PubMed Health⌕ Search

Biomedical subjects

L Le Bodic

Publications and source records attributed to L Le Bodic.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Pseudo-angina pain of esophageal origin. Results of functional study and value of the balloon distention test].

In patients with angina-like chest pain, the diagnostic value of esophageal investigations has not been definitively established. The aim of this study was to assess the diagnostic value of different esophageal investigations in 45 patients (group I) with angina-like chest pain for which a cardiac origin had been previously excluded. These investigations included esophageal manometry, Bernstein test, edrophonium test, balloon distention test, and 24-hour pH monitoring (with event marker). These patients were compared to two control groups: a) 9 subjects with documented coronary disease (group IIa), and b) 9 healthy volunteers (group IIb). Abnormal results were observed in 37 patients in group I (82 percent), and in 4 patients in group IIa (44 percent). In group I, manometry was abnormal in 29 percent of patients and pH monitoring in 41 percent; provocative tests were positive in 10 percent, 15 percent, and 38 percent for the Bernstein test, edrophonium test, and balloon distention test respectively. Esophageal origin of the pain was shown to be likely in 36 percent of patients in group I. These results confirm the high incidence of functional abnormalities of esophagus in patients with angina-like chest pain. They also confirm the diagnostic value of the different provocative tests and especially the balloon distention test.

Adult↗
PubMed1989

Influence of hematoporphyrin derivative concentration, incubation time, temperature during incubation and laser dose fractionation on photosensitivity of normal hemopoietic progenitors or leukemic cells.

Photodynamic therapy represents a new approach for the local control of cancers. It has recently been claimed that photodynamic therapy mediated by hematoporphyrin derivative (HPD) is selectively more efficient for killing leukemic cells than normal progenitors. To improve this effect, we studied the influence of hematoporphyrin dose, temperature during incubation and/or treatment, hematoporphyrin derivative incubation time, and fractionation of the argon laser light (488-514 nm) used for hematoporphyrin stimulation. Plating efficiency calculated after a 7-day period of growth on collagen gel medium showed a dose-dependent phototoxicity of HPD reaching 0.01% for normal hemopoietic progenitors and 0.001% for leukemic cells (dose = 12.5 micrograms/ml). The 10:1 ratio of normal hemopoietic progenitors to leukemic cells was also found to be the same or increased when temperature was 37 degrees C during incubation and 4 degrees C during laser irradiation. Similar results were also found when incubation time was varied from 75-120 min, or when laser irradiation dose was fractionated into 2 or 3 periods. The ratio of normal progenitors to leukemic cells reached 100:1 when 75 J/cm2 were fractionated into 3 periods after an incubation time of 120 min with 10 micrograms/ml HPD. Selectivity in photodynamic treatment seems to occur between normal hemopoietic progenitors and leukemic cells. The mechanism of this selectivity remains unclear, but experiments with the fractionated irradiation dose suggest that as in radiotherapy, better potentially lethal damage repair in normal cells could be a factor for selectivity in photodynamic therapy. Our results obtained with leukemic cells are fully in agreement with data in the literature concerning similar experimental models.

Animals↗
PubMed1989

[Palliative treatment by photochemotherapy of 54 digestive cancers: phase I clinical trial].

Photochemotherapy (PDT) is based on the interaction of a phototoxic drug (HPD) retained by cancer tissues and excited with a specific laser light. We present here a phase I clinical trial including 54 patients selected on the grounds of non-operability and T1 NO MO staging (UICC) and divided into 3 groups: I) 24 squamous cell carcinoma (SCC), II) 14 adenocarcinomas (ADN) of the upper GI tract, III) 16 ADN of the rectosigmoid colon. All received an HPD infusion of 2.5 to 5 mg/kg I.V. 72 hours before being laser irradiated endoscopically (632 nm, 150 to 220 j/cm2). Results documented on histology obtained after grip biopsies and on resected specimens (6 cases), were classified as complete response (ST), partial response (PR) or no change (NC). Eleven patients of group I, 5 of group II, and 8 of group III (24/54 patients) were classified ST with a mean follow-up of 15.2 months. Analysis of resected specimens showed a complete disappearance of tumor tissue and prominent fibrosis all around the treated area. Adverse effects were noted in 22% of patients, PDT of rectosigmoid ADN gave a survival (life table analysis) at least equal to SCC. These results should allow clinical indications for PDT to be broadened in combined protocols.

Adenocarcinoma↗
PubMed1989

[The symptom index: progress in the analysis of esophageal pH metry].

