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Biomedical subjects

D Couturier

Publications and source records attributed to D Couturier.

At least 109 records · Page 6Linked to original sources
PubMed1989

A comparison of metoclopramide and trimebutine on small bowel motility in humans.

Trimebutine meleate and metoclopramide increase small bowel motility. The present manometric study of the human normal interdigestive duodeno-jejunal motility demonstrated two different pharmacological effects in 15 healthy volunteers. Trimebutine constantly induced a premature phase 3 activity (0.81 +/- 0.4 min after a 100-mg intravenous injection) with patterns similar to spontaneous phase 3. Metoclopramide increased the motility index (contractile activity) during phase 2 without inducing a premature phase 3. No significant variations in plasma motilin concentration were noticed after either trimebutine or metoclopramide. The pancreatic polypeptide concentration rose significantly after metoclopramide injection.

Adult↗
PubMed1989

Motility of the jejunum after proctocolectomy and ileal pouch anastomosis.

Proctocolectomy with ileal pouch anastomosis could modify motility of the small intestine through two mechanisms: obstruction or bacterial overgrowth. Motility of the jejunum was measured in 11 patients with ileoanal anastomosis six (n = 6), or 12 (n = 5) months after closure of the loop ileostomy. Manometric recording from the jejunum were made during fasting (four hours) and after a liquid meal (one hour). These findings were compared with those of six healthy volunteers. Motor events were classified as follows: migrating motor complex (MMC), propagated contractions, or discrete clustered contractions. All patients were investigated for bacterial overgrowth (D-glucose breath test). Only two patients had bacterial overgrowth. The frequency of MMC remained unchanged after ileo-anal anastomosis (2.83 (0.37)/four hours) compared with normal volunteers (2.81 (0.29)/four hours). During fasting, four patients had numerous propagated contractions in the jejunum. This condition was associated in two with bacterial overgrowth and in two with intubation of the reservoir. Discrete clustered contractions were found in the seven patients studied postprandially (7.6 (2.5)/h), but not in volunteers. These seven patients emptied their pouch spontaneously and bacterial overgrowth was found in only one. As this motility pattern was previously described in partial small intestinal obstruction, it is postulated that discrete clustered contractions could be the consequence of a functional obstruction as a result of anastomosis of the small intestine to the high pressure zone of the anal sphincters.

Adult↗
PubMed1989

[Protein-losing enteropathy syndrome caused by a localization of Kaposi's sarcoma in AIDS].

A 35-year-old HIV positive patient with skin and gastrointestinal localization of a Kaposi's sarcoma was admitted for severe diffuse edema. Increased alpha-I-antitrypsin clearance (150 ml/24 h) allowed us to confirm the diagnosis of protein loosing enteropathy resulting from sarcoma infiltration in the stomach, the duodenum and the entire small bowel. At autopsy, ileal ulcerations were found. Gastrointestinal involvement occurring during Kaposi's sarcoma is common and usually symptomless. The discovery of a protein loosing enteropathy in our patient suggests that this gastrointestinal involvement could play a role in the hypoalbuminemia often found in these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[Total and segmental colonic transit times. Measurements by radio-opaque markers].

Measurement of the transit time by addition of a marker to the natural alimentary bolus permits an overall evaluation of colonic motricity. Bismuth and barium salts, dyes and radioactive compounds have been used, each of these methods having its own drawbacks, such as insufficient or impossible quantification, influence on transit or partial intestinal absorption. Radio-opaque pellets do not modify transit, are not absorbed, provide quantification readily and measure transit selectively in the ascending colon, the descending colon, the sigmoid colon and the rectum. The progression of pellets is followed by radiography of the abdomen. The number of radiograms can be reduced to 3 or even 1 by graded administration of the pellets over 3 consecutive days. The results obtained in normal subjects are similar in different studies; they are not influenced by age or by the amount of fibrous material present in food. Total and right segmental transit times are longer in women than in men. Measurement of the colonic transit time is indicated in severe constipation to differentiate between colonic inertia and terminal obstruction which have different mechanisms and treatments. Such measurements are also useful for an objective evaluation of constipation.

Colon↗
PubMed1988

Tubulovillous adenoma of the colon with hyperdiploidy, double-minute chromosomes, and inversion of chromosome 1.

A sessile adenoma of the left flexure of the colon was studied after surgical colectomy. Specimens were obtained for complete histologic evaluation. The tumor consisted of glandular tubes with decreased mucin production and a papillary structure on the luminal aspect. The muscularis mucosa was not involved; there was no carcinomatous focus. Cytogenetic study was carried out on 56 cells; none was normal, 77% were hyperdiploid (52-87 chromosomes), 16% were hypodiploid (18-39 chromosomes), and 7% were paradiploid. The supernumerary chromosomes were chromosomes #3, #6, #13, #19, and #20; chromosome #18 was missing in 80% of the cells. A marker for chromosome #1 resulting from a q21.1-q21.2 break with inversion of the centromere-bearing segment (pter-q21) was observed in 58% of the cells. Twenty-five percent of the cells had double minute chromosomes. Despite the histologically benign nature of the tumor, all the cells showed significant cytogenetic aberrations, some of which are considered to be markers of neoplastic transformation (polyploidy, double minutes, chromosome #1 marker).

Adenoma↗
PubMed1988

[Comparative study of the effects of metoclopramide and metopimazine on the duodenojejunal motility during the interdigestive period: a manometric study in healthy subjects].

