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Biomedical subjects

B Moulinier

Publications and source records attributed to B Moulinier.

At least 19 recordsLinked to original sources
PubMed1992

[Esophagectomy without thoracotomy for adenocarcinoma in Barrett's esophagus].

From April 1985 to November 1990, 12 patients with adenocarcinoma in a Barrett's esophagus, all of them men, with a median age of 62 years (range, 46 to 79 years), were operated by transhiatal esophagectomy and were submitted to a periodic follow-up. Dysphagia was the main symptom. Preoperative investigations included esogastroscopy and CT-scan of the abdomen and thorax in all patients. Esophageal endosonography was performed in the last 4 cases and MRI in one case. All patients recovered postoperatively and were discharged from hospital. The resected specimens were staged according to Rosenberg et al.'s classification: stage 1, 3 patients, stage 2, 2 patients, stage 3, 6 patients, stage 4, 1 patient. An anastomotic stricture occurred in 4 patients and was treated successfully by endoscopic dilatation. Five patients died during the follow-up period. Seven patients are alive without evidence of recurrence. Transhiatal esophagectomy appears to be the procedure of choice for adenocarcinoma arising from Barrett's esophagus.

Adenocarcinoma↗
PubMed1991

N-nitroso compounds, genotoxins and their precursors in gastric juice from humans with and without precancerous lesions of the stomach.

We are investigating the interrelationships between levels of total N-nitroso compounds (NOC), genotoxic activity (both before and after nitrosation), degree of bacterial colonization in gastric juice and degree of severity or absence of precancerous lesions of the stomach. The mean level of constitutive total NOC in gastric juice was similar in the different groups of patients, but it was higher in acidic gastric juice (n = 30) than in gastric juice at pH greater than 4.5 (n = 12). Acid-catalysed nitrosation of gastric juice in vitro increased the concentration of total NOC by up to several thousand fold, to a maximum of 1330 mumol/l. Genotoxicity, expressed as SOS-inducing potency per 100 microliters of gastric juice was measurable in only 20% of gastric juice samples tested. After acid-catalysed nitrosation, however, all samples showed genotoxic activity, the mean SOS-inducing potency being four to seven times greater than the corresponding constitutive value. There was no association between the mean SOS-inducing potency of gastric juice and the severity of precancerous lesions. The mean SOS-inducing potency of neutral or basic gastric juice was slightly greater than that of acidic samples. In a kinetic study on N-nitrosation of gastric juice in vitro, a mixture of amino and amido substrates was nitrosated; both qualitative and quantitative individual differences in nitrosatable substrates in gastric juice were seen. Fractionation of acidic, neutral and basic nitrosated gastric juice samples revealed a preponderance of nonvolatile, unknown NOC with varying polarities. The results of our study suggest that only pH determines the nature and level of precursors of NOC and of nitrosation-dependent genotoxins in gastric juice.

Adult↗
PubMed1989

Lymphocytic gastritis versus varioliform gastritis. A historical series revisited.

A historical series of varioliform gastritis published in 1978 by Lambert et al. (Digestion 1978; 17: 159-167) was revisited by two pathologists. The histological preparations from 35 patients were reread and interpreted in the light of endoscopic data found in the files. The results demonstrate a strict correlation between clinical diffuse varioliform gastritis and a recently recognized histopathological entity--lymphocytic gastritis, which is characterized by intense lymphocytic infiltration of the surface and foveolar epithelium. The rare discrepancies occur in Crohn's disease and in varioliform gastritis limited to part of the stomach, mostly the antrum.

Crohn Disease↗
PubMed1985

Adenocarcinoma in columnar-lined Barrett's esophagus. Analysis of 13 esophagectomies.

From 1977 to 1982, 13 patients with adenocarcinoma arising in the distal esophagus lined by columnar epithelium underwent esophagectomy with detailed analysis of the pathologic specimen. In three patients, microinvasive carcinoma was detected before dysplasia occurred. In five patients, the ectopic mucosa was discontinuous, prolonged cranially by islands of columnar epithelium scattered in the squamous mucosa. Variable degrees of dysplasia were found in the columnar epithelium in seven specimens in areas of intestinal metaplasia. In four patients with high-grade dysplasia, several foci of intramucosal carcinoma were identified. They were scattered over the whole length of the ectopic mucosa. These data strongly suggest that adenocarcinoma develops from dysplasia, the real premalignant lesion. Careful periodic screening must be carried out in patients identified as having Barrett's esophagus. Dysplasia may be detected and located by endoscopy with dye spraying with directed biopsies. Patients with high-grade dysplasia should undergo esophagectomy with resection of the whole ectopic mucosa because they are at high risk for development of carcinoma.

Adenocarcinoma↗
PubMed1979

Aspirin and gastrointestional bleeding. Interest of plasma salicylate determination.

From history-taking and from analysis of plasma salicylate levels it is shown that a link exists between aspirin and gastrointestinal bleeding in 68% of cases. Salicylate levels alone indicate that aspirin has been taken in 22% of cases. Plasma salicylate measurement and endoscopy allow a better understanding of haemorrhagic lesions due to aspirin. Aspirin is responsible especially for haemorrhage from ulcers and acute gastritis or duodenitis. Aspirin is seen to be dangerous in a moderate number of susceptible individuals: those with peptic ulcer constitution or cirrhosis.

Aspirin↗
PubMed1979

[G2 technic : a simplified procedure of reconstitution of the angle of His, applied to the treatment of hiatus hernia and malposition of the greater tuberosity (242 cases) (author's transl)].

A simple procedure of reconstitution of the angle of His applied to the treatment of hiatus hernia and malposition of the greater tuberosity is reported. Applied to 242 cases, it presents compared with the classical procedure several advantages : easy to carry out, including no complex manoevre, it does not endanger the vagus nerve and maintains firmly the anastomosis. Radiological control and, above all, the clinical results were excellent or good in 96% of cases, suggesting that this new procedure is perfectly valid.

Aged↗
PubMed1978

Benign tumors of oesophagus: value of endoscopy.

Endoscopic examination carried out in 20,000 patients allowed 7 benign tumors of the oesophagus to be detected. Four of them were intramural tumors corresponding to leiomyomas. Guided biopsies are not sufficient to assure an accurate diagnosis, but a mucosal lesion, particularly a carcinoma, should be ruled out. Endoscopic resection of the 3 intraluminal tumours was performed without incidents, allowing an accurate histologic diagnosis and a reasonable therapeutic approach. Endoscopic supervision is necessary in case of epithelial tumors.

Adult↗
PubMed1978

Diffuse varioliform gastritis.

During 8 years experience, 90 cases of diffuse varioliform gastritis were observed (0.3% of examinations). Symptoms suggest either the presence of a gastroduodenal ulcer or of a digestive carcinoma when weight loss is prevalent. The disease proceeds by subacute evolutive bouts with remissions and further relapses. At endoscopy, lesions associate large folds in the fundus and erosive mucosal bulgings disseminated in the fundus and antrum. Histological alterations correspond to a superficial hyperplasic gastritis. Cellular infiltration of the lamina propria includes increased immunocytes population with an abnormal distribution of immunoglobulin classes. An increased percentage of IgE cells characterizes the disease as compared to inflammation in atrophic gastritis. Therapy is based upon agent inhibiting mastocytes degranulation and histamine antagonists. Diffuse varioliform gastritis must be separated from antral varioliform gastritis, a lesion with a higher frequency but no symptomatic individuality.

Adolescent↗