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Biomedical subjects

G Vantrappen

Publications and source records attributed to G Vantrappen.

At least 199 records · Page 11Linked to original sources
PubMed1984

The influence of 15(R)-15 methyl PGE2, methyl ester, on Nd:YAG laser-induced gastric ulcers.

The effect of 15(R)-15 methyl PGE2 on the evolution of gastric ulcers induced by endoscopic Nd:YAG laser photocoagulation was studied. By continuous application of 50 to 70 watt power for 4 sec at a distance of 15 mm from the gastric mucosa, reproducible ulcers can be induced. The effect of the drug in nonantisecretory doses (10 micrograms/kg) on the acute ulcer formation and on the healing rate was evaluated in mongrel dogs by light microscopy. Local administration or oral pretreatment did not influence the size or depth of acute ulcers (7.4 mm in diameter) as compared to a control series (7.2 mm). Pretreatment for several days, however, had a marked beneficial effect on the healing rate of the ulcers (1.71 mm after 7 days compared to 2.76 mm for the control series). From these data it may be concluded that 15(R)-15 methyl PGE2 has a beneficial effect on ulcer healing, even in nonantisecretory doses.

Administration, Oral↗
PubMed1984

Sclerotherapy of oesophageal varices after variceal haemorrhage.

Fifty-six patients with recent variceal haemorrhage were studied in a trial of repeated injection sclerotherapy through the flexible oesophagoscope, with a mean follow-up of 15.2 months (1-39). Twenty-five patients (45%) did not suffer further bleedings. The risk of bleeding per patient-month of follow-up decreased significantly (p less than 0.05) after starting therapy, in all groups of cirrhosis, classified according to Child's criteria. Mortality during the study period was 39% (19.6% due to recurrence of variceal bleeding). The main complications of the procedure were the development of oesophageal wall ulcerations and oesophageal stricture.

Adolescent↗
PubMed1984

A new and effective technique of Yag laser photocoagulation for severe upper gastrointestinal bleeding.

A new technique of treating acute severe upper gastrointestinal haemorrhage was evaluated. The technique consisted of epinephrine injections in the bleeding lesion combined with YAG laser radiation in short pulses, applied until the bleeding vessel was completely closed. This new treatment modality was tried in 54 consecutive patients with severe upper gastrointestinal bleeding from a spurting artery, or an ulcer with a non-bleeding visible vessel in the floor of the ulcer crater at endoscopy. Permanent haemostasis was achieved in 87% of the 54 patients. Emergency surgery was needed in 13%. The mortality rate was only 10%. No complications occurred. It is concluded that this new technique of treating severe upper gastrointestinal bleeding from a spurting artery, or an ulcer with a visible vessel results in a significant improvement of the success rate (permanent haemostasis) and a marked reduction in the mortality rate.

Adolescent↗
PubMed1984

Positive 14CO2 bile acid breath test in elderly people.

The 14CO2- glycylcholate breath test (also called the bile acid breath test) was performed in a group of 42 normal young volunteers (group A), a group of 25 elderly subjects in apparently good health (group B) and a group of 22 hospitalized geriatric patients presenting with weight loss (group C). The 95 percentile value of the cumulative 14CO2 excretion at the third and the sixth hour in group A was taken as the limit for normal values for 14CO2 excretion. Using these criteria 56% of group B subjects and 50% of group C patients were considered abnormal at the third hour, whereas at the sixth hour these percentages were 56% and 54%, respectively. Repetition of the bile acid breath test after antibiotic treatment in the hospitalized group suggested that bacterial overgrowth in the small intestine was responsible for the abnormal 14CO2 breath test in the elderly persons. However, the large number of abnormal tests in healthy elderly people, not complaining of any gastro-intestinal discomfort, indicates that bacterial overgrowth may remain asymptomatic and that an abnormal test does not necessarily mean that the symptoms of a patient are to be ascribed to this finding.

Adult↗
PubMed1984

Natural history of recurrent Crohn's disease at the ileocolonic anastomosis after curative surgery.

An endoscopical and histological study was carried out in 114 patients, treated by 'curative' resection of the terminal ileum and part of the colon for Crohn's disease, in order to study the natural history of recurrent Crohn's disease. The recurrence rate of Crohn's disease in patients examined within one year of the operation was 72%. This figure did not differ significantly from that in patients examined one to three years or three to 10 years after surgery (79% and 77% respectively). Recurrence was located in the neoterminal ileum and at the anastomosis in 88% of the patients. Early endoscopic signs of recurrence were small aphthous ulcers in the neoterminal ileum. Ileal biopsies at this stage showed an important inflammatory cell infiltrate of the lamina propria with numerous eosinophils and fusion and blunting of the villi. More advanced lesions observed in patients examined one to three years after surgery, consisted of larger, often serpiginous ulcerations and nodular thickening of folds. In patients examined three to 10 years after the operation, the anastomosis was frequently stenosed and rigid, with large ulcers extending from the stenosis into the colon. Mucosal granulomas may be found in normal appearing mucosa as well as in the obviously inflamed mucosa surrounding the ulcers. These studies suggest that recurrence of Crohn's disease almost always develops in the first year after the operation. Significant endoscopic lesions may be present without clinical symptoms, particularly in the earlier stages of the disease.

