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Efficacité et tolérance d’une cure thermale sur la xérose cutanée cicatricelle post-chirurgie du cancer du sein suivie de radiothérapie : résultats d’un essai ouvert, randomisé et contrôlé. Ann Dermatol Venereol 2020. [DOI: 10.1016/j.annder.2020.09.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Patterns of practice of androgen deprivation therapy combined to radiotherapy in favorable and unfavorable intermediate risk prostate cancer. Results of The PROACT Survey from the French GETUG Radiation Oncology group. Cancer Radiother 2020; 24:892-897. [PMID: 33144063 DOI: 10.1016/j.canrad.2020.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/22/2020] [Accepted: 03/26/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE The intermediate-risk (IR) prostate cancer (PCa) group is heterogeneous in terms of prognosis. For unfavorable or favorable IR PCa treated by radiotherapy, the optimal strategy remains to be defined. In routine practice, the physician's decision to propose hormonal therapy (HT) is controversial. The PROACT survey aimed to evaluate pattern and preferences of daily practice in France in this IR population. MATERIALS AND METHODS A web questionnaire was distributed to French radiotherapy members of 91 centers of the Groupe d'Etude des Tumeurs Uro-Genitales (GETUG). The questionnaire included four sections concerning: (i) the specialists who prescribe treatments and multidisciplinary decisions (MTD) validation; (ii) the definition of IR subsets of patients; (iii) radiotherapy parameters; (iv) the pattern of practice regarding cardiovascular (CV) and (iv) metabolic evaluation. A descriptive presentation of the results was used. RESULTS Among the 82 responses (90% of the centers), HT schedules and irradiation techniques were validated by specific board meetings in 54% and 45% of the centers, respectively. Three-fourths (76%) of the centers identified a subset of IR patients for a dedicated strategy. The majority of centers consider PSA>15 (77%) and/or Gleason 7 (4+3) (87%) for an unfavorable IR definition. Overall, 41% of the centers performed systematically a CV evaluation before HT prescription while 61% consider only CV history/status in defining the type of HT. LHRH agonists are more frequently prescribed in both favorable (70%) and unfavorable (98%) IR patients. Finally, weight (80%), metabolic profile (70%) and CV status (77%) of patients are considered for follow-up under HT. CONCLUSION To the best of our knowledge, this is the first survey on HT practice in IR PCa. The PROACT survey indicates that three-quarters of the respondents identify subsets of IR-patients in tailoring therapy. The CV status of the patient is considered in guiding the HT decision, its duration and type of drug.
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Indications et perspectives de l’hormonoradiothérapie des cancers de prostate à haut risque. Cancer Radiother 2020. [DOI: 10.1016/j.canrad.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Réflexions éthiques sur le dépistage génétique préconceptionnel en population générale : le débat français et l’avis de la Société Française de Médecine Prédictive et Personnalisée. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jemep.2019.100439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Tolérance et efficacité de l’implantation et du suivi de marqueurs fiduciels en radiothérapie stéréotaxique robotisée extracrânienne. Cancer Radiother 2019. [DOI: 10.1016/j.canrad.2019.07.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Quadrivalent versus trivalent influenza vaccine: clinical outcomes in two influenza seasons, historical cohort study. Clin Microbiol Infect 2019; 26:101-106. [PMID: 31108229 DOI: 10.1016/j.cmi.2019.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The quadrivalent influenza vaccine (QIV) contains two influenza B antigens (one of each B lineage), while the trivalent vaccine (TIV) contains solely one. As a result, a mismatch between the circulating B lineage and the lineage in the TIV occurs frequently. We aimed to compare the frequency of clinically significant outcomes in a large cohort of vaccinees receiving either TIV or QIV. METHODS Historical cohort study of all inactivated influenza vaccinees (aged 3 years and older) in a Health Maintenance Organization insuring 1.2 million individuals, over two influenza seasons in which both vaccines were provided non-selectively. Primary outcome was hospital admissions during the influenza season. Multivariate analysis was performed using logistic regression to adjust for relevant covariates. RESULTS Our cohort included 150 518 and 168 296 vaccinees in the first (S1) and second season (S2), respectively. The two influenza seasons were characterized by high Influenza B activity. Of those vaccinated with QIV, 2074 of 49 726 (4.2%) and 6563 of 121 741 (5.4%) were hospitalized compared with 7378 of 100 792 (7.3%) and 3372 of 46 555 (7.2%) of those vaccinated with TIV (S1 and S2, respectively). After multivariate analysis adjusting for several covariates (gender, age, socioeconomic status, chronic morbidity, timing of vaccination), compared with TIV recipients, QIV vaccinees had lower odds for hospitalization (OR = 0.92, 95% CI 0.87-0.98 and OR = 0.89, 95% CI 0.85-0.93) or emergency department visit (OR = 0.91, 95% CI 0.87-0.95 and OR = 0.84, 95% CI 0.81-0.87) in S1 and S2, respectively (p < 0.001). Lower odds of mortality and influenza-like illness were also observed in S2 (OR = 0.61, 95% CI 0.50-0.75 and OR = 0.92, 95% CI 0.90-0.95, respectively). CONCLUSIONS In seasons with relatively high influenza B activity, QIV appeared more protective than TIV in Israel.
