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Biomedical subjects

A Cortot

Publications and source records attributed to A Cortot.

At least 181 records · Page 10Linked to original sources

Gastric emptying and gastrointestinal absorption of alcohol ingested with a meal.

We have measured, by an intubation method, gastric evacuation and gastrointestinal absorption of alcohol ingested with a meal in seven healthy nonalcoholic subjects. A homogenized meal containing [14C]PEG and ethanol (1 g/kg body wt) was given intragastrically while saline containing [57CO]vitamin B12 was perfused into the duodenum. Of the ingested alcohol, 39.4 +/- 4.1% was absorbed through the stomach wall during the first postprandial hour and 73.2 +/- 4.2% during the total postcibal period, whereas only 24 +/- 3% was absorbed during the same time in the duodenum. Thus alcohol ingested with a meal is mainly and rapidly absorbed in the stomach; the contribution of the small intestine below the angle of Treitz to alcohol absorption is negligible.

Adult↗

Effect of ethanol ingestion on postprandial gastric emptying and secretion, biliopancreatic secretions, and duodenal absorption in man.

Although abdominal complaints are frequent in both acute and chronic alcoholism, little is known of the effect of ingestion of ethanol with a meal on the function of the upper digestive tract. We have studied the effects of oral ethanol (1 g/kg body wt) taken with food on the gastric emptying rate of a solid-liquid meal as measured by a dual radioisotope technique in six normal subjects; and the gastric response (emptying and secretion), biliopancreatic secretions, and duodenal nutrient absorption after an homogenized meal, as evaluated by a gastroduodenal intubation-marker perfusion technique on seven healthy volunteers. In the latter experiments, radioimmunoassays of gastrin, secretin, cholecystokinin, pancreatic polypeptide, motilin, somatostatin, gastric inhibitory polypeptide, and vasoactive intestinal polypeptide were performed serially. As compared with the control experiment, alcohol induced the following effects: marked delay of gastric emptying of solids, smaller slowing effect on gastric emptying of the liquid phase of the solid-liquid meal and of the homogenized meal; no significant change in gastric acid secretion; no change in the overall postprandial pancreatic enzyme outputs, but a delay of lipase secretion; no change in the early bile salt postprandial output, but a reduced bile salt secretion from the second postprandial hour onwards; no significant change in carbohydrate and lipid duodenal absorption; and a significantly greater postcibal gastrin release. The mechanisms for these effects of alcohol on upper digestive tract function remain to be clarified.

Adult↗

Latent pulmonary involvement in Crohn's disease: biological, functional, bronchoalveolar lavage and scintigraphic studies.

We have investigated the following pulmonary related parameters in 22 patients with Crohn's disease who were free of clinical pulmonary symptoms and had normal chest roentgenograms and in 25 controls: serum angiotensin converting enzyme, pulmonary function tests, bronchoalveolar lavage (lymphocyte count and subpopulations, macrophage viability and superoxide anion release by macrophages) and pulmonary scannings. Serum angiotensin converting enzyme was lower in Crohn's disease (14.1 +/- 5.1) than in controls (25.2 +/- 4.7) (p less than 0.001). Twelve of 22 Crohn's disease (54%) had a bronchoalveolar lavage lymphocytosis (greater than 18% alveolar lymphocytes). Bronchoalveolar lavage lymphocytes subpopulations were quite variable. Twelve of 17 Crohn's disease (71%) had an increase spontaneous and/or stimulated superoxide anion production by alveolar macrophages. Six of 12 Crohn's disease (50%) had an increase physiologic dead space in the upper part of their lung against one of 11 controls (9%). These data suggest that most patients with Crohn's disease have a latent pulmonary involvement.

Adolescent↗

Primary biliary cirrhosis. Subclinical inflammatory alveolitis in patients with normal chest roentgenograms.

