J Pasquier

Institut Paoli Calmettes, Marsiglia, Provence-Alpes-Côte d'Azur, France

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Publications (24)34.46 Total impact

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    ABSTRACT: The purpose of this study was to determine the potential role of the sentinel lymph node (SLN) procedure in limited lymph node dissection in patients with apparently localised prostate carcinoma. In 27 patients with organ-confined prostate cancer, a single injection of 0.3 ml/30 MBq( 99m)Tc-rhenium sulphur colloid was injected transrectally into the peripheral zone of each lobe of the prostate (total 0.6 ml/60 MBq) under ultrasound guidance. Two hours after injection, scintigraphy was performed. The first step in surgery was the detection and dissection of lymph nodes identified as SLNs. Then, standard lymphadenectomy was performed, consisting in a limited dissection that included all lymph nodes from the obturator fossa and along the external iliac vein. Lymphatic tissue along the hypogastric artery was not systematically removed, except in the presence of SLNs. Mean patient age was 66 years (48-77); the mean serum prostate-specific antigen value was 10.6 ng/ml. In a high proportion of patients (21/27, 77.8%) an SLN was located along the initial centimetres of the hypogastric artery. The second most frequent site of SLNs was in the obturator fossa (11/27 patients, 40.7%), followed by the external iliac area (5/27 patients, 18.5%). Four patients had lymph node metastases, all in SLNs: two in the hypogastric area and two in the obturator fossa. The SLN procedure revealed the individual variability in the lymphatic drainage of the prostate. The main site of SLNs was the hypogastric area, and two of the four metastatic nodes were located at this site. A limited standard pelvic lymphadenectomy, excluding the hypogastric lymph nodes, would have missed half of the lymph node metastases in this study. A radionuclide SLN procedure could assist in the correct staging of patients with early prostate cancer, especially when performing limited lymphadenectomy.
    European journal of nuclear medicine and molecular imaging 07/2005; 32(6):635-40. · 5.11 Impact Factor
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    ABSTRACT: A 39-year-old, right-handed woman had seizures for two years which were always triggered by exposure to various types of music: the first occurred while she listened to a tune she particularly liked, Con Te Partiro, by Andrea Boccelli. Other triggering factors were various types of music such as supermarket background music and polyphonic singing or instrumental music played by family members. The seizures had a stereotyped course: she felt anxious, tearful, then occurred slight obtundation, during which she smacked her lips and moved restlessly. There was no complete loss of consciousness, but some degree of amnesia. She never experienced a generalized tonic-clonic seizure, but reported rare spontaneous feelings of déjà-vu that had begun at the same time as the induced seizures. There were no other spontaneous attacks; only one seizure was apparently provoked, not by music but by a loud background noise in her office. She was a music lover and a singer. Interictal EEG showed independent slow waves over the temporal regions. Several seizures with EEG localisation over the right temporal region were elicited after several minutes of exposure to music. Monoauricular stimulation with the same music produced a seizure when applied to the left ear but was ineffective when applied to the right ear. Ictal SPECT demonstrated right temporal hyperperfusion. MRI was normal. On high dose of carbamazepine, seizure frequency decreased. The addition of topiramate resulted in full seizure control. Musicogenic epilepsy is a rare form of reflex epilepsy. Pure cases, when patients do not experience unprovoked seizures, are exceptional. Our report confirms the implication of the right temporal lobe in this epilepsy.