Commercially available pH-monitoring systems include one or more event markers which should allow correlation between reflux episodes and symptoms. However, the clinical relevance of this feature has not yet been thoroughly investigated. In this prospective study, we attempted to establish whether the use of an event marker could improve the accuracy of intraesophageal pH-monitoring and if a correlation between symptoms, as detected by event markers and esophageal exposure to acid could be shown. One hundred seven patients were studied. Only 47 p. 100 used the event marker during 24 h pH-metry. There was no statistical significance in the incidence of gastroesophageal reflux (GER i.e. time spent below pH 4 greater than 4.2 p. 100), age and socioeconomic status between patients who used the marker and those who did not. A concordance index was calculated by dividing the number of reflux episodes associated with a marked event by the total number of marked events. In 50 p. 100 of the 16 patients who used the marker and had GER, the concordance index was greater than 75 p. 100. On the contrary, only 4 out of 35 patients without GER had a concordance index greater than 75 p. 100 (p less than 0.003). Finally, the index was less than 25 p. 100 in 4 patients with GER and in 22 without GER (p less than 0.02). The lowest pH reached within the esophagus was virtually identical during all the reflux episodes, regardless of marker pressing.(ABSTRACT TRUNCATED AT 250 WORDS)

Esophagus↗
PubMed1987

Photochemotherapy mediated by hematoporphyrin derivative in gastroenterology.

While results concerning photodynamic treatments of cancers in pneumology or dermatology have been published regularly, few works have been devoted to gastroenterology. Twenty-seven non-operable patients bearing various G.I. tumors of less than 40 mm dia. have been treated by PDT for palliative purpose to appreciate the local efficacy of a single treatment. Before July, 1985, the parameters of treatment were 2.5 mg/kg of HPD injected intravenously for theoretical power of delivered laser light (630 mm) 300 mW. After July, 1985, HPD was injected at the dose of 5 mg/kg and the laser dose was 400 mW. A normalization of grip biopsies was observed on 12 patients (6 squamous cell carcinomas, 6 adenocarcinomas), transient in 3 cases. Our main finding is that PDT seems able to destroy significant volumes of tumor by itself although subsequent biopsies proved negative in very few cases. This method remains to be compared to others less sophisticated than the YAG laser.

Aged↗
PubMed1987

Low dose omeprazole effects on gastric acid secretion in normal man.

The pharmacological effects of low dose of omeprazole (Om) are not well known. This prompted us to investigate the effects of a 7-day treatment with a low dose of Om, 10 mg/d (Om10), on gastric acid secretion and serum gastrin levels and to compare the results with those obtained with an effective antisecretory dose of 20 mg/d (Om20). Twelve healthy volunteers received randomly and double-blind for three periods of 7 days, separated by at least 7 days, one capsule of placebo (P), Om10, Om20, given daily in the morning, in fasting condition. The last day of each period, 24 h pH was recorded using a glass electrode connected to a Digitrapper (Synectics). At the end of each pH-metry, acid secretion was measured in basal conditions (BAO), after sham-feeding (SAO) and after i.m. injection of 6 micrograms X kg-1 of pentagastrin (PAO). Whatever the threshold pH chosen, there was a statistically significant difference between P and Om10, P and Om20, and Om10 and Om20. Inhibition of acid concentrations was dose-dependent and prolonged, including nocturnal time. However, when considered on an individual basis, five subjects did not respond to Om10. More than 24 h after the last dose of Om has been administered, BAO, SAO and PAO were significantly reduced by either Om10 (respectively -52, -35 and -28 p. cent) and Om20 (respectively -60, -58 and -50 p. cent). Fasting serum gastrin concentration was significantly increased after Om20 treatment but not after Om10. We conclude that treatment with Om10 has a consistent and long lasting inhibitory action on gastric acidity without statistically significant effect on serum gastrin levels. These results suggest that 10 mg Om daily should be sufficient in some duodenal ulcer patients to effectively inhibit gastric acidity specially when long-term treatment seems to be indicated.

Adult↗
PubMed1986

Experimental aspects of in vitro and in vivo photochemotherapy.

