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Biomedical subjects

P Hillon

Publications and source records attributed to P Hillon.

At least 19 recordsLinked to original sources
PubMed1994

Effect of different doses of dietary calcium on murine colonic cell proliferation.

One-hundred and twenty 6-week-old 257BL/65 mice were fed for 2 or 7 weeks with diets supplemented with different combinations of bile acids and calcium. The effect of calcium, bile acids and the duration of these treatments on proliferative indices of the colonic mucosa was studied with a multiway analysis of variance. In mice not treated with bile acids, a low level (0.1%) of calcium in the diet was related to a significantly higher number of cells in each compartment of the crypt, compared with diets supplemented with 0.5 and 1% calcium (P < 0.01). There was no difference between the groups fed with normal and high calcium diets. Bile acids significantly increased proliferative indices in all animal groups whatever the duration of the treatment; however, this effect was significantly lower in the mice fed with 0.5% and 1% calcium than in those fed with 0.1% calcium (P < 0.01). There was a significant interaction between the effect of bile acids and the effect of calcium regarding the number of labeled cells and the labeling indices. Duration of the treatment had little effect on these indices. The effect of bile acids on colonic proliferative activity could be significantly reduced by calcium supplementation, and this effect was stable with time. Although there was no toxic effect of the highest calcium diet, there was no advantage in increasing the calcium dose beyond 0.5%.

Animals↗
PubMed1993

[Bone metastasis of hepatocellular carcinoma. Apropos of 22 cases].

There have been few studies and case-reports of bone metastases from hepatocellular carcinoma. To determine the characteristics of these metastases, we retrospectively studied 22 patients in whom the diagnosis was established either on the basis of concomitant occurrence of malignant bone lesions and hepatocellular carcinoma in the absence of other detectable malignant disease (n = 15) or on the basis of histological evidence of bone metastasis from an hepatocellular carcinoma (n = 7). There were 21 males and one female. Mean age was 62.5 years. Most patients (88.2%) had chronic alcohol abuse. The bone metastases occurred as the first manifestation of the liver cancer in half the cases (11/22). Time interval between onset of bone symptoms and admission was less than one month in 6 of 11 patients; mean interval was 7.4 weeks. Hepatomegaly was found upon initial physical evaluation in 9 of 11 patients. Pain was the main symptom of bone disease (18/22). Palpable bone masses were found in 6 of 22 patients. Purely osteolytic lesions were seen on roentgenograms in every case; rupture of the cortex and spread to adjacent soft tissues were common findings. The radionuclide bone scan was normal in four of 12 patients. An advanced primary hepatic tumor was found in 84.2% of cases. Histologic examination of bone specimens established the diagnosis of metastasis from a hepatocellular carcinoma in 7 of 9 patients (77.8%). Severe bleeding occurred during one of the nine biopsy procedures. Patients were given symptomatic treatment. Systemic chemotherapy was used in five patients, unsuccessfully. Median survival was three months.

Bone Neoplasms↗
PubMed1992

Adenoma--carcinoma sequence or "de novo" carcinogenesis? A study of adenomatous remnants in a population-based series of large bowel cancers.

Although it is well known that colorectal cancers can arise on a preexisting adenoma or de novo, the relative importance of these two pathways is still highly controversial. The authors studied the proportion of cancers with adenomatous remnants in a nonselected population-based series of 1630 resected colorectal cancers, so that they could estimate by subsite the importance of the adenoma-carcinoma sequence. Four factors appeared to be related independently to the presence of adenomatous tissue within cancers in a multiple logistic model: tumor extension, growth pattern, location, and size. It appeared that infiltrating and ulcero-infiltrating tumors, which represented 39.8% of all resected colorectal cancers, very rarely displayed adenomatous tissue (0.5%), whereas it was more common in fungating and ulcero-fungating cancers (25.8%; P less than 0.001). In these exophytic cancers, the presence of adenomatous tissue was related very closely to the tumor size and extension, and it was seen in as many as 83% of small cancers (less than 2 cm) limited to the mucosa or submucosa. Right colon cancer showed consistently fewer adenomatous remnants than left colon or rectal cancer. These figures suggest that there are roughly two types of colorectal cancers, one of the infiltrating or ulcero-infiltrating type, which usually would arise de novo and account for approximately 40% of all colorectal cancer cases, and the exophytic type, which would mainly follow an adenoma-carcinoma sequence, although some might be de novo cancers, in particular in the right colon.