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High prevalence but low recognition of sarcopenia in metastatic cancer patients: Results of the scan study. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ultrastructural Study of the Conjunctiva in Patients with Keratoconjunctivitis Sicca not Associated with Systemic Disorders. Eur J Ophthalmol 2018; 8:131-6. [PMID: 9793764 DOI: 10.1177/112067219800800302] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose The aim of this work was to evaluate ultrastructural alterations of the conjunctiva during the clinical course of keratoconjunctivitis sicca (KCS), and to detect its earliest and most characteristic morphological changes. Methods The conjunctiva was studied in biopsies from 75 patients and 10 controls. Patients were classified according to the results of the Schirmer I test, break-up time, rose Bengal staining, osmolarity and impression cytology. Results The conjunctiva in these KCS patients showed progressive hyperplasia, hypertrophy and cellular flattening, with diminution of goblet cell density and microvilli. In the severe cases, the epithelial cells lost their organelles, and fibrous material increased. From the early phases of KCS, clear nuclear alterations (indentation, binucleation) were found, but pyknotic nuclei or anucleated cells were only observed in the most severe cases. From the earliest stages to the most severe cases of KCS, decreases in cell membrane interdigitations were observed parallel to increases in the number and size of desmosomes. There were also increases in the number of inflammatory cells. Alterations in blood vessels were only observed in the most severe cases. Conclusions Morphological studies alone were able even in the earliest phases of KCS, to detect the squamous metaplasia that progresses from the surface of the epithelium to the connective tissue. This degenerative or adaptative cellular process was characterized mainly by marked proliferation of the cytoskeleton and a general loss of organelles, mitochondria being the least affected.
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Logothérapie, groupe de paroles et analyse existentielle en cours de radiothérapie : expérience pilote d’un centre parisien de radiothérapie. PSYCHO-ONCOLOGIE 2017. [DOI: 10.1007/s11839-017-0640-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Editorial: Neuroglia in Alzheimer's Disease: From Cohort to Contestant in the Disease Progression and its Therapy. Curr Alzheimer Res 2016; 13:318-20. [PMID: 27018260 DOI: 10.2174/156720501304160314173258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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1581 Biosimilar filgrastim treatment patterns and prevention of febrile neutropenia: A multicentric observational national French study in patients with solid tumors (The Zohé study). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30670-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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1567 Overview of French routine clinical practice for the management of chemotherapy-induced anemia (CIA) with biosimilar epoetin alfa in 1298 patients with solid tumors: A national observational study (The OncoBOS study). Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30656-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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[First case of complete genomic sequencing in prostate cancer]. Prog Urol 2014; 24:1041-2. [PMID: 25288584 DOI: 10.1016/j.purol.2014.09.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 09/12/2014] [Indexed: 10/24/2022]
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Hormone-free Protocols for the Control of Reproduction and Artificial Insemination in Goats. Reprod Domest Anim 2014; 49 Suppl 4:22-9. [DOI: 10.1111/rda.12394] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 07/14/2014] [Indexed: 12/01/2022]
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Comparaison entre la dose absorbée dans l’eau et celle dans le silicium pour le contrôle des faisceaux avec modulation d’intensité. Cancer Radiother 2014. [DOI: 10.1016/j.canrad.2014.07.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Does Alzheimer disease exist in all primates? Alzheimer pathology in non-human primates and its pathophysiological implications (II). NEUROLOGÍA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.nrleng.2011.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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L’exploration et le traitement de la région axillaire des tumeurs infiltrantes du sein (RPC 2013). ONCOLOGIE 2013. [DOI: 10.1007/s10269-013-2340-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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WE-E-103-02: Past, Present and Future Roles of ROC Analysis in Medical Imaging and Quantitative Image Analysis. Med Phys 2013. [DOI: 10.1118/1.4815603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Does Alzheimer's disease exist in all primates? Alzheimer pathology in non-human primates and its pathophysiological implications (I). NEUROLOGÍA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.nrleng.2012.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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[Does Alzheimer's disease exist in all primates? Alzheimer pathology in non-human primates and its pathophysiological implications (II)]. Neurologia 2011; 29:42-55. [PMID: 21871692 DOI: 10.1016/j.nrl.2011.05.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 05/29/2011] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In the ageing process there are some species of non-human primates which can show some of the defining characteristics of the Alzheimer's disease (AD) of man, both in neuropathological changes and cognitive-behavioural symptoms. The study of these species is of prime importance to understand AD and develop therapies to combat this neurodegenerative disease. DEVELOPMENT In this second part of the study, these AD features are discussed in the most important non-experimental AD models (Mouse Lemur -Microcebus murinus, Caribbean vervet -Chlorocebus aethiops, and the Rhesus and stump-tailed macaque -Macaca mulatta and M. arctoides) and experimental models (lesional, neurotoxic, pharmacological, immunological, etc.) non-human primates. In all these models cerebral amyloid neuropathology can occur in senility, although with different levels of incidence (100% in vervets;<30% in macaques). The differences between normal and pathological (Alzheimer's) senility in these species are difficult to establish due to the lack of cognitive-behavioural studies in the many groups analysed, as well as the controversy in the results of these studies when they were carried out. However, in some macaques, a correlation between a high degree of functional brain impairment and a large number of neuropathological changes ("possible AD") has been found. CONCLUSIONS In some non-human primates, such as the macaque, the existence of a possible continuum between "normal" ageing process, "normal" ageing with no deep neuropathological and cognitive-behavioural changes, and "pathological ageing" (or "Alzheimer type ageing"), may be considered. In other cases, such as the Caribbean vervet, neuropathological changes are constant and quite marked, but its impact on cognition and behaviour does not seem to be very important. This does assume the possible existence in the human senile physiological regression of a stable phase without dementia even if neuropathological changes appeared.
