[The Cancer Registry of the Jules Bordet Institute, a new tool for the institution and its researchers. Description of cases incident in 2000-2001]. / Le Registre du Cancer de l'Institut Bordet, un nouvel outil à la disposition de l'institution et de ses chercheurs. Présentation des cas d'incidence en 2000 et 2001.

A hospital Cancer Registry has recently been initiated at the Jules Bordet Institute. The collected information allows to report pathology items such as incidence date, site, morphology and stage. It permits to describe the therapeutic choices, which, broken down by organ and stage, can be compared to guidelines in a process assessment. The objectives of this registry are institutional (statistical and organisational finalities as well as quality control ones), extra-institutional (participation to the public network of cancer registration), and scientific (providing the researchers a common database that can be queried using multiple criteria to be completed by further detailed data). This paper reports on 3,587 incident cancer cases in 2000 and 2001 which were managed at the Jules Bordet Institute for the primary episode. Cancers in women represent 64.3% of all records, for only 35.7% of men, while in the Belgian National Cancer Registry, the proportion is reversed to 46.7% of women and 53.3% of men. The distribution of cancer by site is also quite different in our hospital registry where breast cancer in women, melanoma in both sexes, lung cancer and head and neck cancers in men are over-represented compared to the general population, while colorectal cancer is underrepresented in both sexes.

A phase I and pharmacokinetic study of docetaxel administered in combination with continuous intravenous infusion of 5-fluorouracil in patients with advanced solid tumors.

Encouraged by preclinical synergism between docetaxel and 5-fluorouracil (5FU), we conducted a Phase I study of docetaxel in combination with continuous i.v. infusion of 5FU in patients with advanced solid tumors to determine the maximum tolerated dose, the recommended dose for Phase II studies, and the safety and pharmacokinetic profiles of this combination. Forty-two patients with advanced solid tumors, most of whom had been previously treated, received docetaxel on day 1 as a 1-h i.v. infusion, immediately followed by a 5-day continuous i.v. infusion of 5FU, every 3 weeks without hematopoietic growth factor support. All patients were premedicated with methylprednisolone. Dose levels of docetaxel/SFU studied were (daily dose, in mg/m2) 60/300, 75/300, 75/500, 75/750, 85/750, 85/1000, and 75/1000. Forty-one patients were assessable for toxicity. The maximum tolerated dose determined during the first cycle was 1000 mg/m2/day for 5 days of 5FU with either 75 or 85 mg/m2 docetaxel. Dose-limiting toxicities at these dose levels were reversible secretory diarrhea (4 of 12 evaluable patients), stomatitis (2 patients), and febrile neutropenia (2 patients). Overall, grade 3/4 neutropenia and febrile neutropenia were seen in 63.4% and 9.8% of the patients, respectively. Four patients experienced grade 3/4 infection, which led to toxic death in one of them. There were five early deaths: (a) one was clearly treatment related; (b) two others were possibly treatment related or remotely treatment related; and (c) two deaths were not related to the study drugs. Partial responses were documented in 5 of 39 evaluable patients. Pharmacokinetic results of both drugs were consistent with those from single-agent studies. The recommended dose of this combination, which showed acceptable toxicity and antitumoral activity at various dose levels, is 85 mg/m2 docetaxel given as a 1-h i.v. infusion on day 1 immediately followed by a 5-day continuous i.v. infusion of 5FU (750 mg/m2/day). This study has been extended by adding cisplatin on day 1 of the combination of docetaxel and 5FU.

General solution of the diffusion equation: application to formaldehyde sterilization and desorption of polymers.

A general solution of the diffusion equation for gas in polymers is developed by a numerical method. This solution allows diffusion to be calculated in all cases, by gas desorption after an incomplete adsorption, which is not the case for analytical solutions. When the analytical solutions are valid, both types of solution give identical results. The effect of equivalent sterilization treatment at different temperatures and gas concentrations on formaldehyde residuals in 9 polymers is calculated. High temperature gives lower residual content. Short sterilization times at high gas concentration produce a higher residual content at the end of the adsorption and a lower residual content during desorption than longer sterilization times with lower gas concentration. This is due to sharper gradients of diffusant in the polymer.

Solubility and diffusion coefficients of gaseous formaldehyde in polymers.

