Search PubMed⌕ Search

Biomedical subjects

G Lepage

Publications and source records attributed to G Lepage.

At least 73 records · Page 4Linked to original sources
PubMed1984

The composition of preterm milk in relation to the degree of prematurity.

Fifty-one samples of 24-h milk collections obtained during the 1st month of lactation from mothers who delivered after gestations of 26 to 31 wk (VPT) contained higher concentrations of nitrogen (297 +/- 11 mg/dl), total fatty acids (4.46 +/- 0.17 g/dl), percentage medium chain fatty acids (10.8 +/- 0.7), and energy (78.3 +/- 2.0 kcal/dl) than either or both those from 32 to 36 wk (PT) and term (T) gestations. PT collections did not differ from T milk with regard to nitrogen (250 +/- 13 versus 259 +/- 13), total fatty acids (3.94 +/- 0.20 versus 3.20 +/- 0.30), percentage medium chain fatty acids (9.1 +/- 0.5 versus 8.1 +/- 0.7) and energy (69.0 +/- 2.7 versus 66.6 +/- 2.4). Although postpartum age (5 to 10 versus 11 to 30 days) did not change the nutrient and energy content of VPT, PT, and T collections, it is only in 11 to 30 day VPT milk that nitrogen and energy content became higher (p less than 0.05) than either or both PT and T milk. We conclude that the differences in macronutrient composition of PT milk are limited to VPT milk and the data from repeated milk collections in the same mother (28 wk) suggest that there is considerable variability in its composition.

Amino Acids↗
PubMed1983

Effect of diversion of pancreatic secretions on biliary lipids and bile salt kinetics in the rat.

The hypothesis that the absence of pancreatic secretions from the lumen of the intestinal tract could alter the secretion rate of biliary lipids and the kinetics of bile salts was tested in rats with a pancreatic fistula fed intragastrically either a high or a low fat liquid diet over a 4-day period. In animals with external derivation of all pancreatic secretions who were given the high fat diet, stools were pale and bulky, the basal synthesis rate of bile acids was almost twice that of controls, and there was an increase in the secretion rate of cholesterol and phospholipids calculated from the first 2 h of bile collection. On the low fat diet, there was no change in basal bile salt synthesis, but the pool was larger and the secretion rate of bile acids and phospholipids was increased. A study of the quantitative relationship between the excretion rate of phospholipids and of cholesterol to that of bile acids following complete biliary diversion revealed a disproportionately large output of cholesterol at low bile acid flow rates under both diets in rats with a pancreatic fistula. These data suggest that experimental pancreatic insufficiency leads to alterations of the secretion rate of biliary lipids and to uncoupling of the close relationship between bile acids and cholesterol.

Animals↗
PubMed1982

Hepatobiliary disease in cystic fibrosis: a survey of current issues and concepts.

The incidence of hepatobiliary complications of cystic fibrosis (CF) has been increasing in parallel with the rate of survival. Detection of hepatic involvement remains a problem, as liver function tests, serum bile acid determinations, and ultrasonography do not permit an early diagnosis. The pathogenesis of cholelithiasis has been elucidated in the past few years. However, the mechanism leading to the pathognomonic CF lesion, focal biliary cirrhosis, is still unknown. There are indications that mucus plugging may be the ancestral lesion and the triggering factor. The possibility that correction of the abnormalities of bile acid metabolism could slow the progress or prevent CF cirrhosis is discussed in light of recent experimental data.

Adolescent↗
PubMed1981

Separation of sulfated from non-sulfated serum bile acids without the use of Sephadex columns.

Methods currently in use for the quantitative measurement of sulfated serum bile acids usually lead to low recoveries. The present technique uses two internal standards and involves enzymatic hydrolysis followed by extraction of the non-sulfated fraction in ether at pH 4.6. The sulfated fraction is then solvolysed before gas-liquid chromatographic analysis of the individual bile acids of both fractions. Using 200 microliters of serum, recoveries of more than 81% of sulfated bile acids were achieved. This method is of particular significance in view of recent evidence showing that certain sulfated bile acids are cholestatic.

Amidohydrolases↗
PubMed1979

The role of gastric lipolysis on fat absorption and bile acid metabolism in the rat.

In vivo studies were carried out in young Sprague-Dawley rats to examine the role of gastric lipolysis on fat absorption and bile acid metabolism. When fed by gastric perfusion 5 times (corn oil, 4 g/day) their usual dietary intake of fat, rats deprived of lingual lipase by the creation of an esophageal fistula had a significant degree of fat and bile acid malabsorption as well as a shortened bile acid half-life when compared to animals with a gastrostomy. The % fat absorption, bile acid loss and bile acid pool were normal in 2 groups of esophageal fistula rats fed the same quantity of corn oil or twice (8 g/day) that amount as a fine emulsion. In view of a negligible gastric lipase activity in animals with an esophageal fistula and of decreased hydrolysis of a triglyceride test meal, these data suggest that gastric lipolysis is of physiological importance in situations where lipolytic mechanisms are stressed by a large fat intkae. Its principal role is to potentiate intestinal lipolysis by facilitating the emulsification of dietary lipids through its formed products and, therefore, the contact of pancreatic lipase with its substrates.