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Proteolytic activity of lactic acid bacteria strains and fungal biota for potential use as starter cultures in dry-cured ham. J Food Prot 2011; 74:826-9. [PMID: 21549056 DOI: 10.4315/0362-028x.jfp-10-471] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
During the processing of dry-cured meat products, sarcoplasmic and myofibrillar proteins undergo proteolysis, which has a marked effect on product flavor. Microbial proteolytic activity is due to the action of mostly lactic acid bacteria (LAB) and to a lesser extent micrococci. The proteolytic capacity of molds in various meat products is of interest to meat processors in the Mediterranean area. Eleven LAB and mold strains from different commercial origins were tested for proteolytic activity against pork myosin, with a view to possible use of these strains as starter cultures for Iberian dry-cured ham. Proteolytic activity was tested by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The LAB strains with the highest proteolytic activity were Lactobacillus plantarum (L115), Pediococcus pentosaceus (Saga P TM), and Lactobacillus acidophilus (FARGO 606 TM). The best fungal candidate was Penicillium nalgiovense LEM 50I followed by Penicillium digitatum, Debaryomyces hansenii, and Penicillium chrysogenum.
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Abstract
OBJECTIVE To create a short olfactory test, Connecticut Smell Test (CST), based on the CCCRC (Connecticut Chemosensor and Clinical Research Center). DESIGN A prospective patient-based study. SETTINGS Smell and Taste Outpatient Clinic at the Fundación Hospital Alcorcón, Madrid, Spain. MATERIAL AND METHODS We compared a short test based on the CCCRC with the Pocket Smell Test (PST) based on the University of Pennsylvania Smell Identification Test) UPSIT in 40 patients with nasal polyposis, in order to determine the specificity, sensitivity, positive predictive and negative predictive values. The validity index was 95% with an accuracy rate of 10%. We determined unit cost, the time required to perform the test in the outpatient office and the difficulty to perform the test. RESULTS The sensibility was 93.3% and the specificity was 76% with a positive predictive value of 70% and a negative predictive value of 95%. The unitary cost of CST was euro0.65 when it is performed by a doctor. The unitary cost of PST is euro1.76. Our short test took 34 seconds to perform. More than 96% of the patients thought the test was easy to do. CONCLUSION Our test is a valid, easy and quick test to be used in patients with nasal polyposis.
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Auditory discrimination training for tinnitus treatment: the effect of different paradigms. Eur Arch Otorhinolaryngol 2010; 267:1067-74. [DOI: 10.1007/s00405-009-1182-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2009] [Accepted: 12/15/2009] [Indexed: 11/29/2022]
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[Elevation of PSA after prostate radiotherapy: rebound or biochemical recurrence?]. Prog Urol 2008; 18:557-61. [PMID: 18986625 DOI: 10.1016/j.purol.2008.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2007] [Accepted: 06/09/2008] [Indexed: 11/15/2022]
Abstract
The fact that external beam radiotherapy and brachytherapy are now considered to be curative techniques has led to major review of the modalities of follow-up after radiotherapy for prostate cancer. The problem concerns both the diagnosis of recurrence, rapidly announced by elevation of prostatic-specific antigen (PSA), usually at a subclinical stage, and the validity of criteria of biochemical recurrence to allow comparison of various study. Physicians involved in follow-up should be aware of the potential of bounce in PSA follow-up after external beam radiotherapy or brachytherapy. The PSA bounce phenomemon was defined by a rise of PSA values (+0.1 -0.8 ng/ml) with a subsequent fall. Biochemical failure after external beam radiotherapy or brachytherapy (with or without hormonotherapy) was defined by Phoenix criteria by a rise of 2 ng/ml above an initial PSA nadir. This definition was more correlated to PSA bounce phenomenon.
