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Biomedical subjects

J Gastard

Publications and source records attributed to J Gastard.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Lipiodolized angiography in hepatocellular carcinomas. Contribution of iodine-131-labelled lipiodol].

Twelve patients with hepatocellular carcinoma and cirrhosis were investigated by Lipiodol injection into the hepatic artery. A CT scan was done 4-6 days later. Lipiodol was retained by hepatic tumors in each case. This method emphasized the extension of the carcinoma and allowed to discover daughter tumors. I131-lipiodol was also injected in 4 of the 12 patients and then its biodistribution was evaluated. At the 6th hour after injection, I131-lipiodol was detected by scintigraphy over the liver (74-91 percent) and over the lungs (9-16 percent) only. The tumor to normal liver pixel count ratio was about 5. These results indicate that there is a preferential arterial blood flow towards the hepatic tumors, and that we can consider a therapeutic use of I131-Lipiodol in hepatocellular-carcinoma.

Adult↗
PubMed1985

[Evaluation of 2 years' experience with elective endoscopic sclerotherapy of hemorrhagic esophageal varices in cirrhotic patients].

The authors report their 2-year experience of esophageal endoscopic sclerotherapy for prevention of recurrent variceal bleeding in patients with liver cirrhosis. Sixty-three alcoholic cirrhotics underwent sclerotherapy 10 +/- 6 days (SD) after hospital admission for variceal bleeding. Varices were successfully eradicated in 43 patients (68 p. 100), with an average of 3 injection sessions, over a mean period of 5 weeks. Unsuccessful treatment was due to abbreviated course of treatment because of early rebleeding and early mortality. Early rebleeding episodes after therapy occurred in 19 patients (30 p. 100): 10 in whom the esophageal varices were eradicated, 9 in whom sclerotherapy had failed. Recurrent hemorrhage was the cause of death in 6 patients. After variceal eradication had been achieved, new varices were observed in 7 p. 100 of patients after a mean follow-up of 8 months. The risk of further variceal bleeding was 0.008 hemorrhage/patient/month. Minor complications (thoracic pain, dysphagia, esophageal ulcers, pleural effusion) occurred in 60 p. 100 of patients. An esophageal stricture developed in 13 out of the 43 successfully treated patients (30 p. 100). Major complications occurred in 5 patients and was the cause of death in 4: mediastinitis, esophageal perforation, bronchoesophageal fistulae, cardiogenic shock and aspiration pneumonitis. The survival curve, assessed by cumulative life analysis, showed a 60 p. 100 survival rate after 12 months and 56 p. 100 after 18 months. It was significantly different (p less than 0.001) between groups of cirrhosis classified according to Child-Pugh's criteria (95, 52 and 9 p. 100 at 12 months for groups A, B and C respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Correlation between hemodynamic parameters of the portal circulation in cirrhotic patients].

The aim was to study the relationships between portal hemodynamic parameters in cirrhotic patients. Portal hemodynamics was assessed by scintisplenoportography and sonography, and the measurement of portohepatic gradient. Gradient between wedged and free hepatic venous pressures was 2.71 +/- 0.90 kPa (SD), and extrahepatic shunting was 49 +/- 31 p. 100 (SD) in 27 cirrhotic patients. Intrahepatic shunting was present in 17 p. 100 out of 23 cirrhotics. Portal blood flow was 0.582 +/- 0.196 l/min (SD) and hepatic resistance to portal blood flow was 4.84 +/- 2.62 kPa/l/min (SD). Portal blood flow correlated neither with the pressure gradient, nor with portosystemic shunting. The pressure gradient was significantly correlated with portal systemic shunting (r = 0.64, p less than 0.001). Hepatic resistance to portal blood flow was significantly (p less than 0.05) correlated with portal systemic shunting, however the value of the correlation coefficient was low (r = 0.433). The pressure gradient and portosystemic shunting were higher in patients with large esophageal varices than in those with small ones (respectively t = 2.665, p less than 0.02 and t = 3.00, p less than 0.01). Hemodynamic pattern was not correlated with the degree of hepatocellular failure, as assessed by the Child-Pugh index. In conclusion this study provides further evidence for the forward theory of portal hypertension in human liver cirrhosis.