    Epileptic disorders: international epilepsy journal with videotape 10/2003; 5(3):133-7. · 1.17 Impact Factor
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    ABSTRACT: The aim of this study was to define the factors associated with nonvisualization of a sentinel node (SN) in the axilla area during preoperative lymphoscintigraphy. We retrospectively studied 332 women with T0, T1, or T2 <3-cm, N0 invasive breast cancer who underwent a sentinel lymph node biopsy procedure. All patients had intradermal and intraparenchymal injection of 37 MBq (99m)Tc-sulfur colloid in a total volume of 4 x 0.1 mL, above and around the tumor. Anterior and lateral static views were obtained a few minutes and 2-4 h after injection. Surgery was performed the next day. The SNs were localized intraoperatively with the aid of patent blue dye and using a hand-held gamma-probe. SNs were analyzed by serial sections stained with hematoxylin-eosin, with the adjacent section stained with anticytokeratin antibodies. Different parameters, such as the number of positive lymph nodes, presence of lymphovascular invasion, tumor size, tumor grade, histology (invasive vs. in situ), prior excisional biopsy, and patient age were analyzed to determine whether they had any significant correlation with nonvisualization of SNs in the axillary area. An axillary SN was successfully visualized on the preoperative lymphoscintigraphy in 302 of 332 patients (90.7%). No axillary drainage was found in 30 patients on the delayed images, even after a second injection of radiocolloid, and 5 of 30 patients showed uptake outside the axillary area. Positive nodes were identified in 86 of 302 patients (28.5%) with successful axillary drainage and in 19 of 30 patients (63.3%) with unsuccessful axillary drainage. More than 4 invaded axillary nodes (P < 0.0001) and the presence of lymphovascular invasion in the breast tumor (P = 0.004) were the only significant variables on univariate analysis, although multivariate analysis showed that only the increased number of invaded nodes was statistically significant. Patients with unsuccessful axillary mapping have an increased risk for axillary involvement.
    Journal of Nuclear Medicine 09/2003; 44(8):1232-7. · 5.77 Impact Factor
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    ABSTRACT: Despite improved diagnostic accuracy, differentiation of dementia with Lewy bodies (DLB) and Alzheimer's disease (AD) on the basis of clinical findings remains problematic. The purpose of this retrospective study was to evaluate the utility of technetium-99m ethyl cysteinate dimer (ECD) single-photon emission tomography (SPET) as a potential tool for the diagnosis of DLB and discrimination from AD. Cerebral perfusion patterns detected by (99m)Tc-ECD SPET were compared in patients presenting with a probable diagnosis of DLB ( n=34) or AD ( n=28). Tracer distribution was quantified using the region of interest technique in eight symmetrical paired zones and expressed as a perfusion index (ratio of mean uptake in a brain region to that in the cerebellum). Comparison of findings in the DLB and AD groups demonstrated significant differences in mean perfusion indexes in the right occipital region ( P=0.004), left occipital region ( P=0.005) and left medial temporal region ( P=0.013). Mean perfusion indexes in the right and left occipital regions were lower in DLB than in AD patients. Conversely, the mean perfusion index in the left medial temporal region was lower in AD than in DLB patients. DLB was correctly identified in 22 patients (sensitivity, 65%) while AD was correctly identified in 20 patients (specificity, 71%). In the DLB group, right and left occipital perfusion indexes were 0.95 or more in all eight non-hallucinating patients, and bilateral occipital hypoperfusion was observed in 15 of the 26 patients with visual hallucinations (57.7%). To our knowledge, this is the first study in which (99m)Tc-ECD SPET has been used exclusively for the diagnosis of DLB. The results suggest that brain perfusion scintigraphy could be helpful in distinguishing DLB from AD if diagnosis based on clinical criteria alone is difficult. The findings also support a link between visual hallucinations and structural/functional changes in the occipital region in DLB patients.
