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Biomedical subjects

B Champigneulle

Publications and source records attributed to B Champigneulle.

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

[Interobserver and intercenter agreement of gastro-esophageal endoscopic signs in cirrhosis. Results of a prospective multicenter study].

Because of the diagnostic and prognostic value of gastroesophageal endoscopic signs in cirrhosis, we studied their interobserver and intercenter agreement. Fifty cirrhotic patients without previous digestive bleeding were included in this study. The gastroesophageal endoscopic examinations of these patients, recorded on video tape, were independently viewed by 12 observers belonging to different hospitals. Agreement was evaluated by the kappa index (k), the values of which were given with p less than 0.001. Agreement was good for the presence (k = 0.40) or the size (k = 0.51) of esophageal varices as well as for red signs on the mucosa overlying esophageal varices, but it was poor for the color (k = 0.10) or the extent (k = 0.20) of esophageal varices. Agreement was poor for all gastric signs: fundic varices (k = 0.35), red spots (k = 0.28), associated lesions (k = 0.27), mosaic pattern (k = 0.27), gastropathy (k = 0.11). The mean diameter of esophageal varices, evaluated without any scale, varied from 3.5 +/- 1.4 to 7.5 +/- 4.0 mm between the 12 observers (p less than 0.001). Agreement was maximum for the more developed grade of a sign and minimum for the intermediate grade. The value of kappa indexes in this intercenter study was compared to that obtained in a previous study from one institution: interobserver agreement was significantly better within one center than between different centers. In conclusion, intercenter agreement is good for the size of esophageal varices and the presence of red signs, and poor for all the other signs. The millemetric measurement of esophageal varices diameter, without any scale, appears to be unreliable.(ABSTRACT TRUNCATED AT 250 WORDS)

Esophageal and Gastric Varices↗
PubMed1989

[Evaluation of exocrine pancreatic function by the haptocorrin degradation test of the duodenal fluid collected by endoscopy].

Two groups of biological methods are commonly used to evaluate the exocrine pancreatic function: tests which require tubes for the collection of duodenal juice and the tubeless tests which are indirect tests of pancreatic function. In this study we have attempted to improve a new test: the test of haptocorrin degradation (THD). This test measures the transfer of labelled cobalamin from haptocorrin to the intrinsic factor which is provoked by the degradation of the haptocorrin by proteases in the duodenal juice. We present the results of this test in 90 patients with chronic pancreatitis. THD was first assayed with basal duodenal juice collected by naso duodenal tubing during secretin cerulein stimulation. In this study the sensitivity and specificity of THD was 0.86 and 0.93, respectively. In the second part of this study we demonstrated that the means of collecting duodenal juice had no effect on the results of THD. Duodenal juice was collected during a secretin cerulein test or during a routine upper gastrointestinal endoscopy after pancreatic stimulation with secretin. The sensitivity and specificity of THD was 0.90 and 0.94, respectively, when duodenal juice was collected during endoscopy. THD was significantly correlated with the NBT-PABA test, steatorrhea, and with the activity of trypsin and chymotrypsin in the duodenal juice. In this study, NBT-PABA was less sensitive than THD for the diagnosis of chronic pancreatitis (sensitivity was 0.70 and 0.89, respectively). The specificity of THD was estimated at 0.94. THD seemed to be a valuable adjunct to test pancreatic function. As upper gastrointestinal endoscopy is usually performed in patients with proved or suspected chronic pancreatitis, THD seems to have a place of choice among the other tests of pancreatic exocrine function. Further evaluation of this test by a multicentric prospective trial is now needed.

Adult↗
PubMed1988

Radioautographic localisation of iodinated human intrinsic factor in the guinea pig ileum using electron microscopy.

The uptake of iodinated human intrinsic factor by guinea pig ileum was studied in vivo using electron microscopy radioautography. Iodination of intrinsic factor cobalamin complex with N-chlorobenzene-sulphonamide beads did not modify its physicochemical properties in gel filtration, nor in iso-electrofocusing. It didn't affect its biological activity either in vitro in presence of solubilised receptor, or in vivo in the Schilling test. The 125I-intrinsic factor cobalamin complex was instilled in vivo in ileal blind loops in presence of either CaCl2, EDTA, bile or intestinal juice. The labelled complex was predominantly located in the intermicrovillous pits of the apical membrane and in the apical cytoplasm. The uptake was about five-fold lower in presence of EDTA. On the apical membrane, the number of grains (per 80 micron length of epithelium) increased from 2.7 (0.2) up to 9.4 (1.7) respectively for 15 minutes and two hours of delay. This suggests a recycling of the intrinsic factor receptor complex. In the apical compartment, the silver grains were often detected over non-coated vesicles and over the infoldings of the lateral membrane. These results show that intrinsic factor is internalised into enterocytes during cobalamin absorption, and that a part of intrinsic factor enters the blood circulation through transcytosis.