Adolescent↗
PubMed1984

Somatostatin induces ectopic activity fronts of the migrating motor complex via a local intestinal mechanism.

To study the peripheral effect of somatostatin in dogs a tiny Silastic catheter was implanted in an almost terminal branch of the mesenteric artery, providing blood supply to a jejunal segment of 5-10 cm. In 4 dogs one catheter was implanted, perfusing a small bowel segment about 60 cm below the angle of Treitz; in 3 dogs two catheters were implanted, perfusing two small bowel segments about 30 and 60 cm below the angle of Treitz. The catheter was kept open by continuous perfusion with a diluted heparin solution by means of a portable insulin infusion pump fixed to the animal's protection jacket. Small bowel motility was recorded electromyographically. Experiments were started 2 wk after surgery and were performed in conscious fasted animals. Control experiments using intraarterial saline perfusion showed normal migrating motor complexes in the perfused segment. Intraarterial perfusion of somatostatin (50-200 ng/kg X h) induced ectopic activity fronts, which always started just distal to the perfused segment and progressed down the small bowel at a normal propagation velocity. During the occurrence of ectopic fronts no activity fronts were observed in the small bowel proximal to the perfusion site. Apart from ectopic fronts, normal activity fronts, starting in the duodenum and passing the perfused segment, were also observed. The most proximal part of the jejunum was more sensitive to intraarterial somatostatin than the more distal jejunum. Intravenous infusion of the same doses of somatostatin had no effect. Somatostatin, therefore, seems to induce ectopic fronts via a local mechanism. We propose that somatostatin is able to relieve the intestine locally from an inhibitory mechanism that prevents the development of activity fronts.

Action Potentials↗
PubMed1984

Primary gastric actinomycosis: a case report and review of the literature.

A case of primary gastric actinomycosis presenting as a bleeding gastric tumor is reported. The diagnosis of this infection of the stomach is difficult and may often be established only by histological examination. If the disease is recognized, the prognosis is good because antibiotic treatment is very effective. Recent literature findings are reviewed and clinical and endoscopic features are compared.

Actinomycosis↗
PubMed1983

Lymphocytes and Langerhans cells in the human oesophageal epithelium.

Using monoclonal antibodies on fresh frozen endoscopically obtained oesophageal biopsies the distribution of Langerhans cells, B lymphocytes, and various subpopulations of T lymphocytes was studied in the normal human oesophageal mucosa and in oesophagitis. Identification of the lymphocytes was carried out by an immunoperoxidase technique using OKT3 (antihuman T cell antibody), OKT4 (antihuman helper T cell antibody), OKT8 (antihuman cytotoxic T cell) and OKT10 (antihuman null cell antibody). Identification of the Langerhans cells was carried out using an ATPase stain and OKIa (Ia like antigen) and OKT6 (antihuman thymocyte). In the normal oesophageal epithelium cytotoxic T lymphocytes are found as well as Ia positive Langerhans cells. Helper T lymphocytes and B lymphocytes are present mainly in the lamina propria. In oesophagitis an increase in Langerhans cells and cytotoxic T lymphocytes within the epithelium is found. From these findings it can be concluded that the oesophagus contains a reticuloepithelial system as well as a lymphocytic population which are a part of the gut-associated lymphoid tissue.

Adult↗
PubMed1983

The activity front of the migrating motor complex of the human stomach but not of the small intestine is motilin-dependent.

The role of motilin in the generation of the gastric component of phase 3 of the migrating myoelectric complex (MMC) was studied in human volunteers. Interdigestive motor activity was recorded manometrically in five normal subjects after a fast of at least 15 h. Intraluminal pressures were measured in the gastric antrum at 4 levels 3 cm apart and in the upper small bowel at 3 levels 25 cm apart. Blood samples were drawn every 10 min for radioimmunoassay of motilin and PP. After 2 spontaneously occurring activity fronts (AF) had been recorded, bovine PP was infused intravenously at a rate of 50 micrograms/h. Following the third AF a combination of PP (50 micrograms/h) and 13-norleucine-motilin (30 micrograms/h) was infused until after the next AF. It was found that 90% of the spontaneous AFs originated in the stomach. They were preceded by a motilin peak. During the PP infusion, plasma PP levels increased from 29 to 256 pmol/l, motilin decreased from 42 to 15 pmol/l, and all AFs originated in the small bowel. During the combined PP and motilin infusion, plasma motilin increased to 330 pmol/l, and all AFs again originated in the stomach. It is concluded that motilin has an important role in the regulation of the MMC activity front in the stomach, but not in the small intestine. Postprandial rises in plasma PP might be involved in lowering motilin levels after a meal, and indirectly, in the disruption of gastric MMCs during digestion.

Adult↗
PubMed1983

Immunoreactivity of alpha-1-antitrypsin in the human colon.

