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Biomedical subjects

J C Paris

Publications and source records attributed to J C Paris.

At least 109 records · Page 6Linked to original sources
PubMed1987

Palliative treatment of rectosigmoid carcinoma by laser endoscopic photoablation.

Ninety-five patients underwent endoscopic outpatient neodymium:yttrium aluminum garnet or argon laser treatments for palliation (relief of obstruction, control of bleeding or discharge) of rectosigmoid carcinoma at the Lille Multidisciplinary Laser Center. All patients were classified as inoperable because of coincident medical conditions or extent of tumor. Two groups were identified as follows: 10 group 1 patients had exophytic tumors less than 3 cm in diameter, and 85 group 2 patients had more advanced tumors. Local control of the tumor was obtained in all patients in group 1 without complication. Eighty-five percent of group 2 patients were symptomatically improved by the treatment. The survival rate (by life table analysis method) at 24 mo was only 19%, but the percentage of surviving patients who remained symptomatically improved was high [90% (3 mo) to 68% (24 mo)]. Factors influencing improvement or survival rates include the main symptom at the beginning of treatment, reason for choosing laser treatment, and circumferential extent of tumor base. There was one fatal perforation and one perirectal abscess. Laser photoablation was able to locally control small rectosigmoid carcinomas in patients unable to undergo incisional surgery. Laser treatment provided relief of symptoms in inoperable patients with advanced rectosigmoid carcinomas.

Aged↗
PubMed1987

[Palliative treatment of cancer of the esophagus and cardia by laser photo-ablation].

The results of the palliative treatment by laser photo-ablation for esophageal and gastric cancers in 79 nonsurgical patients are reported. The aim of treatment was to relieve dysphagia in 60 patients with an obstructive tumor, to maintain esophageal lumen patency in 8 patients with a nonobstructive tumor, and to completely destroy 11 small tumors. The success rate in the patients with dysphagia was 78 p. 100. Functional improvement lasted as long as patients survived with further treatment required once or twice a month. The best results were obtained in exophytic, non circumferential lesions, and in adenocarcinomas of the esophagogastric junction. The localization at the upper third of the esophagus was associated with poor prognosis. The complication rate was 6.6 p. 100. Eight of the 11 small lesions were completely destroyed, but radiation therapy had been associated in four cases with invasive cancer, one of which recurred after 6 months. No complications occurred in this last group of patients.

Aged↗
PubMed1987

[Comparative effectiveness of ranitidine (150 mg X 2) and cimetidine (400 mg x 2) in the treatment of acute duodenal ulcer. A French multicenter controlled clinical trial].

In a single-blind multicenter trial, 444 patients with duodenal ulcer (DU) proven by endoscopy were randomly assigned to treatment with either ranitidine, 150 mg, or cimetidine, 400 mg, morning and evening. Clinical assessments were carried out at 2 and 4 weeks and endoscopy at 4 weeks. The patients in the 2 groups were comparable. Cumulative healing rates at 4 weeks were 78.3 p. 100 in the ranitidine group (n = 226) and 65.6 p. 100 in the cimetidine group (n = 218) (p less than 0.003). Pain at the start was of similar severity in both groups, and disappeared at the same rate under ranitidine or cimetidine: 64 p. 100 patients were painless at 1 week, 80 p. 100 at 2 weeks and 88 p. 100 at 4 weeks. Thirty-eight patients complained of mild side effects: 22 on ranitidine (2 trial withdrawals) and 16 on cimetidine (1 trial withdrawal). Multifactorial analysis (logistic model) revealed that linear ulcers had a lower healing probability than round ulcers (p less than 0.002) whatever the treatment group (cimetidine: 47 p. 100 vs 68 p. 100, ranitidine 57 p. 100 vs 80 p. 100 respectively). Smoking habits (p less than 0.057) and age less than 40 years (p = 0.056) did not significantly influence healing rates, although smokers and younger patients under cimetidine had the lowest healing rate. Thus, at the dosage used in our trial, ranitidine is more efficient for healing DU at 4 weeks than cimetidine but not for pain relief.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1986

Latent pulmonary involvement in Crohn's disease: biological, functional, bronchoalveolar lavage and scintigraphic studies.

We have investigated the following pulmonary related parameters in 22 patients with Crohn's disease who were free of clinical pulmonary symptoms and had normal chest roentgenograms and in 25 controls: serum angiotensin converting enzyme, pulmonary function tests, bronchoalveolar lavage (lymphocyte count and subpopulations, macrophage viability and superoxide anion release by macrophages) and pulmonary scannings. Serum angiotensin converting enzyme was lower in Crohn's disease (14.1 +/- 5.1) than in controls (25.2 +/- 4.7) (p less than 0.001). Twelve of 22 Crohn's disease (54%) had a bronchoalveolar lavage lymphocytosis (greater than 18% alveolar lymphocytes). Bronchoalveolar lavage lymphocytes subpopulations were quite variable. Twelve of 17 Crohn's disease (71%) had an increase spontaneous and/or stimulated superoxide anion production by alveolar macrophages. Six of 12 Crohn's disease (50%) had an increase physiologic dead space in the upper part of their lung against one of 11 controls (9%). These data suggest that most patients with Crohn's disease have a latent pulmonary involvement.

