.2 mo.) of extrahepatic metastases (EHM). Liver function tests were normal in 20.5% of the patients in whom LM were first diagnosed by LUS. Most LM were hypoechoic (70.9%) BLL corresponded to cysts, hemangiomas, calcifications, and focal fatty infiltration. LUS appears indicated for (i) pretherapy disease staging, and in particular for detection of BLL, and (ii) follow-up of patients without EHM for early diagnosis of LM.

Bistability and nonlinearity in optically addressed ferroelectric liquid-crystal spatial light modulators: applications to neurocomputing.

We report the characteristics of a truly bistable optically addressed ferroelectric liquid-crystal spatial light modulator that is capable of storing binary images. We show that, in addition to this bistability, a nonlinear response and gray scales can be observed under certain operating conditions. We then report on how these capabilities can be used in implementing optical neurocomputing architectures.

Biochemical and pharmacological consequences of the interaction between methotrexate and ketoprofen in the rabbit.

Severe methotrexate (MTX) toxicity is a proven complication of associations of MTX and non-steroidal anti-inflammatory drugs (NSAIDs). This study investigated the interaction between MTX (50 or 100 mg kg-1) and ketoprofen (KP) (3 mg kg-1 day-1, pretreatment for 8 days) in the rabbit. The drug association induced a reversible increase in blood urea and creatinine. The severity degree of renal dysfunction was significantly related to the MTX dose; it was not modified by prolonged exposure to KP after MTX administration. The biological markers of haematopoietic and hepatic functions were unchanged. Pretreatment by KP induced a marked reduction (70%) in the urinary excretion of the prostaglandin 6-keto-PGF1 alpha. MTX dose-related alterations in MTX pharmacokinetics were also observed with the drug association: at a MTX dose of 100 mg kg-1, the presence of KP significantly reduced the total body clearance, the renal clearance and the fraction of MTX eliminated in urine as compared to controls. An appreciable reduction in the plasma binding of MTX was also noted in vivo when KP was associated. This experimental study confirms the existence of an interaction between MTX and KP and demonstrates its renal origin.

[Hepatic x-ray computed tomography. Value of delayed (6 hours) scanning in patients with normal biliary function]. / Scanographie hépatique. Utilité des coupes tardives (6 heures) chez des patients ayant une fonction biliarie normale.

Delayed hepatic CT (DH-CT) was studied in 250 patients without any major bile duct pathology. One hundred thirty-five of these patients had liver metastases. All patients were administrated 76 grams of iodine. Tolerance of the examination was good. Six hours after injection, average contrast enhancement in the normal liver was 24 HU (greater than 1.3 g/kg iodine), 22 HU (1 to 1.3 g/kg) and 14 HU (1 g/kg). Comparison of scans taken before, immediately after, and 6 hours post-injection revealed the frequent superiority of postinjection scans for diagnosis of liver metastases. Focal steatosis is the only benign pathology to benefit from DH-CT, because of the parallelism in the difference in density between the normal and steatotic tissue regardless of the time of scanning. Aside from isolated tumors requiring exploration by conventional CT (pre- and post-contrast studies), the workup of liver metastases can be optimized by postcontrast and DH-CT scans.

Liver, spleen, and vessels: preliminary clinical results of CT with perfluorooctylbromide.

This phase 1-2 trial investigated the use of a 100% wt/vol emulsion of perfluorooctylbromide (PFOB) in computed tomography (CT) of 30 patients with metastatic cancer. Injection of 3 g/kg (maximum dose administered to these patients) provided an average liver enhancement of +31 HU on CT scans obtained after 48 hours. Maximum splenic opacification occurred immediately after injection; 1 g/kg, which allowed an immediate enhancement of +35 HU, appeared sufficient for the diagnosis of splenic conditions. Vascular opacification was insufficient for diagnostic purposes. In four patients with metastases, more lesions were seen with the use of PFOB with CT than with conventional CT. Adverse effects included five cases of low back pain that were reversible when the infusion rate was reduced. Fever and trembling were also noted 6 hours after injection in five patients. In all patients, symptoms regressed spontaneously within several hours. Clinically inapparent and dose-independent splenomegaly (volume increase of at least 20% on CT examinations) was noted in eight patients.

Mathematical morphology processor using ferroelectric liquid crystal light valves: principle.

We describe the principle of an optical digital processor for mathematical morphology (MM). The proposed central processing unit is based on binary logic using states of polarization and spatial data shift using geometric optics. Two dimensional Boolean operations are performed by means of logical gates using ferroelectric liquid crystal light valves, which are shown to be able to perform iterative processes well suited to MM operation implementation. A complete optical architecture is proposed from which the programming of elementary MM transformations is demonstrated.