To determine whether a subclinical inflammatory alveolitis is associated with primary biliary cirrhosis (PBC), we compared the numbers and types of cells recovered by bronchoalveolar lavage from 12 patients with PBC, ten healthy control subjects, and nine patients with alcoholic cirrhosis (AC). All were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. Total BAL cell count did not differ among patients with PBC (mean 9.6 X 10(4) cells/ml), patients with AC (mean 14.8 X 10(4) cells/ml), and control subjects (mean 9.9 X 10(4) cells/ml). Patients with PBC but not patients with AC had an increased proportion of lymphocytes in bronchoalveolar lavage fluid (respectively 22.4 percent +/- 5.2 and 11.6 percent +/- 2.52 compared with the normal value of 9.9 percent +/- 1.5 p less than 0.05). In the same way, alveolar lymphocytosis of the lower respiratory tract from PBC patients predominantly comprised T4+ (helper/inducer) T-lymphocyte subset in patients showing an increased alveolar lymphocytosis. Alveolar macrophages from PBC patients showed a dramatic increased chemiluminescence response before and after stimulation by phorbol-myristate-acetate, regardless of the intensity of alveolar lymphocytosis. Thus, our data demonstrated that subclinical alveolar inflammation comprising T-lymphocytes and activated alveolar macrophages mimicking sarcoid alveolitis is present in a high proportion of patients with PBC.

Adult↗

[Human anisakiasis: 5 cases in northern France].

We report 5 cases of human anisakiasis revealed respectively by an acute intestinal obstruction due to multiple small bowel stenosis, an acute inflammatory ileitis simulating appendicitis, ulcer type epigastralgia, purulent peritonitis and a latent small bowel tumor. Diagnosis was established in 4 cases on microscopic analysis of bowel specimens (eosinophilic granulomas and/or parasitic fragments) and in 1 case at gastroscopy. Serodiagnosis was positive in 2 of 4 cases and the consumption undercooked fishes was found in 4. In small samples we estimated the infestation (1 to 50 parasites) by anisakis larvae of 3 fish species: 80 p. 100 for herrings, 63 p. 100 for mackerels and 100 p. 100 for whitings. This work emphasizes the role of anisakiasis as a source of digestive symptoms and intestinal eosinophilic granuloma.

Adult↗

Investigation of drug absorption from the gastrointestinal tract of man. I. Metoprolol in the stomach, duodenum and jejunum.

Gastrointestinal (GI) absorption of the beta-adrenoceptor blocker metoprolol was investigated in five healthy subjects by means of an intubation method, employing a triple-lumen tube introduced into the intestine, and a twin-lumen tube in the stomach. Metoprolol was introduced into the stomach with a homogenized meal containing a nonabsorbable marker, [14C]-PEG 4000, and another marker, PEG 4000, was perfused continuously into the duodenum just below the pylorus. Samples of GI contents were collected at regular intervals over 4 h in the stomach and at two different levels in the upper small intestine. Metoprolol was not absorbed from the stomach. Approximately 60% of the amount of drug emptied from the stomach was absorbed from the duodenum; about 50% of that leaving the duodenum was absorbed from the first part of the jejunum. The delivery process was the rate-limiting factor of metoprolol absorption in these segments of the gut. Plasma concentrations reflected drug loss from the lumen and were higher in subjects exhibiting faster gastric emptying and higher absorption rates in the duodenum and jejunum. The intubation technique appeared to be a suitable method for investigating drug absorption from the GI tract in man.

Adult↗

Investigation of drug absorption from the gastrointestinal tract of man. V. Effect of the beta-adrenoceptor antagonist, metoprolol, on postprandial gastric function.

The role of the adrenergic system in normal gastric function was assessed in five healthy volunteers by measuring gastric secretion and emptying after a mixed meal containing a non-absorbable marker, [14C]-PEG 4000, with and without 100 mg of metoprolol, a beta 1-adrenoceptor antagonist. Intraduodenal perfusion of PEG 4000, and gastric and jejunal sampling was achieved by means of a gastrointestinal intubation technique. Gastric function was assessed from the degree of dilution of the duodenal marker. Analysis of acid content by titration allowed the gastric acid secretory rate to be determined. Gastric emptying of a meal over 4 h was similar with and without metoprolol, the time to 50% emptying being 100 min. In the presence of metoprolol, gastric acid content was significantly increased during the late postprandial period producing a corresponding increase in acid load delivered to the duodenum. beta 1-adrenoceptor blockade appears to prolong the gastric secretory response to food without altering gastric emptying.

Food↗

Evidence of lymphocyte alveolitis in Crohn's disease.

