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Biomedical subjects

J Boulez

Publications and source records attributed to J Boulez.

At least 37 records · Page 2Linked to original sources
PubMed1989

Esophageal squamous cell carcinoma associated with gastric adenocarcinoma.

Adenocarcinoma of the stomach occurred in six of 425 consecutive patients with esophageal squamous cell cancer. In two cases, the gastric cancer, which was recognized at 17 and 29 months, respectively, after the nonsurgical treatment of the esophageal tumor, was treated by surgical resection. In three cases, the tumors which were diagnosed simultaneously, were treated by surgery (one case) resection of the gastric tumor and nonsurgical therapy for the esophageal tumor (one case), and nonsurgical therapy for both tumors (one case). In one case, a gastric cancer was resected 6 years before diagnosis of an esophageal tumor and a second cancer in the gastric stump. A nonsurgical protocol was then adopted for both tumors. The association of these two cancers raises questions concerning their epidemiology, diagnosis, prognosis, and management. There is room for nonsurgical multimodality protocols and, in association with surgery, survival was prolonged for more than 1 year in five of six patients.

Adenocarcinoma↗
PubMed1989

Sham feeding for testing gastric secretory capacities before and after parietal cell vagotomy.

The usefulness of acid secretory data collected during a modified sham-feeding (MSF) test was examined in 50 patients suffering from duodenal ulcer before and after parietal cell vagotomy. In these patients basal acid output pentagastrin-stimulated acid output and MSF-stimulated acid output were measured. Preoperative MSF-stimulated acid output was found to be correlated with preoperative basal acid output, and postoperative MSF-stimulated acid output was correlated with both preoperative basal acid output and postoperative basal and pentagastrin-stimulated acid outputs. The addition of preoperative MSF-stimulated acid output to preoperative pentagastrin-stimulated acid output did not noticeably increase the close relationship between the latter and postoperative pentagastrin-stimulated acid output. It is concluded that basal and MSF-stimulated secretory rates overlap. Therefore, it is suggested that in both preoperative and postoperative conditions the addition of the sham-feeding test to the more simple basal and pentagastrin-stimulated studies could be discarded.

Adolescent↗
PubMed1982

Carcinoma of the thoracic esophagus. Results of one-stage surgery (271 cases).

A group of 271 squamous carcinomas of the thoracic esophagus were studied. All of these patients underwent the same operation: one-stage esophagogastrectomy through a combined abdominal and right thoracic approach. Adenocarcinomas, tumors of the cardia and excisions through a left-sided thoracic approach were excluded. The resectability of these tumors has increased progressively and, at present, applies to 74 percent of operative cases. A majority of these excisons (73 percent) were only palliative. Operative mortality was 16.6 percent for the group as a whole. In the last 3 years this rate has fallen to 4.6 percent. Overall survival at 5 years was 9.3 percent (8.7 percent without recurrence). There was a marked difference between the 5 year survival rate after curative excision (28 percent) and after palliative excision (2.3 percent). Despite such poor results, palliative excision remains justified and offers the patient longer and more comfortable survival than any other type of treatment. Two-stage excision represents a longer, more complex and more grave procedure than one-stage esophagogastrectomy. The addition of postoperative radiotherapy with or without chemotherapy in the last 3 years had led to a marked improvement in survival.

Aged↗
PubMed1981

[Early measurement of portal pressure as a deciding factor in the treatment of ruptured oesophageal varices (author's transl)].

A retrospective study of 51 patients with ruptured oesophageal varices showed a clear-cut difference in mean portal pressure between those who underwent elective surgery (33.7 cm/H2O) and those who were operated upon while still bleeding after failure of medical treatment (41.3 cm/H2O). It would appear that medical treatment is likely to be unsuccessful in 75% of the cases when portal pressure exceeds 35 cm/H2O. These findings tend to indicate that a rapid therapeutic decision would improve the results of emergency treatment. Early measurement of portal pressure by jugular vein catheterization seems to be essential, but other diagnostic procedures, such as laboratory tests and liver biopsy, are also important. A prospective study of 11 recent cases where these procedures were carried out appears to confirm their value as deciding factors in the treatment of ruptured oesophageal varices.

Blood Pressure↗
PubMed1981

[Post-operative cobalt irradiation and chemotherapy in cancer of the oesophagus (author's transl)].

Oesophago-gastrectomy through combined abdominal and right thoracic incision was performed on 271 patients with epidermoid carcinoma of the thoracic oesophagus. The overall post-operative mortality rate of 16.6% dropped to 4.8% during the last 3 years. The global survival rate at 5 years was 9.3% but could be as high as 28% in patients with good prospects of cure. At the moment, the resectability rate is 74% and the "curability index" approximately 27%. The authors emphasize the need for a post-operative medical treatment capable of improving upon the results obtained with surgery. After reviewing the benefits provided by various therapeutic measures, they have adopted a treatment combining cobalt irradiation and chemotherapy. The results over a period of 2 1/2 years and in a limited number of cases appear to be encouraging.

Bleomycin↗
PubMed1980

[Carcinoma of transverse colon (author's transl)].

A personal series of 83 cases of carcinoma of transverse colon has been analysed, as the recent works of international literature. The low percentage of success of these cancers is justified by the anatomical conditions and the pathological findings. Particularly, this prognosis is made worse by the high percentage of multivisceral cancers, hepatic metastases and emergency cases. The operative technics are very different. Beside the typical resections (right or left hemicolectomy), there remains one more important place for segmental colectomy. At least the subtotal colectomy gets some more indications, especially in the high risk patients. Only 28% of the resected cases shows a 5 years survival rate. This percentage is nearly the same as most of the recents statistics.

Aged↗