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C Moulin

Publications and source records attributed to C Moulin.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Systemic granulomatous reaction in hip prosthesis. Apropos of 2 anatomoclinical cases].

PURPOSE OF THE STUDY: The production of particulate wear debris is a recognised complication of joint arthroplasty. Focus was made on local tissue reactions. Systemic distribution of wear debris are less know. We report two new cases of distant granulomatous reaction. MATERIAL: The first case concerned a 71-year-old man with lymph node histiocytosis incidentally discovered during the staging of a prostatic carcinoma. The second case concerned a 61-year-old man with a visceral granulomatosis reaction (liver, spleen and lymph node) associated to hepatic ans splenic enlargement. METHODS: We realised an histological analysis of several tissue specimens for these two patients and for one case an inductively coupled plasma-mass spectrometry technique (ICPMS). RESULTS: In all specimens we identified a foreign body granulomatous reaction characterized by the presence of particles coming from hip arthroplasty. The ICPMS identified titanium in spleen. DISCUSSION: Distant granulomatous reaction are generally localised in regional lymph nodes and discovered by accident. A systemic granulomatous reaction attributable to wear particles raises the question of long term biocompatibility of prosthetic materials. CONCLUSION: Besides local reaction, it is of utmost importance that physicians involved in prosthetic field take into consideration the possible systemic adverse effect of wear particles from arthroplasty.

Aged↗
PubMed1996

[Unilateral acro-keratoelastoidosis].

INTRODUCTION: Acrokeratoelastoidosis was first described by O. Costa in 1953. We report a new case with a unilateral localization. CASE REPORT: A 27-year-old woman had atypical acrokeratoelastoidosis lesions of the right hand and foot since adolescence. Diagnosis was confirmed by histology. DISCUSSION: Several cases of acrokeratoelastoidosis have been reported in the literature, but this case is novel because of the unilateral localization. We recall the characteristic features of this disease and emphasize the heterogeneous nature of the manifestations. Differential diagnosis is discussed for this disease which is one of the group of acral lenticular keratoses.

Acrodermatitis↗
PubMed1994

Noninvasive detection of an increased vascular mass in untreated hypertensive patients.

Structural changes of the arterial vasculature are of major pathophysiologic and prognostic significance in human hypertension. A high-resolution ultrasonic echotracking device was used to measure internal diameter and intima-media thickness of the radial artery, a medium-sized muscular conduit artery, in 60 hypertensive patients and in 40 age-matched control subjects. Of the 60 hypertensives, 33 were never treated and 27 were well-controlled by antihypertensive therapy. Radial artery mass and thickness/radius ratio were used to describe the radial artery structure. Radial artery mass was validated in vitro by comparing the weight of arterial segments to the ultrasonographic determination of their mass, calculated as: rho L(pi Re2-pi Ri2), where rho is the arterial wall density, L the length of the arterial segment, and Re and Ri the ultrasonic values of internal and external radii, respectively. Diastolic internal diameter did not differ among the three groups, but wall thickness, radial artery mass, and thickness/radius ratio were significantly higher in the untreated hypertensive group than in the control group. In treated well-controlled hypertensive subjects, radial artery mass and thickness/radius ratio were not different from that of control subjects. Among the population of untreated patients, significant univariate relations existed between radial artery mass and blood pressure and radial artery mass and age. In multivariate analysis, radial artery mass was independently predicted by mean blood pressure, age, and sex. Circumferential wall stress, calculated from diastolic internal diameter, wall thickness, and diastolic blood pressure, was not different in the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

[Can early recurrent hemorrhage in gastroduodenal ulcer be predicted?].

OBJECTIVE: To evaluate clinical, biological and endoscopic predictive factors of early recurrent bleeding from gastric or duodenal ulcers. PATIENTS AND METHODS: Seventy six patients (26 females and 50 males) with a mean age of 65.9 years (SD = 17.2) were included in a prospective study. Among the 76 patients, there were 39 NSAIDs users (51.3%). An endoscopy was performed systematically until 12 hours after admission. Treatment modalities were identical for all patients. The predictive value of 11 factors was evaluated through an univariate and multivariate analysis. RESULTS: Three factors had independent significant predictive value: a) the number of blood units used to treat a shock and to increase the haemoglobin level up to 100 g/L (P < 0.05); b) "high endoscopic risk" of recurrent bleeding including Forrest Ia, IIa and IIb ulcers (P < 0.05); c) a non steroidal anti-inflammatory treatment was associated with no recurrent bleeding contrary to the other factors (P < 0.05). Based on a second multivariate analysis including clinical factors only, a predictive score was calculated: 5 + number of blood units -5 x (NSAID = 0/1). The cut off point with maximum discrimination was 6 (specificity = 79.6%; sensitivity = 77.2%). CONCLUSION: A combination of clinical and endoscopic factors is useful to predict ulcer recurrent bleeding. Our clinical predictive score is interesting because of its simplicity. Its predictive value is of interest but have to be evaluated in another sample of patients.

