Biomedical subjects
Publications and source records attributed to J Loygue.
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Systematic investigations testing for the presence of polyps and cancers of the large bowel were conducted in a population of 1,369 inpatients and outpatients, aged 45-70 years, in eight university departments of gastroenterology or abdominal surgery (Toulouse, Dijon, Paris, Marseille, and Strasbourg). Double-contrast barium enema and proctosigmoidoscopy examinations were carried out in all cases, whereas total coloscopy was performed only in the case of detected tumors. A questionnaire including 233 parameters (age, sex, family, and personal history and symptoms) was completed for each patient. A total of 414 lesions were detected in 252 patients, including 245 adenomatous or villous polyps, 8 transformed polyps, and 30 carcinomas; 3 of 4 lesions were located in the rectum or sigmoid. Cancer or adenomatous or villous polyps were found in 13% of the patients. The prevalence of these lesions in the population studied was increased in patients with rectorrhagia (19%) or with a personal history of surgery for colorectal cancer or polyp (23%). In the patients without rectorrhagia or a history of intestinal tumor, the incidence was 9.7%. It was significantly increased in males and patients more than 50 year old. The efficacy of proctosigmoidoscopy and double-contrast barium enema was compared in 909 patients. Sensitivity and specificity were, respectively, 35% and 99% for endoscopy, 96% and 94% for radiology.
The Maclet magnetic stoma seal already used by the authors for colostomies was applied to the closure of permanent terminal ileostomies. A reservoir is constructed upstreams of the closure with the last loop of ileum, so that the faeces accumulate and can be evacuated by intermittence. Patients empty the reservoir by removing the cap which blocks the intestinal lumen and introducing a probe into it. The technique was used on 2 patients who had undergone total proctocolectomy for familial polyposis of the colon. One patient has now been followed up for 3 years and the other for 6 months. The perfect continence obtained by this method favourably compares with Kock's continent ileostomy.
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Recto-colonic polyposis is typical of pre-malignant lesions. Recognition and the application of appropriate treatment offer true prophylaxis against recto-colonic carcinoma in sufferers. Careful study should be made of other family members, the only way in which latent forms may be discovered before the stage of malignant change.
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The reinstillation of the digestive juice in the lower end of an enterostomy has a retrograde inhibitory effect on the upper digestive secretions (average inhibition of 30,2%) particularly on the intestinal juice during the digestive syndromes associated with one or several interruptions of the continuity of the bovel. It should be noted, however, that the observation has not been made on normal men, but rather on severely ill patients treated in the intensive care unit of a gastro-intestinal disease department.
The levels of A, H, I, and i plasma antigens and of anti-B, anti-I, and anti-T antibodies were measured in 70 subjects with colonic or gastric carcinoma. These studies showed a significant increase in A plasma activity of the A subjects, and in H plasma activity of the O subjects, while 25% of the tested subjects showed increased I plasma activity. There was no difference in i plasma activity between cancer patients and healthy subjects. These results take into account the marked polymorphism acquired by neoplastic tissue, which is capable also of producing a greater quantity of antigens than that of healthy subjects. Nevertheless this heterogeneity forms a barrier to the clinical measurement of these plasma antigens for screening neoplasms. The significant fall in the amount of anti-T antibodies seemed to be secondary to the absorption of these antibodies on the surface of the tumour cells.
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