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Martinez JS, Grégoire E, Fernandez P, Dugué D, Jikia D, Gruel G. Twenty-two years later: consistent dose estimation of an accidental overexposure by retrospective biological dosimetry. Radiat Prot Dosimetry 2023; 199:1572-1577. [PMID: 37721056 DOI: 10.1093/rpd/ncac260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 10/21/2022] [Accepted: 11/16/2022] [Indexed: 09/19/2023]
Abstract
The goal of this study was to retrospectively estimate the exposure dose of a victim from the Lilo radiological accident in Georgia after 22 y and compare it with the original cytogenetics-based analysis performed in our laboratory. Similar types of studies have been published, notably involving victims of the Chernobyl, Goiânia and Tammiku accidents. Nevertheless, their estimations were done after shorter periods of time post-exposure, and in some cases, the exposure might not have been exclusively of an external nature. In this study, Fluorescence In Situ Hybridization (FISH) was used to score chromosomal translocations in lymphocytes from a recent blood sample of the victim and the dose assessment was performed using our laboratory's FISH calibration curve. The resulting whole-body exposure dose of 0.35 Gy [0.12, 0.72] was similar to the one obtained when reanalysing the original scoring data from 1997 (0.38 Gy [0.13-0.75]), suggesting that our current calibration curve could be used for relative dose estimations long time after external exposure.
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Affiliation(s)
- J S Martinez
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc, Fontenay-aux-Roses 92262, France
| | - E Grégoire
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc, Fontenay-aux-Roses 92262, France
| | - P Fernandez
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc, Fontenay-aux-Roses 92262, France
| | - D Dugué
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc, Fontenay-aux-Roses 92262, France
| | - D Jikia
- Department of General Surgery, Tbilisi State Medical University (TSMU), 33, Vazha-Pshavela ave. 0186, Tbilisi 0186, Georgia
| | - G Gruel
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-Santé, SERAMED, LRAcc, Fontenay-aux-Roses 92262, France
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Benderitter M, Herrera-Reyes E, Gigov Y, Souleau B, Huet JC, Trompier F, Fagot T, Grégoire E, Malfuson JV, Konopacki-Potet J, Buglova E, Lataillade JJ, Tamarat R, Gourmelon P, de Revel T. Hematopoietic Recovery using Multi-Cytokine Therapy in 8 Patients Presenting Radiation-Induced Myelosuppression after Radiological Accidents. Radiat Res 2021; 196:668-679. [PMID: 34554263 DOI: 10.1667/rade-21-00169.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 08/27/2021] [Indexed: 11/03/2022]
Abstract
Treatment of accidental radiation-induced myelosuppression is primarily based on supportive care and requires specific treatment based on hematopoietic growth factors injection or hematopoietic cell transplantation for the most severe cases. The cytokines used consisted of pegylated erythropoietin (darbepoetin alfa) 500 IU once per week, pegylated G-CSF (pegfilgrastim) 6 mg × 2 once, stem cell factor 20 μg.kg-1 for five days, and romiplostim (TPO analog) 10 μg.kg-1 once per week, with different combinations depending on the accidents. As the stem cell factor did not have regulatory approval for clinical use in France, the French regulatory authorities (ANSM, formerly, AFSSAPS) approved their compassionate use as an investigational drug "on a case-by-case basis". According to the evolution and clinical characteristics, each patient's treatment was adopted on an individual basis. Daily blood count allows initiating G-CSF and SCF delivery when granulocyte <1,000/mm3, TPO delivery when platelets <50,000/mm3, and EPO when Hb<80 g/L. The length of each treatment was based on blood cell recovery criteria. The concept of "stimulation strategy" is linked to each patient's residual hematopoiesis, which varies among them, depending on the radiation exposure's characteristics and heterogeneity. This paper reports the medical management of 8 overexposed patients to ionizing radiation. The recovery of bone marrow function after myelosuppression was accelerated using growth factors, optimized by multiple-line combinations. Particularly in the event of prolonged exposure to ionizing radiation in dose ranges inducing severe myelosuppression (in the order of 5 to 8 Gy), with no indication of hematopoietic stem cell transplantation.
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Affiliation(s)
- Marc Benderitter
- Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France
| | - Eduardo Herrera-Reyes
- Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France
| | - Yvan Gigov
- Military Hospital, Department of Hematology and Chemotherapy for Solid Tumors, Sofia, Bulgaria
| | - Bertrand Souleau
- Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France
| | - Jean Christelle Huet
- Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France
| | - François Trompier
- Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France
| | - Thierry Fagot
- Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France
| | - Eric Grégoire
- Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France
| | - Jean Valère Malfuson
- Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France.,Blood Transfusion Center, Percy Armed Forces Hospital, 101 avenue Henri Barbusse, 92140 Clamart, France
| | | | - Elena Buglova
- International Atomic Energy Agency, Wagramerstrasse 5, A-1400 Vienna, Austria
| | - Jean-Jacques Lataillade
- Ecole du Val de Grâce, 75005 Paris, France.,Blood Transfusion Center, Percy Armed Forces Hospital, 101 avenue Henri Barbusse, 92140 Clamart, France
| | - Radia Tamarat
- Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France
| | - Patrick Gourmelon
- Institute of Radioprotection and Nuclear Safety (IRSN), Health Division, BP17, 92262 Fontenay-aux-Roses, France
| | - Thierry de Revel
- Percy Armed Forces Hospital, Department of Hematology, 92140 Clamart, France.,Ecole du Val de Grâce, 75005 Paris, France