Adolescent↗
PubMed1985

Evidence of lymphocyte alveolitis in Crohn's disease.

Cellular characteristics of bronchoalveolar lavage (BAL) were investigated in 18 consecutive patients with Crohn's disease, who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. Total BAL cell count and cellular viability of alveolar macrophages did not differ significantly between patients and control subjects. Percentage of alveolar lymphocytes was increased in 11 of 18 patients (from 18 percent to 79 percent). There was no apparent correlation between BAL differential cell count and abnormal pulmonary function tests noted in 11 patients, drug treatment or Crohn's disease site, and activity. These results demonstrate a high proportion of latent lymphocyte alveolitis as assessed by BAL, suggesting a latent involvement of the lung in Crohn's disease.

Adolescent↗
PubMed1985

Villous adenomas of the rectum. Results of endoscopic treatment with argon and Nd:YAG lasers.

Endoscopic treatment of rectal villous adenomas with argon and neodymium:yttrium aluminum garnet lasers is reported in 56 patients. Patients treated include 25 who had polyp recurrence after non-laser polyp treatment, 8 who had small sessile polyps that would otherwise require major surgery, and 23 who had contraindications to surgery. Complete tumor ablation was documented over a 3-24-mo follow-up period in 42 of the 56 treated patients. Of the remaining 14 patients, 5 were referred for other therapy because invasive carcinoma developed during treatment, 5 could not be assessed with confidence because of radiation proctitis, and 4 were lost to follow-up. In all patients with symptoms, improvement was noted when 75% of the tumor was destroyed. Treatment was well tolerated with no major complications. The results compare favorably with conventional treatment. Because laser tissue destruction precludes complete histologic evaluation of polyp tissue, laser ablation of polyps should presently be limited to (a) patients with recurrent tumors after previous non-laser treatment who refuse surgery, (b) patients with serious contraindications to surgery, and (c) small benign tumors that would require major surgery.

Adenoma↗
PubMed1984

[Gastric metastasis of a malignant melanoma of the choroid].

Gastric metastases of choroid malignant melanoma seem to be exceptional since less than 10 cases have been previously published. We report the case of a 71 year old patient with a gastric melanosarcoma secondary to a choroid malignant melanoma. Gastric metastasis was revealed by digestive bleeding occurring 18 years after right eye enucleation. Gastroscopy showed black ulcerated tumors. Histology confirmed the diagnosis portraying typical melanic pigments within the gastric mucosa. Laser photocoagulation of the gastric lesion was used for the first time in this indication. As a result, hemorrhage decreased and the patient's comfort was improved.

Aged↗
PubMed1983

[Crohn disease. Results of surgical treatment].

The aim of this study was to describe and to analyze the results of surgery for Crohn's disease in a retrospective series of 155 operations performed in 124 patients from 1949 to 1981 by the same surgical team. Indications for surgical treatment were as follows: acute complications (25 p. 100), intestinal obstruction (35 p. 100), systemic inflammatory manifestations (40 p. 100). Three patients died postoperatively and complications necessitated a reintervention in 10 other subjects. Surgical indications and late postoperative prognosis were significantly different in patients with right-sided bowel lesions (i. e. terminal ileitis, ileocolitis of the ascending colon) and in those with left colonic involvement (i.e. colitis of the whole or descending colon, rectitis and anoperineal lesions). Surgery was required because of failure of medical treatment in 73 p. 100 of Crohn's disease affecting the left colon and in 17 p. 100 of the right-sided lesions (p less than 0.001). After resection a recurrence rate after 1 year and 3 years of respectively 50 and 62 p. 100 was observed in the left colonic disease group and in 5 and 23 p. 100 of the cases respecting the left colon. Finally 31 reoperations were necessary; no surgical mortality occurred in 12 patients with right-sided lesions whereas 5 among 19 patients with involvement of the left colon died postoperatively. These results: a) confirm the high postoperative rate of recurrence (or relapse) after surgical bowel resection for Crohn's disease (especially when the left colon is affected), b) emphasize the need for the surgeon to be very cautious when determining the extent of resection.

Adolescent↗
PubMed1982

[Continuous haemofiltration in encephalopathy associated with hepatic failure (author's transl)].

Thirty-one comatose patients (18 with cirrhosis of the liver, 13 with severe hepatitis) were treated with continuous haemofiltration on polyacrylonitrile membrane (AN 69). The mean duration of sessions was 45 +/- 37 h, during which 136 +/- 108 1 of ultrafiltrate were dialyzed. Sixteen patients emerged from coma, 14 (7 with cirrhosis, 7 with hepatitis) completely and 2 partially. Blood ammonium levels decreased by 47 +/- 21% during the first 24 hours. Aminoacid clearance ranged from 20 to 50 ml/min, but only non significant changes were observed in the branched-chain/aromatic aminoacid ratio. Provided the haemodynamic balance is preserved, the technique is well tolerated. The duration of dialysis depends upon the degree of thrombopenia induced. Since the long-term prognosis of both cirrhosis patients and severe hepatitis patients is unmodified, continuous haemofiltration can only be helpful in cases where hepatic regeneration is possible; failing this, liver transplantation should be considered.

Amino Acids↗