Search PubMed⌕ Search

Biomedical subjects

G Devroede

Publications and source records attributed to G Devroede.

At least 55 records · Page 3Linked to original sources
PubMed1987

Stimulation of colonic peristalsis by vasopressin: electromyographic study in normal subjects and patients with chronic idiopathic constipation.

The effects of vasopressin on colonic motility were investigated in 6 healthy subjects and 10 patients with chronic idiopathic constipation. Recordings of the colonic myoelectric spiking activity were performed by means of 50-cm long silastic tube, equipped with four bipolar ring electrodes fixed at 10-cm intervals, which was introduced by flexible colonoscopy into the left colon. Tracing were obtained for 1 h in the fasting state and for another hour after an intramuscular injection of a pharmacological dose of vasopressin (0.3 U/kg). The different types of spike bursts generated by the colonic smooth muscle were compared before and after vasopressin injection. In both controls and patients, the tracing showed (i) rhythmic stationary spike bursts (RSB) that were seen at only one electrode site; and (ii) sporadic bursts that were either propagating over all four electrodes (SPB) or nonpropagating (SNPB). Injection of vasopressin in controls was followed for 30 min by a significant increase in the number of propagating bursts from 2.7 +/- 0.6 (mean +/- SEM) to 5.2 +/- 1.4 bursts (p less than 0.05); RSB and SNPB were not altered by vasopressin. In the constipated patients, the number of propagating bursts during the control period was significantly lower (0.8 +/- 0.2 bursts/30 min) than in the volunteers (p less than 0.05). After vasopressin, there was a significant increase to 3.6 +/- 0.8 bursts/30 min (p less than 0.001); RSB and SNPB also did not show significant alteration after vasopressin. Finally, 4 out of the 10 patients passed stools during the recording session.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Action of trimethyl 3,3-N-hexene-5-lactam on the mechanical properties of the longitudinal fibers of the rat colon. An in vitro study].

The effects of trimethyl 3,3-N-hexene-5-lactam (T. H. L.) on the mechanical properties of longitudinal muscle strips of the distal rat colon were investigated through stretching, electrical stimulation and addition of pharmacologic agents. T. H. L. abolished the contraction induced by electrical stimulation and decreased amplitude of contractions induced by carbamoylcholine and serotonin. It further reduced the relaxation induced by adrenaline.

Animals↗
PubMed1986

Hindgut dysgenesis as a cause of constipation with delayed colonic transit.

In a patient complaining of constipation since birth, delayed transit time in the ascending colon was related to a congenital malformation of the hindgut, different from Hirschsprung's disease. This was associated with absence of the left lobe of the liver. There was no propagating electrical muscular activity in the distal bowel.

Adult↗
PubMed1985

Measuring the anorectal angle.

Lateral radiographs of the rectum and anus were taken in 90 children with chronic idiopathic constipation. A computer program was developed to obtain an objective quantitative assessment of the anorectal angle; it averaged 120 degrees at rest, decreased during forceful anal contraction and increased during defecation. It was noted that 24% of the children, when asked to defecate, decreased their anorectal angle as normally observed during forceful anal contraction and, that 21% when asked to contract the anus, increased the angle as if they were defecating. This 'sphincteric disobedience' is probably of major clinical relevance to an understanding of the symptoms of these patients.

Adolescent↗
PubMed1985

Comparative esophageal and anorectal motility in scleroderma.

Esophageal and anorectal pressures were recorded in 26 patients (4 men and 22 women) with scleroderma. Eleven patients suffered from a localized form of the disease and 15 from progressive systemic sclerosis. The latter only had marked functional abnormalities in esophageal and anorectal motility. Mean resting pressure at the lower esophageal sphincter of patients with progressive system sclerosis and controls was, respectively, 6 +/- 2 and 25 +/- 1 mmHg (p less than 0.001); mean closing pressure was 5 +/- 5 and 48 +/- 3 mmHg (p less than 0.001); coordination of opening the lower esophageal sphincter with the oncoming contraction in the distal esophagus was 0% and 68% +/- 5% (p less than 0.001); and relaxation (fall of the lower esophageal sphincter pressure to resting levels in the stomach) was 18% +/- 12% and 98% +/- 1% (p less than 0.001). The rectoanal inhibitory reflex was of lesser amplitude than normal in 74% of patients with progressive system sclerosis and was absent in 13%. Quantitative analysis demonstrated a significant reduction in response to rectal distention with 20 or more ml of air (p less than 0.001). There was a correlation between the amplitude of the lower esophageal sphincter relaxation and the amplitude of the rectoanal inhibitory reflex in response to rectal distention with 30-50 ml of air (p less than 0.05 to p less than 0.025). Our data show that in systemic sclerosis, anorectal motility is as frequently abnormal as esophageal motility.

Adult↗
PubMed1985

Beneficial effects of naloxone in a patient with intestinal pseudoobstruction.

