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Biomedical subjects

P Bellon

Publications and source records attributed to P Bellon.

18 recordsLinked to original sources
PubMed2002

Anal endosonography for assessment of anal incontinence with a linear probe: relationships with clinical and manometric features.

BACKGROUND AND AIMS: This study determined correlations of clinical and manometric features with those of anal endosonography (AES). PATIENTS AND METHODS: Between 1996 and 1999 we examined 58 patients suffering from anal incontinence (AI) by AES using a linear probe and anorectal manometry following a standardized protocol. RESULTS: Twelve of the 58 patients (21%) had a history of anal surgery. Of the 40 women who had under-gone at least one vaginal delivery 22 (55%) sustained an obstetric tear and 12 (30%) required forceps for delivery. A perineal descent was observed in 24 of 32 women with AI (75%) and urinary incontinence in 24 of 44 (54%). An anal sphincter defect was diagnosed in 45 of the 58 patients (77%). The internal anal sphincter defects occurring in 42 patients (72%) were significantly associated with a decrease in the resting anal pressure. The external anal sphincter defects occurring in 33 patients (57%) were significantly associated with a decrease in the voluntary anal contraction. CONCLUSION: Considering AES and manometric findings, a good correlation was observed between internal sphincter defect and the resting anal pressure and between external sphincter defects and the voluntary anal contraction. AI is usually associated with a global perineal insufficiency requiring special attention in terms of both training and medical management.

Adult↗
PubMed2002

Early refeeding after endoscopic biliary or pancreatic sphincterotomy: a randomized prospective study.

BACKGROUND AND STUDY AIMS: Patients who have undergone endoscopic sphincterotomy (ES) are usually left to fast for arbitrary reasons until they are examined on the following day. The aim of this study was to check whether this systematic fasting after ES is actually justified. PATIENTS AND METHODS: A blinded randomized prospective study, involving 146 patients, was carried out from January 1999 to September 2001. All patients undergoing biliary and/or pancreatic endoscopic sphincterotomy during this period were randomly allocated to one of two groups: group 1 patients were re-fed 4 hours after ES, and the group 2 patients were only re-fed 24 hours after the procedure. These two groups were comparable for clinical and procedural data except for stenting. RESULTS: Eight patients in group 1 (11 %) and 26 patients in group 2 (37 %) suffered from abdominal pain which resolved with analgesic drug treatment (P = 0.01). Eight patients in the first group(11 %) and five patients in the second group (7 %) had to be given major opiate analgesics (P = 0.56). Refeeding resulted in abdominal pain in five patients in group 1 and 13 in group 2 (P = 0.04). The serum amylase and lipase levels increased significantly after refeeding in group 1, but lipasemia did not increase significantly in group 2. No significant differences in post-ES complications were observed between the two groups. The mean hospital stay was significantly shorter in group 1 : 2.6 days on average, vs. 3.8 days in group 2 (P = 0.03). CONCLUSIONS: In the absence of any perforation of the digestive tract or immediate severe acute pancreatitis, early refeeding could be helpful to decrease pain and shorten the hospital stay in patients who have undergone endoscopic sphincterotomy.

Amylases↗
PubMed2001

[Risk factors for Crohn's disease relapse after treatment of intestinal stenosis].

BACKGROUND: Postoperative recurrences of Crohn's disease (CD) has been widely investigated in previous studies. Nevertheless, the risk factors for CD recurrence in patients presenting with intestinal stenosis are not clearly identified. PATIENTS AND METHOD: Thirty consecutive patients out of a cohort of 134 patients with CD presented with an intestinal stenosis diagnosed between 1995 and 1999. Epidemiological, clinical, and therapeutic data were carefully recorded. A univariate analysis followed by stepwise descending discriminant analysis was performed. RESULTS: Sixteen patients (53%) underwent surgery, six received steroid therapy, eight were given antibiotics, and seven took immunosuppressive drugs. The mean follow-up after medical or surgical management was 2.8 years. Thirteen patients (43%) had CD relapse during the follow-up. Considering the univariate analysis, the existence of a previous appendectomy and the persistence of tobacco consumption were significantly associated with the risk of CD relapse during the follow-up. The stepwise descending discriminant analysis identified three independant factors: tobacco consumption (p = 0.007), previous appendicectomy (p = 0.04) and duration of the follow-up (p = 0.02). CONCLUSION: The CD relapse after the management of small bowel stenosis occurred in 43% of the patients within a mean follow-up of 2.8 years. The significant factors associated with the risk of CD relapse were tobacco consumption, previous appendectomy and duration of the follow-up.

