Sainte-Foy-lès-Lyon, France
Sainte-Foy-lès-Lyon, France

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Lecomte M.,INSA Lyon | Bourlieu C.,French National Institute for Agricultural Research | Bourlieu C.,Agrocampus Ouest | Meugnier E.,French Institute of Health and Medical Research | And 13 more authors.
Journal of Nutrition | Year: 2015

Background: Polar lipid (PL) emulsifiers such as milk PLs (MPLs) may affect digestion and subsequent lipid metabolism, but focused studies on postprandial lipemia are lacking. Objective: We evaluated the impact of MPLs on postprandial lipemia in mice and on lipid digestion in vitro. Methods: Female Swiss mice were gavaged with 150 μL of an oil-in-water emulsion stabilized with 5.7 mg of either MPLs or soybean PLs (SPLs) and killed after 1, 2, or 4 h. Plasma lipids were quantified and in the small intestine, gene expression was analyzed by reverse transcriptase-quantitative polymerase chain reaction. Emulsions were lipolyzed in vitro using a static human digestion model; triglyceride (TG) disappearance was followed by thin-layer chromatography. Results: In mice, after 1 h, plasma TGs tended to be higher in the MPL group than in the SPL group (141 μg/mL vs. 90 μg/mL; P = 0.07) and nonesterified fatty acids (NEFAs) were significantly higher (64 μg/mL vs. 44 μg/mL; P < 0.05). The opposite was observed after 4 h with lower TGs (21 μg/mL vs. 35 μg/mL; P < 0.01) and NEFAs (20 μg/mL vs. 32 μg/mL; P < 0.01) in the MPL group compared with the SPL group. This was associated at 4 h with a lower gene expression of apolipoprotein B (Apob) and Secretion Associated, Ras related GTPase 1 gene homolog B (Sar1b), in the duodenum of MPL mice compared with SPL mice (P < 0.05). In vitro, during the intestinal phase, TGs were hydrolyzed more in the MPL emulsion than in the SPL emulsion (decremental AUCs were 1750%/min vs. 180%/min; P < 0.01). MPLs enhance lipid intestinal hydrolysis and promote more rapid intestinal lipid absorption and sharper kinetics of lipemia. Conclusions: Postprandial lipemia in mice can be modulated by emulsifying with MPLs compared with SPLs, partly through differences in chylomicron assembly, and TG hydrolysis rate as observed in vitro. MPLs may thereby contribute to the long-term regulation of lipid metabolism. © 2015 American Society for Nutrition.


Pallud J.,Sainte Anne Hospital | Pallud J.,University of Paris Descartes | Pallud J.,Institute Pasteur Paris | Audureau E.,Henri Mondor Teaching Hospital | And 40 more authors.
Neuro-Oncology | Year: 2015

Background. The standard of care for newly diagnosed glioblastoma is maximal safe surgical resection, followed by chemoradiation therapy. We assessed carmustine wafer implantation efficacy and safety when used in combination with standard care. Me th od s. Included were adult patients with (n = 354, implantation group) and without (n = 433, standard group) carmustine wafer implantation during first surgical resection followed by chemoradiation standard protocol. Multivariate and case-matched analyses (controlled propensity-matched cohort, 262 pairs of patients) were conducted. Results. The median progression-free survival was 12.0 months (95% CI: 10.712.6) in the implantation group and 10.0 months (9.010.0) in the standard group and the median overall survival was 20.4 months (19.022.7) and 18.0 months (17.019.0), respectively. Carmustine wafer implantation was independently associated with longer progression-free survival in patients with subtotal/total surgical resection in the whole series (adjusted hazard ratio [HR], 0.76 [95% CI: 0.630.92], P =.005) and after propensity matching (HR, 0.74 [95% CI: 0.600.92], P =.008), whereas no significant difference was found for overall survival (HR, 0.95 [0.801.13], P =.574; HR, 1.06 [0.871.29], P =.561, respectively). Surgical resection at progression whether alone or combined with carmustine wafer implantation was independently associated with longer overall survival in the whole series (HR, 0.58 [0.440.76], P <.0001; HR, 0.54 [0.410.70], P <.0001, respectively) and after propensity matching (HR, 0.56 [95% CI: 0.400.78], P <.0001; HR, 0.46 [95% CI: 0.330.64], P <.0001, respectively). The higher postoperative infection rate in the implantation group did not affect survival. Conclusions. Carmustine wafer implantation during surgical resection followed by the standard chemoradiation protocol for newly diagnosed glioblastoma in adults resulted in a significant progression-free survival benefit. © 2015 The Author(s).


