Benign breast disease: studies of prostaglandin E2, steroids, and thermographic effects of inhibitors of prostaglandin biosynthesis.

Plasma levels of estradiol (E2), prostaglandin (PG)E2, and progesterone (P) were measured in both phases of the menstrual cycle in 22 women with benign mastopathies and in 5 normal women. In both phases of the cycle, PGE2 blood levels were significantly higher in patients with benign mastopathies than in normal women. In contrast, the plasma levels of both steroids were lower in patients than in controls. An estrogen-directed synthesis of PGE2 is proposed. In 10 patients, breast thermogenic response to inhibitors of PG biosynthesis (aspirin and indomethacin) revealed a cooling effect in 4 cases, a partly positive response in 3 cases, and no response in 3 cases. The 7 cases with positive responses also had a deficiency of variable magnitude of both steroids without an unbalanced P/E2 ratio. In contrast, patients with a negative thermographic response manifested very low levels of progesterone and a low P/E2 ratio. The significance of patients' unresponsiveness to inhibitors of PGE2 biosynthesis is discussed, as well as the implications with regard to breast cancer.

[Ovarian tumor biology]. / Biologie des tumeurs de l'ovaire.

The authors studied endocrine ovarian tumor secretions capable of causing a clinic and/or biological syndrome. The plasmatic hormonal determinations and the in-vitro incubation methods revealed that the mesenchymal tumors discharged a full range of steroidsid hormones. Their feminizing or masculinizing clinic aspects depend on each respective hormonal ratio and on the field where they are acting. Ultrastructural studies show that steroid cells derive from the mesenchymal cells and that they often have an ambiguous structure (male or female). Tumors with functional stroma capable of producing steroïds appear to be frequent if correct plasmatic determinations and histochemical studies for their diagnosis are used. The polypeptidic hormonal secretions are much more uncommon. Aside chorioepithelioma and carcinoïde tumors in which the hormonal secretion is in agreement with the histological aspect, ACTH, TSH, PRL, para-hormone or insulin secretions responsible for endocrine paraneoplastic syndromes, may be found as well.

[Threatened premature labor. Account of our recent experience]. / Menaces d'accouchement prématuré. Bilan actuel de notre expérience

We have been using two products, one an alpha-blocker (Vadilex) and the other a beta-stimulating drug (Ritodrine) to treat cases with threatened premature labour. Our experience is with 93 women who were treated in a continuous series. The overall result of our treatment show that 72 per cent of the cases were treated successfully and 28 failed. Analysing these preliminary figures in greater detail we have observed that the prognosis depends mainly on the state of the cervix at the time treatment is started in cases of threatened premature labour. The chances for success are much greater if the cervix is long and closed that if it is taken up or open. Since the trial was not carried out with a "double blind" control, we cannot really tell which of the two products we used was more efficacious.

[Surgery in utero on a two-headed monster. The value of echography]. / Intervention in utero sur monstre double. Intérêt de l'échographie.

A binovular triplet pregnancy with a normal fetus and bicephalic monster was diagnosed by ultrasound after 19 weeks of amenorrhoea. After selective amniocentesis and genetic studies the diagnosis led us to kill the double monster in utero by injecting hypertonic saline into its aorta. The healthy twin went on growing normally in the following weeks. Premature vaginal delivery resulted in the expulsion of a macerated double monster and the birth of a baby weighing 1,650 g in blood health. This case history leads us to discuss the value of ultrasound in multiple pregnancies and the ability to carry out intra-uterine procedures in these special cases.

[Prostaglandins and benign mastopathies (author's transl)]. / Prostaglandines et mastopathie bénigne.

During both phases of their menstrual cycle, women who suffer from benign mastopathies evidence hormonal deficiency, which is total although of variable magnitude, as shown by oestradiol (E2) and progesterone (p) plasma levels. by contrast, these women show a concomitant and large rise of prostaglandin E2 (PGE2) plasma level. An oestrogen directed PGE2 synthesis by the mammary epithelium is likely to occur. The patients whose mammary thermography displays PG synthesis can be cooled by the administration of PG synthesis inhibitors. They show a steroid deficiency which is more or less pronounced without having any marked imbalance of the E2-P ratio. By contrast, patients who exhibit no thermographic response show a marked relative rise in oestrogen during both phases of the menstrual cycle. The significance of PG synthesis and relatively raised oestrogen levels will be discussed in relationship to the risk of breast cancer.

[OEstradiol and progesterone steroid hormone receptors in cancer of the endometrium. The significance of the progesterone receptor (author's transl)]. / Les récepteurs hormonaux stéroïdiens de l'estradiol et de la progestérone dans les cancers de l'endomètre. Signification du récepteur de la progestérone.

It would seem that the satisfactory way for the clinician to orientate the treatment by hormones in cancers of the endometrium lies in the presence at the same time of oestrogen and progesterone receptors and in particular of the latter. This applies when treating cancers of the endometrium with hormones in a way that is directed by chemical determination of hormone susceptibility.

PIP: This study investigates the frequency of the presence of estrogen and progesterone receptors in the different anatomopathological types of endometrial cancer. The study has been conducted on cancerous tissues samples before and after hormonotherapy. From a clinical point of view it is very important to know that, at least apparently, the best results are obtained when both estrogen and progesterone receptors are present in the cancerous tissues.

[Hormone receptors in fibroadenomas of the breast]. / Les récepteurs hormonaux dans les fibroadénomes du sein.

This study is about hormone receptivity carried out on 84 fibroadenomata of the breast. In displaying the intracellular receptors for oestradiol and progesterone it shows that hormone receptivity was maximum in benign conditions as they were starting in young women with a short clinical history and with most marked cellular density on anatomo-pathological examination. We compare our results with those that were obtained in cases of cancer of the breast and show in parallel the plasma steroid levels that were obtained in women with benign pathological conditions of the breast.

[Carcinoembryonic antigen (C.E.A.). Its value in the care of malignant tumours of the ovary (author's transl)]. / L'antigène carcion-embryonnaire (A.C.E.). Son intérêt dans la surveillance des tumeurs malignes de l'ovaire.

The authors report on 466 serial levels of carcinoembryonic antigens (C.E.A.) carried out with the aim of surveying 44 patients who had malignant tumours of the ovaries : - one third of the cases had a positive level more than 10 ng per ml; - the presence and the serial level depend more on the histological nature of the tumour than the stage of its evolution; - when a serial level has been negative before treatment it has never become positive in in a definite and continuous manner when the tumour progresses. On the other hand, when the test is positive before any therapy is started then there is a good correlation between its clinical evolution, its response to treatment and the serial variations. Relying on their experience and on the results given in the literature, the authors suggest a scheme of practical use of levels of C.E.A. in the care of malignant tumours of the ovary.