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Biomedical subjects

P Hillon

Publications and source records attributed to P Hillon.

At least 55 records · Page 3Linked to original sources
PubMed1987

Hepatic vein thrombosis in paroxysmal nocturnal hemoglobinuria. A spectrum from asymptomatic occlusion of hepatic venules to fatal Budd-Chiari syndrome.

In a series of 40 patients with Budd-Chiari syndrome, 5 (12%) were found to be afflicted with paroxysmal nocturnal hemoglobinuria. The clinico-pathological features in these 5 patients and in 26 well-documented previously reported cases could be ascribed to three groups of increasing severity: thrombosis limited to small-sized hepatic veins with no or transient ascites, partial thrombosis of large-sized hepatic veins with chronic ascites, and complete thrombosis of large-sized hepatic veins with a life-threatening course. These three groups did not differ with regard to sex, age, and duration and characteristics of paroxysmal nocturnal hemoglobinuria. In view of the relationship between prognosis and the extent of hepatic vein obstruction, we suggest that early therapy directed toward limiting the extension of thrombosis, or toward dissolving formed thrombi, should improve the prognosis of this severe complication of paroxysmal nocturnal hemoglobinuria.

Adult↗
PubMed1986

[Cancer of the esophagus in the department of Côte-d'Or].

The registry of digestive tract tumors established for the department of Côte-d' Or was used to study the incidence and characteristics of oesophageal cancer in the area. The crude annual incidence rate was 15.5/100,000 for males, ans 1.1/100,000 for females. The corresponding age standardized rate (world standard) were 12.7 and 0.6. The sex ratio was 21.2. As compared to other cancer registries the Côte-d' Or is in intermediate range for males, in the low range for females. The incidence of oesophageal cancer was similar in urban and rural areas. The risk of oesophageal cancer in males was five times higher in workers than in high executives and professionals. There was no significant variation in oesophageal cancer incidence over the 8 years of the study. Rates tended to decrease slightly in both sexes. Most cancers were squamous cell carcinomas (92%). Adenocarcinomas represented 5% of the cases. The risk of an associated tumour of the upper respiratory and digestive tract was important (17.5%). Only 10.4% of the patients underwent curative surgery, while 53.4% were referred for radiotherapy alone. The overall 1-year survival rate was 18.4%, and the 5-year survival rate was 2.8%. The 5-year survival rate was 7.2% after curative surgery, and 3.2% after radiotherapy. These results underline the fact that the prognosis of oesophageal cancer in a well defined population where only one patient out of ten can benefit from curative surgery, remains poor.

Adenocarcinoma↗
PubMed1986

[Management by specialists of patients with digestive cancers in the Department of Côte-d'Or].

The relative frequency of consultation of the different specialists involved in the diagnosis and treatment of cancer is not well known in France. This study was completed with data collected by the Digestive Tract Cancer Registry in Côte d'Or. Among 3.192 digestive tract cancers diagnosed between 1976 and 1982, 64 p. 100 were treated by gastroenterologists or surgeons. Only 18% of the patients consulted an oncologist. The frequency of consultation of gastroenterologists in the care of digestive tract cancers was independent on the location of the cancer but varied with the place of residence, fluctuating from 69.7% for patients living in the town of Dijon, to 39.9% for patients living in a town with a regional hospital without gastroenterologist. The inverse phenomenon was observed for oncologists. They treated 63.2% of the patients with esophageal cancer and 31.2 p. 100 of patients with rectal cancer, but less than 10 p. 100 of the patients with gastric, colonic, liver, biliary tract or pancreatic cancer. The number of surgeons consulted depended essentially on the operability of the cancer. Between 1976 and 1982 consultation with gastroenterologists and surgeons by patients with digestive tract cancer increased by 4.4 p. 100 (p less than 0.05) and 2.1 p. 100 per year (p less than 0.01), respectively. The frequency of consultation of oncologists remained stable: +0.3 p. 100 per year. These results confirm the importance of a training policy oriented towards specialists who are not oncologists. They must take note of their importance in the diagnosis and the organization of the fight against digestive tract cancers.

Aged↗
PubMed1986

[Does Ming's classification of gastric carcinomas have epidemiologic or prognostic value?].