Adenocarcinoma↗
PubMed1992

Prognosis of gastric carcinoma after curative surgery. A population-based study using multivariate crude and relative survival analysis.

A population-based series of 246 gastric cancer patients operated for cure and who survived the postoperative phase was reviewed to determine prognostic factors after potentially curative treatment. The overall five-year observed survival rate was 34.8%, and the relative survival rate was 43.9%. Previous history of gastric ulceration, tumor location, tumor size, gross appearance, extension within the gastric wall, and number of proximal lymph nodes involved were significantly related to both crude and relative survival rates. Age was a significant prognostic factor when considering crude survival rates, but it had no influence on relative survival rates. Multivariate analysis of crude and relative survival gave similar results except for age. The covariates retained in the final model were, by decreasing importance, extension within the gastric wall, lymph node involvement, gross appearance and tumor location. Combining the two major prognostic criteria, tumor extension through the gastric wall and lymph node involvement, four prognostic categories could be determined with five-year corrected survival rates ranging from 92% in patients with a carcinoma limited to the gastric wall to 17% in patients with more than two positive nodes whatever the extension in the gastric wall. Gross appearance had no influence on prognosis for carcinomas limited to the gastric wall, but had a significant impact on prognosis of more extended carcinomas. From these data, a simple staging system requiring only routinely available pathological data was proposed. This classification could be helpful for planning multicenter clinical trials on this disease where progress in therapy is needed.

Carcinoma↗
PubMed1992

Epidemiology, management, and prognosis of malignant large bowel polyps within a defined population.

The population based registry of digestive tract tumours established for the department of Côte d'Or, France (population 480,000) was used to study the epidemiology and management of malignant large bowel polyps. In a 10 year period (1976-85), 146 cases were recorded in the area. Age standardised incidence rates were 2.7 per 100,000 for men and 1.4 per 100,000 for women. Although incidence rates increased significantly during the study period, large bowel cancer diagnosed as a malignant polyp remained relatively rare (6.2% of all registered large bowel cancers). Two malignant polyps (1.4%) were less than 1 cm in diameter, 34 (23.3%) were more than 30 mm. Sixty patients were treated by endoscopic polypectomy, four by contact radiotherapy, 21 by surgical local excision, 58 by colectomy (10 preceded by polypectomy), and three by colotomy. Operative mortality was 8.2% after intra-abdominal surgery, 4.8% after local surgical excision, and 0% after polypectomy (p less than 0.05). All deaths occurred in patients over 65 years. The five year cumulative recurrence rates were 8.9% after surgical excision and 11.3% after endoscopic polypectomy (NS). The corresponding five year net survival rates were 86.1% and 95.9%. Endoscopic excision alone can be considered a sufficient treatment for adenomas with malignant change unless there is evidence of incomplete resection or a high risk of lymph node metastases.

Aged↗
PubMed1991

[Incidence, diagnosis, treatment and prognosis of cancer of the pancreas: development in Côte-d'Or from 1976 to 1985].

The aim of this study was to analyze the epidemiological aspects of pancreatic cancers and their time trends in the Côte-d'Or population between 1976 and 1985. Over a period of ten years, 444 cases were diagnosed. The incidence rates standardized according to the world reference population were 8.2/100,000 in males and 3.8/100,000 in females. The Côte-d'Or is an intermediate risk area for pancreatic cancer. This cancer was slightly more common in urban than in rural areas (NS). The initially urban predominance of pancreatic cancer in males was no longer present 10 years later. Between 1976 and 1985, incidence of pancreatic cancer decreased by a mean of 4.7% per year in males (NS) and 0.5% per year in females (NS). A high proportion of the cancers (73.9%) were located in the head of the pancreas; among histologically confirmed cases, 69.7% were adenocarcinomas. Criteria for diagnosis evolved throughout the 10 years. The rate of histological confirmation increased annually by a mean of 3.0% (P less than 0.001). The relative importance among diagnostic procedures of direct biliary and pancreatic examinations decreased (P less than 0.05) whereas that of ultrasonography and radioscan increased (P less than 0.001). The overall surgical rate was 64.4% and the rate of curative surgery was 4.4%. The operability rate increased annually by a mean of 2.0% (NS). The overall survival rate was 13.2% after 1 year, 4.5% after 3 years and 3.2% after 5 years. Prognosis depended neither on age nor on sex or cancer location. The 5-year survival rate was 38.5% in the limited group of patients (n = 13) who underwent surgery for cure, and 0.0% in patients with palliative treatment. These data emphasize the severity of pancreatic cancers and the absence of any therapeutical improvement between 1976 and 1985 in spite of the evolution in diagnostic procedures.