[Value of bead-type cassettes for antibiograms of Streptococci in Autobac units]. / Intérêt des cassettes "à billes" pour l'antibiogramme des streptocoques sur Autobac.

Antimicrobial susceptibility testing of Streptococci in automated units (Autobac) is not always satisfactory: aggregates formed spontaneously by Streptococci in the medium used can reduce the reliability of tests by interfering with correct reading, and, in many cases, bacterial growth is very slow, necessitating long periods for analysis (up to 6 hours). Owing to the fact that use of "bead type" cassettes for antifungal susceptibility testing in the Autobac improved results, and in particular prevented the formation of aggregates, we decided to adopt the same system for tests of streptococci. Each compartment in these cassettes contains glass microbeads which prevent aggregate formation thanks to an agitation mechanism. Rapid sedimentation of these beads allows normal reading with the Autobac. A comparative study of 66 strains of streptococci with various antibiotics was performed. Three techniques were used: classical diffusion technique, susceptibility testing with the standard cassette in the Autobac, and test with the bead type cassette in the Autobac. Parameters evaluated included the effective duration of each test, and comparison of the results (Autobac with and without beads, diffusion method). Results are detailed and discussed.

[An intercenter study of the validity of nutritional evaluation]. / Etude intercentre de la validité d'un bilan nutritionnel.

Malnutrition is one of the most frequent consequences of neoplastic disease. During specific therapies, in order to improve the quality of life of cancer patients, it is necessary to correct their bad nutritional status, allowing thus a better quality of response to the treatment and a better survival. Therefore, it may be needful to realize repetitive nutritional evaluations. The authors have tested the validity of a nutritional assessment in patients with head and neck cancer undergoing radiotherapy, and known to have a progressive impairment of pre-existent nutritional alterations during this therapy. Results show the interest of ponderal curve and serum prealbumin level monitoring, associated with a quantified evaluation of alimentary practice of the patients ("Nutritional Status Index") during cancer therapy. Those investigations are cheap and easy to realize, and could be done often and regularly, giving thus essential data for nutritional status evaluation; the consequence is the possibility of improving the correction of malnutrition.

Chronic obstructive pancreatitis due to tiny (0.6 to 8 mm) benign tumors obstructing pancreatic ducts: report of three cases.

Three cases of obstructive pancreatitis are described in nonalcoholic women aged 56 to 58 years with a 2-month to 5-year history of recurrent attacks of pancreatic pain associated with intermittent raised serum pancreatic enzymes. The diagnosis was made by sonography showing an enlarged hyperechogenic tail of the pancreas, with a dilated duct, the rest of the pancreas being normal, and by ERCP showing a partial stenosis of the main pancreatic duct with regular dilatation of collateral branches distally to it. Surgical resection of the pancreatic tail cured all three patients. In the obstructed part of the pancreas, the lesions are typical of obstructive pancreatitis with perilobular and sometimes intralobular fibrosis of the same degree in the different lobules of the diseased area and not patchy as in chronic calcifying pancreatitis. The changes in collateral ducts are not marked, and there is an absence of intraductal plugs. Fat necrosis and pseudocysts may be found. Tumors responsible for the obstruction were the smallest islet cell tumors (0.6 and 8 mm) and serous cystadenoma (5 mm) responsible for symptoms ever published. Cephalad to the stricture, the pancreas was normal. When the etiology of chronic pancreatitis is atypical, especially when it occurs in nonalcoholic women aged greater than 50 years, a careful sonography (or computed tomographic scan) and ERCP must be done. Serial sections of the resected pancreas at the level of the obstruction and distal to it are often necessary to demonstrate the tumor.

Alpha 1 isoenzyme of alkaline phosphatases. Clinical importance and value for the detection of liver metastases.

Measurement of the alpha 1 (fast liver) fraction of alkaline phosphatases in the serum for 217 cancer patients, 92 patients with nonmalignant hepatic affections and 131 controls, revealed that the alpha 1 fraction offers better global value (94%), sensitivity (96%), and specificity (93%) than gamma GT or total alkaline phosphatase determinations for the detection of liver metastases during cancer. Initial data from study of the time of appearance of the alpha 1 fraction reveals that this fraction shows up earlier than rises in the gamma GT or total alkaline phosphatases. Results of a multiparametric study conducted on the alpha 1 fraction and various hepatic enzymatic tests (SGOT, SGPT, GLDH, ALP, gamma GT) indicate that the alpha 1 fraction used alone is better than any other test or combination of tests for biological detection of liver metastases. As concerns the influence of chemotherapy on the appearance of the alpha 1 fraction, the majority of the drugs used for anticancer chemotherapy do not seem to affect measurement of the alpha 1 ALP fraction. The alpha 1 fast liver fraction of alkaline phosphatases, detected by electrophoresis on cellulose acetate, can be considered one of the best known tests for the detection of liver metastases.