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Manceau G, Sabbagh C, Mege D, Lakkis Z, Bege T, Tuech JJ, Benoist S, Lefèvre JH, Karoui M, Bridoux V, Venara A, Beyer‐Berjot L, Codjia T, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Rullier E, Tresallet C, Tetard O, Rivier P, Fayssal E, Collard M, Moszkowicz D, Lupinacci R, Peschaud F, Etienne JC, Loge L, Bege T, Corte H, D’Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, Villeon B, Pautrat K, Eveno C, Abdalla S, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Panis Y, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K, Voron T, Parc Y. Colon sparing resection versus extended colectomy for left-sided obstructing colon cancer with caecal ischaemia or perforation: a nationwide study from the French Surgical Association. Colorectal Dis 2020; 22:1304-1313. [PMID: 32368856 DOI: 10.1111/codi.15111] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 04/02/2020] [Indexed: 02/08/2023]
Abstract
AIM It is not known whether patients with obstructive left colon cancer (OLCC) with caecal ischaemia or diastatic perforation (defined as a blowout of the caecal wall related to colonic overdistension) should undergo a (sub)total colectomy (STC) or an ileo-caecal resection with double-barrelled ileo-colostomy. We aimed to compare the results of these two strategies. METHOD From 2000 to 2015, 1220 patients with OLCC underwent surgery by clinicians who were members of the French Surgical Association. Of these cases, 201 (16%) were found to have caecal ischaemia or diastatic perforation intra-operatively: 174 patients (87%) underwent a STC (extended colectomy group) and 27 (13%) an ileo-caecal resection with double-end stoma (colon-sparing group). Outcomes were compared retrospectively. RESULTS In the extended colectomy group, 95 patients (55%) had primary anastomosis and 79 (45%) had a STC with an end ileostomy. In the colon-sparing group, 10 patients (37%) had simultaneous resection of their primary tumour with segmental colectomy and an anastomosis which was protected by a double-barrelled ileo-colostomy. The demographic data for the two groups were comparable. Median operative time was longer in the STC group (P = 0.0044). There was a decrease in postoperative mortality (7% vs 12%, P = 0.75) and overall morbidity (56% vs 67%, P = 0.37) including surgical (30% vs 40%, P = 0.29) and severe complications (17% vs 27%, P = 0.29) in the colon-sparing group, although these differences did not reach statistical significance. Cumulative morbidity included all surgical stages and the rate of permanent stoma was 66% and 37%, respectively, with no significant difference between the two groups. Overall survival and disease-free survival were similar between the two groups. CONCLUSION The colon-sparing strategy may represent a valid and safe alternative to STC in OLCC patients with caecal ischaemia or diastatic perforation.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - C Sabbagh
- Department of Digestive Surgery, Amiens University Hospital, Amiens, France
| | - D Mege
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Marseille, Timone University Hospital, Marseille, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - T Bege
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, North University Hospital, Marseille, France
| | - J J Tuech
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - S Benoist
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Bicêtre University Hospital, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - J H Lefèvre
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Sorbonne Université, Paris, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique-Hôpitaux de Paris, Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
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Manceau G, Mege D, Bridoux V, Lakkis Z, Venara A, Voron T, De Angelis N, Ouaissi M, Sielezneff I, Karoui M, Dazza M, Gagnat G, Hamel S, Mallet L, Martre P, Philouze G, Roussel E, Tortajada P, Dumaine AS, Heyd B, Paquette B, Brunetti F, Esposito F, Lizzi V, Michot N, Denost Q, Tresallet C, Tetard O, Regimbeau JM, Sabbagh C, Rivier P, Fayssal E, Collard M, Moszkowicz D, Peschaud F, Etienne JC, loge L, Beyer L, Bege T, Corte H, D'Annunzio E, Humeau M, Issard J, Munoz N, Abba J, Jafar Y, Lacaze L, Sage PY, Susoko L, Trilling B, Arvieux C, Mauvais F, Ulloa‐Severino B, Lefevre JH, Pitel S, Vauchaussade de Chaumont A, Badic B, Blanc B, Bert M, Rat P, Ortega‐Deballon P, Chau A, Dejeante C, Piessen G, Grégoire E, Alfarai A, Cabau M, David A, Kadoche D, Dufour F, Goin G, Goudard Y, Pauleau G, Sockeel P, De la Villeon B, Pautrat K, Eveno C, Brouquet A, Couchard AC, Balbo G, Mabrut JY, Bellinger J, Bertrand M, Aumont A, Duchalais E, Messière AS, Tranchart A, Cazauran JB, Pichot‐Delahaye V, Dubuisson V, Maggiori L, Djawad‐Boumediene B, Fuks D, Kahn X, Huart E, Catheline JM, Lailler G, Baraket O, Baque P, Diaz de Cerio JM, Mariol P, Maes B, Fernoux P, Guillem P, Chatelain E, de Saint Roman C, Fixot K. Thirty-day mortality after emergency surgery for obstructing colon cancer: survey and dedicated score from the French Surgical Association. Colorectal Dis 2019; 21:782-790. [PMID: 30884089 DOI: 10.1111/codi.14614] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/27/2019] [Indexed: 02/08/2023]
Abstract
AIM The aim was to define risk factors for postoperative mortality in patients undergoing emergency surgery for obstructing colon cancer (OCC) and to propose a dedicated score. METHOD From 2000 to 2015, 2325 patients were treated for OCC in French surgical centres by members of the French National Surgical Association. A multivariate analysis was performed for variables with P value ≤ 0.20 in the univariate analysis for 30-day mortality. Predictive performance was assessed by the area under the receiver operating characteristic curve. RESULTS A total of 1983 patients were included. Thirty-day postoperative mortality was 7%. Multivariate analysis found five significant independent risk factors: age ≥ 75 (P = 0.013), American Society of Anesthesiologists (ASA) score ≥ III (P = 0.027), pulmonary comorbidity (P = 0.0002), right-sided cancer (P = 0.047) and haemodynamic failure (P < 0.0001). The odds ratio for risk of postoperative death was 3.42 with one factor, 5.80 with two factors, 15.73 with three factors, 29.23 with four factors and 77.25 with five factors. The discriminating capacity in predicting 30-day postoperative mortality was 0.80. CONCLUSION Thirty-day postoperative mortality after emergency surgery for OCC is correlated with age, ASA score, pulmonary comorbidity, site of tumour and haemodynamic failure, with a specific score ranging from 0 to 5.