A 15-day course of Naloxone treatment was given to a patient with intestinal pseudoobstruction who had previously undergone subtotal colectomy with terminal ileostomy for invalidating constipation. The effects of the drug were assessed according to symptoms, by recording the myoelectric activity of the stomach, and by measuring gastric emptying of a radiolabeled solid-liquid meal and the intestinal transit time of radiopaque markers. All tests were performed 1) at baseline; 2) after 2 wk with Naloxone 1.6 mg subcutaneous per day; and 3) after 8 days of placebo. Results showed that before treatment gastric emptying of solids was delayed, emptying of liquids was normal, myoelectric activity of the stomach was normal, small intestinal transit time of radiopaque markers was considerably increased while ileal output was markedly decreased. After Naloxone, gastric emptying of solids was markedly accelerated, emptying of liquids remained normal, gastric electrical spiking activity increased, small intestinal transit time strikingly decreased, and ileal output increased. After placebo, a tendency to return to pretreatment values was observed. This observation suggests that Naloxone may be helpful in the treatment of some patients with intestinal pseudoobstruction.

Adult↗
PubMed1984

Sex differences in the changing anatomic distribution of colorectal carcinoma.

The anatomic site distribution of large bowel cancer was studied in 2079 patients between 1967 and 1980. To measure the trend in the localization of the carcinomas, the slope of the regression line of the proportions at each site over the years was computed. The large bowel was divided into five segments: cecum, ascending colon and hepatic flexure, transverse and descending colon, sigmoid and rectosigmoid junction, and rectum. A significant decrease in the proportions of cancer in the sigmoid for both sexes (slope parallel b = -0.89; P less than 0.001) and an increase of cecal cancer (b = 0.54; P less than 0.004) was observed. Sex-specific results indicated the diminishing proportion of sigmoid cancer in men (b = -1.04; P less than 0.004) with an increase in transverse and descending colon cancer proportions (b = 0.52; P = 0.012). In women, a negative slope of -0.74 was not significant for sigmoid cancer, but cancer of the cecum showed an increase in proportions (b = 0.80; P = 0.01). The age distribution indicated a significant decrease in proportion of men older than 80 years and of women in the age group of 40 to 49 years and an increase in women older than 80 years. However, age adjustment did not change any of the previous conclusions. The observed sex differences in the changing distribution within the large bowel over a 14-year period cannot be explained by the improvement of diagnostic tools in the last years. In view of these findings, it is important to evaluate the possible sex-related bias in the application of screening and preventive measures as well as the changes in the ecologic features of the large intestine.

Adult↗
PubMed1984

Risk of large-bowel cancer in synthetic fiber manufacture.

In a previous study, the authors found an increased incidence of colorectal cancer among workers in a textile factory producing synthetic fiber. To answer the crucial question of whether the risk is confined to one section of the plant, a case-control study was done. For each of 43 cancers that occurred in the plant between 1965 and 1979, 3 controls were selected at random from company files of 24,270 current and past employees. They were matched for age, date of beginning employment, and duration of employment. Forty-four percent of the cancer patients worked in one of three departments: "extrusion D," "extrusion TM," and "textile," whereas only 21% of the controls worked in one of these departments (P less than 0.005). After 1974, when the peak incidence was observed, 10 of 21 patients had worked in either or both extrusion departments; only 8 of 63 controls had worked in these departments. (P less than 0.002). It took more than 10 years (10 of 33 cases versus 8 of 95 controls; P less than 0.002) before a risk became apparent. According to work areas, the relative risk was increased for those who had worked in building 3, where the extrusion D department was located (P less than 0.02). These results offer a basis for the prevention and surveillance of colorectal cancer in this industry.

Colonic Neoplasms↗
PubMed1984

Anorectal motility after surgery for spina bifida.

Anorectal motility was studied in 93 children (aged 15 days to 16 1/2 years) who had undergone surgery for myelocele or meningomyelocele, and 80 controls, matched for age and sex. Mean resting pressure in the anal canal of patients was markedly decreased, particularly in the presence of incontinence, and unstable. The recording of a rectoanal inhibitory reflex both in the upper anal canal and at the anal margin was associated with the presence of fecal incontinence and motor disorders of the lower extremities. Patients could be divided into four groups according to manometric pattern: 1) those with normal recordings (incontinence in 63 per cent), 2) those with spontaneous intermittent relaxations of the upper anal canal and simultaneous rectal contractions (incontinence in 91 per cent), 3) those with normal manometry except for unstable upper anal canal pressure (incontinence in 92 per cent), and 4) those with absence of the rectoanal inhibitory reflex and hypotonic anal canal (patients too young to appraise continence, all under 2 years).

Anal Canal↗
PubMed1984

Functional abnormalities of the anal sphincters in patients with myotonic dystrophy.