The population based registry of digestive tract tumours of the country of Cote-d'Or was used to assess the epidemiological and prognostic value of Ming classification. The 211 gastric carcinomas operated or autopsied between 1976 and 1981 in this population were reviewed on a pathological basis. The expansive type (46.0%) was nearly as frequent as the infiltrative type (47.9%). In 6.2% of the cases it was impossible to classify carcinomas in one of these two types. The male/female ratio was higher in the expansive type (3.0) than in the infiltrative type (2.2) and the mean age of patients at the time of diagnosis was higher in the expansive type (69.5 years) than in the infiltrate type (66.4 years p less than 0,05). Ming classification was difficult to use with superficial carcinomas: 9 out of 12 could not be classified. Among invasive cancers only 1.5% were not classified in one of the two types. Polypoid and fungating carcinomas were more often of the expansive type (70.1%). On the contrary infiltrative carcinomas (ulcerated or not) corresponded to the infiltrative type of Ming in 65.6%. It was not possible to extrapolate the WHO classification to the Ming classification. Infiltrative carcinomas were more often associated with hyperplastic stroma (38.1%) than did expansive carcinomas (5.2%) the proportion of carcinomas limited to the digestive wall was higher in the expansive type (21.7%) than in the infiltrative type (5.0%). The survival rate was better in the expansive type (41.4%) than in the infiltrative type (30.1%) but the difference was not significant. The prognosis depended partly on the time of diagnosis. The results suggest that Ming classification has an epidemiological interest. It allows us to distinguish two types of carcinomas that appear quite different on basis of their growth and penetration capacity. However its prognostic interest appears limited.

Adult↗
PubMed1985

Gastric carcinoma in Côte d'Or (France). A population-based study.

The registry of digestive cancer in the Department of Cote d'Or, France, recorded newly diagnosed cases of gastric cancer between 1976 and 1980. The annual incidence rate, adjusted to the world population, was 15.2/100,000 for men and 6.1/100,000 for women. Stomach cancer incidence showed a substantial decline during the 5 yr of the study and this decline was more pronounced in men than in women. The operability rate was 62.4% and the resectability rate was 40.2%. Operative mortality after curative surgery was 17.6%. For all subjects, 17.6%, 29.1%, and 26.0% had localized, regional, and distant disease, respectively. The remaining 27.3%, not operated upon, with no evidence of metastases, had unclassifiable disease. The overall 5-yr corrected survival rate was 16.5%. In the absence of curative surgery all patients died in the 4 yr after diagnosis. After curative surgery the 5-yr corrected survival rate (excluding operative mortality) was 42.8%. The most important determinant of the survival was the pathological stage of the tumor. The age-corrected 5-yr survival was 98.7% for cases limited to the digestive wall, 45.5% for cases involving the serosa, and 26.6% for cases with locoregional extension. These results support the fact that, although declining, gastric cancer remains relatively frequent. Its overall prognosis in a well-defined population, where cases limited to the digestive wall are rare, remains poor.

Actuarial Analysis↗
PubMed1985

[Cancers of the rectum and colon in the Côte-d'Or department: treatment, prognosis].

The population based registry of digestive cancers in the french county of Côte-d'Or enables a study of the treatment and prognosis of colorectal cancers. During 1976-1981, 587 rectal cancers and 717 colon cancers were diagnosed. Curative resection was performed in 61 p. 100 of rectal and colon cancers. Operative mortality after curative resection was 9.7 p. 100 for rectal cancers and 13.1 p. 100 for colon cancers. The overall 5 year observed survival rate was 26.5 p. 100 for rectal cancers and 29.8 p. 100 for colon cancers. After curative surgery, 5 year corrected survival rates was 57.2 p. 100 for rectal cancers and 66.9 p. 100 for colon cancers. Five year survival rate was related to the topography of the cancer (it was lower for caecal cancers), to the macroscopic type of growth (it was higher for exophytic carcinomas than for infiltrative carcinomas) and to the size (it was higher for tumors less than 3 cm than for larger tumors). The major determinant of the survival was the pathological stage of the tumor. Patients with Dukes' A lesions at the time of curative surgery had almost the same life expectancy as persons without rectum or colon cancer. These data suggest that a substantial improvement in prognosis might result from earlier diagnosis of the disease. This commands modifications in the policy of detection of colorectal cancers.

Adult↗
PubMed1985

[Malpighian cancer of the anal canal in Côte-d'Or. Epidemiological and therapeutic aspects].

The registry of digestive tract tumours established for the department of Côte-d'Or was used to study the incidence and the treatment of squamous cell cancer of the anal canal. In the course of 7 years (1976-1982), 45 new cases of anal canal cancer were recorded. Age standardized rates using world standard population are 1.3/100,000 for females, 0.3/100,000 for males. As compared to other cancer registries, Côte-d'Or is in the high range for females, in the average range for males, the cases included 44% with T1-T2 tumours (less than 4 cm), 47% with T3-T4 tumours (more than 4 cm) and 9% unknown (Tx). Lymph node involvement was found in 1/3 of cases, metastatic disease in 11%. Six patients were treated by local excision, 13 by abdomino-perineal resection (combined with postoperative radiotherapy in 5 cases), 20 by radiotherapy (combined with a derivation in 2 cases) and 6 by symptomatic treatment. For T1-T2 normal anal function was preserved in 79% of cases. The 5 year local recurrence rate for curative treatment was 44%. The 5 year observed survival rate was 42.6%; the 5 year relative survival rate was 53.3%. The survival was related to the age, to the sex, to the size of the tumour, and to the nodal status.