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Immunohistochemical increase in cyclooxygenase-2 without apoptosis in different brain areas of subchronic nicotine- and D-amphetamine-treated rats. J Neural Transm (Vienna) 2008; 115:1093-108. [PMID: 18351285 DOI: 10.1007/s00702-008-0040-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Accepted: 02/26/2008] [Indexed: 11/25/2022]
Abstract
Cyclooxygenase-2 (COX-2) upregulation has been related to both neurodegeneration and physiological processes. To clarify whether nicotine-induced upregulation of COX-2 occurs, and to analyse its significance, a comparative immunohistochemical and Western blot study was performed on the frontoparietal cortex, hippocampus and cerebellar cortex of rats treated (14 days) with nicotine, D(+)amphetamine (0.35 and 1.16 mg free base/kg/day, respectively), or both drugs simultaneously. None of these treatments promoted neuronal apoptosis. Lipid peroxidation increased in the hippocampus of the nicotine-treated rats and in all the brain regions examined in the D(+)amphetamine rats, but not in the double-treated animals. Both molecules increased the COX-2 content (as determined by the number of immunopositive neurons and the intensity of their immunodeposits) in an area-, layer- and neuron type-dependent manner, in all brain regions in which a large number of COX-2 immunopositive neurons were observed in controls (the somatosensory cortical areas, CA-1, CA-3, the gyrus dentatus, the ectorhinal/perirhinal areas, and the gyrus cingularis). No increase was seen in the motor cortical areas, while a reduction was recorded in the cerebellar cortex; these regions had only a few immunopositive neurons in controls. Western blot analysis revealed a 50-80% increase in COX-2 in the brain cortex and hippocampus of nicotine-treated rats, and similar increases (150-200%) in the cortex of the D(+)amphetamine- and nicotine + D(+)amphetamine-treated rats. Nicotine-induced upregulation of COX-2 seems to be related to neuronal plasticity rather than neurodegeneration. Nicotine agonists might be useful in the treatment of cognitive disorders.
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FTIR microspectroscopic analysis of the effects of certain drugs on oxidative stress and brain protein structure. Biopolymers 2008; 89:548-54. [DOI: 10.1002/bip.20944] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Amphetamine effects on brain protein structure and oxidative stress as revealed by FTIR microspectroscopy. Biopolymers 2007; 86:437-46. [PMID: 17480001 DOI: 10.1002/bip.20753] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Amphetamines are psychostimulants abused by man, that eventually leads to drug dependence. Amphetamine administration to rodents has been shown to provoke significant neurotoxicity involving dopaminergic nerve terminal degeneration. However, little information related to the effect of amphetamines on reactive oxygen species (ROS) production and neurotoxicity in brain is currently available. Herein we report the biochemical alterations of lipids and proteins in brain sections from amphetamine-treated rodents using infrared microspectroscopy, immunohistochemistry, and immunoblotting. The spectroscopic changes reveal for the first time the formation of beta-sheet-rich proteins in the cortex, but no significant protein alterations are visible in hippocampus region where hydroperoxide concentration is found to be lower relative to cortex. These result suggest that ROS generated by amphetamine-mediated oxidative stress induce formation beta-sheet-rich proteins which can be of amyloid beta-like character.
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[Progress in radiation therapy and integration in Tenon hospital (AP-HP) of new advances in routine practices of radiotherapy for non-small-cell lung cancer]. REVUE DE PNEUMOLOGIE CLINIQUE 2007; 63:211-22. [PMID: 17675945 DOI: 10.1016/s0761-8417(07)90126-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Much progress has been made in recent years in administration modalities for external radiotherapy of non-small-cell lung carcinoma. Three-dimensional conformal radiotherapy with or without intensity modulation, with respiratory gated radio-therapy (4D radiotherapy), and image-guided radiotherapy (IGRT) can be considered as a third revolution in radiation therapy after total dose fractionation and the development of megavoltage radiation therapy equipment. We describe progress in the three-dimensional radiotherapy technique and the integration of this technique in the department of Radiation Oncology at Tenon hospital (AP-HP).
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MESH Headings
- Carcinoma, Non-Small-Cell Lung/radiotherapy
- Dose Fractionation, Radiation
- Humans
- Image Processing, Computer-Assisted
- Imaging, Three-Dimensional
- Lung Neoplasms/radiotherapy
- Radiosurgery
- Radiotherapy Planning, Computer-Assisted
- Radiotherapy, Computer-Assisted
- Radiotherapy, Conformal
- Radiotherapy, High-Energy
- Radiotherapy, Intensity-Modulated
- Technology, Radiologic
- Tomography, Spiral Computed
- User-Computer Interface
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Influence sur les résultats des rebonds du PSA après curiethérapie de prostate: étude de 295 cas avec trois ans de suivi. Cancer Radiother 2007; 11:105-10. [PMID: 17158082 DOI: 10.1016/j.canrad.2006.