Animals↗
PubMed1978

Vulnerability of keto bile acids to alkaline hydrolysis.

Rigorous alkaline hydrolysis of the two primary (cholic and chenodeoxycholic) and of the two preponderant secondary (deoxycholic and lithocholic) bile acids found in bile led to excellent recoveries. Such was not the case with 11 different keto bile acid standards. Recoveries for a number of standards were unacceptably low and a variety of artefactural products were tentatively identified by gas-liquid chromatography. Keto bile acids bearing a keto gropu on C-3 were particularly vulnerable. In view of thee findings, quantitative and qualitative data reported on biological specimens submitted to saponification in ethanol, methanol, or even in water are of questionable significance.

Bile Acids and Salts↗
PubMed1977

Thromboembolic complications with the cloth-covered Starr-Edwards aortic prosthesis in patients not receiving anticoagulants.

A comparison of the incidence of thromboembolic (TE) episodes was made in three groups of patient who underwent aortic valve replacement with the cloth-covered Starr-Edwards prostheses. Group 1 consisted of patients who received anticoagulants for either the entire period of follow-up or for a period of variable duration, after which these agents were no longer administered. When anticoagulants were stopped, 22 patients were categorized as Group 3 for study. Group 2 comprised patients who never received anticoagulants. Of the 147 patients followed in Group 1, 14 suffered one episode of TE. Six patients experienced major emboli; 3 of them died. Twenty of the 82 patients followed in Group 2 (no anticoagulants) suffered TE complications. There were 10 episodes of major emboli. Five of the 22 patients in Group 3 suffered an episode (all major) of TE. It is concluded from this study that anticoagulants should be given permanently to all patients with cloth-covered Starr-Edwards prostheses. Indeed, there is no period after operation when the incidence of TE is so low that anticoagulation may be safely discontinued.

Acenocoumarol↗
PubMed1976

Relationship between bile acid malabsorption and pancreatic insufficiency in cystic fibrosis.

Bile acid loss (mg/m2 24h) in the stools of 43 cystic fibrosis (CF) children with pancreatic insufficiency was 751-1 +/- 48-3, while that of six without clinical evidence of pancreatic disease (133-4 +/- 15-9) did not differ from values in 25 controls (109-8 +/- 9-8). There was a good correlation between the degree of bile acid (BA) and fat sequestration. Concomitant changes in bile acid and fat loss were observed in the one group of six patients studied on and off pancreatic enzymes as well as in a second group of seven children treated with pancreatic supplements and maintained on a normal diet followed by a low fat diet supplemented with medium chain triglycerides. Administration of NA bicarbonate led to a significant decrease in fat loss (15-8 +/- 2-7 leads to 10-3 +/- 1-9) without any simultaneous change in bile acid excretion (533-1 +/- 58-3 leads to 500-4 +/- 58-6). Qualitative bile acid patterns in controls, in infants after an ileal resection, and in patients with CF or with coeliac disease showed that the percentage of primary BA followed closely the total amount excreted except in situations where antibiotics were administered. The exact mechanism for the increased loss of BA in CF is unknown. It is found in all age groups and is related to the presence and degree of pancreatic insufficiency. The possibility that unhydrolysed triglycerides may interfere with the intestinal absorption of bile acid needs further confirmation.

Adolescent↗
PubMed1976

[Use of intra-aortic balloon in cardiac surgery].

Use of the intra-aortic balloon in the treatment of circulatory failure after cardiac surgery has resulted in the long-term survival of 7 patients out of 20. The failures occured when the myocardium is severely compromised so that any treatment is likely to fait (8/13), and where there is the ultimate complication of renal or hepatic failure (4/13), irreversible ventricular failure or secondary haemorrhage. In urgent coronary bypass surgery (4/13) it would appear that the use of the balloon preoperatively would have avoided or at least slowed the progress toward the anatomical changes of massive infarction. As the use of the balloon has often been associated with a reduction in the number of circulating platelets and a pathological increase in the breakdow products of fibrin, heparin is now used systematically in an attempt to prevent the development of a true intravascular coagulation syndrome. The use of lidocaine is also recommended to prevent fatal or dangerous ventricular arrhythmias when the balloon is functioning well. A combination of the intra-aortic balloon with the infusion of small doses of adrenaline would seem to be an interesting therapeutic combination, especially at the onset of counterpressure.

Arrhythmias, Cardiac↗