University Hospital of Brest

Brest, France

University Hospital of Brest

Brest, France

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Kamide R.,Jikei University School of Medicine | Misery L.,University Hospital of Brest | Sibaud V.,Institute Claudius Regaud | Taieb C.,Public Health and Quality of Life
Journal of Dermatology | Year: 2013

Sensitive skin syndrome was first described in 1977; however, no robust study has been carried out to evaluate its prevalence in Japan. A national representative sample of the Japanese population over the age of 18 years was taken. Individuals were questioned by telephone and selected according to the quota method. When asked "Do you have a sensitive skin?", 52.84% of men and 55.98% of women answered "rather sensitive" or "very sensitive". There was no significant difference (P = 0.22) between the two sexes. The non-response rate among respondents was zero, suggesting that the term "sensitive skin" held a meaning for the majority of the population. Concerning questions about the onset of a rash, tingling or irritation in the presence of various factors, such as emotional issues, cold, heat, sun, dry air, air-conditioning, water, air pollution and temperature variations, respondents with rather sensitive or very sensitive skin responded "yes" more often than others: approximately three-times more often for water (18.97%/6.15%), air pollution (39.29%/12.45%) and warm climatic conditions (29.74%/9.8%). To our knowledge, this epidemiological study is the first to focus on sensitive skin among Japanese people of this century. It is of particular interest for two reasons: (i) it was conducted on a representative sample of the Japanese population; and (ii) the methodology used was identical to that used for sensitive skin assessment studies conducted in Europe and the USA, making it possible to draw certain comparisons. © 2012 Japanese Dermatological Association.


Abgral R.,University Hospital of Brest | Leboulleux S.,University Paris - Sud | Deandreis D.,University Paris - Sud | Auperin A.,Institute Gustave Roussy | And 9 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2011

Objective: The purpose of this prospective study was to compare the performance of 111In-octreotide somatostatin receptor scintigraphy (SRS) and 18fluorodesoxyglucose positron emission tomography (FDG-PET) in aggressive well-differentiated endocrine carcinoma (WDEC) defined by a high Ki67 (≥10%). Methods: Eighteen consecutive patients explored in a single hospital between November 2003 and 2008 for high Ki67 (≥10%) WDEC were prospectively included. WDEC were sporadic in 17 cases and secreting in 16 cases. FDG-PET, SRS, and computed tomography (CT) were performed within a maximum of 3 months and reviewed by two independent readers. For each patient, an analysis per organ and lesion was performed. Both the results of conventional imaging and the highest number of metastatic organs and distinct lesions visualized by all imaging methods including SRS, FDG-PET, and thoraco-abdomino-pelvic CT were considered for the determination of the standard. Correlation between tumor slope and maximum standardized uptake value, Ki67 value, and grade of uptake at SRS was evaluated. Results: FDG-PET, SRS, and CT showed at least one lesion in 18 (100%), 15 (83%), and 17 (94%) patients, respectively. A total of 254 lesions were diagnosed in 59 organs. FDG-PET, SRS, and CT detected 195 (77%), 109 (43%), and 195 (77%) lesions in 53 (90%), 30 (51%), and 39 (66%) organs, respectively. FDG-PET, compared to SRS, detected more, the same as, and less lesions in 14 (78%), one (6%), and three (17%) patients, respectively. A statistical trend was found between Ki67 value and tumor slope (P = 0.07). Median survival after diagnosis was 25 months (range, 6-71 months). Conclusion: These results suggest that FDG-PET is more sensitive than the SRS for high Ki67 WDEC staging. Copyright © 2011 by The Endocrine Society.


Robin P.,University Hospital of Brest | Abgral R.,University Hospital of Brest | Valette G.,University Hospital of Brest | Le Roux P.-Y.,University Hospital of Brest | And 6 more authors.
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2015