Adult↗
PubMed1994

[Measurement of the vascular mass of the human radial artery by ultrasonics].

OBJECTIVE: To determine the reproducibility of radial artery mass (RAM), in hypertensive patients. DESIGN AND METHODS: In 49 patients, RAM was measured using a high resolution echotracking device (Nius-02) which allows noninvasive measurement of diameter and wall thickness of the radial artery. RAM was validated in vitro by comparing weight of arterial segments to ultrasonographic measurement and determined as RAM = r (pi Re2-pi Ri2) where r is the arterial wall density (1.06 g/cm3), and Re and Ri are values of internal and external radii, respectively. Repeatability coefficient (RC2 = SDi2/n) was 1.3 mg. RESULTS: Blood pressure was (mean +/- SD) 146 +/- 19/85 +/- 15 mmHg, radial arterial diameter was 2,449 +/- 376 microns, radial wall thickness was 302 +/- 68 microns, RAM was 28 +/- 9 mg (range 13-43 mg). CONCLUSION: These results indicate that radial artery mass can be measured using a high resolution echotracking device.

Humans↗
PubMed1993

Interest of the detection of hepatitis C virus RNA in patients with alcoholic liver disease. Comparison with the HBV status.

HCV-RNA detection was investigated in 66 chronic alcoholic patients divided into 3 groups according to the severity of liver injury: group 1 included 22 chronic alcoholics without cirrhosis, group 2, 20 patients with alcoholic cirrhosis and group 3, 24 patients with alcoholic cirrhosis and hepatocellular carcinoma. The 'nested' polymerase chain reaction (PCR) technique amplifying the 5' non-coding region was used to detect HCV-RNA. For comparison, ELISA1, ELISA2 and RIBA2 tests (Ortho Diagnostics System) were also used to detect anti-HCV antibodies. Finally HBV markers (HBsAg, anti-HBc and anti-HBs antibodies) were detected in all patients as well as HBV-DNA by PCR. In group 1, only 1 patient (4.5%) showed an HCV-RNA-positive PCR, while 3 patients (13.6%) were found to have anti-HCV antibodies detected by RIBA2. In group 2, 3 patients (15%) showed positive PCRs, whereas 4 patients (20%) had anti-HCV antibodies. Finally, in group 3, the PCR was positive in 3 patients (12.5%), while 9 (37.5%) had anti-HCV antibodies. All patients with positive PCRs showed positive anti-HCV antibodies detected by second-generation assays. On the other hand, these patients often had past HBV infection markers but rarely had HBV-DNA detected by PCR. These results suggest that in chronic alcoholic patients, regardless of the severity of liver injury, HCV replication is rarely observed by PCR. Indeed, replication is only observed when anti-HCV antibody detection is positive in second-generation assays, particularly with strong reactivity against C33-C and C22-3 antigens. The relatively high prevalence of anti-HCV antibodies in this population compared to the usual rates could be explained by the age, geographic and perhaps even socioeconomic origin of the patients.

Adult↗
PubMed1992

[Pathogenesis of cholelithiasis in chronic pancreatitis].