Adult↗
PubMed2000

Compositional patterning in systems driven by competing dynamics Of different length scale

We study an alloy system where short-ranged, thermally driven diffusion competes with externally imposed, finite-ranged, athermal atomic exchanges, as is the case in alloys under irradiation. Using a Cahn-Hilliard-type approach, we show that when the range of these exchanges exceeds a critical value labyrinthine concentration patterns at a mesoscopic scale can be stabilized. Furthermore, these steady-state patterns appear only for a window of the frequency of forced exchanges. Our results suggest that ion beams may provide a novel route to stabilize and tune the size of nanoscale structural features in materials.

Journal Article↗
PubMed2000

Analysis of the ex vivo specificity of human gelatinases A and B towards skin collagen and elastic fibers by computerized morphometry.

Cutaneous aging and chronic exposure to UV irradiation leads to alterations in the appearance and biochemical composition of the skin. Members of the MMP family have been involved in the destruction of the extracellular matrix. Among them, gelatinases A and B were found to display elastolytic activity, in vitro. In this study, we first determined the ex vivo elastolytic potential of both endopeptidases, using human skin tissue sections and computerized morphometric analyses, and compared it with those of neutrophil elastase. In such conditions, gelatinase B (50 nM) induced 50% elastolysis. The percentage of elastic fibers degraded by gelatinase A (10-100 nM) never exceeded 10%. Elastolysis by gelatinase B and leukocyte elastase was characterized by a decrease in fiber length and an increase in the average diameter of the fibers. In addition, gelatinase B exhibited fibrillin-degrading activities. On the contrary, gelatinase A (50 nM) elicited up to 50% hydrolysis of collagen fibers, preferentially degrading type III collagen fibers. Gelatinase B did not promote any collagen degrading activity. Our data suggested that in vivo gelatinases could disrupt most extracellular matrix structures of human skin. Gelatinase B and to a much lesser extent, gelatinase A would degrade components of the elastic fibers network while gelatinase A, but not gelatinase B, would alter mostly collagen fibers and also degrade constituents of the dermo-epidermal junction.

Collagen↗
PubMed1989

[Impingement syndrome of the shoulder. 50 cases treated by Neer's anterior acromioplasty].

The authors present the preliminary results of 50 cases of impingement syndrome treated surgically using an operative technique which at least included an anterior Neer acromioplasty. Surgery was performed after a period of progression ranging from several months to several years. These included 2 Neer stage 1 (4%), 29 stage II (58%) and 19 stage III (38%). In all cases an anterior Neer acromioplasty was carried out. In 18 cases, an additional procedure was also performed (resection of the acromial extremity of the clavicle, suture of a rotator cuff rupture, resection reinsertion of the long head of biceps and an Apoil and Augereau deltoid flap procedure). Results could be assessed in 48 cases (2 cases lost to follow up). They demonstrated 31 very good (i.e. 64.5%), 12 good results (i.e. 25%) and 5 poor results (i.e. 10.5%).

Acromioclavicular Joint↗
PubMed1988

[Meniscal lesions in so-called "isolated" ruptures of the anterior cruciate ligament. Apropos of 59 cases].

Between December 1984 and March 1987, i.e. a period of 27 months, the authors operated on 59 "isolated" fresh ruptures of the ACL with routine evaluation of the posterior horns of the medial and lateral menisci. Lesions were investigated either by arthroscopy (23 cases) or by anterior arthrotomy with routine medial and lateral retro-ligamentous counter-incision (36 cases). This revealed 21 lesions of the medial meniscus (i.e. 35.5%) and 38 lesions of the lateral meniscus (i.e. 64.5%). Lesions of both menisci were present in 16 knees (27%) and only 16 knees (27%) were found to be free of any meniscal lesion. The majority of meniscal lesions were viable and could be sutured in 86% of cases for the medial meniscus and 87% of cases for the lateral meniscus. From the standpoint of operative technique, posterior lesions are relatively poorly visualized by arthroscopy (notably concerning the posterior horn of the medial meniscus though it is easier to assess the stability of the meniscus by this technique using the palpating hook. Lesions are well visualized by medial and lateral retroligamentous counter-incisions, but it is difficult to assess meniscus stability. Finally it should be noted that all of these ruptures of the ACL were dealt with by reconstruction of the central pivot either by suture and a strengthening procedure (semitendinous) or by ligament plasty from the outset.

Arthroplasty↗