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Affiliation(s)
- G Manceau
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - D Mege
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - V Bridoux
- Department of Digestive Surgery, Charles Nicolle University Hospital, Rouen, France
| | - Z Lakkis
- Department of Digestive Surgery, Besançon University Hospital, Besançon, France
| | - A Venara
- Department of Digestive Surgery, Angers University Hospital, Angers, France
| | - T Voron
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Saint Antoine Hospital, Sorbonne Université, Paris, France
| | - N De Angelis
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Henri Mondor Hospital, Université Paris-Est (UEP), Créteil, France
| | - M Ouaissi
- Department of Digestive Surgery, Tours University Hospital, Tours, France
| | - I Sielezneff
- Department of Digestive Surgery, Timone University Hospital, Marseille, France
| | - M Karoui
- Department of Digestive Surgery, Assistance Publique Hôpitaux de Paris, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
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Guéguen Y, Priest ND, Dublineau I, Bannister L, Benderitter M, Durand C, Ebrahimian TG, Grégoire E, Grison S, Ibanez C, Legendre A, Lestaevel P, Roch-Lefèvre S, Roy L, Tack K, Wyatt H, Leblanc J, Jourdain JR, Klokov D. In vivo animal studies help achieve international consensus on standards and guidelines for health risk estimates for chronic exposure to low levels of tritium in drinking water. Environ Mol Mutagen 2018; 59:586-594. [PMID: 30151952 DOI: 10.1002/em.22200] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 03/06/2018] [Accepted: 04/08/2018] [Indexed: 06/08/2023]
Abstract
Existing and future nuclear fusion technologies involve the production and use of large quantities of tritium, a highly volatile, but low toxicity beta-emitting isotope of hydrogen. Tritium has received international attention because of public and scientific concerns over its release to the environment and the potential health impact of its internalization. This article provides a brief summary of the current state of knowledge of both the biological and regulatory aspects of tritium exposure; it also explores the gaps in this knowledge and provides recommendations on the best ways forward for improving our understanding of the health effects of low-level exposure to it. Linking health effects specifically to tritium exposure is challenging in epidemiological studies due to high uncertainty in tritium dosimetry and often suboptimal cohort sizes. We therefore argued that limits for tritium in drinking water should be based on evidence derived from controlled in vivo animal tritium toxicity studies that use realistically low levels of tritium. This article presents one such mouse study, undertaken within an international collaboration, and discusses the implications of its main findings, such as the similarity of the biokinetics of tritiated water (HTO) and organically bound tritium (OBT) and the higher biological effectiveness of OBT. This discussion is consistent with the position expressed in this article that in vivo animal tritium toxicity studies carried out within large, multi-partner collaborations allow evaluation of a great variety of health-related endpoints and essential to the development of international consensus on the regulation of tritium levels in the environment. Environ. Mol. Mutagen. 59:586-594, 2018. © 2018 The Authors Environmental and Molecular Mutagenesis published by Wiley Periodicals, Inc. on behalf of Environmental Mutagen Society.
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Affiliation(s)
- Yann Guéguen
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Nicholas D Priest
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk-River, ON, Canada
| | - Isabelle Dublineau
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Laura Bannister
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk-River, ON, Canada
| | - Marc Benderitter
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Christelle Durand
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Teni G Ebrahimian
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Eric Grégoire
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Stéphane Grison
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Chrystelle Ibanez
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Audrey Legendre
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Philippe Lestaevel
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Sandrine Roch-Lefèvre
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Laurence Roy
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Karine Tack
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Heather Wyatt
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk-River, ON, Canada
| | - Julie Leblanc
- Canadian Nuclear Safety Commission, Ottawa, ON, Canada
| | - Jean-René Jourdain
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PSE-SAN, Fontenay-aux-Roses, France
| | - Dmitry Klokov
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk-River, ON, Canada
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON, Canada
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Roch-Lefèvre S, Grégoire E, Martin-Bodiot C, Flegal M, Fréneau A, Blimkie M, Bannister L, Wyatt H, Barquinero JF, Roy L, Benadjaoud M, Priest N, Jourdain JR, Klokov D. Cytogenetic damage analysis in mice chronically exposed to low-dose internal tritium beta-particle radiation. Oncotarget 2018; 9:27397-27411. [PMID: 29937993 PMCID: PMC6007944 DOI: 10.18632/oncotarget.25282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 03/23/2018] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to carry out a comprehensive examination of potential genotoxic effects of low doses of tritium delivered chronically to mice and to compare these effects to the ones resulting from equivalent doses of gamma-irradiation. Mice were chronically exposed for one or eight months to either tritiated water (HTO) or organically bound tritium (OBT) in drinking water at concentrations of 10 kBq/L, 1 MBq/L or 20 MBq/L. Dose rates of internal β-particle resulting from such tritium treatments were calculated and matching external gamma-exposures were carried out. We measured cytogenetic damage in bone marrow and in peripheral blood lymphocytes (PBLs) and the cumulative tritium doses (0.009 - 181 mGy) were used to evaluate the dose-response of OBT in PBLs, as well as its relative biological effectiveness (RBE). Neither tritium, nor gamma exposures produced genotoxic effects in bone marrow. However, significant increases in chromosome damage rates in PBLs were found as a result of chronic OBT exposures at 1 and 20 M Bq/L, but not at 10 kBq/L. When compared to an external acute gamma-exposure ex vivo, the RBE of OBT for chromosome aberrations induction was evaluated to be significantly higher than 1 at cumulative tritium doses below 10 mGy. Although found non-existent at 10 kBq/L (the WHO limit), the genotoxic potential of low doses of tritium (>10 kBq/L), mainly OBT, may be higher than currently assumed.
