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Biomedical subjects

G Bommelaer

Publications and source records attributed to G Bommelaer.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Mixed cryoglobulins and autoimmunity in hepatitis C].

We explored and studied cryoglobulins and autoantibodies in 149 patients with hepatitis C. 49% of untreated patients have cryoglobuliemia (36% polyclonal cryoglobulins) and 76% of ineffectively treated patients since more than 6 months (50% polyclonal cryoglobulins). Other observed cryoglobulins are half of type II and half oligoclonal. In 22 cryoglobulinemic patients before treatment, a good clinical response to IFN is induced only among patients for which cryoglobulins are negative at the end of treatment. Cryoglobulins could be indicators of viremia. The prevalence of autoantibodies is low and without clinical significance (they are more frequently detected in cryoglobulinemic patients, except anti-thyroid autoantibodies). Nevertheless, autoantibodies induced by IFN in our study (anti-thyroid autoantibodies, ANCA) are associated with clinical symptoms.

Adolescent↗
PubMed1996

Intraoperative esophageal manometry and fundoplications: prospective study.

The purpose of this study was to validate the use of intraoperative manometry for assessing fundoplication and to search for predictive manometric criteria. This prospective study concerned 48 patients operated for gastroesophageal reflux. The manometry was carried out pre- and intraoperatively for all patients and postoperatively as well for 30 patients. The operative procedures were total fundoplication (n = 25) and posterior (partial) fundoplication (n = 5). The lower esophageal sphincter (LES) pressures and lengths were similar in the preoperative and intraoperative measurements before any esophageal mobilization, whereas the intraoperative LES pressure was significantly higher after fundoplication. The mean postoperative LES pressure decreased by 50 +/- 19% compared with the intraoperative pressure after fundoplication. The final intraoperative pressures of two dysphagic patients were not the highest of the study. More importantly, their final intraoperative pressures were 7.5 and 8.2 times the initial pressure, respectively, which was significantly greater than the intraoperative pressure increase of the nondysphagic patients (4.6 +/- 2.0 times). The final intraoperative pressure of the only patient with recurrence (18.2 mmHg) was the lowest of the study. In conclusion, intraoperative manometry is an effective method for evaluating the LES, and it could have predictive value for the surgical management of gastroesophageal reflux disease.

Esophagus↗
PubMed1995

[Interactions between chronic viral hepatitis C and pregnancy].

OBJECTIVES AND METHODS: In France, the positive rate for unit-HCV antibodies in the sera of pregnant women is usually found to be between 0.7 and 3.9%. The aim of our prospective study was to determine the interactions between pregnancy and chronic viral hepatitis C in 12 pregnant women. RESULTS: In our study, chronic viral hepatitis C did not influence maternal or neonatal outcome. The mean gestational age was 38.4 +/- 3 weeks. During follow-up, mean serum ALT levels were significantly lower (36 +/- 17 mU/mL) during the last three months of pregnancy compared to before pregnancy (237 +/- 144 mU/mL, P < 0.002) and after pregnancy (141 +/- 62 mU/mL, P < 0.0005). During the third trimester, serum ALT levels were normal in 90% of the women. However, the persistence of viremia during pregnancy and a rebound in serum ALT during the post-partum period have been noticed. CONCLUSION: The normalization of serum ALT levels during pregnancy, the persistence of viremia, and a rebound in serum ALT during post-partum could be related to pregnancy-induced changes in the immune system.

Adult↗
PubMed1994

Cholecystokinin and nitric oxide in transient lower esophageal sphincter relaxation to gastric distention in dogs.

BACKGROUND/AIMS: Transient lower esophageal sphincter relaxations have been found to be involved in gastroesophageal reflux. The purpose of this study was to determine whether cholecystokinin (CCK) and nitric oxide are involved in the occurrence of these relaxations. METHODS: Pharyngeal, esophageal, lower esophageal sphincter, and gastric pressures were monitored in five dogs through a cervical esophagostomy. Gastric distentions with air, at a constant pressure of 1.56 kPa, were performed for 30-minute sessions using a barostat. RESULTS: During gastric distention at 1.56 kPa, transient relaxations occurred at a mean rate of 7.2 +/- 0.6 every 30 minutes. CCK-8 infused intravenously (0.1-1 microgram.kg-1.h-1) dose dependently increased the occurrence of relaxations while it was reduced by the CCK-A receptor antagonist devazepide but not the CCK-B antagonist L365260, both administered intravenously in a dose range of 0.1-100 micrograms/kg. The two antagonists administered intracerebroventricularly (1 microgram/kg) did not modify the occurrence of relaxations. Both devazepide and L365260 (10 micrograms/kg) reduced the CCK-induced relaxations, but devazepide was more potent. The nitric oxide synthase inhibitor NG-nitro-L-arginine-methyl ester (20 mg/kg) reduced the number of relaxations during gastric distention in the presence or absence of CCK infusion. This effect was reversed by L-arginine but not D-arginine (200 mg/kg). CONCLUSIONS: CCK is involved in the occurrence of transient lower esophageal sphincter relaxations through peripheral CCK-A receptors and an L-arginine nitric oxide pathway.