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2006] [Revised: 10/12/2006] [Accepted: 10/19/2006] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess the frequency of the PSA "bouncing" phenomenon after a significant follow-up in a series of patients treated by permanent implant brachytherapy for a prostate cancer. To look for the clinical and dosimetric parameters possibly linked to this transitory secondary PSA increase. To evaluate in which percentage of cases this bouncing could have mimicked a biochemical relapse according to the ASTRO consensus criteria. PATIENTS AND METHODS From January 1999, to December 2001, 295 patients were treated by a permanent prostate implantation (real-time technique, with free (125)I seeds- Isoseed Bebig-) by the Institut Curie-Hôpital Cochin-Hôpital Necker Paris group. The mean follow-up is 40.3 months (9-66 months). The PSA level was regularly checked, at least every 6 months. We defined as a "bouncing" all increase in PSA, starting at 0.1 ng/ml, subsequently followed by a spontaneous (without any treatment) decrease, with return to the previous level or lower. We particularly focused on the patients fulfilling the criteria for a biochemical relapse according to the ASTRO consensus (Three successive increases in PSA). A multivariate analysis tried to identify independent factors among the usual clinical and dosimetric parameters. RESULTS In our series, 161 patients (55%) showed a transitory PSA increase (bouncing) of at least 0.1 ng/ml; 145 patients (49%) a bouncing of 0.2 ng/ml, 93 patients (32%) a bouncing of 0.4 ng/ml and 43 patients (15%) a bouncing of at least 1 ng/ml. Mean PSA bounce was 0.8 ng/ml (0.1-4.1), and mean time to bounce was 19 months. Thirty-two patients (11% of the total number) presented three successive PSA increases with a significant (3 months) interval between the dosages, and therefore were to be considered as being in biochemical relapse according to the ASTRO consensus criteria. Actually, among those 32 patients, 18 (56%) subsequently showed a complete normalization of their PSA, without any treatment. Ten patients went on increasing their PSA, and were considered to be really in biochemical relapse. For the last 4 patients, the situation still remains ambiguous. In multivariate analysis, age<70 years (P<0.00001) and D90>200 Gy (P<0.003) were identified as independent factors for a PSA bouncing of at least 0.4 ng/ml. CONCLUSIONS The observed rate of 32% of patients showing a PSA bouncing of at least 0.4 ng/ml in our series is in good agreement with what has been previously reported in the literature. Age<70 years and D90>200 Gy were found to be independent factors predicting for such a secondary transitory increase in PSA. Interestingly, among 32 patients fulfilling the classical criteria of the ASTRO for a biochemical relapse, 18 (56%) subsequently showed a spontaneous PSA decrease, demonstrating that the ASTRO consensus is not well adapted to the biochemical follow-up of our patients undergoing permanent implant prostate Brachytherapy.
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Abstract
OBJECTIVES Polyposis handicap evaluation through Spanish validation of the Rhinosinusitis Disability Index. MATERIAL AND METHODS Spanish validation of the Polyposis Disability Index (PDI). One hundred and fifty one patients referred to our Nose Unit in Fundación Hospital Alcorcón. The Spanish version of the PDI was administered after translation and retrotranslation. Internal consistency and reliability were established. RESULTS Spanish adaptation of the PDI and ists subscales (functional, emotional and physical) showed a high reliability and internal consistency (Cronbach's alfa: 0,90). CONCLUSIONS Spanish adaptation of the PDI is valid, reliable and can be used in a clinical setting to quantify the impact of polyposis on patient's quality of life.
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Trans-electrical nerve stimulation (TENS) for somatic tinnitus. PROGRESS IN BRAIN RESEARCH 2007; 166:389-94. [DOI: 10.1016/s0079-6123(07)66037-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Chimiothérapie et radiothérapie concomitantes ou séquentielles après chirurgie conservatrice des cancers du sein de stades I-II: résultats de l'essai clinique français de phase III randomisé ARCOSEIN. Cancer Radiother 2006. [DOI: 10.1016/j.canrad.2006.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Impact on the cosmetic outcome of concurrent administration of adjuvant chemotherapy and radiotherapy after breast-conservative surgery: Differences between patient’s and doctor’s views. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.8554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8554 Purpose: A multicenter randomized study comparing after breast-conservative surgery, sequential versus concurrent adjuvant chemotherapy (CT) with radiation therapy (RT) was initiated (ARCOSEI). After a median follow-up of 6.7 (4.3–9) years, we assessed prospectively late effects and cosmesis satisfaction of these two strategies. Methods and material: After breast-conserving surgery, patients were treated either with sequential treatment with CT first followed by RT (arm A) or CT administered concurrently with the same normofractinnated breast RT (arm B).With structured questions, 214 patients (107 in each arm) rated their satisfaction considering cosmesis, the difference in overall appearance, and specific changes of the breast. Late toxicity (LENT/SOMA scale) and cosmesis were blinded to treatment and assessed by a radiation oncologist by a qualitative scale and another semi-qualitative and semi-quantitative evaluation. Results: Subcutaneous fibrosis (SF), telangectasia (T), skin pigmentation (SP), and breast atrophy (BA) were significantly increased in arm B. Patient’s cosmesis satisfaction was not statistically different between the two arms with 92.6% of good results in arm A and 86% in arm B (p=0.72); although patients have found more important differences in the treated breast in arm B than in arm A, with 28.8% vs 14.3% of bad results, respectively. Physician’s prospective assessment found less favorable cosmesis results with concomitant treatment than with sequential one, with 40% and 15% of unsatisfaction, respectively (p=0.0014) using a semi-quantitative and qualitative scale; The use of a subjective 5-point scale found also a worse physician’s cosmesis satisfaction in arm B than in arm A (p=0.0013) Conclusion: The concurrent use of CT with RT is significantly associated with an increase incidence of grade 2 or greater late side effects. Rating of cosmesis is also subjective. Patients’ satisfaction with cosmesis is greater than the doctors’ for concomitant radiochemotherapy in breast cancer, and is not only determined by radiation late effects. With two methods, physician found a worse cosmesis outcome for concomitant radiochemotherapeutic arm. No significant financial relationships to disclose.