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Affiliation(s)
- Sandrine Roch-Lefèvre
- Institut de Radioprotection et de Sûreté Nucléaire, IRSN, Pôle Santé et Environnement, Direction de la Santé, Fontenay-aux-Roses, France
| | - Eric Grégoire
- Institut de Radioprotection et de Sûreté Nucléaire, IRSN, Pôle Santé et Environnement, Direction de la Santé, Fontenay-aux-Roses, France
| | - Cécile Martin-Bodiot
- Institut de Radioprotection et de Sûreté Nucléaire, IRSN, Pôle Santé et Environnement, Direction de la Santé, Fontenay-aux-Roses, France
| | - Matthew Flegal
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Amélie Fréneau
- Institut de Radioprotection et de Sûreté Nucléaire, IRSN, Pôle Santé et Environnement, Direction de la Santé, Fontenay-aux-Roses, France
| | - Melinda Blimkie
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Laura Bannister
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Heather Wyatt
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Joan-Francesc Barquinero
- Present address at: Autonomous University of Barcelona, Faculty of Biosciences, Cerdanyola del Vallès, Spain
| | - Laurence Roy
- Institut de Radioprotection et de Sûreté Nucléaire, IRSN, Pôle Santé et Environnement, Direction de la Santé, Fontenay-aux-Roses, France
| | - Mohamed Benadjaoud
- Institut de Radioprotection et de Sûreté Nucléaire, IRSN, Pôle Santé et Environnement, Direction de la Santé, Fontenay-aux-Roses, France
| | - Nick Priest
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
| | - Jean-René Jourdain
- Institut de Radioprotection et de Sûreté Nucléaire, IRSN, Direction des Affaires Internationales, Fontenay-aux-Roses, France
| | - Dmitry Klokov
- Radiobiology and Health, Canadian Nuclear Laboratories, Chalk River, Ontario, Canada
- Department of Biochemistrty, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
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Grégoire E, Roy L, Buard V, Delbos M, Durand V, Martin-Bodiot C, Voisin P, Sorokine-Durm I, Vaurijoux A, Voisin P, Baldeyron C, Barquinero JF. Twenty years of FISH-based translocation analysis for retrospective ionizing radiation biodosimetry. Int J Radiat Biol 2018; 94:248-258. [DOI: 10.1080/09553002.2018.1427903] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Eric Grégoire
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - Laurence Roy
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - Valérie Buard
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - Martine Delbos
- Institut Fédératif de Biologie, CHU Toulouse Purpan, Toulouse, France
| | - Valérie Durand
- Bureau des Etudes Biomédicales chez l’Animal, Commissariat à l’Energie Atomique, Fontenay-aux-Roses, France
| | - Cécile Martin-Bodiot
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - Pascale Voisin
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - Irène Sorokine-Durm
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - Aurélie Vaurijoux
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - Philippe Voisin
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
| | - Céline Baldeyron
- Laboratoire de Radiobiologie des expositions Accidentelles, Institut de Radioprotection et de Sureté Nucléaire (IRSN), Fontenay-aux-Roses Cedex, France
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Mohkam K, Farges O, Vibert E, Soubrane O, Adam R, Pruvot FR, Regimbeau JM, Adham M, Boleslawski E, Mabrut JY, Ducerf C, Pradat P, Darnis B, Cazauran JB, Lesurtel M, Dokmak S, Aussilhou B, Dondero F, Allard MA, Ciacio O, Pittau G, Cherqui D, Castaing D, Sa Cunha A, Truant S, Hardwigsen J, Le Treut YP, Grégoire E, Scatton O, Brustia R, Sepulveda A, Cosse C, Laurent C, Adam JP, El Bechwaty M, Perinel J. Risk score to predict biliary leakage after elective liver resection. Br J Surg 2017; 105:128-139. [DOI: 10.1002/bjs.10647] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 05/29/2017] [Accepted: 06/11/2017] [Indexed: 12/31/2022]
Abstract
Abstract
Background
Biliary leakage remains a major cause of morbidity after liver resection. Previous prognostic studies of posthepatectomy biliary leakage (PHBL) lacked power, population homogeneity, and model validation. The present study aimed to develop a risk score for predicting severe PHBL.
Methods
In this multicentre observational study, patients who underwent liver resection without hepaticojejunostomy in one of nine tertiary centres between 2012 and 2015 were randomly assigned to a development or validation cohort in a 2 : 1 ratio. A model predicting severe PHBL (International Study Group of Liver Surgery grade B/C) was developed and further validated.
Results
A total of 2218 procedures were included. PHBL of any severity and severe PHBL occurred in 141 (6·4 per cent) and 92 (4·1 per cent) patients respectively. In the development cohort (1475 patients), multivariable analysis identified blood loss of at least 500 ml, liver remnant ischaemia time 45 min or more, anatomical resection including segment VIII, transection along the right aspect of the left intersectional plane, and associating liver partition and portal vein ligation for staged hepatectomy as predictors of severe PHBL. A risk score (ranging from 0 to 5) was built using the development cohort (area under the receiver operating characteristic curve (AUROC) 0·79, 95 per cent c.i. 0·74 to 0·85) and tested successfully in the validation cohort (AUROC 0·70, 0·60 to 0·80). A score of at least 3 predicted an increase in severe PHBL (19·4 versus 2·6 per cent in the development cohort, P < 0·001; 15 versus 3·1 per cent in the validation cohort, P < 0·001).
Conclusion
The present risk score reliably predicts severe PHBL. It represents a multi-institutionally validated prognostic tool that can be used to identify a subset of patients at high risk of severe PHBL after elective hepatectomy.
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Affiliation(s)
- K Mohkam
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Ecole Doctorale Interdisciplinaire Sciences Santé 205 – Equipe Mixte de Recherche 3738, Université Lyon 1, Lyon, France
| | - O Farges
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital Beaujon, Clichy, France
| | - E Vibert
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital Paul Brousse, Villejuif, France
| | - O Soubrane
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital Beaujon, Clichy, France
| | - R Adam
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital Paul Brousse, Villejuif, France
| | - F-R Pruvot
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital Claude Huriez, Lille, France
| | - J-M Regimbeau
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - M Adham
- Department of Hepatopancreatobiliary Surgery, Hôpital Edouard Herriot, Lyon, France
| | - E Boleslawski
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital Claude Huriez, Lille, France
