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Biomedical subjects

P Barbier

Publications and source records attributed to P Barbier.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Esophageal carcinoma: surgery using transhiatal esophagectomy without thoracotomy].

During the period between 1982 and 1984, 25 patients with carcinoma of the esophagus underwent esophageal resection by the technique of blunt transhiatal esophagectomy without thoracotomy. The esophagus was replaced with stomach. The indications for blunt dissection of the esophagus are discussed and the operative technique is described. There was no postoperative mortality. Complications included pulmonary complications (19), anastomotic leak (9), left vocal cord paralysis (5) and stenosis of the cervical anastomosis (7). Postoperative hospitalization averaged 18 days. Following discharge from hospital patients are seen in follow-ups at 3-month intervals for 1 year, then at 6-month intervals. Quality of life is good. In the majority of patients with esophageal carcinoma, the goal of esophagectomy is palliation, not cure. Therefore, long-term prognosis of esophageal carcinoma is poor. Actual survival among the patients is 49% at 12 months, and mean survival 10.2 months. Transhiatal esophagectomy without thoracotomy is a safe procedure and far better tolerated by elderly and debilitated patients than a combined transthoracic and abdominal operation. We believe that this procedure is the treatment of choice for esophageal carcinoma at all levels.

Aged↗
PubMed1984

[Experiences with endoscopic placed endoprosthesis in stenosing malignancies of the esophagus and cardia].

Seventy-five patients with obstructing esophagogastric malignancies were palliatively treated by fiberendoscopic insertion of prosthetic tubes. The indications for endoscopic intubation are discussed, the procedure is described. The mortality rate was 6.6%. Complications were obstructions due to food impaction (10), tumor overgrowth (5) or mucosa folds (3), reflux and aspiration (7), dislocation of the prosthesis (5), perforation (1) and desintegration of the tube (1). Normal swallowing was restored in 98% and in general, there was a marked improvement in the quality of life. In summary, we conclude palliative fiberendoscopic intubation as the best existing procedure in patients with an incurable obstructing esophagogastric neoplasm.

Aged↗
PubMed1984

Quantitative analysis of diethyl-IDA reflux. Comparison of controls and dyspeptic, gastric ulcerated, and gastrectomized patients.

The administration of a radioactive tracer through the liver cell and the elimination of bile following an induced vesicular contraction permits duodenogastric reflux to be objectively diagnosed without intubation. This quantitative study of the reflux using 99mTC diethyl-IDA is based on 214 patients and demonstrates: 1) a frequent association with the gastric ulcer, 2) a considerable frequency in gastric resection surgery with duodenogastric anastomosis, 3) a constant occurrence in gastric resection surgery using jejunogastric anastomosis. These findings point to the involvement of biliopancreatic reflux in the genesis of gastric ulcer as well as gastritis and carcinoma of the gastric stump.

Duodenogastric Reflux↗
PubMed1983

Endoscopic discovery and capture of Necator americanus in the stomach.

We report a case of the endoscopic discovery and removal of a specimen of Necator americanus hooked into the gastric mucosa of a black woman from Zaire. We extracted the parasite by means of biopsy forceps. Signs of previous bites were seen in the antrum. This exceptional localization might be due to a jejuno-duodeno-gastric reflux.

Adult↗
PubMed1983

The influence of limonene on induced delayed hypersensitivity to citral in guinea pigs. II. Label distribution in the skin of 14C-labelled citral.

14C-labelled citral was applied on four groups of guinea pigs: (a) one sensitized to citral alone; (b) one sensitized to a citral-d-limonene 1 : 1 molar mixture; (c) FCA-treated controls; (d) controls. The most important results concern the amount of labelled material in soluble compared with insoluble skin protein extracts (SPE). In citral-sensitized animals, more label was found in the soluble SPE when citral + limonene was applied to the skin; in citral + limonene sensitized animals, the same trend (i.e. more label in soluble SPE) was found. The possible role of limonene in alleviating the allergic reaction to citral is discussed.

Acyclic Monoterpenes↗
PubMed1982

[Current status of esophageal neoplasms. I].