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La chimiothérapie concomitante de la radiothérapie augmente la toxicité tardive après chirurgie conservatrice du cancer du sein. Cancer Radiother 2006; 10:158-67. [PMID: 16632399 DOI: 10.1016/j.canrad.2006.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2006] [Revised: 03/07/2006] [Accepted: 03/14/2006] [Indexed: 11/19/2022]
Abstract
PURPOSE In 1996, a multicenter randomized study comparing after breast-conservative surgery, sequential vs concurrent adjuvant chemotherapy (CT) with radiation therapy (RT) was initiated (ARCOSEIN study). Seven hundred sixteen patients were included in this trial. After a median follow-up of 6.7 (4.3-9) years, we decided to prospectively evaluate the late effects of these two strategies. PATIENTS AND METHODS A total of 297 patients were asked to follow-up from the five larger including institutions. Seventy-two percent (214 patients) were eligible for late toxicity. After breast-conserving surgery with axillary dissection, patients were treated either with sequential treatment with CT first followed by RT (arm A) or CT administered concurrently with RT (arm B). In all patients, CT regimen combined mitoxantrone (12 mg/m(2)), 5-FU (500 mg/m(2)), and cyclophosphamide (500 mg/m(2)), 6 cycles (day 1-day 21). In arm B, patients received concurrently the first 3 cycles of CT with RT. In arm A, RT started 3 to 5 weeks after the 6th cycle of CT. Conventional RT was delivered to the whole breast using a 2 Gy-fraction protocol to a total dose of 50 Gy (+/-boost to the primary tumour bed). The assessment of toxicity was blinded to treatment and was graded by the radiation oncologist according to the LENT-SOMA scale. Skin pigmentation was also evaluated using a personal 5-points scoring system (excellent, good, moderate, poor, very poor). RESULTS Among the 214 evaluated patients, 107 were treated in each arm. The two populations were homogeneous for patients', tumors' and treatment characteristics. Subcutaneous fibrosis (SF), telengectasia (T), skin pigmentation (SP), and breast atrophy (BA) were significantly increased in arm B. Twenty patients experienced grade superior or equal to 2 (SF) in arm B vs five in arm A (P=0.003). Twenty-five and seven patients showed grade superior or equal to 2 (T) in arm B and A, respectively (P=0.001). Forty-four and twenty patients showed grade superior or equal to 2 (BA) in arm B and A, respectively (P=0.0006). Thirty patients experienced grade superior or equal to 3 (SP) in arm B vs fifteen in arm A (P=0.02). No statistical difference was observed between the two arms concerning grade superior or equal to 2 pain, breast oedema, and lymphoedema. No deaths were caused by late toxicity. CONCLUSION Following breast conserving surgery, the concurrent use of CT with RT is significantly associated with an increase incidence of grade 2 or greater late side effects.
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Impact on the cosmetic outcome of concurrent administration of adjuvant chemotherapy and radiotherapy after breast-conservative surgery: Differences between patient's and doctor's view. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80046-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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[Radiation oncology training in France: demography, analysis of motivations of the young specialists, evaluation of the training]. Cancer Radiother 2005; 9:435-43. [PMID: 16256392 DOI: 10.1016/j.canrad.2005.09.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
During the 5 past national courses organised by the French society of radiation oncology (SFRO), three different types of survey were performed to analyse demography, motivations and quality of training of the young specialists. During the 5 past years, 50 radiation oncologists were training for the whole country (about 15 per year were graduated). A recent increase the number of young specialists is observed with a total number of 50 in 2000 to 75 in 2005. Nevertheless, the number of young specialists is dramatically insufficient and exposes for the future to an important demographic crisis. Analysis of motivations of choice for radiation oncology confirms the influence of a practical stage of oncology during the second cycle of the medical studies for 60% of the young specialists. Analysis of practical and theoretical training was performed according to the point of view and living experiences of the students. On the other hand, informations from teachers were less complete. Some needs are emphased as: 1) the quality of the follow during the training (importance of the recent implementation of a logbook); 2) importance of theoretical and practical training at the radiotherapy department; 3) help and incentive for research and scientific publication.
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Lesions and dysfunctions of the nucleus basalis as Alzheimer's disease models: general and critical overview and analysis of the long-term changes in several excitotoxic models. Curr Alzheimer Res 2005; 1:189-214. [PMID: 15975067 DOI: 10.2174/1567205043332117] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The cholinergic hypothesis of Alzheimer's Disease (AD) has led to a number of animal models to study in vivo the pathogeny of cortical cholinergic involution. The lesion of the cholinergic neurons of the basal forebrain, especially of the nucleus basalis magnocellularis (nbm) of rodents, has been the most utilized method for obtaining these models. Toxic substances such as quinolic, kainic, NMDA, ibotenic and quisqualic acids, the specific cholinergic toxin AF64, amyloid, and antibodies to neurotrophic factors; etc, have been used to produce such lesions. These investigations have helped our understanding of the role of cerebral cholinergic innervation in cognitive disorders and their treatments. However, this research has provided conflicting results, and much controversy has developed surrounding the role of the cholinergic systems and the suitability of these models. It is very important to take into account the exact type of nbm/cortical lesion produced, and its evolution, if meaningful results are to be obtained. This review covers the theoretical and practical use of nbm lesion models, and examines the main positive and negative results obtained by different authors in the light of our own observations on the long-term (3 years) morphological and biochemical changes that occur in several kinds of nbm-lesion model rats. The changes seen were very different, but many of them were increased up to the end of life with no clear relationship with the development of the original lesion.