Animals↗
PubMed1988

Increased serum corrinoids correlates with disease severity and IgA levels in alcoholic cirrhosis.

Relationship between increased serum cobalamin level and liver disease have been recently reported. In this work, levels of total corrinoids, cobalamin (vitamin B12) and cobalamin analogues and levels of IgA were determined by radioisotope dilution assay and nephelometric laser analyses. They all have been measured in superior vena cava, inferior vena cava and hepatic vein of controls and of alcoholic cirrhotic patients grouped according to the Child-Pugh classification. Compared with normal subjects, venous blood content of total corrinoids, of cobalamin and of IgA in alcoholic cirrhotics increased significantly with the severity of the disease (p less than 0.01). In severe, moderate, and mild alcoholic cirrhosis total corrinoids and cobalamin were, respectively, about 5-, 2-, and 1.5-fold higher than in controls, whereas IgA was 3-, 2.5- and 1.5-fold higher, respectively. The serum IgA level was significantly correlated with the level of seric saturated haptocorrin (r = 0.54; p less than 0.01) and with the seric total corrinoids (r = 0.39; p less than 0.01). In the absence of significant hepatic cytolysis, the enhanced level of seric corrinoids in cirrhosis could be partly explained by a competitive inhibition of the liver uptake of haptocorrin by circulating asialoglycoproteins, including IgA.

Adult↗
PubMed1988

[Endoscopic sclerotherapy versus propranolol after hemorrhage caused by rupture of esophageal varices in patients with cirrhosis. Results of a 4-year randomized study].

Between December 1982 and April 1987, we conducted a prospective randomized trial comparing the efficiency of endoscopic sclerotherapy with oral propranolol after variceal hemorrhage in cirrhosis. We present our results after a median follow-up of 3 years (range = 57-231 weeks). The sclerotherapy group (S) consisted of 28 patients and the propranolol group (P), 27 patients. The two groups were similar for age, sex, etiology and severity of liver disease, and severity of hemorrhage; the only difference concerned previous hemorrhages which were significantly more numerous in the S group. Sclerotherapy was performed with polidocanol 1 p. 100. A slow-release preparation of propranolol was used; the average daily dose was 160 mg. Eighteen patients in the S group had at least one hemorrhagic recurrence as opposed to 12 in the P group. This difference was not significant nor was the difference between actuarial curves of no-rebleeding (p = 0.30). No difference was noted concerning total deaths (15 in S versus 12 in P). Cumulative survival curves showed a non-significative difference (p = 0.99) percentages of survival in S and P groups were 75.0 p. 100 and 73.6 p. 100 at 1 year, 67.9 p. 100 and 64.6 p. 100 at 2 years, and 51.1 p. 100 and 52.7 p. 100 at 3 years respectively. Stratification according to Child's group, variceal size and history of variceal hemorrhage did not modify these results. However, male patients had less hemorrhagic recurrences with propranolol than after sclerotherapy. Length of hospitalization was not different in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Esophageal and Gastric Varices↗
PubMed1986

In-vitro test of haptocorrin degradation for biological diagnosis of exocrine pancreatic dysfunction using duodenal juice collected during endoscopy.

An in-vitro test of degradation of haptocorrin, a cobalamin-binding glycoprotein, was used to diagnose exocrine pancreatic dysfunction. This radioisotopic test (TDH) required only 50 microliters duodenal juice collected during endoscopy after stimulation with 1 U/kg secretin intravenously. The initial reaction mixture, composed of salivary haptocorrin saturated with cobalt-57-labelled cyanocobalamin and unsaturated intrinsic factor, was incubated with 25 microliters duodenal juice. The percentage of degraded haptocorrin was estimated from the proportion of labelled cyanocobalamin that was transferred from haptocorrin to intrinsic factor. The TDH result was 41.6 +/- 31.7% (SD) in a group of chronic pancreatitis patients (n = 22) and 91.5 +/- 4.8% in the control group (n = 47). The sensitivity and specificity for exocrine pancreatic dysfunction were estimated as 0.91 and 0.96, respectively, for a lower limit of normal values of 81.7%. A hyperbolic relation was found between the TDH and the trypsin or chymotrypsin activity in duodenal juice (p less than 0.001). In this study, the N-benzoyl-tyrosyl-p-aminobenzoic acid test was less sensitive than the TDH, since its result was abnormal in only 64% of the patients. The TDH was easier to carry out and less time-consuming than the determination of pancreatic enzyme output in duodenal juice collected after hormonal stimulation.