The prevalence and the pathogenesis of gallstones in patients with chronic pancreatitis have never been studied prospectively. The aim of this study was to evaluate prospectively the prevalence of gallstones with ultrasonography and to look for markers of pigment or cholesterol stone formation in gallbladder bile. Ultrasonography was performed in 39 patients and detected gallstones in 7 patients and sludge in 3. Common bile duct and intrahepatic bile duct dilatation were observed in 16 and 13 patients, respectively. Liver biopsies were obtained in 31 patients and cirrhosis was found in 4. There were calcium bilirubinate granules in 7 of the 27 bile samples examined. Cholesterol crystals were not found in any case. The nucleation time (median: 21 days) was higher in patients with chronic pancreatitis than in patients with cholesterol stones (median: 2 days) (P < 0.001) but was not different from nucleation time in patients either free of stones (median: 21 days) or with pigment stones (median: 21 days). The cholesterol saturation index was similar in patients with chronic pancreatitis and in controls. The 2 patients with chronic pancreatitis who underwent cholecystectomy had pigment stones. Calcium bilirubinate granules were more frequent in patients with intrahepatic bile ducts dilatation (P < 0.02). In conclusion, this study demonstrates a high prevalence of cholelithiasis in chronic pancreatitis patients. Pigment stone formation could be favored by cholestasis.

Adult↗
PubMed1991

Fate of orally ingested enzymes in pancreatic insufficiency: comparison of two pancreatic enzyme preparations.

The effect on steatorrhoea of a pH-sensitive enteric-coated pancreatic preparation (Eurobiol 25,000) was compared with a conventional pancreatic enzyme preparation (Eurobiol) in six adult patients with exocrine pancreatic insufficiency. In addition, the fate of orally ingested pancreatic enzymes in the upper digestive tract was evaluated by measuring gastric and duodenal pH, amount of enzymes in the stomach, duodenal enzyme output, and fat absorption at the angle of Treitz for the 4 hours following a standard meal. When compared with placebo, Eurobiol and Eurobiol 25,000 reduced daily faecal fat excretion by 24% (not significant) and 43% (P less than 0.05), respectively. With the conventional preparation, enzyme output and fat absorption at the duodeno-jejunal flexure were significantly improved (P less than 0.05). Marked inter-individual differences in duodenal enzyme recovery (lipase 3% to 80%; chymotrypsin 26% to 100%) and, consequently, in the reduction of steatorrhoea (0% to 67%) were observed, with the gastric emptying rate emerging as a key determinant factor. With the enteric-coated preparation, enzyme output and fat absorption at the duodenojejunal flexure were not significantly improved. Discrepancy between the marked reduction of faecal fat excretion and the low duodenal enzyme recovery could indicate that enzyme delivery from microtablets occurs further down in the small bowel. Efficacy of enteric-coated preparations could be enhanced by adding unprotected enzymes, especially in patients with rapid gastric emptying.

Adult↗
PubMed1991

[Thrombosis of renal veins].

According to whether they are acute or progressive, complete or partial, uni- or bilateral, renal venous thromboses have quite various clinical expressions and biological consequences. The diagnosis is readily suggested by acute pain in the side with an increase in the size of one or both kidneys, associated with hematuria, proteinuria, or in case of renal failure, which is characteristic of acute bilateral thrombosis. On the other hand, chronic thrombosis of a renal vein is sometimes suggested only when complications such as pulmonary embolism occur. This explain why it is often discovered on autopsy. The diagnosis is confirmed on the basis of radiology, with ultrasound combined with vascular Doppler becoming increasingly important. Renal venous thrombosis may have various causes: disorders in renal blood flow, especially in the acute forms in newborns; hypercoagulability, in particular in nephrotic syndromes and above all in extramembranous glomerulonephritis; extension of vena cava thrombosis; retroperitoneal diseases involving the renal pedicle or extension of a renal tumor. The treatment of renal vein thrombosis is mainly medical and based on anticoagulants. The role of fibrinolytic treatment is controversial. Surgery is exceptional.

Humans↗
PubMed1986

A novel enzyme immunoassay for total thyroxine using immobilized antibodies and hydrophobic chromatography purified thyroxine-peroxidase conjugate.

A new and simple competitive enzyme immunoassay method for the measurement of total thyroxine in serum is described. Anti-thyroxine antibodies, raised in sheep with a bovine serum albumin-thyroxine conjugate prepared with carbodiimide as coupling initiator, were physically adsorbed onto a large surface area polypropylene support. Competition occurred between thyroxine in the sample and a thyroxine-peroxidase conjugate prepared with a glutaraldehyde spacer and further purified by octyl Sepharose hydrophobic chromatography. The entire assay was performed in 2 h with a useful range of 10-300 micrograms/l. The coefficients of variation ranged from 6.9 to 12% and good agreement (r = 0.93-0.97) was found between this method and 2 radioimmunoassays on 71 serum samples having well distributed thyroxine values.

Animals↗