Adult↗
PubMed1985

[Scintigraphy with indium 111-labeled polynuclears: correlation with the extensiveness and activity of cryptogenetic enterocolitis].

We have studied prospectively the usefulness of indium 111 granulocytes scanning in patients with Crohn's disease and ulcerative colitis. Abdominal scans were performed 1 h, 3 h and 20 h after the injection of a pure autologous granulocyte preparation containing 3.7-5.5 MBq of radioindium. The extent of bowel involvement, evaluated on the 3-hour scan, was compared to the X-rays and endoscopic findings. The disease activity was assessed by the intensity of intestinal radionuclide uptake (IRU), the fecal indium 111 measurement (FIM) after a 4-day fecal collection, the decrease of the hepatic and splenic uptake (DHSU). It was compared to clinical and biological data as CDAI, sedimentation rate, albumin and alpha-2-globulin levels. Thirty-three examinations were performed in 26 patients, 16 with Crohn's disease and 10 with ulcerative colitis. The correlation of disease location between indium scan and other diagnosis procedures was good in 81 p. 100 of cases. CDAI was significantly correlated with radionuclide indexes: IRU, FIM, DHSU. FIM was not significantly different between mild and moderates diseases (respectively 1.5 +/- 1.0 p. 100 and 3.6 +/- 3.2 p. 100), but was different between moderate and moderately severe diseases (respectively 3.6 +/- 3.2 p. 100 and 23.6 +/- 16.7 p. 100, p less than 0.001). DHSU was significantly different between mild and moderate diseases (respectively 10.9 +/- 7.2 p. 100 and 22.5 +/- 10.7 p. 100, p less than 0.05) and between moderate and moderately severe diseases (respectively 22.7 +/- 10.7 and 42.4 +/- 7.3 p. 100, p less than 0.001). The radionuclide activity indexes were significantly correlated between themselves.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Assessment of portal blood flow by isotope splenoportography. Methodology and 1st results in cirrhosis].

The authors report a new non-invasive method of portal blood flow (PBF) measurement, after injection of a radiotracer into the spleen. PBF was equal to the product of the radiotracer bolus velocity and the cross-section area of the portal vein as measured by ultrasonography. In 16 patients with cirrhosis, the velocity of the portal blood flow (V) and PBF were determined in 11 cases. In the remaining 5 patients, failures were explained by either a total extrahepatic shunt (3 cases) or difficulties of scanning view analysis (2 cases). Mean values of V and PBF were 8.8 +/- 2.5 cm/s and 579 +/- 193 ml/min respectively, which represent a reduction of 50 p. 100 compared to estimated normal values. This method was also useful to appreciate the fraction of PBF which is supposed to reach the liver cells called the "actual portal blood flow" (APBF). APBF was equal to PBF minus the fraction of blood flowing through intrahepatic shunts and/or the recanalized umbilical vein. In the 16 cases, mean values were 528 +/- 184 ml/min for APBF, 11.9 +/- 1.7 cm for the portal vein diameter, and 53 +/- 34 p. 100 for spleen blood flow fraction going through porto-systemic collateral veins. Significant intrahepatic shunt was observed in one patient only out of 13 without total extrahepatic shunt, i. e., in 8 p. 100 of the cases. The impossibility of measuring PBF when a total extrahepatic shunt is present is a drawback in the use of this new technique.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1984

[Aspirin and gastroduodenal toxicity. A double-blind endoscopic study of the effects of placebo, aspirin and lysine acetylsalicylate in healthy subjects].