In Europe, carcinoma of the esophagus is a relatively rare disease with an annual mortality rate of 4-7 deaths per 105 inhabitants. Institution of appropriate therapy for esophageal carcinoma depends mainly on accurate diagnosis and staging. Computed tomography displays the anatomy of the esophagus and mediastinum with a high degree of accuracy and is a good method of assessing extra-esophageal spread of carcinoma. Preoperative nutritional support may reduce operative mortality and morbidity in high-risk patients. Today there is still no alternative to resection of the carcinoma. Esophagogastrectomy with (cervical) esophagogastrostomy with or without thoracotomy is the treatment of choice for patients with squamous cell carcinoma of the esophagus. Prognosis is still poor, with a 5-year survival rate of less than 20%. If resection is technically impossible, an endoesophageal tube can be inserted or a bypass procedure carried out to increase the quality of life with near normal ability to swallow. Radiotherapy can be used when surgery primarily is not applicable for medical reasons or is refused. Preoperative radiotherapy does not produce statistically significant short- or long-term benefit in the management of esophageal squamous cell carcinoma. Chemotherapy or combination chemotherapy have so far been insufficiently tested and cannot be recommended today for routine use. A combined modality approach is promising but needs further evaluation.

Adenocarcinoma↗
PubMed1982

Allergenic alpha-methylene-gamma-butyrolactones. Stereospecific syntheses of (+)- and (-)-gamma-methyl-alpha-methylene-gamma-butyrolactones. A study of the specificity of (+) and (-) enantiomers in inducing allergic contact dermatitis.

The enantiomers of gamma-methyl-alpha-methylene-gamma-butyrolactone have been prepared stereospecifically from (R)- and (S)-glutamic acid. Three groups of guinea pigs have been sensitized (Feund complete adjuvant technique) to the (+) isomer, the (-) isomer, and the (+/-) mixture. The animals have been tested with each of the enantiomers and with a mixture of the compounds. Only the (-) enantiomer showed some specificity: guinea pigs sensitized to this enantiomer react weakly to the other compound; in turn, animals sensitized to the (+) enantiomer react similarly to both antipodes. Interestingly, reaction to the (+/-) mixture in each group of guinea pigs was the sum of skin responses to the individual enantiomer. These results should be contrasted with sensitization to (+)- and (-)-frullanolides, sesquiterpene lactones for which strong stereospecificity was observed.

4-Butyrolactone↗
PubMed1981

Low-dose heparin in gynecologic surgery: effect on blood coagulation tests.

The laboratory control of low-dose heparin therapy is generally regarded as unnecessary. A laboratory study of the effects of low-dose heparin was performed using different methods: an amidolytic method and a method involving the inhibition of factor Xa in a coagulation test. Variations in partial thromboplastin time, recalcification clotting time, thrombin time and the plasma antithrombin III levels were also studied. These tests were repeated (days 0, 1, 3, 8) in 27 women between the ages of 27 and 62 years who were undergoing gynecological surgery. They received 5,000 IU of heparin either twice or thrice daily. There was no correlation between heparin levels in the blood and global clotting tests simultaneously performed. The plasma heparin levels varied between 0 and 0.15 IU/ml with both methods. A detectable heparin concentration on days 1, 3 and 8 was present in only half of the cases receiving the twice daily regimen. The plasma antithrombin III activity and concentration were not modified during treatment.

Adult↗
PubMed1980

[Laparotomy for acute abdomen in larvate depression].

35--40% of psychosomatic disturbances among depressive patients present as abdominal troubles. These are difficult to interpret in the case of larvate depression which manifests itself mainly in the somatic sphere. For the last twenty years, we have noticed an increased incidence of larvate depressions. As a result, patients are often inadequately treated or submitted to surgery. This report is about a 37-year-old female patient who was referred to us with the diagnosis of an acute abdomen. After extensive investigations we were able to rule out as well a mechanical as a reflectory ileus. Nevertheless, the rapid deterioration of her general condition, increasing peritonism and radiological evidence of ileus made us suspect a perforated ulcer with accompanying paralytic ileus and perform an exploratory laparotomy 24 h later. We were very surprised not to discover any abnormal findings at operation. The consultant psychiatrist eventually diagnosed a depression. Up to this date, we have not been able to discover any information about similar patients presenting with such an acute history, even in specialised psychiatric literature. Should one refer such patients with acute abdomen to the psychiatrist before operating?

Abdomen, Acute↗