Louvel G.,French Institute of Health and Medical Research | Metellus P.,Clairval Private Hospital | Metellus P.,Aix - Marseille University | Noel G.,University of Strasbourg | And 26 more authors.
Radiotherapy and Oncology | Year: 2016

Background To assess the influence of the time interval between surgical resection and standard combined chemoradiotherapy on survival in newly diagnosed and homogeneously treated (surgical resection plus standard combined chemoradiotherapy) glioblastoma patients; while controlling confounding factors (extent of resection, carmustine wafer implantation, functional status, neurological deficit, and postoperative complications). Methods From 2005 to 2011, 692 adult patients (434 men; mean of 57.5 ± 10.8 years) with a newly diagnosed glioblastoma were enrolled in this retrospective multicentric study. All patients were treated by surgical resection (65.5% total/subtotal resection, 34.5% partial resection; 36.7% carmustine wafer implantation) followed by standard combined chemoradiotherapy (radiotherapy at a median dose of 60 Gy, with daily concomitant and adjuvant temozolomide). Time interval to standard combined chemoradiotherapy was analyzed as a continuous variable and as a dichotomized variable using median and quartiles thresholds. Multivariate analyses using Cox modeling were conducted. Results The median progression-free survival was 10.3 months (95% CI, 10.0-11.0). The median overall survival was 19.7 months (95% CI, 18.5-21.0). The median time to initiation of combined chemoradiotherapy was 1.5 months (25% quartile, 1.0; 75% quartile, 2.2; range, 0.1-9.0). On univariate and multivariate analyses, OS and PFS were not significantly influenced by time intervals to adjuvant treatments. On multivariate analysis, female gender, total/subtotal resection and RTOG-RPA classes 3 and 4 were significant independent predictors of improved OS. Conclusions Delaying standard combined chemoradiotherapy following surgical resection of newly diagnosed glioblastoma in adult patients does not impact survival. © 2016 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 118 (2016) 915.


PubMed | APHP Beaujon Hospital, Bordeaux University Hospital Center, Lyon Civil Hospitals, Amiens University Hospital and 16 more.
Type: Journal Article | Journal: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology | Year: 2016

To assess the influence of the time interval between surgical resection and standard combined chemoradiotherapy on survival in newly diagnosed and homogeneously treated (surgical resection plus standard combined chemoradiotherapy) glioblastoma patients; while controlling confounding factors (extent of resection, carmustine wafer implantation, functional status, neurological deficit, and postoperative complications).From 2005 to 2011, 692 adult patients (434 men; mean of 57.5 10.8 years) with a newly diagnosed glioblastoma were enrolled in this retrospective multicentric study. All patients were treated by surgical resection (65.5% total/subtotal resection, 34.5% partial resection; 36.7% carmustine wafer implantation) followed by standard combined chemoradiotherapy (radiotherapy at a median dose of 60 Gy, with daily concomitant and adjuvant temozolomide). Time interval to standard combined chemoradiotherapy was analyzed as a continuous variable and as a dichotomized variable using median and quartiles thresholds. Multivariate analyses using Cox modeling were conducted.The median progression-free survival was 10.3 months (95% CI, 10.0-11.0). The median overall survival was 19.7 months (95% CI, 18.5-21.0). The median time to initiation of combined chemoradiotherapy was 1.5 months (25% quartile, 1.0; 75% quartile, 2.2; range, 0.1-9.0). On univariate and multivariate analyses, OS and PFS were not significantly influenced by time intervals to adjuvant treatments. On multivariate analysis, female gender, total/subtotal resection and RTOG-RPA classes 3 and 4 were significant independent predictors of improved OS.Delaying standard combined chemoradiotherapy following surgical resection of newly diagnosed glioblastoma in adult patients does not impact survival.


Mbaye M.,Lyon Civil Hospitals | Popa C.,Lyon Civil Hospitals | Signorelli F.,Lyon Civil Hospitals | Signorelli F.,University of Catanzaro | And 4 more authors.
Oncology Letters | Year: 2013

Ethmoid adenocarcinoma is the most frequent ethmoid tumor. To date, only a single case of spinal cord compression resulting from ethmoid adenocarcinoma has been reported. The current case study presents a recent case of vertebroepidural metastasis of an ethmoid adenocarcinoma leading to spinal cord compression. Modern imaging studies, including magnetic resonance imaging (MRI) and 18 fludeoxyglucose positron emission tomography (FDG PET), as well as histological and immunohistochemical analyses, have led to diagnoses of a metastasis of an ethmoid adenocarcinoma, which is a mucinous variant, dedifferentiated when compared to the primary tumor. The present case discusses current diagnostic and treatment protocols of this condition. Since survival rates associated with the primary tumor are improving, the incidence of spinal metastasis of ethmoid carcinomas is likely to increase in the future, therefore requiring appropriate diagnostic and therapeutic management.

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