    European journal of nuclear medicine and molecular imaging 11/2002; 29(10):1342-8. · 5.11 Impact Factor
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    ABSTRACT: Evaluation of the response to therapy is important for optimal selection of treatment strategy in patients with Hodgkin's disease (HD). Refractory disease requires intensive high-dose chemotherapy, whereas unnecessary treatment should be avoided in patients in complete remission. The purpose of this study was to evaluate the contribution of gallium-67 scintigraphy in predicting the clinical outcome in patients with HD and mediastinal involvement on the basis of scan results at the end of chemotherapy. Seventy-four patients with HD and mediastinal involvement were retrospectively investigated with 67Ga scintigraphy 72 h after injection of 220 MBq 67Ga citrate (planar and single-photon emission tomographic studies) following the completion of chemotherapy. At the same time, they all underwent computed tomography (CT). Patients were followed up for an average of 63 months (range 28-124 months). The disease status was newly diagnosed disease in 64 of the patients and relapse in 10. Systemic symptoms were absent (A) in 34 cases and present (B) in 40 cases. Forty-one patients had stage I or II disease and 33 patients had stage III or IV disease. Twenty-two patients had bulky disease on initial diagnosis. At the end of chemotherapy, all 74 patients showed regression of the mass by more than 50% (50%-100%) on CT. Patients were divided into two groups according to the positivity or negativity of the gallium scan after chemotherapy: 61 patients had negative and 13 patients had positive gallium scans. In the gallium-negative group, 19.7% of the patients relapsed and 91.8% were alive at the end of the follow-up. Relapse occurred in 20% of the patients with residual mass and in 19.6% of the patients without residual mass. In the gallium-positive group, 84.6% of the patients had recurrent disease and 61.5% were alive after intensive chemotherapy. There was a statistically significant difference in overall survival between patients with positive and patients with negative gallium results (P=0.0034). Disease-free survival differed significantly between patients with positive and patients with negative gallium scans at the end of chemotherapy (P<0.0001). The relative risk of death was 5.2 and the relative risk of relapse was 11.3 for patients with positive gallium scans, in comparison to those with negative gallium scans. The positive and negative predictive values for predicting relapse were 85% and 87%, respectively. It is concluded that even if gallium scan is performed at the end of chemotherapy, it can predict outcome. Alternative therapy may be required on the basis of gallium scan results obtained after treatment.
    European Journal of Nuclear Medicine 10/2001; 28(10):1482-8.
  • Immuno-analyse & Biologie Specialisee - IMMUNO-ANAL BIOL SPEC. 01/1996; 11(6):372-378.
  • Immuno-analyse & Biologie Spécialisée 01/1996; 11(6). · 0.13 Impact Factor
  • Annales de gastroentérologie et d'hépatologie 01/1995; 31(2):109-13.
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    ABSTRACT: The goal of this study was to confirm the capacity of occupational medicine to become involved in cooperative screening programs with a dosage of the PSA (Prostate Specific Antigen) determined by immunoradiometric assay. Two thousands and five hundred seventy three salaried workers in the building sector, between 50 and 65 years old, participated in this investigation. Thirty seven individual ie 1.4% had a PSA level above or equal to 10 micrograms/l. Among them, 35 were checked within three months and 17 were found to have a persistently elevated PSA level. In this subgroup 15 pathologies including two cancers were found. We observed a great variability in the results of PSA determination in the groups of individuals whose initial assay level was above or equal to 10 micrograms/l. The linear correlation coefficient between the two assays (on the same individual), carried out at a six week interval on average, was low (r = 0.52 for N = 35). In our series, 3.5% of patients followed up had undergone a rectal examination less than a year previously. Occupational medicine seems to be an efficient setting for screening intervention. However, the people mainly concerned by our study, (salaried workers seen through the physicians interviewed) did not seem very aware of this type of action.
    Bulletin du cancer 12/1994; 81(11):921-7. · 0.61 Impact Factor
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    ABSTRACT: We describe our experience using an implantable Port-A-Cath access system for intrapleural administration of gamma-interferon (gamma-IFN) in malignant mesothelioma patients. Twenty nine patients, with histologically proven malignant mesotheliomas were included in this study. To avoid complications the device was implanted in a subcutaneous pocket, and the catheter was connected via a tunnel. Also, a suction drain was installed in the pocket after placement. This procedure greatly reduced the high infection rate (64%) encountered with conventional open chest tubes. Patients' tolerance was excellent and maintenance minimal. In our opinion, the Port-A-Cath system is the most suitable device for intra-cavitary long-term therapy of malignant pleural effusions.