Cellular characteristics of bronchoalveolar lavage (BAL) were investigated in 18 consecutive patients with Crohn's disease, who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. Total BAL cell count and cellular viability of alveolar macrophages did not differ significantly between patients and control subjects. Percentage of alveolar lymphocytes was increased in 11 of 18 patients (from 18 percent to 79 percent). There was no apparent correlation between BAL differential cell count and abnormal pulmonary function tests noted in 11 patients, drug treatment or Crohn's disease site, and activity. These results demonstrate a high proportion of latent lymphocyte alveolitis as assessed by BAL, suggesting a latent involvement of the lung in Crohn's disease.

Adolescent↗

Villous adenomas of the rectum. Results of endoscopic treatment with argon and Nd:YAG lasers.

Endoscopic treatment of rectal villous adenomas with argon and neodymium:yttrium aluminum garnet lasers is reported in 56 patients. Patients treated include 25 who had polyp recurrence after non-laser polyp treatment, 8 who had small sessile polyps that would otherwise require major surgery, and 23 who had contraindications to surgery. Complete tumor ablation was documented over a 3-24-mo follow-up period in 42 of the 56 treated patients. Of the remaining 14 patients, 5 were referred for other therapy because invasive carcinoma developed during treatment, 5 could not be assessed with confidence because of radiation proctitis, and 4 were lost to follow-up. In all patients with symptoms, improvement was noted when 75% of the tumor was destroyed. Treatment was well tolerated with no major complications. The results compare favorably with conventional treatment. Because laser tissue destruction precludes complete histologic evaluation of polyp tissue, laser ablation of polyps should presently be limited to (a) patients with recurrent tumors after previous non-laser treatment who refuse surgery, (b) patients with serious contraindications to surgery, and (c) small benign tumors that would require major surgery.

Adenoma↗

Serotonin-secreting and insulin-secreting ileal carcinoid tumor and the use of in vitro culture of tumoral cells.

The authors report the case of a patient with a typical carcinoid syndrome and a severe hypoglycemia due to hyperinsulinism. He was found to have an ileal carcinoid tumor with hepatic metastasis and no evidence of pancreatic insulinoma at surgery and autopsy. By assaying serotonin and insulin in the tumor and in the supernatants of the culture derived from hepatic metastasis, the authors have been able to show that both hormones were produced by the carcinoid tissue. Cultured cells also synthesized minute amounts of gastrin and thyrocalcitonin.

Blood Glucose↗

[Gastric metastasis of a malignant melanoma of the choroid].

Gastric metastases of choroid malignant melanoma seem to be exceptional since less than 10 cases have been previously published. We report the case of a 71 year old patient with a gastric melanosarcoma secondary to a choroid malignant melanoma. Gastric metastasis was revealed by digestive bleeding occurring 18 years after right eye enucleation. Gastroscopy showed black ulcerated tumors. Histology confirmed the diagnosis portraying typical melanic pigments within the gastric mucosa. Laser photocoagulation of the gastric lesion was used for the first time in this indication. As a result, hemorrhage decreased and the patient's comfort was improved.

Aged↗

Parallel gastric emptying of nonhydrolyzable fat and water after a solid-liquid meal in humans.

Our aim was to examine the control of gastric emptying of the oil phase of a mixed solid and liquid meal. Previous studies had shown that liquid dietary fats normally leave the stomach at a slower rate than does water. We wished to determine whether the slower emptying of fats was due to the physical characteristics of food (lower density and greater viscosity than water), to retardation by duodenal feedback mechanisms, or whether both factors contributed. Thus, we quantified the emptying rates of water and sucrose polyester (a nonabsorbable analog of dietary fat) ingested by healthy volunteers as a mixed solid and liquid meal. Gastric emptying was quantified by an intubation-perfusion method incorporating an occlusive jejunal balloon to facilitate recovery. Four phase-specific, nonabsorbable markers were used. [14C[Sucrose octaoleate and polyethylene glycol were incorporated in the meal and traced the lipid and water phases, respectively; [3H]glycerol triether and phenolsulfonphthalein were used as duodenal recovery markers. Sucrose polyester (substituting for dietary fat) was emptied very rapidly, and at about the same rate as was water, in contrast to natural fat, which empties very slowly. Emptying of water was rapid and comparable to that observed after mixed meals containing natural fat. These results imply that gastric emptying of the oil phase is controlled by receptors sensitive to the hydrolytic products of fat digestion and that the slow emptying of dietary fat is not simply due to its lower density.

Adult↗