Adult↗
PubMed1991

[Postoperative mortality for colorectal cancer in the Côte-d'Or (France) from 1976 to 1985].

Postoperative mortality from colorectal cancers in the resident population of the department of Côte-d'Or was studied for the 1976-1985 period through the data collected by the Registry of Digestive Tumors of the Côte-d'Or (France). The overall postoperative mortality was 14.7 percent for colonic cancers and 11.2 percent for rectal cancers. After surgery with curative intent (n = 1,411), the corresponding figures were 10.3 percent and 6.8 percent, respectively. In patients operated with curative intent, postoperative mortality was slightly less in females than in males (NS), and in patients less than 65 than in older patients (P less than 0.001). It was higher when cancer was discovered through an acute event (20.0 percent) than in the other patients (7.7 percent; P less than 0.001). Stage at diagnosis, gross macroscopical appearance, and tumour size had no influence on postoperative mortality for colonic cancers. For rectal cancers, postoperative mortality was lower in tumors less than 3 cm in diameter (1.3 percent) than in larger tumors (7.5 percent; P less than 0.05). Postoperative mortality decreased by a mean of 9.7 percent per year between 1976 and 1985 (P less than 0.001). This trend was more pronounced after curative surgery: 10.9 percent (P less than 0.001) than after palliative surgery: 5.5 percent (P less than 0.05). After curative surgery, postoperative mortality decreased more in men (annual variation: 13.9 percent; P less than 0.001) than in women (6.3 percent; NS), before age 75 (20.2 percent; P less than 0.001) than in older patients (5.6 percent; NS), and for colonic cancers (13.1 percent; P less than 0.001) than for rectal cancers (9.1 percent; NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Is the Tru-Cut needle more efficient than the fine needle in the diagnosis of hepatic lesions? Comparative study of 45 echography-guided punctures].

A comparison of diagnostic efficiency of fine needle biopsy (22 G) versus coarse needle biopsy (Tru-Cut 14 G) was performed on ultrasound-guided liver biopsies in 45 patients. Diagnosis was established through clinical, paraclinical and pathologic features. For each patient pathologic examination of both fine needle biopsy (cytology and histology) and coarse needle biopsy (histology) were performed by a pathologist unaware of any clinical data. Of 36 malignant tumors, diagnosis of malignancy was made in 83 percent of the cases by fine needle biopsy and in 81 percent of the cases by Tru-Cut biopsy, and distinction between primary and secondary cancer, in 83 and 86 percent of cases respectively. Specificity was 100 percent with both techniques. Of 9 benign lesions, the 6 focalized fatty infiltrations were diagnosed by both fine and coarse needle biopsies. As fine needle biopsy is less invasive than coarse needle biopsy and gave equally satisfying results, we suggest that it should be used preferentially in the diagnosis of focalized liver lesions.

Biopsy, Needle↗
PubMed1989

[Trends in the incidence of colorectal cancer at the Department of Côte-d'Or between 1976 and 1985].

Colorectal cancer is the leading cause of cancer morbidity in France when both sexes are considered together. There are few available data on time trends, although such data would prove both necessary for planning screening programs and usefull to construct hypotheses on etiological factors. Data from the Registre des Tumeurs Digestives de Côte d'Or permitted to establish time trends for the different locations of colorectal cancer during the 1976-1985 period. Changes in incidence rates as based on the world reference population were studied using a log linear model as well as the Armitage test. Overall colon cancer rates have increased in both sexes. The mean annual increase of left colonic cancer was 3.1 p. 100 in men (p less than 0.05) and 4.0 p. 100 in women (NS), whereas rectal cancer decreased by 2.4 p. 100 in men and 3.3 p. 100 in women (NS). In men, left colonic cancer rates increased mainly in rural areas (+ 7.3 p. 100; p less than 0.05) whereas it increased mainly in urban areas in women (+ 6.0 p. 100; NS). In both sexes, the left colonic cancer increase was particularly noticeable in the 45-64 age group, which could indicate that the observed trend is likely to become more important in the next years. As for rectal cancer, the decrease was most important in the 65-74 age groups. That inversed trend for colon and rectum cancer has already been observed in other countries including the USA and Canada. As the trends we observed for right colon, left colon and rectal cancer differ, colorectal cancer etiology should be studied separately.