    European Respiratory Journal 11/1994; 7(10):1889-92. · 6.36 Impact Factor
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    ABSTRACT: Immunotherapy using recombinant interleukin 2 (rIL-2) has been shown to induce thyroid dysfunction in some cancer patients. The purpose of the present study was to evaluate the incidence and risk factors of this adverse autoimmune response. Triiodothyronine, thyroxine and thyrotropin levels were measured serially in 146 consecutive patients treated with rIL-2 for refractory solid tumor (77 patients) or malign hemopathy (69 patients); rIL-2 was administered intravenously in 5-day cycles (18 x 10(6)-24 x 10(6) IU.m-2.day-1) either alone in 79 cases or in combination with autologous bone marrow transplantation in 26 cases, with interferon-gamma in 37 cases, with tumor necrosis factor-alpha in 13 and with cyclophosphamide in five cases. Some patients underwent more than one therapeutic protocol. Peripheral hypothyroidism was present upon entry in nine (6.2%) patients. Thyroid dysfunction appeared or worsened during rIL-2 therapy in 24 (16.4%) patients. Sixteen (10.9%) patients exhibited peripheral hypothyroidism, out of which four exhibited biphasic thyroiditis. Another five (3.4%) patients developed transient hyperthyroidism. Anomaly could not be classified in three patients. Thyroid dysfunction appeared early after one or two cycles. All surviving patients recovered. Only gender and presence of antithyroid antibody were correlated significantly with rIL-2-induced thyroid abnormalities. No correlation was found with any of the other risk factors studied, i.e. type of malignancy, rIL-2 treatment procedure, clinical efficacy, evolution of circulating lymphocyte subsets or other autoimmune antibodies. Antithyroid antibodies were detected in 60.9% of patients with this complication. Thyroid-stimulating antibodies were never detected.(ABSTRACT TRUNCATED AT 250 WORDS)
    Acta endocrinologica 08/1993; 129(1):31-8.
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    ABSTRACT: The renal function of sixty one adult patients was monitored by 99mTc-DMSA renal scan after cystectomy for a malignant tumour followed by ileal conduit urinary diversion. The postoperative follow-up period was 10 years. The stenosis rate of the uretero-ileal anastomosis was 12.8% and the incidence of pyelonephritis was 8% The mean value for overall renal function and for the function of each kidney did not deteriorate significantly (p = 0.1 and p = 0.7, respectively) over time. However, 26% of kidneys evaluated at 1 year and at 5 years showed a markedly decreased uptake on the renogram. In 70% of cases, this decreased uptake was related to the development of stenosis of the uretero-ileal anastomosis or pyelonephritis. Renal function remained stable at 5 years in group A, corresponding to patients with good initial renal function (n = 22, p = 0.07), and in group B, corresponding to patients with poor initial renal function (n = 7, p = 0.9). Similarly, the function of solitary kidneys did not deteriorate over the 5-year postoperative follow-up period (n = 7, p = 0.5). The functional value of the kidneys was therefore not globally altered after ileal conduit urinary diversion. The existence of a mechanical or infectious complication should be systematically investigated in the presence of a deterioration in renal function. DMSA isotope renal scan is a complete, qualitative and quantitative, follow-up examination after this type of urinary diversion.(ABSTRACT TRUNCATED AT 250 WORDS)
    Progrès en Urologie 11/1991; 1(5):871-9. · 0.80 Impact Factor
  • F Fincker, R Sauvan, J Pasquier
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    ABSTRACT: Prostate-specific antigen (PSA) was compared to prostatic acid phosphatase (PAP) in patients with prostatic cancer suspected to have bone metastases. Bone scans were classified according to metastatic skeletal involvement. The sensitivity of PSA in predicting the presence of metastatic disease (68%) was better than that of PAP (53%). Specificity was 79% for PSA and 90% for PAP. Thirty-five patients had a positive PSA level and a normal scintigraphy (false-positive); 14 of them had only endoscopic prostate resection. Thirty-eight patients underwent a further exploration 3-18 months later. PSA level during disease was correlated to scintigraphy in 32 of 38 patients.