The objective of this paper was to compare the effects of metoclopramide (MTC) and of metopimazine (MTP) on intestinal motility in normal subjects in the period between digestion by injecting these two agents at a well-defined time of the migrating motor complex (MMC). Duodenojejunal motility was recorded by manometry (four microperfused catheters; study segment: 30 cm) during the period between phases of digestion (fasting greater than 12 hrs), for 4.6 hrs on average (3, 4, 6 hrs). 14 normal volunteer subjects (6 males, and 8 females 19 to 49 years of age) were randomly assigned to 2 study groups and were given MTC (10 mg) or MTP (10 mg) in slow IV injection (5 mins.) at a controlled rate, performed 25 mins after onset of a phase 3 (P3) in the study segment. As a reference, results obtained in a control group of seven subjects recorded under the same conditions are reported, in addition. Changes in MMC were evaluated in each group by the mean number of P3 hourly and the percent of subjects presenting a P3 within the two hours following injection of the test drug. Variations in phase 2 type motility (P2) were measured using motility indices (MI): the sum of the amplitudes, number of waves, per 5 minute interval. The number of hourly P3 was 0.40 for MTC vs 0.28 for MTP (control 0.47); 90 minutes after an injection, the first P3 appeared in 71% of patients in the MTC groups vs. 14% in the MTP group (control 57%). P3 recorded following injection were not different from the preceding in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Effects of an enkephalinase inhibitor on esophageal motility in man.

Enkephalins are short lived peptides which are rapidly cleaved by 2 membrane peptidases: an enkephalinase and a carboxypeptidase. Enkephalin-like immuno-reactivity has been demonstrated in the smooth muscle and in the myenteric plexus of the human lower esophageal sphincter (LES). Opioid receptors have been found in the gastrointestinal tract and recently an enkephalin analog has been shown to inhibit LES relaxation and modify the peristaltic progression of the esophageal contractions. Acetorphan is an enkephalinase inhibitor which prevents, at least to some extent, the hydrolysis of endogenous enkephalins. Thus, the present work was designed to study the effect of acetorphan on esophageal motility. Ten healthy volunteers (mean age: 23 years) were studied. On 2 separate days, each subject received in random order acetorphan (2.5 mg/kg intravenously at a constant rate in 20 min) or placebo. Esophageal manometry was performed with a Dentsleeve. Wet swallows (5 ml) were performed at 1 min intervals during 80 min and results were pooled in 10 min periods. Acetorphan inhibited significantly (p less than 0.02) LES relaxation 20 min after the beginning of the infusion and throughout the study. The maximal effect occurred 50 min after the beginning of acetorphan infusion and LES relaxation (m +/- SEM) was reduced from 92 +/- 2.6 to 79.5 +/- 2.9 p. 100 (p less than 0.01). Duration, amplitude, and velocity of esophageal contractions were not modified. Acetorphan an enkephalinase inhibitor, is able to reproduce the effect of IV exogenous enkephalins on LES relaxation in man. This result suggest that endogenous enkephalins might play a role in the normal control of the LES relaxation.

Enkephalins↗
PubMed1987

[Intrahepatic collections of fluid of pancreatic origin. A case].

A case of intrahepatic liquid collections of pancreatic origin is reported. A search in the literature yielded 8 cases of pancreatic pseudocysts which developed in the liver left lobe. The present case was original owing to its localization in the right hepatic lobe, to the large volume of the intrahepatic effusions and to the scarcity of underlying pancreatic symptoms. Ultrasonography and computerized axial tomography were useful aids to the diagnosis as well as to the therapeutic procedures. Surgery, which usually is a matter of discussion in chronic pancreatitis, was necessary to obtain the favourable outcome expected in such diseases.

Humans↗
PubMed1987

Induction of phase 3 of the migrating motor complex in human small intestine by trimebutine.

The effects of trimebutine, a drug used in the treatment of various gastrointestinal motility disorders, have been investigated fed and fasted healthy subjects. Duodenojejunal motility was recorded manometrically with a 4-lumen probe. Trimebutine 50 or 100 mg was injected i.v. 3 or 25 min after observing a spontaneous Phase 3 complex in the fasted state. Other experiments were done in the postprandial state and after intravenous naloxone 0.8 mg. In the fasted state, trimebutine 100 mg, injected 25 min after a spontaneous Phase 3 complex consistently induced a premature Phase 3 complex. The mean duration of the migrating motor complex cycle decreased from 86.4 +/- 10.8 min to 32.5 +/- 1.0 min. Trimebutine 50 mg injected 3 and 25 min after a spontaneous Phase 3 complex did not significantly modify the periodicity of the migrating motor complex. Trimebutine 100 mg initiated Phase 3-like activity in the post-prandial state. Previous intravenous administration of naloxone 0.8 mg (Narcan) suppressed the stimulatory action of TMB. Thus, trimebutine is able to modify the motility pattern in the small intestine of man, possibly by acting at opioid receptors.

Adult↗
PubMed1987

[Effect of trimebutine on the motility of the normal human small intestines: mechanism of action].

The effects of intravenous trimebutine (TMB) on duodenojejunal motility were investigated in normal subjects in fed and fasted states. The motility was recorded manometrically. In the fasting state TMB 100 mg, 25 min after a spontaneous phase 3 (P3) constantly induced a premature P3. The mean period (means +/- SE) of the migrating motor complex (MMC) cycle decreased from 84 +/- 10.9 to 32.5 +/- 1.0 min. TMB 50 mg, 3 and 25 min after a spontaneous P3 did not significantly modify the periodicity of MMC. TMB 100 mg initiated P3-like activity in post-prandial state. Previous administration of a low dose of naloxone suppressed the stimulating action of TMB. After a TMB injection the motilin plasma level did not vary; a brief increated of PP plasma level was observed. It may be concluded that in the human small intestine TMB included a typical modification of the motility pattern. Opiate receptors might be involved.

Adult↗