Aged↗
PubMed1988

Nadolol for prophylaxis of gastrointestinal bleeding in patients with cirrhosis. A randomized trial.

This controlled trial was designed to evaluate the prophylactic effect of nadolol on gastrointestinal bleeding in cirrhotic patients with large oesophageal varices who had never bled. Nadolol or placebo was given randomly to two groups of 53 patients. The percentage of patients free of gastrointestinal bleeding 1 year after inclusion in the study was 83 +/- 6% (mean +/- S.D.) in the nadolol group and 80 +/- 6% in the placebo group. In the nadolol and placebo groups, 40 and 47 patients, respectively, were compliant, i.e., took nadolol or placebo continuously. The percentage of patients who were free of bleeding 1 year after inclusion was 97 +/- 3% in the subgroup of compliant nadolol patients. This percentage was significantly higher than that of patients who were free of bleeding in the placebo group (P less than 0.03) as well as in the subgroup of compliant placebo patients (77 +/- 6%; P less than 0.02). We concluded that, although there was no overall significant effect of nadolol on the risk of bleeding in cirrhotic patients in good condition with large oesophageal varices, this study suggests that nadolol reduced the risk of bleeding in compliant patients.

Clinical Trials as Topic↗
PubMed1988

Primary liver cancer in Côte d'Or (France).

The registry of digestive tract tumours established for the department of Cote d'Or (France) was used to study the incidence and some of the characteristics of primary liver cancer (PLC) in this area. The annual age-standardized incidence rate was 7.6/100,000 for males, and 1.8/100,000 for females. As compared to other areas the Cote d'Or is in the intermediate incidence areas. The risk of PLC was higher in urban than in rural areas in men (p less than 0.01). There was no significant variation in PLC incidence over the eight years of the study. Alfafoetoprotein levels over 200 ng/ml were observed in only 48.9% of the cases. Alfafoetoprotein measurement has to be complemented by other investigations in screening of high-risk patients. Liver cirrhosis was present in 70.9% of the cases in which the information was available. The male:female ratio in the non-cirrhotic group was 1.5:1, very different to the 8.8:1 in the cirrhotic group. Cirrhosis was associated with excessive alcohol consumption in 92% of cases. The prevalence of serological markers of hepatitis B virus infection was investigated in 91 patients. Hepatitis Bs-antigen was found in 8.8% and evidence of past or present infection in 28.2%. In view of the prevalence of chronic alcoholism in patients with cirrhosis it is suggested that alcohol leads to an increased risk of cirrhosis followed by an increased incidence of PLC. Further studies are needed to elucidate the eventual role of HBV infection and other suspected environmental factors in the aetiology of PLC.

Adolescent↗
PubMed1988

[Primary biliary cirrhosis: therapeutic trial using plasma exchange and immunosuppression. Preliminary results].

Four women aged 35 to 57 years (m: 49.2) with primary biliary cirrhosis and intractable pruritus had an estimated median survival time according to Christensen between 6 and 50 months (m: 27). They were enrolled in a therapeutic trial associating plasma exchange (PE) and immunosuppressive drugs. During the first 2 months, they received prednisone 15 mg/day, cyclophosphamide 2 mg/kg BW/day and 28 PE (60 ml/kg BW). Pruritus disappeared rapidly. After 2 months, mean levels of bilirubin, alkaline phosphatases, IgM and anti-mitochondrial antibodies dropped by 27 p. 100, 47 p. 100, 50 p. 100 and 85 p. 100 respectively, whereas amino-transferase and gamma-glutamyl-transpeptidase activities were unaltered. Two patients then received supportive therapy only: one was lost to follow-up after one year, the other died 50 months later from liver failure. The third patient received PE only when intractable pruritus reappeared: anti-mitochondrial antibodies, IgM and alkaline phosphatases remained below initial values for 38 months, until successful liver transplantation was performed. The fourth patient was treated on a long term basis by PE twice a month, prednisone 10 mg/day for 3 years and cyclophosphamide 1 mg/kgBW/day for one year only. Her initial estimated survival time was 6 months, but 3 years later she developed portal hypertension; anti-mitochondrial antibody titer was between 0 and 1/80, alkaline phosphatase levels reduced by 80 p. 100 to 70 p. 100; bilirubin level up by 50 p. 100. The mean survival time for the 4 patients exceeded 34 months, results better than those obtained with other kinds of therapy.

Adult↗