The aim of this double-blind endoscopic study was to compare the effects of placebo (group I, 5 patients), lysine acetylsalicylate (group II, 7 patients) and acetylsalicylic acid (group III, 7 patients) on the gastric and duodenal mucosa in healthy humans. Endoscopy was performed before and one hour after endoscopic instillation of aspirin (500 mg) or placebo in the stomach. Endoscopy was repeated after one week of aspirin-treatment (2 g per day) or placebo. Endoscopic findings were graded from 0 to 6 with regard to the aspect of the lesions (petechiae, erosions, ulcers) and to their number (less than 10; greater than 10). One hour after placebo instillation endoscopic findings were normal in all the patients of group I. Three and 5 patients of groups II and III, respectively, developed gastric lesions but none had duodenal lesions. At day 8 only one subject from group I had gastric petechiae. After one week of aspirin-treatment, 13 out of the 14 subjects of groups II and III developed gastric lesions and 3 in each group had duodenal lesions. The endoscopic score was significantly higher in group III than in group II for the following localisations: fundus, antrum, entire stomach, and stomach + duodenum. However the duodenal score was not significantly different between these 2 groups. It is concluded that, after a one-week treatment in normal patients, standard aspirin produces 2 fold more gastric mucosal damage than does soluble aspirin.

Adult↗
PubMed1983

Healing of malignant ulceration in a case of early oesophageal carcinoma presenting as haematemesis.

A 77-year-old male was hospitalised following haematemesis of sudden onset. Emergency endoscopy revealed an oesophageal ulcer 5 cms in length. Biopsies taken from the margin of this lesion showed severe dysplastic changes. The patient was seen one month later, at which time his general condition was good, and there was no dysphagia. A second endoscopy showed that the ulcer had healed, and in its place was found a mucous plaque which was redder than normal. This plaque was iodonegative. Biopsies taken from this region confirmed a diagnosis of carcinoma in situ of the oesophagus. To our knowledge this is the first recorded case in which a malignant ulcer has healed.

Aged↗
PubMed1983

[Pharmacokinetics of intravenous ranitidine and its effect on gastric acid secretion stimulated by pentagastrin in the cirrhotic].

The pharmacokinetics of 50 mg intravenous ranitidine and the consequences on pentagastrin (2 micrograms/kg/h)-stimulated gastric acid secretion were studied in ten cirrhotic patients. Group I (n = 5) included patients without ascite; group II (n = 5) was characterized by the presence of ascites. Blood creatinine was normal in all the subjects. In non-ascitic cirrhotic patients, pharmacokinetic parameters are similar to those published in healthy subjects. In group II ascitic cirrhotic patients, the half-life is significantly increased by 50 p. 100 (P less than 0.05), as compared to group I, due to a 38 p. 100 decrease of total clearance and to a 45 p. 100 decrease of renal clearance (P less than 0.05). Hepatic clearance and volume of distribution are similar in both groups. The percentage of the inhibition by ranitidine of pentagastrin-stimulated acid out-put, in 6 cirrhotic patients, is 95 +/- 4 p. 100 (SD) when measured at the maximal inhibition peak, and 71 +/- 4 p. 100 (SEM) on the average, during the 3 h following the injection. In conclusion, ranitidine may be considered as an effective anti-secretory drug in cirrhotic patients; the pharmacokinetic variations observed in ascitic cirrhotic patients are the result of the decrease of ranitidine renal clearance.

Aged↗
PubMed1982

[Evaluation of protein-losing enteropathy in the cirrhotic patient by assessing the intestinal clearance of alpha 1 antitrypsin (author's transl)].

The purpose of this study was to evaluate protein-losing enteropathy in cirrhotic patients by assaying the intestinal clearance of alpha 1 antitrypsin (C alpha 1), 28 patients were divided into 5 groups: group A = 4 controls, group B = 6 patients with peptic ulcer, group C = 5 cirrhotic patients without esophageal varices (EV), group D = 6 cirrhotic patients with EV but without ascites, group E = 7 cirrhotic patients with EV and ascites. A significant increase in C alpha 1 was found only in groups D and E. The C 1 level was equal to the mean level found in controls multiplied by 2.5 and added to 2 standard deviations. Increases in C alpha 1 levels were not statistically significant when ascites or gastrointestinal involvement were present. C alpha 1 was significantly correlated to the size of EV (p greater than 0.05) and with the Child ratio (p greater than 0.01). No significant correlation was found between C alpha 1 and serum albumin or prothrombin.

Humans↗