East Pacific Rise Near 13{degrees}N: Geology of New Hydrothermal Fields.

Abundant massive sulfide deposits are present at the crest of the East Pacific Rise near 13 degrees North, where the opening rate is about 12 centimeters per year. Large manganese and helium-3 anomalies in seawater samples, evidence of intense present-day activity of hydrothermal springs, indicate that sulfides are still being produced along this segment of the rise. Massive sulfides also occur on adjacent off-axis seamounts.

Comparative study of gamma glutamyl transferase, alkaline phosphatase and its alpha 1 isoenzyme as biological indicators of liver metastases.

Biological detection of liver metastases represents an important factor in the surveillance of the course of cancerous affections. The authors present a report on a potential new indicator, the isoenzyme of alkaline phosphatase migrating to the alpha 1 region (alpha 1 ALP). In comparison to those tests considered the most sensitive at present-gamma glutamyl transferase and total alkaline phosphatase-this alpha 1 isoenzyme appears more sensitive and more specific, capable of detecting 97% of liver metastases with a specificity of 90%.

The diagnostic and prognostic value of urinary polyamine measurement in bladder cancer.

This study concerns a group of 54 patients with bladder cancer aged from 51 to 80 years (50 males, 4 females). Polyamines (putrescine -PU, spermidine - SPD) were measured on 24 h urine collections prior to surgery by an automatic ion exchange analyzer. Both polyamines, and especially PU, correlated well with the degree of tumor infiltration (JEWETT - MARSHALL stage) and mitotic activity (BROD -ER'S grade). Retrospectively, 28 patients for whom follow-up after surgery was 6 months to one year were classified into two groups: R+ (21) patients with disease recurrence or progression, and R0 (8) patients remaining tumour free. Twenty patients with high preoperative PU levels were in the R+ group. By contrast, 6 patients with normal preoperative PU levels were in the R0 group.

[Polyamines and malignant diseases (author's transl)]. / Polyamines et affections malignes.

The aliphatic polyamines (putrescine, spermidine, spermine) are associated with the phenomena of normal and neoplastic cellular growth. Two third of cancers generally show elevated urinary excretion of polyamines. The urinary levels of polyamines are significantly higher in cancer in evolution than in cancer in remission. The variable association of polyamines with different localisations is reviewed. The potential interest of polyamines analysis in the diagnosis and prognosis of cancer is discussed. The more exciting application of this test remains in the possibility of a short term appreciation of the oncostatic treatment efficiency.

An improved method for routine analysis of polyamines in biological fluids with a conventional amino acid analyzer.

An accurate and precise mechanized ion-exchange chromatographic method for the estimation of polyamines in biological fluids is described. The method includes the recent improvements developed for ion-exchange analysis of polyamines: the use of sulfonated polystyrene cation-exchange resin with a bead diameter of less than 10 micrometers and a continuous fluorescent detection with o-phthalaldehyde. Four different procedures for the removal of protein before analysis of polyamines in plasma have been compared. Linearity of the fluorescence detection, reproducibility (intra, inter assay) and precision of the retention times are reported. Furthermore, the method is characterised by the simplicity of the sample preparation, a clear and rapid elution programme and especially by its routine applicability, as shown during the last six months in the Centre Antoine-Lacassagne.

Polyamines in lymphomas: their value in disease staging and monitoring of therapy efficiency.

The urinary polyamines putrescine and spermindine were evaluated in a population of 49 patients with malignant lymphomas (40 with non-Hodgkin's lymphoma and 9 with Hodgkin's disease). Analyses were performed on a regular basis during the course of treatment. Polyamine levels were found to increase significantly with the disease stage. Results show that: (a) polyamines closely reflect disease evolution (clinical deterioration/clinical improvement); (b) comparison of polyamine measurements effected 24 h prior to and 48 h after initiation of a chemotherapy course allows evaluation of the response to treatment.

The clinical value of urinary polyamine analyses in cancer patients.

The polyamines, putrescine (P) and spermidine (S), have been measured in 185 cancer patients. Patients in remission exhibited significantly different levels from those with active disease. In a dynamic patient study, followed over a period of 5-6 months, the urinary polyamine levels correlated closely with the clinical status. Furthermore, polyamines have been measured 24 h before beginning chemotherapy (P1, S1) and 48 h after its onset (P2, S2). The value of the ratio, (S2/P2)/(S1/P1), was found to correlate with the type of response to chemotherapy.