Air↗
PubMed1994

[Primary antiphospholipid syndrome of fatal course and osteoarticular cytosteatonecrosis].

The antiphospholipid syndrome produces acute occlusions of arteries and veins. This syndrome can cause a multiple organ systems failure whose outcome is often fatal. The authors report a case of the primary, antiphospholipid syndrome characterized by this fatal outcome, a so-called "devastating" syndrome following pulse steroids. In this patient, the antiphospholipid antibodies had been found after presenting bone-marrow fat necrosis, which led to extensive lesions of knees, hips and shoulders. Damage to the cell membranes in necrotic lesions might have promoted the immune response against phospholipids. The potential risks of pulse doses of steroids in the antiphospholipid syndrome are documented by the present observation, which also suggests that antiphospholipid antibodies should be determined in cases of fat necrosis of all origins.

Antiphospholipid Syndrome↗
PubMed1994

Short report: treatment of gastric ulcer with lansoprazole or ranitidine: a multicentre clinical trial.

We studied the effectiveness of lansoprazole and ranitidine in promoting gastric ulcer healing in a multicentre double-blind trial, by comparing the proportion of healed ulcers after 4 and 8 weeks of treatment. One hundred and fifty-eight patients were randomly given either ranitidine (150 mg each morning and at bedtime) or lansoprazole (30 mg each morning and placebo at bedtime). One hundred and twenty-eight patients completed the trial (62 taking lansoprazole, 66 taking ranitidine). Fifty-one (80%) of those treated with lansoprazole and forty-two (62%) of those treated with ranitidine had healed ulcers at 4 weeks (P < 0.05). Sixty-one (98%) patients who received lansoprazole and 57 (86%) who received ranitidine had healed ulcers at 8 weeks (P < 0.05). The observed differences were not significant in the intention-to-treat analysis. No serious adverse event was reported with lansoprazole.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1994

Leucine kinetics are different during feeding with whole protein or oligopeptides.

To determine if the molecular form of nitrogen intake affects protein metabolism during feeding, 12 normal volunteers received, by continuous nasogastric infusion, a protein or a peptide-based diet. Leucine kinetics (oral [13C]leucine and intravenous [2H3]leucine) were measured during the following three consecutive periods: first carbohydrates and lipids alone, then with either whole casein or oligopeptides in a randomized crossover design, with these two latter periods being isonitrogenous, isocaloric, and of identical amino acid compositions. Leucine concentration, turnover, oxidation, and nonoxidative disposal increased during nitrogen administration (all P < 0.01) and were higher with oligopeptides than with casein (242 +/- 44 vs. 188 +/- 31 mumol/l; 2.75 +/- 0.45 vs. 2.23 +/- 0.31; 1.14 +/- 0.19 vs. 0.82 +/- 0.22 mumol.kg-1.min-1, all P < 0.001; 1.64 +/- 0.32 vs. 1.44 +/- 0.33 mumol.kg-1.min-1, P < 0.05, respectively). Endogenous leucine production was less inhibited by oligopeptides than by casein (0.82 +/- 0.41 vs. 0.38 +/- 0.31 mumol.kg-1.min-1, P < 0.001), whereas splanchnic extractions were similar. Finally, leucine balance was more positive with casein than with oligopeptides (P < 0.001). In conclusion, the response of leucine kinetics to feeding is modified by the molecular form of nitrogen intake, with the oligopeptides inducing a higher oxidation and protein synthesis and a lesser inhibition of protein breakdown.

Adult↗
PubMed1993

Effect of ethanol on rat gastric surfactant: a fluorescence polarization study.