The solubility and diffusion (desorption) coefficients of gaseous formaldehyde in 14 materials have been measured at different temperatures. Cellulose, paper, polyamide (Nylon 6), polyester and natural rubber (latex) show very high values of formaldehyde solubility and very low diffusion coefficients, with a weak or inversed influence of the temperature, leading to the conclusion that a chemical reaction occurs with the formaldehyde. The behaviour of the other polymers follows the classical laws of solubility and diffusion of gases except for silicone rubber which shows two-phase desorption curves.

[Anomalies of the urogenital system associated with anorectal malformations]. / Anomalies du système urogénital associées aux malformations anorectales.

Urinary anomalies associated with anorectal malformations were found in more than one half of 61 consecutive cases treated during the last ten years. This well known high frequency stresses the necessity of systematic investigations in order to diagnose these associated anomalies early in the life. The high incidence of associated anomalies (40%) found in the group of translevator deformities makes careful clinical examination and complete radiological investigation mandatory in all cases. Vesico-ureteral reflux (14 cases), renal agenesis (6 cases), multicystic kidneys (2 cases), urogenital sinus (3 cases) and hypospadias (6 cases) were the most significant findings. A normal aspect of renal ultrasonography at birth should allow to postpone intravenous pyelography which can be tricky in the neonatal period.

The management of abdominal wall stomata: skin protection, peristomal wound healing and support for the collecting bag. A multi-center study.

The specific properties of Stomahesive tested in 116 stomal and 20 fistulous patients render it really useful in stomatherapy where it increases the comfort of the patients: 1. it offers an excellent peristomal skin protection whatever the nature of the stoma or origin of the fistula; 2. it promotes rapid healing of skin lesions, even in ileostomy, transverse colostomy, ureterostomy and fistula patients; 3. it ensures an effective degree of impermeability; 4. it provides a large base for adhesion of the collecting bag; 5. it can be kept on for about 6 days in most cases; 6. The local tolerance is excellent (Acta chir. belg., 1977, 76, 533-537).

[Ureteral lithiasis. Development of the therapeutic strategy and the place of endoscopic treatment]. / Lithiases urétérales. Evolution de la stratégie thérapeutique et place du traitement endoscopique.

In order to evaluate the impact of endourological techniques and extracorporeal lithotripsy on the management of ureteral calculi, we reviewed the charts of 838 patients requiring hospitalization for this pathology from 1982 till 1987. 314 patients were managed conservatively and 524 required intervention therapy: 52 with blind endoscopic techniques, 93 with open surgery, 122 with retrograde ureteroscopy, 168 with percutaneous extraction and 92 with ESWL. Evolution of the therapeutic strategy is discussed and our present approach to ureteral stone management is outlined.

[Urea treatment of Ménière's disease and other labyrinth disorders]. / Traitement par l'urée de la maladie de Ménière et d'autres troubles labyrinthiques.

Urea (9 g a day) is a very useful drug in the treatment of Meniere's disease. Results are also effective in other labyrinthine disorders (sudden deafness, tinnitus) but less constant. The mechanism of the action of urea on the pathologic labyrinth is discussed.

[Auditory asymmetry and tinnitus]. / Asymétrie auditive et acouphènes.

Tinnitus are more frequent when the hearing loss is different, asymmetric for each ear. This means probably an interauricular action through the assistance of efferent nervous fibers.

[Complete duplication of the urethra: apropos of a case]. / Duplication complète de l'urètre: à propos d'un cas.

Case report of a complete duplication of the urethra in an 11-year-old boy. Urodynamic exploration of both urethrae was performed before removal of the accessory urethra.

Effect of sterilization on osteoinduction. Comparison of five methods in demineralized rat bone.

The aim of this study was to find a safe, effective sterilization method that does not destroy the bone-inductive capacity of demineralized bone implants. Five sterilizing agents were tested in rats. Implants procured and processed under sterile conditions served as controls. New bone formation was evaluated by determining dry weight, calcium content, and Sr-85 incorporation of the induced ossicles. Glutaraldehyde solution, formaldehyde gas, and ethylene oxide destroyed almost all the bone-inductive capacity. Irradiation by 2.5 Mrads Co-60 resulted in a loss of about half of the inductive capacity. Merthiolate (0.18 per cent) was the only sterilizing agent that did not reduce the bone-inductive capacity of the demineralized implants. Because merthiolate is not sporicidal, gamma irradiation appears to be the most appropriate sterilizing agent for demineralized bone in clinical use.

Estrogen receptor analysis in primary breast tumors by ligand-binding assay, immunocytochemical assay, and northern blot: a comparison.