Purpose: Posttreatment follow-up for the recurrence of head and neck squamous cell carcinoma (HNSCC) is a diagnostic challenge. Tissue distortion from radiation and surgery can obscure early detection of recurrence by conventional follow-up approaches such as physical examination or conventional imaging. Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT is widely validated for the diagnosis of suspected recurrence. Moreover, we have shown in a previous prospective study the high effectiveness of FDG PET/CT in the assessment of subclinical recurrence 12 months after treatment. The aim of this prospective study was to evaluate the effectiveness of an earlier FDG PET/CT, at 6 months after the end of treatment.Methods: All patients treated for histologically proven HNSCC from April 2009 to May 2012 at the University Hospital of Brest who did not show any findings suggestive of recurrence at 6 months of their usual follow-up underwent an FDG PET/CT examination. FDG PET/CT findings were correlated with histopathology or imaging follow-up.Results: The study included 116 patients. FDG PET/CT examinations were performed within a mean period ± SD of 5.6 ± 1.8 months after treatment. FDG PET/CT examinations exhibited abnormal FDG uptake in 34 patients and found no suspected recurrence in 82 cases. Of these 82 FDG PET/CT considered as negative, only 1 had a recurrence. Among the 34 positive FDG PET/CT, 22 relapsed whereas 12 did not show evidence of recurrence. The sensitivity and specificity of FDG PET/CT in this study for the diagnosis of occult HNSCC recurrence were 96 (22/23) and 87 % (81/93), respectively. The positive predictive value was 65 % (22/34). The negative predictive value was 99 % (81/82). The overall accuracy was 89 % (103/116). Of the 116 patients, FDG PET/CT highlighted 22 (19 %) subclinical recurrences.Conclusion: Our study showed the high effectiveness of FDG PET/CT in the assessment of subclinical HNSCC recurrence 6 months after completion of treatment. These results confirmed that FDG PET/CT is more accurate than conventional follow-up physical examination alone in the assessment of recurrence after previous curative treatment for HNSCC, as we previously demonstrated in patients clinically asymptomatic at 12 months. © 2014, Springer-Verlag Berlin Heidelberg.


Misery L.,University Hospital of Brest | Misery L.,University of Western Brittany
Expert Review of Dermatology | Year: 2011

The World Congress on Itch, previously named the International Workshop for the Study of Itch, is the official workshop of the International Forum for the Study of Itch. The scientific program covered all aspects of research from biology to psychology, from epidemiology to clinics, from physiology to neuroimaging and so on. The contribution of distinguished invited speakers guaranteed a state-of-the art update, while selected free communications and posters provided the newest information. It is not feasible to attempt comprehensive coverage of the conference. We focus on presentations that are most topical, interesting or thought-provoking. © 2011 Expert Reviews Ltd.


Le Roux P.-Y.,University Hospital of Brest | Gastinne T.,University of Nantes | Le Gouill S.,University of Nantes | Nowak E.,French Institute of Health and Medical Research | And 7 more authors.
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2011

Purpose: Interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) has shown to be an accurate predictor of prognosis in Hodgkin's lymphoma (HL). However, FDG PET response criteria are a matter of ongoing debate. The aim of this study was to confirm the prognostic value of interim PET/CT in HL patients treated with an interim response-adapted strategy and to compare the respective performances of different published criteria. Methods: Newly diagnosed patients with HL underwent interim PET/CT after four courses of Adriamycin, bleomycin, vinblastine and dacarbazine (ABVD). The treatment strategy was adapted according to prognostic factors at diagnosis and interim PET/CT and CT results. PET images were prospectively interpreted visually: a negative result was defined as no residual uptake above local background. All other findings were considered as positive. Retrospectively, interim PET/CT was analysed according to International Harmonization Project (IHP), Gallamini and London criteria Results: The analysis included 90 patients; 6 of 31 patients with positive interim PET/CT and 7 of 59 patients with negative interim result presented treatment failure. The negative predictive value (NPV) and positive predictive value (PPV) for predicting 2-year progression-free survival (PFS) was 95 and 16%, respectively. With the other criteria, NPV remained very high (from 95 to 96%). The PPV increased from 19 to 45% according to the threshold used. Interim PET/CT was significantly correlated with PFS with Gallamini (p=0.01) and London criteria (p<0.0001). Conclusion: Our study confirms the high NPV of interim PET/CT for predicting treatment outcome in HL and a probably better prognostic value using a higher threshold for positivity even after four cycles of chemotherapy as used in Gallamini and London criteria. © 2011 Springer-Verlag.


Misery L.,University of Western Brittany | Misery L.,University Hospital of Brest
Journal of Investigative Dermatology | Year: 2011

Acne may cause psychological distress that is associated with many psychiatric disorders. In this issue, Halvorsen et al. report suicidal ideation, mental health problems, and affective isolation to be relatively frequent in adolescents with acne. This report suggests that adverse events that have been attributed to therapies for acne, including suicidal ideation and depression, may reflect the burden of substantial acne rather than the effect of medications. © 2011 The Society for Investigative Dermatology.


Pons C.,University Hospital of Brest | Remy-Neris O.,French Institute of Health and Medical Research | Medee B.,University Hospital of Brest | Brochard S.,French Institute of Health and Medical Research
Developmental Medicine and Child Neurology | Year: 2013

Aim: The aim of this systematic review was to assess the current validity and reliability of radiological methods used to measure proximal hip geometry in children with cerebral palsy. Method: A search was conducted using relevant keywords and inclusion/exclusion criteria of the MEDLINE, CINALH Plus, Embase, Web of Science, Academic Search Premier, The Cochrane Library, and PsychINFO databases. Results: The migration percentage using X-rays showed excellent reliability and concurrent validity with three-dimensional (3D) measurements from computed tomography (CT) scans. The acetabular index, measured using X-rays had good reliability but moderate concurrent validity with 3D CT measurements; 3D CT scan indexes had greater reliability. The measurement of the neck shaft angle using X-rays showed excellent concurrent validity with measurements from 3D CT scans and excellent reliability. Regarding femoral anteversion, one study found an excellent correlation between two-dimensional CT and clinical assessment and excellent reliability. Two others showed less evidence for the use of CT ultrasounds. Interpretation: Most of the X-ray-based measurements showed good to excellent metrological properties. More metrological evidence is needed for the assessment of femoral anteversion. Magnetic resonance imaging and ultrasound-based measurements have great potential although very little metrological evidence is available. © 2013 Mac Keith Press.