| | - J-Y Mabrut
- Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Ecole Doctorale Interdisciplinaire Sciences Santé 205 – Equipe Mixte de Recherche 3738, Université Lyon 1, Lyon, France
| | - C Ducerf
- Hôpital de la Croix-Rousse, Lyon, France
| | - P Pradat
- Hôpital de la Croix-Rousse, Lyon, France
| | - B Darnis
- Hôpital de la Croix-Rousse, Lyon, France
| | | | - M Lesurtel
- Hôpital de la Croix-Rousse, Lyon, France
| | | | | | | | | | - O Ciacio
- Hôpital Paul Brousse, Villejuif, France
| | - G Pittau
- Hôpital Paul Brousse, Villejuif, France
| | - D Cherqui
- Hôpital Paul Brousse, Villejuif, France
| | | | | | - S Truant
- Hôpital Claude Huriez, Lille, France
| | | | | | | | - O Scatton
- Hôpital de la Pitié-Salpétrière, Paris, France
| | - R Brustia
- Hôpital de la Pitié-Salpétrière, Paris, France
| | - A Sepulveda
- Hôpital de la Pitié-Salpétrière, Paris, France
| | - C Cosse
- Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - C Laurent
- Hôpital Haut-Lévêque, Bordeaux, France
| | - J-P Adam
- Hôpital Haut-Lévêque, Bordeaux, France
| | | | - J Perinel
- Hôpital Edouard Herriot, Lyon, France
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9
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Hallet J, Sa Cunha A, Adam R, Goéré D, Bachellier P, Azoulay D, Ayav A, Grégoire E, Navarro F, Pessaux P. Factors influencing recurrence following initial hepatectomy for colorectal liver metastases. Br J Surg 2016; 103:1366-76. [PMID: 27306949 DOI: 10.1002/bjs.10191] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 01/11/2016] [Accepted: 03/09/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Data on recurrence patterns following hepatectomy for colorectal liver metastases (CRLMs) and their impact on long-term outcomes are limited in the setting of modern multimodal management. This study sought to characterize the patterns of, factors associated with, and survival impact of recurrence following initial hepatectomy for CRLMs. METHODS A retrospective cohort study of patients undergoing initial hepatectomy for CRLMs at 39 institutions (2006-2013) was conducted. Kaplan-Meier methods were used for survival analyses. Overall survival landmark analysis at 12 months after hepatectomy was performed to compare groups based on recurrence. Multivariable Cox and regression models were used to determine factors associated with recurrence. RESULTS Among 2320 patients, tumours recurred in 47·4 per cent at median of 10·1 (range 0-88) months; 89·1 per cent of recurrences developed within 3 years. Recurrence was intrahepatic in 46·2 per cent, extrahepatic in 31·8 per cent and combined intra/extrahepatic in 22·0 per cent. The 5-year overall survival rate decreased from 74·3 (95 per cent c.i. 72·2 to 76·4) per cent without recurrence to 57·5 (55·0 to 60·0) per cent with recurrence (adjusted hazard ratio (HR) 3·08, 95 per cent c.i. 2·31 to 4·09). After adjusting for clinicopathological variables, prehepatectomy factors associated with increased risk of recurrence were node-positive primary tumour (HR 1·27, 1·09 to 1·49), more than three liver metastases (HR 1·27, 1·06 to 1·52) and largest metastasis greater than 4 cm (HR 1·19; 1·01 to 1·43). CONCLUSION Recurrence after CRLM resection remains common. Although overall survival is inferior with recurrence, excellent survival rates can still be achieved.
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Affiliation(s)
- J Hallet
- Institut Hospitalo-Universitaire, Institute for Minimally Hybrid Invasive Image-Guided Surgery, Université de Strasbourg, Strasbourg, France.,Institut de Recherche sur les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France.,Division of General Surgery, Sunnybrook Health Sciences Center - Odette Cancer Center, Toronto, Ontario, Canada
| | - A Sa Cunha
- Department of Surgery, Hôpital Paul Brousse, Villejuif, France
| | - R Adam
- Department of Surgery, Hôpital Paul Brousse, Villejuif, France
| | - D Goéré
- Department of Surgery, Institut Gustave Roussy, Villejuif, France
| | - P Bachellier
- Department of Surgery, Hôpital Hautepierre, Strasbourg, France
| | - D Azoulay
- Department of Surgery, Hôpital Henri Mondor, Créteil, France
| | - A Ayav
- Department of Surgery, Hôpital de Brabois, Centre Régional Hospitalier Universitaire de Nancy, Nancy, France
| | - E Grégoire
- Department of Surgery, Hôpital de la Timone, Marseilles, France
| | - F Navarro
- Department of Surgery, Université de Montpellier, Hôpital Saint-Eloi, Montpellier, France
| | - P Pessaux
- Institut Hospitalo-Universitaire, Institute for Minimally Hybrid Invasive Image-Guided Surgery, Université de Strasbourg, Strasbourg, France.,Institut de Recherche sur les Cancers de l'Appareil Digestif (IRCAD), Strasbourg, France.,General Digestive and Endocrine Surgery, Nouvel Hôpital Civil, Strasbourg, France
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Roch-Lefèvre S, Martin-Bodiot C, Grégoire E, Desbrée A, Roy L, Barquinero JF. A mouse model of cytogenetic analysis to evaluate caesium137 radiation dose exposure and contamination level in lymphocytes. Radiat Environ Biophys 2016; 55:61-70. [PMID: 26781448 DOI: 10.1007/s00411-015-0620-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 09/18/2015] [Indexed: 06/05/2023]
Abstract
In case of external overexposure to ionizing radiation, an estimation of its genotoxic effects on exposed individuals can be made retrospectively by the measurement of radiation-induced chromosome aberrations on circulating lymphocytes. Compared with external irradiation, intakes of radionuclides may, however, lead to specific features influencing dose distribution at the scale of body, of tissue or even of cell. Therefore, in case of internal contamination by radionuclides, experimental studies, particularly using animal models, are required to better understand mechanisms of their genotoxic effects and to better estimate the absorbed dose. The present study was designed to evaluate a cytogenetic method in mouse peripheral blood lymphocytes that would allow determination of yields and complexities of chromosome aberrations after low-dose rate exposure to (137)Cs delivered in vitro either by irradiation or by contamination. By using M-FISH analysis, we compared the low-dose rate responses observed in mouse to the high-dose rate responses observed both in mouse and in human. Promising similarities between the two species in the relative biological effect evaluation show that our cytogenetic model established in mouse might be useful to evaluate various radiation exposures, particularly relevant in case of intakes of radionuclides.
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Affiliation(s)
- Sandrine Roch-Lefèvre
- Laboratoire de Dosimétrie Biologique (PRP-HOM/SRBE/LDB), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 92262, Fontenay aux Roses Cedex, France.