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Abstract
The ability to smell is commonly altered by head injuries. However, the nature, prevalence, prognosis and etiology of such alterations are poorly understood. Patients complaining of head-trauma and a related olfactory dysfunction typically have anosmia and rarely regain normal olfactory ability. Parosmia prevalences decreases over time in such patients, and damage to olfaction-related brain structures can be observed in most such patients using an appropriate MRI protocol. In this article, we review the recent knowledge about postraumatic anosmia.
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Abstract
OBJECTIVE To assess the nature and the number of potential adverse drug interactions by analysis of outpatient prescriptions for elderly patients, of medications taken during the week before hospitalization in a general surgery department. METHOD The study of 56 patients older than 65 years was conducted from November 2002 through February 2003. The outpatient prescriptions corresponding to medications taken during the 7 days before admission were analyzed by a pharmacy resident, who used data-processing tools and databases. RESULTS Most patients (83%) knew the reason for their prescription. Thirteen (28%) reported using over-the-counter medication. Only 89% of the patients reported complete compliance with the prescription. The average age of the patients was 72.1 +/- 6.3 years and the median was 71 years [65-91]; 43% were women and 57% men. The 257 lines of prescriptions analyzed averaged 5.7 +/- 2.6 drugs (range: 2-10) per prescription. The average number of possible interactions was 3.1 +/- 2.8 per prescription for a total of 89 listed potential interactions. The levels observed were 3 warnings (3%), 37 precautions (42%) and 49 possible adverse interactions (55%). No contraindication was noted. The drugs mentioned most often were benzodiazepines, diuretics, conversion enzyme inhibitors, angiotensin II inhibitors, and beta-blockers. The potential risks most often found were hypotension, depression of the central nervous system, hypoglycemia and acute renal failure. The drug interactions were mainly due to the accumulation of the effects of separate drug classes. Deterioration in renal function was often noted as plasma concentration of the second drug increased. DISCUSSION This exploratory study shows the reality of the iatrogenic risk for elderly patients. This analysis of outpatient prescriptions is consistent with findings in the literature. Analysis of interactions is conducted on a pairwise basis. It is thus difficult to envisage the consequences of the association of 5 or more drugs in patients with complex illnesses and diminished physiological and metabolic capacity. Patient files kept by the pharmacist could provide information about individual combinations ofthe prescription and over-the-counter drugs.
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Desarrollo de un test de screening olfatorio a partir del test de Connecticut (CCCRC). ACTA OTORRINOLARINGOLOGICA ESPANOLA 2005; 56:116-21. [PMID: 15819519 DOI: 10.1016/s0001-6519(05)78585-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To create a screening olfactory test based on the CCCRC (Connecticut Chemosen-sory Clinical Research Center). MATERIAL AND METHODS We compare the screening test based on CCCRC with PST (Pocket Smell Test) based on UPSIT in 40 patients with nasal poliposis, in order to de-termine the specificity, sensitivity, positive predictive and negative predictive value. The validity index was 95% and accuracy rate was 10%. We determine unit cost, the time required to perform the test in outpatients office and how difficult it is to do the test. RESULTS Sensibility was 88%, specificity was 77%. The positive predictive value was 34% and the negative predictive value was 94%. The unitary cost of our screening test was 0.57 euros when it is performed by a nurse. The unitary cost of PST is 1.76 euros. To perform our screening test took 2.8 +/- 0.4 minutes. The 96% of the patients thought the test was easy to do. CONCLUSION Our test is a valid screening test to be used in patients with nasal poliposis.
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Chronic nicotine administration increases NGF-like immunoreactivity in frontoparietal cerebral cortex. J Neurosci Res 2003; 73:708-16. [PMID: 12929138 DOI: 10.1002/jnr.10688] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Nicotine/nicotine agonists, which have been proposed as therapeutic agents for the treatment of Alzheimer's disease and other neurodegenerative disorders, produce a wide variety of effects on the nervous system. Some mechanisms involved remain poorly understood. In this work, immunohistochemical techniques were used to determine the effect of nicotine on nerve growth factor (NGF) in the frontoparietal (motor, somatosensory) brain cortex of the albino rat. Nicotine was chronically administered intraperitoneally using osmotic pumps (0.35 mg nicotine base/kg body weight/day for 14 days). An increase in the number and the immunoreaction intensity of NGF-like positive pyramidal and nonpyramidal neurons of these cortical areas was observed after treatment. Immunopositive astroglial cells were always seen in sections of treated animals but not in controls. The neuropil of control animals was, in general, devoid of reaction, but in treated animals, immunopositive prolongations were located randomly, some in close association with capillaries. At the electron microscopic level, these prolongations were demonstrated as belonging to neurons (dendrites and axons) and astroglial cells. Nicotinic activation of selected neurons and glial cells seems to trigger NGF/neurotrophic mechanisms, suggesting their use may be of benefit in prevention and treatment of neurodegenerative diseases.