BACKGROUND: Gastric surfactant is believed to protect gastric mucosa by the hydrophobic properties of its phospholipidic component, which are reflected in the fluorescence polarization of a lipophylic fluorescent probe. The present study aimed to observe the consequences of intragastric administration of 40% ethanol on the physical properties of rat gastric surfactant. METHODS: Fluorescence polarization studies and lipid composition of gastric mucosal surface scrapings were performed. RESULTS: Time course experiments indicated that the ulcerogenic action of ethanol occurred along with a fluidization of the surface scrapings followed by secondary rigidification. The fluidizing effect of ethanol was related to modifications of the molecular dynamics of lipid structures. The rigidifying effect of ethanol was a result of an increase in the cholesterol-triglyceride and cholesterol-phospholipid ratios and an increase in the percent composition of phosphatidyl-ethanolamine of surface scrapings. CONCLUSIONS: The results suggest that alcohol could alter the gastric mucosal barrier by its disorganizing effect on the molecular dynamics of the gastric surfactant. The second rigidifying effect of ethanol could be a part of the damage repair phenomenon.

Animals↗
PubMed1993

The effect of midazolam on motility of the sphincter of Oddi in human subjects.

Midazolam, a water-soluble benzodiazepine, has recently been introduced and found to be beneficial for sedation in upper GI endoscopy. Whereas it has been proven that diazepam does not have any effect on sphincter of Oddi (SO) motility in humans, no respective data exist on midazolam. On evaluation of the possible effects of midazolam on SO motility recording by means of endoscopic manometry, we found that midazolam had no effect on basal pressure (24.2 +/- 12.59 mm Hg before and 23.85 +/- 12.63 mm Hg after midazolam, p = 0.55), amplitude (39.75 +/- 22.62 versus 44.55 +/- 27.15, p = 0.097), duration (4.9 +/- 1.8 sec versus 5.05 +/- 1.7 sec, p = 0.614), and frequency of SO contractions (7.75 +/- 1.68 waves/min versus 7.15 +/- 1.92 waves/min, p = 0.083). These results suggest that in patients with normal manometric findings midazolam does not interfere with SO recording.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1993

Chronic gastritis: prevalence in the French population. CIRIG.

Chronic gastritis (CG) which can be associated with severe complications, is a frequent phenomenon in gastroenterological practice. No data concerning the prevalence of GC are available in France. The aim of this study was to evaluate the prevalence of CG on biopsy specimens in the French population. All outpatients coming from different towns of seven French areas and undergoing an upper endoscopy on one or two randomly selected consecutive days were included in the study. A case report form was filled out and 5 biopsy specimens were taken from the fundus and antrum. Pathologists graded the specimens on the basis of Whitehead's classification. Seven hundred and forty-two patients were enrolled by 102 private gastroenterologists. Mean age was 53 years; 52% were males. Endoscopically, the gastric mucosa was abnormal in 53%. Superficial and atrophic CG was diagnosed in 53% of cases. Superficial gastritis was observed in 101 patients (14%), antral chronic atrophic gastritis (CAG) in 189 (26%) and fundic CAG in 17 (2%). Patients with CAG were significantly older than the other patients. There were more smokers and heavy alcohol drinkers in the group of CAG patients. Endoscopy and histology were in accordance in only 55.2% of the patients: most cases of CAG were not detected by endoscopy. These results are similar to other studies in European populations. The principal pattern among the various types of gastritis was CAG. The other forms were rare. Autoimmune gastritis was uncommon in this French population (4% of the CAG patients).

Adolescent↗
PubMed1991

[Validation of an ultrasonographic method of gastric emptying measurement in men].

Our purpose was to validate an ultrasonographic technique based on the assessment of the gastric antrum. Sixteen patients presenting with various functional disorders were studied by ultrasound on two occasions. Ten healthy volunteers were simultaneously studied by scinti- and ultrasonic scans. After an overnight fast, the healthy subjects ingested a 2,000 kJ test meal containing 150 microCi of 111In DTPA in 250 ml orange juice and 3 mCi of 99m Tc sulfur colloid in chicken liver. Using an ultrasound scanner fitted with a 3.5 MHz transducer, the area of the gastric antrum section was always measured in the same plane. Ultrasonographic measurement of gastric emptying rate was feasible in all of the 10 healthy subjects and in 14 of 16 selected patients. The ultrasonographic method was reproducible, and repeated t 1/2 measurements in 14 patients correlated well (95.3 +/- 27.9 vs 99.2 +/- 20.6 min; r = 0.70, P less than 0.001). The t 1/2 measurement was 39.4 +/- 7.7 min with the ultrasonographic method, and correlated well with 36.4 +/- 4.3 min for the t 1/2 measurement of the liquid phase with the scintigraphic method. We conclude that the ultrasonic method was reproducible and could be used for assessment of gastric emptying rate when repeated measurements are necessary, especially in pharmacologic studies.

Adult↗