| | - Cécile Martin-Bodiot
- Laboratoire de Dosimétrie Biologique (PRP-HOM/SRBE/LDB), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 92262, Fontenay aux Roses Cedex, France
| | - Eric Grégoire
- Laboratoire de Dosimétrie Biologique (PRP-HOM/SRBE/LDB), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 92262, Fontenay aux Roses Cedex, France
| | - Aurélie Desbrée
- PRP-HOM/SDI, Laboratoire d'Evaluation de la Dose Interne, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 92262, Fontenay aux Roses Cedex, France
| | - Laurence Roy
- Laboratoire de Dosimétrie Biologique (PRP-HOM/SRBE/LDB), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 92262, Fontenay aux Roses Cedex, France
| | - Joan Francesc Barquinero
- Laboratoire de Dosimétrie Biologique (PRP-HOM/SRBE/LDB), Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 92262, Fontenay aux Roses Cedex, France
- Unitat d'Antropologia Biològica, Departament de Biologia Animal, Biologia Vegetal i Ecologia, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
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11
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de Sainte Marie B, Coze S, Grégoire E, Jean R, Durand JM, Chiche L. [Sudden epigastric pain]. Rev Med Interne 2015; 36:634-5. [PMID: 25819071 DOI: 10.1016/j.revmed.2015.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 02/09/2015] [Accepted: 02/18/2015] [Indexed: 02/07/2023]
Affiliation(s)
- B de Sainte Marie
- Service de médecine interne, CHU de la Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13005 Marseille, France
| | - S Coze
- Service de radiologie, CHU de la Conception, Aix-Marseille université, 147, boulevard Baille, 13005 Marseille, France
| | - E Grégoire
- Service de chirurgie digestive, CHU de la Timone, Aix-Marseille université, 147, boulevard Baille, 13005 Marseille, France
| | - R Jean
- Service de médecine interne, CHU de la Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13005 Marseille, France
| | - J-M Durand
- Service de médecine interne, CHU de la Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13005 Marseille, France
| | - L Chiche
- Service de médecine interne, CHU de la Timone, Aix-Marseille université, 264, rue Saint-Pierre, 13005 Marseille, France.
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12
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Pastene B, Grégoire E, Blasco V, Albanèse J. [Alpha and theta toxin Clostridium perfringens infection complicated by septic shock and hemolysis]. ACTA ACUST UNITED AC 2014; 33:552-3. [PMID: 25154792 DOI: 10.1016/j.annfar.2014.07.729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 07/10/2014] [Indexed: 11/24/2022]
Affiliation(s)
- B Pastene
- Service d'anesthésie réanimation, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France
| | - E Grégoire
- Service de chirurgie générale, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France
| | - V Blasco
- Service d'anesthésie réanimation, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France
| | - J Albanèse
- Service d'anesthésie réanimation, hôpital de la Conception, 147, boulevard Baille, 13385 Marseille, France.
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13
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Grégoire E, Hadjidekova V, Hristova R, Gruel G, Roch-Lefevre S, Voisin P, Staynova A, Deleva S, Ainsbury EA, Lloyd DC, Barquinero JF. Biological dosimetry assessments of a serious radiation accident in Bulgaria in 2011. Radiat Prot Dosimetry 2013; 155:418-422. [PMID: 23460030 DOI: 10.1093/rpd/nct032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In 2011, a serious radiation accident occurred in Stamboliyski, Bulgaria, in an industrial sterilisation facility using very-high-activity (60)Co sources. For the five persons accidentally exposed, biological dosimetry based on dicentric analysis was performed in Sofia and in Paris, where the patients were transferred for treatment. Before completing the chromosomal dose assessment, and for the most exposed person, a preliminary cytogenetic evaluation based on electronically transmitted metaphase images was made. The averaged acute whole-body dose estimates for the five patients ranged from 5.2 to 1.2 Gy, and good agreement was obtained between the two laboratories. The patients were also assessed by their prodromal responses and depressed blood cell counts over the first week. The cytogenetic dose estimates were in good accord with those derived from the blood counts, and both techniques indicated that, for the two most seriously exposed persons both techniques indicated that the initial prodromal reactions had suggested somewhat less severe exposure.
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Affiliation(s)
- E Grégoire
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay aux Roses, France
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Gruel G, Grégoire E, Lecas S, Martin C, Roch-Lefevre S, Vaurijoux A, Voisin P, Voisin P, Barquinero JF. Biological Dosimetry by Automated Dicentric Scoring in a Simulated Emergency. Radiat Res 2013; 179:557-69. [DOI: 10.1667/rr3196.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cottin Y, Lorgis L, Gudjoncik A, Buffet P, Brulliard C, Hachet O, Grégoire E, Germin F, Zeller M. Observance aux traitements : concepts et déterminants. Archives of Cardiovascular Diseases Supplements 2012. [DOI: 10.1016/s1878-6480(12)70845-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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16
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Roy L, Grégoire E, Gruel G, Roch-Lefevre S, Voisin P, Busset A, Martin C, Voisin P. Effect of lymphocytes culture variations on the mitotic index and on the dicentric yield following gamma radiation exposure. Radiat Prot Dosimetry 2012; 151:135-143. [PMID: 22234421 DOI: 10.1093/rpd/ncr460] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Fundamentals of biological dosimetry are described in the International Atomic Energy Agency manual, but all over the world each laboratory is using its own protocol. To test the influence of protocol variations, some blood samples were exposed to 0.5 Gy of gamma radiation and mitotic index and dicentric rates were measured under different experimental conditions. The effect of seven parameters [bromodeoxyuridin (BrdU), phytohaemagglutinin and colcemid concentrations, blood and medium volumes, culture duration and incubation temperature] was tested using a Placket and Burman experimental design. The analysis reveals that the mitotic index was influenced by the concentration of BrdU, medium and blood volumes, the culture duration and the temperature. However, none of the factors has a significant impact on the yield of dicentrics. The dicentric assay is robust against reagent variations within the range tested. These results could be used by relevant laboratories as elements of their procedures robustness in any event requiring such demonstration.
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Affiliation(s)
- L Roy
- Laboratoire de Dosimétrie Biologique, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses Cedex, France.
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Roch-Lefèvre S, Pouzoulet F, Giraudet AL, Voisin P, Vaurijoux A, Gruel G, Grégoire E, Buard V, Delbos M, Voisin P, Bourhis J, Roy L. Cytogenetic assessment of heterogeneous radiation doses in cancer patients treated with fractionated radiotherapy. Br J Radiol 2011; 83:759-66. [PMID: 20739344 DOI: 10.1259/bjr/21022597] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The purpose of this study was to evaluate the in vivo dose-response relation of chromosome aberration formation and distribution in a context of localised and fractionated radiotherapy. Cytogenetic analysis was applied to eight patients, all treated for the same tumour localisation; the same localisation was used to prevent the variability usually observed between patients treated with radiotherapy and to allow the corresponding roles of the size of irradiation field and of the dose rate to be studied. The yield of dicentrics, centric rings and fragments was measured in blood samples taken before treatment, during the course of radiotherapy and up to 6 months after. After the first fraction of radiotherapy, we observed that the whole-body dose estimated from the yield of dicentrics and rings was higher (0.35+/-0.2 Gy) than the calculated equivalent whole-body dose (0.07+/-0.04 Gy). By contrast, the partial-body dose derived from the Qdr (quotient of dicentrics and rings) model was estimated to be 2.2+/-0.3 Gy, which agreed quite well with the dose delivered to the tumour (2.1+/-0.1 Gy). We also found a correlation between the yield of induced chromosome aberrations and the target field size (p = 0.014). U-value analysis showed that the distribution of dicentrics and rings was overdispersed, despite the fractionation of the exposure, and a positive correlation between the U-value and the dose rate was observed (p = 0.017). Overall, these results suggest that the proportion of undamaged lymphocytes could increase with the dose rate.