The selectivity of in vitro photodynamic reactions and the in vivo effects induced by PRT, whether the irradiation is applied interstitially or externally, still remains unclear. In vitro studies were performed using leukemic cell lines and syngeneic normal hemopoietic progenitors. For these, cells incubated with hematoporphyrin derivative (HPD) and non-incubated cells were irradiated with an argon laser. Data were obtained as the count of cell colonies found after a 7-day incubation period on semi-solid collagen gel medium. In vivo studies employed the HT 29 tumor model grafted into nude mice. Both animals injected with HPD and non-infected controls were irradiated with a dye laser pumped by an argon laser (Coherent) using a 400 micron optic fiber located either at a distance of 65 mm from the skin or inserted into the tumor. The temperature increase occurring during PRT was measured using non-absorbing thermocouples. In vitro, after HPD treatment and argon irradiation leukemic cells showed a greater phototoxicity (greater than 2 log10) than did the normal cells (0.25 log10). In vivo, when the heat rise is very similar (less than 4 degrees C) in both the tissues irradiated externally and those irradiated interstitially after HPD injection, histological examination of these did not reveal any quantitative differences (90% of tumor mass). These results are discussed.

Animals↗
PubMed1986

[Hormone immunocytochemical studies of 46 endocrine tumors of the pancreas in 24 patients].

The aim of this retrospective study was to correlate the results of hormonal immunocytochemistry of 46 endocrine tumors to the corresponding clinical syndromes in 24 patients. They were divided as following: 14 cases of insulinoma, 3 cases of Zollinger-Ellison syndrome, 1 case of glucagonoma, 1 case of carcinoid syndrome and 5 cases without any obvious endocrine manifestations. Each tumor was tested with anti-insulin, anti-glucagon, anti-pancreatic polypeptide, anti-vasoactive intestinal peptide, anti-gastrin immune sera according to the peroxidase-antiperoxidase method. The presence of insulin was proved in 13 of 14 cases of insulinomas and the presence of gastrin in 2 of 3 cases of Zollinger-Ellison syndrome. Among the 5 asymptomatic cases, a somatostatinoma and a vipoma were individualized. More than 50 p. 100 of the tumors showed plurihormonal secretion with one predominantly secreted hormone responsible for the clinical syndrome. This study demonstrated the diversity of the hormonal secretion by some tumors and their metastasis in the same patient. Malignant insulinomas correspond either to poorly secreting tumors or to plurihormonal tumors secreting gastrin and glucagon as well.

Adenoma, Islet Cell↗
PubMed1986

[Ogilvie's syndrome: results of endoscopic exsufflation in a series of 29 cases].

The aim of this study was to assess the value of endoscopic decompression of the colon in a series of 29 patients affected with Ogilvie's syndrome. During the first period (1980-1982), 14 patients were treated by colonoscopic decompression alone. During the second period (1982-1985), 15 endoscopic decompressions were systematically completed by intubation of the colon. The tube was removed after 2 to 13 days. Whatever the procedure, endoscopic decompression was successfully achieved in all cases. The death rate (8/29) and number of cecostomies (2/29) were similar in the two groups of patients. Only one death was directly related to Ogilvie's syndrome itself, whereas 7 patients died from other severe underlying diseases. However, colonic dilatation recurred in 6 patients in the first group and in one patient in the second group (p less than 0.05). No complications due to the endoscopic procedures occurred in this series. It may be concluded that endoscopic treatment of Ogilvie's syndrome is a safe and effective procedure. Our results also suggest that colonoscopic intubation should be used prophylactically in order to avoid recurrences, frequently observed after simple endoscopic decompression.

Acute Disease↗
PubMed1985

Thermography as a predictive tool for laser treatment of port-wine stains.

The argon laser, which has been proven both useful and safe for port-wine stain therapy, interacts with the hemoglobin of the vessels. In a percentage of cases, this treatment is still inefficient, and there is a lack of correlation between these bad results and clinical or histologic criteria. Thermography, which explores the vascularization of the port-wine stain, leads us to consider port-wine stains from a physical point of view. This very simple test shows no correlation with the clinical parameters of port-wine stain but is closely related to the results obtained with laser therapy. It seems to be a good criterion to estimate the argon laser treatment prognosis.

Adolescent↗
PubMed1985

[Peritoneal amyloidosis in Waldenström's macroglobulinemia. X-ray computed tomographic aspects].

A 74 years old man, know to have Waldenström's macroglobulinemia was hospitalized for intestinal obstruction. Upper gastrointestinal barium study revealed an extrinsic stenosis of duodenum. Ultrasonography and abdominal computed tomography revealed a diffuse mesenteric infiltration with medium level echoes and encasing of mesenteric vessels. Histologic examination of biopsies taken at exploratory laparotomy disclosed amyloidosis of the epiploon and mesentery. The review of amyloidosis in macroglobulinemia shows peritoneal amyloidosis to be a very rare event. Sonographic, computed tomographic and pathologic findings of this unusual case are discussed.

Aged↗