Adult↗
PubMed1986

[Percutaneous endoscopic gastrostomy].

Gastrostomy by endoscopy is a simple and fast procedure which does not require general anaesthesia. Its morbidity and mortality rates are low. With the initial technique, the gastrostomy tube was pulled in by a thread introduced percutaneously into the stomach. In cases with oesophageal stenosis, using a Foley balloon catheter is useful. Gastrostomy can be transformed into jejunostomy by a similar method. The main indications of percutaneous endoscopic gastrostomy are cancer of the upper respiratory or digestive tract, notably those complicated by fistulae, and disorders of deglutition due to abnormal buccal and pharyngeal stages.

Gastroscopy↗
PubMed1984

[Acquired hypogammaglobulinemia and malabsorption with villous atrophy sensitive to a gluten-free diet].

The observation of a 21 year-old man with primary common variable hypogammaglobulinemia and total villous atrophy is reported. Gluten withdrawal induced considerable improvement in malabsorption and mucosal damage. However, protein-losing enteropathy, nodular lymphoid hyperplasia and immunoglobulin deficiency were persistent. To our knowledge, improvement on gluten-free diet has been reported until now in 18 previous cases. This report illustrates the links between immunodeficiency and malabsorption, which are discussed.

Adult↗
PubMed1980

Gastric retention and gastric ileus in diabetes mellitus.

Report of 2 cases of paralytic ileus of the stomach (gastric atony) and of 14 cases of gastric retention, diagnosed from the radiographs obtained from a group of 1500 diabetic patients within seven years. These disorders occur in diabetes mellitus present for many years and associated with peripheral neuropathy. The above findings often present diagnostic and therapeutic problems. Conservative drug therapy is usually sufficient management.

Adolescent↗
PubMedDate not supplied

[A comparative prospective study of an edrophonium test and an esophageal balloon distension test in 78 patients with non-coronary angina and 12 healthy controls].

UNLABELLED: The aim of this study was to compare the most current tests used for the diagnosis of esophageal angina-like pain: manometry, balloon distension, edrophonium provocation. METHOD: 78 patients with angina-like pain, who had normal coronary arteriograms, and 12 healthy controls were prospectively evaluated with esophageal manometry, esophageal balloon distension, according to Barish's method (2), edrophonium provocation and 3 h pH-monitoring. Provocation tests were considered positive if they reproduced the angina-like pain. RESULTS: basal manometry was abnormal in 23 patients (29%); nutcracker esophagus; 8, achalasia; 1, diffuse esophageal spasm: 1, hypertensive LES: 2, non specific motility disorders: 5, It was abnormal in 1 healthy control (1 nutcracker esophagus). Edrophonium provocation was positive in 19 patients (24%) and in none of the controls. Balloon distension was positive in 33 patients (42%) and none of the controls, but 3 controls experienced a back pain at 7, 9 and 9 cc. Balloon distension was more sensitive than edrophonium provocation (p less than 0.001). There was no correlation between the results of the basal manometry and those of balloon distension and no correlation between pH monitoring and balloon distension. 1) Balloon distension is the most sensitive test and should be used at first. 2) If balloon distension is negative edrophonium provocation can be useful because the pain mechanism is different. 3) Some controls can experience a back pain without irradiation, then balloon distension must be considered positive only if it strictly reproduces the spontaneous angina-like pain.

Adult↗
PubMedDate not supplied

[Study of the small bowel and mesentery in Crohn's disease: comparison of ultrasonics, x-ray computed tomography and small bowel transit in 18 patients].

The advantages of tomodensitometry and ultrasonography were compared with those of small bowel series in Crohn's disease of the small bowel in 18 patients. These two examinations give results which are inferior to those of small bowel series, for the positive diagnosis and the evaluation of the intraluminal extension of the disease, since their sensitivity was only 60 p. cent in identifying the pathological loop. On the contrary, their advantage lies in the evaluation of the intraluminal extension of the disease, which was correctly demonstrated with ultrasonography in 22 p. cent of cases, and tomodensitometry in 45 p. cent. This confirms the supplementary value of these two examinations in the study of the mesenteric involvement of the disease, screening of abscesses, and makes desirable a prospective evaluation of the influence of mesenteric abnormalities on the prognosis and surgical indications.

Adolescent↗