Motility of the anorectal area was studied in 19 patients with myotonic dystrophy and in 20 control subjects, before and after pudendal block. In patients with myotonic dystrophy, before anesthesia, resting pressure in the upper anal canal ( p less than 0.001) and duration and amplitude of relaxation of the rectoanal inhibitory reflex (p less than 0.01) were decreased. A myotonic contraction of high amplitude followed relaxation in all patients, but in control subjects this was not the case. In the lower anal canal, the duration of the rectoanal contractile reflex was prolonged as compared with control subjects (p less than 0.001). The pudendal block had no effect in the upper anal canal either on resting pressure or on amplitude and duration of the rectoanal inhibitory reflex, neither in patients nor in controls. After blockade, however, the myotonic contraction subsequent to the reflex in patients was significantly reduced in amplitude (p less than 0.01). In lower anal canal, the resting pressure was reduced to similar levels, both in patients and in control subjects, after pudendal block (p less than 0.01), and the rectoanal contractile reflex was abolished in both groups. This study demonstrates a number of functional abnormalities in the anorectal structures of patients with myotonic dystrophy. These abnormalities produce a decrease in resting pressure in the anal canal, and a reflex myotonic contraction subsequent to rectal distention due to both external and internal sphincter dysfunction.

Adolescent↗
PubMed1983

A case-control study of risk factors for large bowel carcinoma.

Two hundred and seven large bowel cancer patients (93% of all cases diagnosed in a defined community between 1965 and 1976) were matched at random with non-cancer subjects of same age, sex, and place of residence. Men with cancer, aged 75 years and younger than, had a more frequent history of work in a local factory handling synthetic fiber than controls (22 versus 10; P less than 0.025). In this factory 45% of cancers occurred before age 60, while this was true in only 24% of cancer cases outside the factory (P less than 0.05). There was a greater tendency for cancers in factory workers to occur in the colon than in the rectum. Heredity was not found to be a risk factor for large bowel cancer. The rate of prior appendectomy was higher in men with colon cancer (P less than 0.05) and the rate of prior cholecystectomy was lower in females with colonic cancer (P less than 0.05). A previous hemorroidectomy was also found more often in males with colonic cancer (P less than 0.05). Long-standing severe constipation was present more often in patients with cancer (P less than 0.01). There was some evidence for a compounding influence of different risk factors, as studied by relative risk ratio. This study confirms the existence of a high risk of large bowel cancer in a group of workers in a synthetic fiber factory and suggests other factors antecedent to large bowel cancer.

Age Factors↗
PubMed1983

Constipation with colonic inertia. A manifestation of systemic disease?

Transit of radiopaque markers was delayed in the ascending colon of 51 females and 3 males treated for severe idiopathic constipation. Onset of symptoms was between age 10 and 20 in more than half of the patients. Eighteen percent had previously undergone unnecessary laparotomy for large bowel pseudoobstruction. Stool frequency ranged from 1 stool every three days to 1 every 2 months. Twenty-six percent suffered from fecal incontinence. In addition, 30% had orthostatic hypotension and 15% galactorrhea of idiopathic origin. Patients had a higher than normal anal pressure (P less than 0.001). They all had a rectoanal inhibitory reflex, but it was abnormal in 76%. In the upper esophageal sphincter, resting pressure was higher (P less than 0.02), and coordination poorer (P less than 0.05) than in normal control subjects. Incidence of spontaneous tertiary contractions in the body of the esophagus was greater than normal (P less than 0.03). In the lower esophageal sphincter, resting pressure was lower (P = 0.001) and gastroesophageal gradient weaker (P = 0.05). Closing pressure of the sphincter was lower (P less than 0.001) and coordination less adequate (P less than 0.02). After subcutaneous injection of 0.035 mg/kg bethanechol, urinary bladder intraluminal pressure increased by over 15 cm H2O in 31% of patients but never did in controls, and average maximal pressure was greater (P less than 0.025). Time taken to reach peak pressure was shorter (P less than 0.01). This study provides evidence that patients who suffer from constipation with colonic inertia also have abnormal function in other hollow viscera.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1983

Fasting and postprandial myoelectric spiking activity in the human sigmoid colon.

The colonic myoelectric spiking activity was recorded in 10 healthy subjects using an intraluminal tube equipped with four bipolar Ag-AgCl ring electrodes fixed 10 cm apart. The probe was introduced into the sigmoid colon by endoscopy so as to place the electrodes at 50, 40, 30, and 20 cm, respectively, from the anal verge. Recordings were performed for 2 h in the fasting state and for an additional 2 h after an 800-kcal mixed meal. The tracings showed two patterns of spiking activity. One was made of rhythmic and stationary potentials; the other was made of sporadically occurring potentials that were either propagating (at a speed of 8.4 +/- 2.5 cm/s, mean +/- SD) or nonpropagating. Food intake provoked a significant increase in both the propagating potentials (from 2.6% to 7.7% of the recording time, p less than 0.05) and the nonpropagating potentials (from 15.8% to 34.8% of the recording time, p less than 0.05). No significant change was observed for the stationary rhythmic potentials. After the meal, the sporadic nonpropagating spiking activity showed a first peak within 10-20 min and another peak within 60-70 min. Propagating spiking activity only showed one peak 70-80 min after the meal.

Action Potentials↗