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[Multi-sensory interaction in tinnitus: visual evoked potentials and somatosensory stimulation]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2003; 54:329-36. [PMID: 12916476 DOI: 10.1016/s0001-6519(03)78421-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Anomalous cross-modal interactions along the audiovestibular, visual and soma-tosensorial pathways could be the responsible for aberrant signals, clinically expressed as phantom perceptions. This results in tinnitus that can be modified by gaze movements or somatosensorial stimulation through skin, orofacial (jaw) and cervical movements. This phenomenon has also been described in some patients with acute unilateral deafferentation of the auditory peripheral system as a result of surgery to remove a tumour in the posterior fossal. Neuroimaging preliminary studies (PET, f-MRI) describe multisensorial interactions and cortical reorganisation processes in chronic tinnitus. Treatment approaches are still unknown although counselling regarding the benignity of the process and the high percentage of habituation to the symptom is the most effective framework. We present our experience in four cases.
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Abstract
OBJECTIVES Description of the epidemiological and clinical characteristics of hyperacusis in a tinnitus clinic unit. STUDY DESIGN Transversal descriptive. PATIENTS Two hundred and fifty patients referred to our Tinnitus Unit a Teaching Hospital, between January 1999 and December 2000. OUTCOME MEASURES Questionnaires to evaluate hyperacusis and tinnitus interference in life quality. Epidemiological and audiological data as well as tinnitus characteristics in hyperacustic patients are reported. RESULTS Sixty three percent of the patients showed hyperacusis according to sound threshold level. Hearing loss was present in 83%. Discomfort with background noise was referred in 54% of cases and 52% avoided at least one daily activity because of this discomfort. Tinnitus in hyperacusis population showed a disability level of 47% using the Tinnitus Handicap Inventory (THI). CONCLUSIONS A physiopathological relation between tinnitus and hyperacusis could be explained by the high prevalence of both symptoms in the same population. It is necessary to agree in the criteria to define hyperacusis as well as for the evaluation of its effect in quality of life. The tinnitus retraining therapy (TRT) is the more accepted hyperacusis treatment approach in the literature.
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Abstract
OBJECTIVE To know the values of the olfactory test (CCCRC) performed in healthy people. To analyse how the age and sex affect the test. MATERIAL AND METHODS Descriptive study in 100 volunteers with no olfactory disorders. We used CCCRC olfactory test, which it has an odor threshold component, an odor identification component and a composite score. We analysed how age and sex variables affect olfactory test data, listing a t-Student test. The size sample is calculated to 0.05 alfa error. RESULTS Threshold test data mean was 5.8. Identification test data mean was 7.5. Composite score mean was 6.7. CONCLUSION Age is a significant factor in our study but not sex. Sample size is sufficient to analyze normal values. Our results are similar to other authors.
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Aneurisma de arteria basilar: a propósito de un caso. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2003; 54:533-7. [PMID: 14671927 DOI: 10.1016/s0001-6519(03)78446-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
We present a case of a patient with vertigo, disequilibrium and facial palsy. Nistagmus features pointed to a diagnosis of central vertigo. MRI showed a basilar aneurysm that compressed the brain stem and caused a stroke. We review the diagnosis.
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[Innervation of the lachrymal gland in patients with primary Sjögren's syndrome. An immunohistopathological study]. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2002; 77:623-29. [PMID: 12410409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
PURPOSE Histopathological parameters of the main lachrymal gland from patients with primary Sjögren's syndrome (SS1) were investigated, and the relation between morphological and immunohistochemical changes in the innervation of lachrymal gland in patients with SS1, as well as the immunopathological differences between SS1, non-autoimmune keratoconjunctivitis sicca (KCS) and controls were analysed. METHODS Lachrymal glands from patients with SS1, KCS and control subjects were biopsied and examined using standard transmission electron microscopic techniques and an immunohistochemical method (vasoactive intestinal polypeptide-VIP). RESULTS Moderate numbers of myelinated and non-myelinated nerve fibres were found in the connective tissue around lachrymal glands in patients with SS1. Non-myelinated nerve fibres made contact with glandular epithelium, myoepithelial cells, vascular endothelium, plasma cells and fibroblasts. Patients with non-immunological KCS had similar characteristics as SS1 in number and activity, showing a normal morphological pattern. Control subjects showed a higher number of active nerve fibres. CONCLUSION Main lachrymal gland from patients with SS1 were therefore definitively innervated with moderate activity and normal structures. The ultrastructural study demonstrated there were no statistical differences with respect to patients with non-autoimmune KCS. Immunohistochemical studies showed a similar VIP activity in lachrymal gland between patients with SS1 and KCS, but there was a significant decrease in the innervation activity with regard to control subjects. All this implies that the autoimmunological factor in patients with SS1 does not significantly affect the lachrymal gland innervation.
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