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Affiliation(s)
- S Roch-Lefèvre
- DRPH/SRBE/LDB, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France.
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Roch-Lefèvre S, Pouzoulet F, Giraudet AL, Voisin P, Vaurijoux A, Gruel G, Grégoire E, Buard V, Delbos M, Voisin P, Bourhis J, Roy L. Cytogenetic assessment of heterogeneous radiation doses in cancer patients treated with fractionated radiotherapy. Br J Radiol 2010. [DOI: 10.1259/bjr/210225597] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Vaurijoux A, Gruel G, Pouzoulet F, Grégoire E, Martin C, Roch-Lefèvre S, Voisin P, Voisin P, Roy L. Strategy for population triage based on dicentric analysis. Radiat Res 2009; 171:541-8. [PMID: 19580489 DOI: 10.1667/rr1664.1] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
After large-scale accidental overexposure to ionizing radiation, a rapid triage of the exposed population can be performed by scoring dicentrics and ring chromosomes among 50 metaphases. This is rapid but is not accurate because the sensitivity is around 0.5 Gy. After the triage step, dose can be estimated by scoring 500 metaphases. This is lengthy but very accurate because the sensitivity is between 0.1 and 0.2 Gy. To improve the methodology, we propose the use of software for automatic dicentric scoring that was tested on victims of an accident in Dakar. Manual scoring of 50 metaphases was carried out, then manual scoring of 500 metaphases, and automatic scoring. Comparison between the dose classifications obtained with manual scoring on 50 metaphases and 500 metaphases showed 50% misclassification with the manual scoring on 50 metaphases. Comparison between the dose classifications obtained with the automatic scoring and manual scoring on 500 metaphases showed only 4.35% misclassification with the automatic scoring. The automatic scoring method is more accurate than the manual scoring on 50 metaphases and can therefore be used for triage, and in place of the manual scoring on 500 metaphases method for individual dose estimation, because it is as accurate and much faster.
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Affiliation(s)
- Aurélie Vaurijoux
- Laboratoire de Dosimétrie Biologique, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 92262 Fontenay-aux-Roses, France.
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Gruel G, Voisin P, Vaurijoux A, Roch-Lefevre S, Grégoire E, Maltere P, Petat C, Gidrol X, Voisin P, Roy L. Broad modulation of gene expression in CD4+ lymphocyte subpopulations in response to low doses of ionizing radiation. Radiat Res 2008; 170:335-44. [PMID: 18763857 DOI: 10.1667/rr1147.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Accepted: 04/17/2008] [Indexed: 11/03/2022]
Abstract
To compare the responses of the different lymphocyte subtypes after an exposure of whole blood to low doses of ionizing radiation, we examined variations in gene expression in different lymphocyte subpopulations using microarray technology. Blood samples from five healthy donors were independently exposed to 0 (sham irradiation), 0.05 and 0.5 Gy of ionizing radiation. Three and 24 h after exposure, CD56+, CD4+ and CD8+ cells were negatively isolated. RNA from each set of experimental conditions was competitively hybridized on 25k oligonucleotide microarrays. Modifications of gene expression were measured after both intervals and in all cell types. Twenty-four hours after exposure to 0.5 Gy, we observed an induction of the expression of BAX, PCNA, GADD45, DDB2 and CDKN1A. However, the numbers of modulated genes greatly differed between cell types. In particular, 3 h after exposure to doses as low as 0.05 Gy, the number of down-modulated genes was 10 times greater for CD4+ cells than for all other cell types. Moreover, most of these repressed genes were taking part in the cell processes of protein biosynthesis and oxidative phosphorylation. The results suggest that several biological pathways in CD4+ cells could be sensitive to low doses of radiation. Therefore, specifically studying CD4+ cells could help to understand the mechanisms involved in low-dose response and allow their detection.
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Affiliation(s)
- Gaëtan Gruel
- Laboratoire de Dosimétrie Biologique, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), 92262 Fontenay-aux-Roses, France
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Le Treut YP, Grégoire E, Belghiti J, Boillot O, Soubrane O, Mantion G, Cherqui D, Castaing D, Ruszniewski P, Wolf P, Paye F, Salame E, Muscari F, Pruvot FR, Baulieux J. Predictors of long-term survival after liver transplantation for metastatic endocrine tumors: an 85-case French multicentric report. Am J Transplant 2008; 8:1205-13. [PMID: 18444921 DOI: 10.1111/j.1600-6143.2008.02233.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Liver transplantation (LTx) for metastatic endocrine tumors (MET) remains controversial due to the lack of clear selection criteria. From 1989 to 2005, 85 patients underwent LTx for MET. The primary tumor was located in the pancreas or duodenum in 40 cases, digestive tract in 26 and bronchial tree in five. In the remaining 14 cases, primary location was undetermined at the time of LTx. Hepatomegaly (explanted liver > or =120% of estimated standard liver volume) was observed in 53 patients (62%). Extrahepatic resection was performed concomitantly with LTx in 34 patients (40%), including upper abdominal exenteration (UAE) in seven. Postoperative in-hospital mortality was 14%. Overall 5-year survival was 47%. Independent factors of poor prognosis according to multivariate analysis included UAE (relative risk (RR): 3.72), primary tumor in duodenum or pancreas (RR: 2.94) and hepatomegaly (RR: 2.63). After exclusion of cases involving concomitant UAE, the other two factors were combined into a risk model. Five-year survival rate was 12% for the 23 patients presenting both unfavorable prognostic factors versus 68% for the 55 patients presenting one or neither factor (p < 10(-7)). LTx can benefit selected patients with nonresectable MET. Patients presenting duodeno-pancreatic MET in association with hepatomegaly are poor indications for LTx.
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Affiliation(s)
- Y P Le Treut
- Department of Surgery, Hôpital La Conception, Marseille, France.
