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Biomedical subjects

F Mearin

Publications and source records attributed to F Mearin.

66 records · Page 4Linked to original sources
PubMed1987

Acute upper gastrointestinal bleeding as primary symptom of gastric carcinoma.

Little information is available regarding acute upper gastrointestinal bleeding as a presenting sign of gastric carcinoma. Of 427 patients with gastric cancer, 36 (8.4%) underwent early endoscopy due to hematemesis. The hemorrhage was self-limited in 16 patients (44.4%), most of whom underwent elective surgery. Twenty patients (55.6%) had persistent or massive bleeding, and 13 of these underwent early surgery with a surgical mortality of 3 cases (23.1%); the remaining 7 patients were not operated on, and died secondary to the hemorrhage. The total mortality rose to 10 patients (27.7%). The mean age was higher in patients with persistent or massive bleeding, mainly in those who did not undergo surgery and died. We conclude that the immediate outcome is related to age and previous general condition, rather than to the definite diagnosis of gastric cancer. Moreover, emergency endoscopy may be useful in determining the exact source of hemorrhage and in identifying potential candidates for emergency surgery.

Acute Disease↗
PubMed1987

Antroduodenal resistance to flow in the control of duodenogastric bile reflux during fasting.

Our objectives in this study were (a) to determine the role of antroduodenal resistance in the control of fasting duodenogastric bile reflux in the dog and (b) to elucidate the contribution of the pylorus both to resistance and to reflux. Thus, we measured simultaneously throughout the interdigestive motor cycle (a) antroduodenal pressure activity by manometry, (b) antroduodenal resistance by a pneumatic resistometer, and (c) bile acid concentrations in duodenal and gastric juices. Experiments were performed in 15 conscious dogs (9 with pylorus intact and 6 with extramucosal pyloric myotomy). We found that antroduodenal resistance was lowest during phase I, increased gradually during phase II, and peaked during phase III (linear trend, p less than 0.001). Duodenogastric bile reflux was low during phase I, peaked during late phase II, and decreased again during phase III (quadratic trend, p less than 0.05). Therefore, variations in net resistance and reflux were differently related to the phases of the interdigestive motor complex. Pyloric myotomy significantly decreased antroduodenal resistance (linear trend different from control, p less than 0.001), but had no significant effect on duodenogastric bile reflux. We conclude (a) that changes in net antroduodenal resistance do not regulate duodenogastric bile reflux and (b) that the pylorus is an important determinant of antroduodenal resistance, but has no major role in the control of fasting duodenogastric bile reflux.

Animals↗
PubMed1987

Pyloric contribution to antroduodenal resistance to flow in the conscious dog.

We have developed a pneumatic resistometer to monitor antroduodenal resistance to flow for prolonged periods of time in conscious dogs. To investigate the specific contribution of the pylorus to antroduodenal resistance we compared resistance during fasting in four control dogs and in four dogs with extramucosal pyloric myotomy (1.5 cm long). After pyloric myotomy, as in controls, resistance to flow changed cyclically, being lowest during phase I and highest during phase III of the interdigestive motor cycle. Pyloric myotomy decreased resistance during phase III. Atropine (0.1 mg X kg-1 X h-1) administered during motor quiescence (phase I) reduced resistance in the control group (P less than 0.05) but not in myotomized animals. Bethanechol (0.2 mg X kg-1 X h-1) significantly increased resistance in both groups (P less than 0.05). We conclude that antroduodenal resistance to flow is related to cyclic interdigestive motility. The pylorus is the predominant determinant of antroduodenal resistance during motor quiescence, but its contribution diminishes markedly during motor activity.

Animals↗
PubMed1986

Pyloric dysfunction in diabetics with recurrent nausea and vomiting.

Diabetes mellitus has been associated with a variety of gastrointestinal motor disturbances. Pyloric activity, however, has not been specifically investigated. We have quantified the pyloric manometric profile in 24 diabetics with recurrent nausea or vomiting, or both, without evidence of mechanical obstruction. Twelve healthy volunteers served as controls. A multilumen pneumohydraulic perfusion assembly with five side openings, each 1 cm apart, was positioned fluoroscopically across the antroduodenal junction and used to monitor pressure activity for 5 h (3 h fasting and 2 h fed). Three patterns of pyloric activity were defined and quantified: (a) baseline elevation of greater than or equal to 3 mmHg for greater than or equal to 1 min (tonic pattern); (b) antral-type phasic pressure activity mixed with duodenal phasic activity (phasic pattern); and (c) phasic pattern superimposed on tonic activity (combined tonic-phasic pattern). The duration of the total pyloric activity before and after the meal was greater in diabetics than in controls (p less than 0.005). Furthermore, episodes of unusually prolonged (greater than or equal to 3 min) and intense (greater than or equal to 10 mmHg) tonic contraction, "pylorospasm," were observed in 14 of 24 diabetics but in only 1 control (p = 0.025). In diabetics, episodes of pylorospasm had a peak amplitude of tonic activity of 13 +/- 1 mmHg and a duration of 7 +/- 0.7 min (mean +/- SE). We conclude that pyloric dysmotility forms part of the widespread disruption of gut motility that affects some patients with diabetes.

Adult↗
PubMed1986

Measurement of resistance to flow across antroduodenal area during fasting.

Changes in antroduodenal resistance to flow may participate in the regulation of gastric emptying and duodenogastric reflux. Little is known, however, about the relationship between antroduodenal resistance and the physiological patterns of contractile activity in this area. We have developed an instrument that maintains an electronically regulated constant-pressure gradient of 2 mmHg across both ends of a flaccid cylinder positioned fluoroscopically across the pylorus. Because resistance bears a constant inverse relationship to flow at a fixed pressure gradient, changes in the recorded rate of airflow through the cylinder are a measure of antroduodenal resistance. In vitro studies showed that, under these conditions, airflow was a function of the diameter and length of the air path and the frequency and duration of external pressure waves greater than 2 mmHg. In vivo studies in four dogs examined the relationship between interdigestive phases of motor activity and variations in resistance exerted by the antroduodenal area. We found that flow rates varied markedly with each phase. Antroduodenal resistance was lowest during motor quiescence (phase I), rose gradually during irregular activity (phase II), and reached its peak during maximal contractile activity (phase III) (P less than 0.05). Resistance was similar for antegrade and retrograde flow. Additional studies suggested that the pyloric area contributes mostly to resistance during phase I, whereas duodenal resistance at least matches that of the pylorus during phase III.

Air↗
PubMedDate not supplied

Ulcerative colitis, autoimmune hemolytic anemia and rectovaginal fistula: report of a case.

A case of autoimmune hemolytic anemia associated with ulcerative colitis and rectovaginal fistula in a 27-year-old woman is reported. It appeared during the first episode of ulcerative colitis occurring in the immediate puerperium. Laboratory studies revealed a positive direct Coombs test with polyspecific sera and monospecific for IgG. Panagglutinins and cold agglutinins with titers under 1:50 were also demonstrated. Treatment with steroid therapy was sufficient for a swift and complete recovery of the patient, the direct Coombs test becoming negative six weeks after admission.

Adult↗