Cheret J.,University of Western Brittany | Lebonvallet N.,University of Western Brittany | Buhe V.,University of Western Brittany | Carre J.L.,University of Western Brittany | And 4 more authors.
Journal of Dermatological Science | Year: 2014

Background: Close interactions exist between primary sensory neurons of the peripheral nervous system (PNS) and skin cells. The PNS may be implicated in the modulation of different skin functions as wound healing. Objective: Study the influence of sensory neurons in human cutaneous wound healing. Methods: We incubated injured human skin explants either with rat primary sensory neurons from dorsal root ganglia (DRG) or different neuropeptides (vasoactive intestinal peptide or VIP, calcitonin gene-related peptide or CGRP, substance P or SP) at various concentrations. Then we evaluated their effects on the proliferative and extracellular matrix (ECM) remodeling phases, dermal fibroblasts adhesion and differentiation into myofibroblasts. Results: Thus, DRG and all studied neuromediators increased fibroblasts and keratinocytes proliferation and act on the expression ratio between collagen type I and type III in favor of collagen I, particularly between the 3rd and 7th day of culture. Furthermore, the enzymatic activities of matrix metalloprotesases (MMP-2 and MMP-9) were increased in the first days of wound healing process. Finally, the adhesion of human dermal fibroblasts and their differentiation into myofibroblasts were promoted after incubation with neuromediators. Interestingly, the most potent concentrations for each tested molecules, were the lowest concentrations, corresponding to physiological concentrations. Conclusion: Sensory neurons and their derived-neuropeptides are able to promote skin wound healing. © 2014 Japanese Society for Investigative Dermatology.


Cheret J.,University of Western Brittany | Lebonvallet N.,University of Western Brittany | Carre J.-L.,University of Western Brittany | Misery L.,University of Western Brittany | And 3 more authors.
Wound Repair and Regeneration | Year: 2013

Due to the close interactions between the skin and peripheral nervous system, there is increasing evidence that the cutaneous innervation is an important modulator of the normal wound healing process. The communication between sensory neurons and skin cells involves a variety of molecules (neuropeptides, neurohormones, and neurotrophins) and their specific receptors expressed by both neuronal and nonneuronal skin cells. It is well established that neurotransmitters and nerve growth factors released in skin have immunoregulatory roles and can exert mitogenic actions; they could also influence the functions of the different skin cell types during the wound healing process. © 2013 by the Wound Healing Society.


Sheehan F.T.,U.S. National Institutes of Health | Brochard S.,U.S. National Institutes of Health | Brochard S.,University Hospital of Brest | Brochard S.,French Institute of Health and Medical Research | And 4 more authors.
Journal of Shoulder and Elbow Surgery | Year: 2014

Background: Obstetrical brachial plexus palsy (OBPP) is a common birth injury, resulting in severe functional losses. Yet, little is known about how OBPP affects the 3-dimensional (3D) humeral morphology. Thus, the purpose of this study was to measure the 3D humeral architecture in children with unilateral OBPP. Methods: Thirteen individuals (4 female and 9 male patients; mean age, 11.8 ± 3.3 years; mean Mallet score, 15.1 ± 3.0) participated in this institutional review board approved study. A 3D T1-weighted gradient-recalled echo magnetic resonance image set was acquired for both upper limbs (involved and noninvolved). Humeral size, version, and inclination were quantified from 3D humeral models derived from these images. Results: The involved humeral head was significantly less retroverted and in declination (medial humeral head pointed anteriorly and inferiorly) relative to the noninvolved side. Osseous atrophy was present in all 3 dimensions and affected the entire humerus. The inter-rater reliability was excellent (intraclass correlation coefficient, 0.96-1.00). Discussion: This study showed that both humeral atrophy and bone shape deformities associated with OBPP are not limited to the axial plane but are 3D phenomena. Incorporating information related to these multi-planar, 3D humeral deformities into surgical planning could potentially improve functional outcomes after surgery. The documented reduction in retroversion is an osseous adaptation, which may help maintain glenohumeral congruency by partially compensating for the internal rotation of the arm. The humeral head declination is a novel finding and may be an important factor to consider when one is developing OBPP management strategies because it has been shown to lead to significant supraspinatus inefficiencies and increased required elevation forces. © 2014 .

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