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Roy L, Roch-Lefevre S, Vaurijoux A, Voisin P, Martin C, Grégoire E, Voisin P. Optimization of cytogenetic procedures for population triage in case of radiological emergency. RADIAT MEAS 2007. [DOI: 10.1016/j.radmeas.2007.05.044] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Hérodin F, Roy L, Grenier N, Delaunay C, Baugé S, Vaurijoux A, Grégoire E, Martin C, Alonso A, Mayol JF, Drouet M. Antiapoptotic cytokines in combination with pegfilgrastim soon after irradiation mitigates myelosuppression in nonhuman primates exposed to high irradiation dose. Exp Hematol 2007; 35:1172-81. [PMID: 17560010 DOI: 10.1016/j.exphem.2007.04.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2007] [Revised: 04/10/2007] [Accepted: 04/30/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Preservation of hematopoietic stem and progenitor cells from early radiation-induced apoptosis is the rationale for emergency antiapoptotic cytokine therapy (EACK) after radiation accidents. This strategy is based on the combination of stem cell factor + Flt3-ligand + thrombopoietin + interleukin 3 (SFT3). The long-term safety and efficacy of EACK in managing severe radiation exposure were evaluated. MATERIAL AND METHODS Early administration of SFT3 + pegfilgrastim was assessed in 7-Gy gamma total body-irradiated (TBI) monkeys. Efficiency of delayed administration was also addressed after 5-Gy TBI. RESULTS Here we showed that a single, intravenous injection of SFT3 2 hours after 7-Gy TBI reduced the period of thrombocytopenia (platelet count <20 x 10(9)/L: 0.8 +/- 1.5 day vs 23.8 +/- 15.9 days in controls; p < 0.05) and blood transfusion needs. Moreover, addition of pegfilgrastim to SFT3 treatment shortened the period of neutropenia compared with SFT3 and control groups (neutrophil count <0.5 x 10(9)/L: 7 +/- 1.4 days vs 13 +/- 3.2 days and 15.2 +/- 1.5 days; p < 0.05). In both SFT3 groups, bone marrow activity recovered earlier and, in contrast with controls, platelet count returned to baseline values from 250 days after irradiation. Furthermore, delayed (48 hours) single SFT3 administration in 5-Gy irradiated monkeys significantly reduced thrombocytopenia compared to controls. Finally, SFT3 did not increase frequency of total chromosome translocations observed in the blood lymphocytes of controls 1 year after 5 Gy TBI. CONCLUSION These results suggest the safety and efficacy of EACK in managing severe radiation exposure.
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Affiliation(s)
- Francis Hérodin
- Centre de Recherches du Service de Santé des Armées, la Tronche, France.
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Roy L, Buard V, Delbos M, Durand V, Paillole N, Grégoire E, Voisin P. International intercomparison for criticality dosimetry: the case of biological dosimetry. Radiat Prot Dosimetry 2004; 110:471-476. [PMID: 15353693 DOI: 10.1093/rpd/nch349] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The Institute of Radiation Protection and Nuclear Safety (IRSN) organized a biological dosimetry international intercomparison with the purpose of comparing (i) dicentrics yield produced in human lymphocytes; (ii) the gamma and neutron dose estimate according to the corresponding laboratory calibration curve. The experimental reactor SILENE was used with different configurations: bare source 4 Gy, lead shield 1 and 2 Gy and a 60Co source 2 Gy. An increasing variation of dicentric yield per cell was observed between participants when there were more damages in the samples. Doses were derived from the observed dicentric rates according to the dose-effect relationship provided by each laboratory. Differences in dicentric rate values are more important than those in the corresponding dose values. The doses obtained by the participants were found to be in agreement with the given physical dose within 20%. The evaluation of the respective gamma and neutron dose was achieved only by four laboratories, with some small variations among them.
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Affiliation(s)
- L Roy
- Institut de Radioprotection et de Sûreté Nucléaire, Direction de la radioprotection de l'homme, IRSN, BP 17 92262 Fontenay-aux roses, France.
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Aurich-Costa J, Vannier A, Grégoire E, Nowak F, Cherif D. IPM-FISH, a new M-FISH approach using IRS-PCR painting probes: application to the analysis of seven human prostate cell lines. Genes Chromosomes Cancer 2001; 30:143-60. [PMID: 11135431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
We have developed an alternative multicolor karyotyping technique based on multiplex fluorescence in situ hybridization (M-FISH) and our own optical device with a specific filter set. The most innovative part of our development is the use of interspersed polymerase chain reaction (IRS-PCR) painting probes that show an R-band pattern simultaneous to the combinatorial labeling. This allows us not only to recognize the origin of chromosomal fragments, but to identify the breakpoints as well. We have used this technique to analyze seven cell lines: four prostate cancer cell lines (CA-HPV-10, LNCaP, DU145, and PC3), and three normal transformed epithelial prostate cell lines (PNT1B, PNT2, and PZ-HPV-7). In order to validate our IRS-PCR multiplex FISH (IPM-FISH) technique and to complement the results, we applied comparative genomic hybridization (CGH) and FISH analysis, showing good correlation with the IPM-FISH results. To date, molecular and cytogenetic studies have identified several chromosomal regions that are altered in human prostate cancer; several candidate genes have been suggested. However, reliable markers for predicting the aggressiveness of early prostate cancer are not yet available. Our results show several common, unbalanced rearrangements in the cell lines. These rearrangements are similar to regions already implicated in prostate cancer, validating these cell lines as a good model system.
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Affiliation(s)
- J Aurich-Costa
- Cytogenetics Department, Genomic Research Center, GENSET, S.A., Evry, France.
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Aurich-Costa J, Vannier A, Grégoire E, Nowak F, Cherif D. IPM-FISH, a new M-FISH approach using IRS-PCR painting probes: Application to the analysis of seven human prostate cell lines. Genes Chromosomes Cancer 2001. [DOI: 10.1002/1098-2264(2000)9999:9999<::aid-gcc1076>3.0.co;2-e] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Aurich-Costa J, Vannier A, Grégoire E, Nowak F, Cherif D. IPM-FISH, a new M-FISH approach using IRS-PCR painting probes: Application to the analysis of seven human prostate cell lines. Genes Chromosomes Cancer 2001. [DOI: 10.1002/1098-2264(200102)30:2<143::aid-gcc1076>3.3.co;2-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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