Adult↗
PubMed1984

[Colorectal cancer in the Department of Côte-d'Or].

The present study is based on the data of the digestive tract cancer registry set up for the French department of Cote d'Or (population 455,727). During 1976-1980, 581 colon cancers and 489 rectal cancers were diagnosed. They represent 47 per cent of all recorded gastro intestinal cancers. The annual adjusted incidence rates for colon cancers, adjusted to the world population were 17.5 for males, 13.3 for females. The corresponding rates for rectal cancers were 18.2 for males, 9.7 for females. These rates rank among the high rates found in North America and Western Europe. They are particularly high for rectal cancers. There was an urban predominance for colon cancer in males. Among colorectal cancers, 75 per cent were located in the rectum or sigmoid. Sixty-one per cent of the cases of large bowel cancer underwent curative surgery. The overall 5-year survival rate was 30.0 per cent for colon cancer, 27.4 per cent for rectal cancer. After curative surgery the 5 year survival rates were respectively 53.7 per cent and 47.8 per cent. The most important determinant of survival was the pathological stage of the tumour. These results underline the fact that by its frequency and its severity, colorectal cancer represents a major cancer problem.

Adult↗
PubMed1982

[Type E botulism. Two recent cases (author's transl)].

Two brothers, aged 29 and 31, developed severe type E botulism 12 hours after eating salted herrings. The younger died rapidly, the other survived after treatment with type E botulinus antitoxin under intensive care. Limited electromyographic exploration of the surviving patient showed characteristic signs of presynaptic block. This method may be helpful in the diagnosis of atypical forms of the disease. Type E botulism is uncommon in France. It is almost exclusively transmitted by raw, smoked or salted fish and, for some obscure reason, rarely affects all those who shared the same meal. Contrary to types A and B botulism, it usually responds to its specific antitoxin, which must be administered as early as possible. The other therapeutic measures (tracheostomy, controlled ventilation, tube feeding) are the same for all types.

Adult↗
PubMed1982

Effect of propranolol on hepatic blood flow in normal and portal hypertensive rats.

1. The effects of propranolol on heart rate, arterial pressure, portal venous pressure and fractional hepatic blood flow were studied in rats with hepatic artery ligature or with portal vein stenosis, and in sham-operated rats. The effect of propranolol on cardiac output was also studied in normal rats. 2. In rats with hepatic artery ligature or with portal vein stenosis, and in sham-operated rats, propranolol decreased heart rate and portal venous pressure significantly and did not alter arterial pressure. Propranolol decreased fractional hepatic blood flow significantly in rats with hepatic artery ligature, but did not change hepatic blood flow in rats with portal vein stenosis or in sham-operated rats. 3. We conclude therefore that: (a) propranolol decreases portal venous pressure in rats; (b) this decrease in portal venous pressure results in a reduction in portal blood flow which is related, in part, to a reduction in cardiac output; (c) propranolol does not alter hepatic blood flow in normal rats or in rats with portal hypertension.

Animals↗
PubMed1981

Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a controlled study.

It has been suggested that because propranolol decreases portal venous pressure, it may prevent gastrointestinal bleeding associated with portal hypertension. We randomly assigned 74 patients with cirrhosis, who were admitted because of gastrointestinal bleeding, to either oral propranolol given in doses that reduced the heart rate by 25 per cent (38 patients) or to a placebo (36 patients). The proportion of patients free of recurrent gastrointestinal bleeding one year after inclusion in this study was 96 per cent in the propranolol group and 50 per cent in the placebo group (P less than 0.0001). We conclude that continuous administration of propranolol by mouth is effective in preventing recurrent gastrointestinal bleeding in patients with cirrhosis.

Administration, Oral↗
PubMedDate not supplied

The effect of propranolol on portal hypertension in patients with cirrhosis: a hemodynamic study.

The gradient between wedged and free hepatic venous pressures was measured in patients with alcoholic cirrhosis before and 1, 3, and 9 months after continuous oral administration of propranolol at doses reducing the heart rate by 25% or after administration of a placebo. The gradient between wedged and free hepatic venous pressures decreased throughout the duration of propranolol administration, and it did not significantly change in the patients receiving placebo. Since the gradient between wedged and free hepatic venous pressures closely reflects portal venous pressure in alcoholic cirrhosis, it is concluded that continuous oral administration of propranolol produced sustained reduction in portal venous pressure in these patients.

Administration, Oral↗