    American Journal of Clinical Oncology 02/1988; 11 Suppl 2:S68-70. · 2.55 Impact Factor
  • F. Fincker, R. Sauvan, J. Pasquier
    European Journal of Cancer and Clinical Oncology 01/1987; 23(8):1239-1239.
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    ABSTRACT: In an immunohistochemical study 31 patients with bronchial cancer (squamous cell 9, large cell 4, small intermediate cell 11 and oat cell 7) were investigated for keratin and NSE. Keratin seems to be a valuable marker since only oat cell cancers and 45% of small intermediate cell cancers were negative. In contrast, marking with NSE seems to be non-discriminating. The low value of NSE as marker was confirmed by 133 serum NSE assays performed in 39 bronchial cancer patients. Although NSE values were significantly higher in oat cell cancer, in any given patient serum assays can, at best, detect relapses.
    Revue de Pneumologie Clinique 02/1986; 42(3):119-24. · 0.20 Impact Factor
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    ABSTRACT: The authors have studied 58 cases of primitive aseptic osteonecrosis of the hips, 35 cases of coxarthrosis, 12 algodystrophies and 11 cases of coxitis, using numerical scintigraphy with Technetium 99m pyrophosphate. They have studied the ration of uptake by the femoral head over the uptake by the soft issues. The values obtained are compared to those observed in the study of normal hips. The result is that the technique offers the possibility of establishing, in a more differential manner, a diagnosis of lesion of the hips at an infraradiologic stage.
    Revue du rhumatisme et des maladies ostéo-articulaires 01/1978; 45(7-9):469-71.
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    ABSTRACT: One thousand liver scans were carried out using technetium phytate. This soluble compound is transformed in the circulating blood into a colloid by chelation of serum calcium, thereby forming a macromolecular phytate of calcium and technetium. The presenting symptoms are compared with the isotopic findings. This microcolloid has the advantages common to all technetium tracers and, in addition, is easy to prepare and has the advantage of a distribution between the liver, spleen and bone of the same type as that seen with colloidal gold 198 without the dosimetric problems associated with the latter. Although it has a level of hepatic fixation which is less than that of certain sulphide complexes of technetium, the authors feel that it appears to provide a better relfection of the colloidopexic function of the liver.
    Journal de radiologie, d'électrologie, et de médecine nucléaire 11/1977; 58(10):647-52.
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    ABSTRACT: The availability of a 99mTc red blood cell labeling procedure, using a commercial kit to label at high activity level a small volume of autologus red blood cells, permitted measuring 131 ventricular ejection fractions and regional contraction abnormalities with a non-invasive technique. An individual cardiac synchronizer was connected to the patient to trigger counts and picture recording from a gamma camera. In 32 left ventricular contraction patterns, both selective contrast angiography and scintigraphic techniques were performed. Good correlation was demonstrated between the two methods of ejection fraction measurement (r=0.86) and also in regional contraction abnormalities. Results may be improved by using more expensive equipment, but the technique proved to be suitable, nevertheless, especially in the screening and follow-up of left ventricular abnormalities.
    European journal of nuclear medicine and molecular imaging 01/1977; 2(1):13-18. · 5.11 Impact Factor
  • R Paulin, F Roux, J Pasquier, R Sauvan
    La Nouvelle presse médicale 01/1977; 5(41):2805-6.
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    ABSTRACT: The authors report the results of 1258 chemical synovectomies carried out in subjects with rheumatoid polyarthritis on joints at Steinbrocker stage I and of 470 chemical synovectomies carried out during the first year of evolution of rheumatoid polyarthritis. Comparison with the results of chemical synovectomy carried out later demonstrate the superiority of early chemical synovectomy.
    Revue du rhumatisme et des maladies ostéo-articulaires 06/1976; 43(5):327-32.