Estrogen receptor (ER) status is an important parameter in breast cancer management. In this study, ER protein contents established by two conventional techniques were confronted to ER mRNA level, to analyze whether the latter may be introduced in routine assay. Eighty-seven breast tumor samples were examined. ER amounts were determined by ligand-binding assay (LBA) and by computer-assisted immunocytochemical assay (ICA), ER mRNA was analysed and quantified by northern blot. Seventy-seven percent of tumor samples examined were positive for ER mRNA and they all expressed the 6.7-kb receptor signal. No trace of small-sized ER mRNA variants was detected in any sample. Following akaike information criterion (AIC) discriminant analysis, a simple linear correlation was found between ER mRNA levels and ER amounts provided by LBA. This was not observed when either mRNA or LBA values were compared to ICA values. These latter were found to rapidly reach a plateau at increasing mRNA or LBA values. In conclusion, our data points to the linear correlation between ER amounts determined in breast tumors at both protein and mRNA levels by quantitative methods; they also indicate that the semi-quantitative computer-associated ICA may complement rather than replace these quantitative methods.

Polyorchidism: report of three cases and further embryological considerations.

We report 3 new cases of polyorchidism. Review of the literature allows two groups of anatomical variations to be identified: (1) where the Wolffian duct is duplicated longitudinally or absent, and (2) where the two testes are drained by the same epididymis and vas deferens. We postulate that the first group results from a primary anteroposterior division of the genital ridge, whereas the second group is the result of a transverse duplication.

[Hypospadias: surgical aspects and personal experience]. / Hypospadias: aspects chirurgicaux et expérience personnelle.

In the last eight year period, a series of 102 hypospadias reconstruction performed in our institution were reviewed. 50% presented with marked degree of chordee. Four types of repair where used: MAGPI (n degree 18), Mathieu (n degree 41), Duckett (n degree 28), two stage repair (Duplay) (n degree 12), other procedures (n degree 3). Overall complication rate was 18% and was related to major procedure and difficult technical situations. It never compromised the final outcome of the procedure. The relatively high complication rate mentioned in the literature and in our series emphasizes that hypospadias surgery has to be done by well trained surgeons in this field.

[Sexual ambiguity: urologic aspects]. / L'ambiquïté sexuelle: aspects urologiques.

Ambiguous genitalia require prompt decision in the neonatal period to give the child the best opportunity to avoid later major problems of sexual identification. A team approach including the neonatologist, the pediatric endocrinologist, the geneticist and the pediatric urologist seems to be the best way to make the right decision. This paper is a review of 48 cases of ambiguous genitalia referred to our center for management. The diagnosis of female pseudohermaphroditism was established in 30 cases with 21 presented with adrenogenital syndrome. Ten patients were considered as having a diagnosis of male pseudohermaphroditism, six presented with gonadal dysgenesis and two were true hermaphrodites. Principles of surgical management for each category of patients is exposed, discussed and will be the way to treat subsequent cases.

EORTC 10968: a phase I clinical and pharmacokinetic study of polyethylene glycol liposomal doxorubicin (Caelyx, Doxil) at a 6-week interval in patients with metastatic breast cancer. European Organization for Research and Treatment of Cancer.

BACKGROUND: We performed a phase I study of polyethylene glycol (pegylated, Stealth) liposomal doxorubicin (Caelyx, Doxil) using a prolonged (6-week) dose interval to reduce the incidence of skin toxicity that was dose-limiting at more conventional dose intervals, and which appeared to be schedule dependent. PATIENTS AND METHODS: Eligible for the study were metastatic breast cancer patients who had received a maximum of one prior therapy for metastatic disease. The defined dose levels were 60, 70, 80 and 90 mg/m2. RESULTS: Twenty patients were assessed at starting doses of 60 mg/m2 (n = 9) or 70 mg/m2 (n = 11). The dose-limiting toxicity was mucositis. Severe skin toxicity was not observed at the 60 mg/m2 dose level, and occurred in only one patient treated at 70 mg/m2. Significant neutropenia, alopecia, and nausea and vomiting were rare events. No clinical cardiac events occurred, despite a median cumulative doxorubicin dose of 323 mg/m2 (range 5-630 mg/m2). Partial responses were documented in five patients. Pharmacokinetics were assessed in 15 patients, and confirmed the long terminal half-life of the agent (median 77 h) demonstrated in earlier studies. CONCLUSIONS: The recommended dose of Caelyx/Doxil using this schedule is 60 mg/m2 every 6 weeks. This is a safe and effective regimen that permits prolonged administration of anthracycline to patients with metastatic breast cancer.