Alpha-1-antitrypsin (AAT) was detected by an indirect immunofluorescent technique and a peroxidase antiperoxidase technique in the human colon. It was present along the luminal border, in Paneth cells, in occasional epithelial cells and in macrophages. In idiopathic inflammatory bowel diseases an increased number of AAT positive macrophages can be seen. Although AAT is scarcely present in the human it might play a role in a local defence mechanism and thus in the pathogenesis of inflammatory bowel diseases.

Adenocarcinoma↗
PubMed1983

Immunohistochemical identification of lysozyme in pseudopyloric gland metaplasia in Crohn's disease.

Using an immunoperoxidase technique lysozyme (LZM) was identified in the ileum of patients with Crohn's disease in inflammatory cells of the lamina propria, in Paneth cells and in pseudopyloric gland metaplasia. These observations demonstrate a further analogy of pseudopyloric gland metaplasia with true pyloric glands, and may offer an additional explanation for the raised concentration of serum-LZM in patients with Crohn's disease.

Crohn Disease↗
PubMed1983

Neodymium-Yag laser photocoagulation for haemostasis of gastrointestinal non-variceal haemorrhage.

Neodymium-Yag laser treatment in 130 patients with upper gastrointestinal bleeding, including spurting arterial bleeding, active oozing or fresh stigmata of bleeding (fresh clot or non-bleeding vessel), permitted overall initial haemostasis in 95% of the patients. Total laser failures (rebleeds) amounted to 22%. Considering only the ulcers with vessels in 36 patients, initial control of haemorrhage was achieved in 83%, but the total failure rate amounted to 50%. A controlled randomized study in 129 patients with oozing bleeding and patients with stigmata of bleeding showed a significant (p less than 0.001) reduction of duration and of the recurrence rate of bleeding and a significant decrease (p less than 0.05) of operative indications. Mortality rates however were not lowered by laser therapy. Complications of lasertherapy did not occur. One hundred thirty-eight gastrointestinal angiomas were treated by Yag laser photocoagulation in 32 patients without complications. Although the results of Yag laser treatment of gastrointestinal bleeding seem promising, endoscopic laser techniques should be improved to optimise the results and to improve the prognosis of life-threatening gastrointestinal bleedings.

Gastrointestinal Hemorrhage↗
PubMed1983

Tauro-7 alpha, 12 alpha-dihydroxy-5 beta-cholanic acid as internal standard in the gas-liquid chromatographic analysis of bile acid methyl ester acetates.

Tauro-7 alpha, 12 alpha-dihydroxy-5 beta-cholanic acid has been used as internal standard in the gas-liquid chromatographic analysis of bile acid methyl ester acetates. The advantage of this compound over other internal standards is that its use takes into account the hydrolysis rate of the bile acids. The entire procedure is monitored by thin-layer chromatography, gas-liquid chromatography, and by radioactivity measurement and zonal scanning.

Bile Acids and Salts↗
PubMed1983

Does intercurrent hepatitis have a beneficial effect on the course of Crohn's disease?

Four patients who developed acute viral hepatitis in the course of active Crohn's disease are reported upon. Three of these patients (1 with hepatitis A and 2 with hepatitis B) had a very striking and unusual clinical remission or apparent healing on regression of the hepatitis. These observations suggest that intercurrent hepatitis may have a beneficial effect on the course of active Crohn's disease.

Adult↗
PubMed1983

The enterohepatic circulation of bile acids during continuous liquid formula perfusion of the duodenum.

The enterohepatic circulation of bile acids was studied in 16 normal volunteers and 8 cholecystectomy patients during continuous liquid formula perfusion of the duodenum. The fasting bile acid pool size in the 16 normals (5.534 +/- 1.472 mmol) exceeded the circulating pool size (3.643 +/- 1.126 mmol) by 33.4% +/- 13.4. The difference between fasting and circulating pool sizes was significantly and inversely related to the percentage of the fasting pool that was emptied in the duodenum during the first perfusion hour (r = -0.76; P < 0.001). No relation was found between the circulating bile acid pool size and the calculated rate of recycling of the pool, but a strong relation was found between the cycling pool and the basal hourly bile acid outputs (2.08 +/- 0.77 mmol/hr) in the duodenum (r = 0.82; P < 0.001). In cholecystectomy patients the circulating pool size (3.30 +/- 1.39 mmol) and the basal bile acid output (1.65 +/- 0.98 mmol/hr) were slightly lower than in the normal volunteers. The bile acid pool size was not related to the cycling rate and there was a strong relation between pool size and bile acid secretion (r = 0.85; P < 0.001). As the fasting pool, measured using the method of Duane et al. (1975. J. Lipid Res. 16: 155-158), is probably overestimated by +/-14%, the remaining difference of +/-19% with the pool circulating during formula perfusion might be caused by incomplete gallbladder emptying. In these experimental conditions basal bile acid outputs reflect closely the size of the circulating bile acid pool in normals as well as in cholecystectomy patients.-Rutgeerts, P., Y. Ghoos, and G. Vantrappen. The enterohepatic circulation of bile acids during continuous liquid formula perfusion of the duodenum.

Adult↗
PubMed1982

Yersinia enteritis.

Y. enterocolitica has been shown to be a fairly common human pathogen in many countries. The clinical picture produced by Y. enterocolitica infections is quite variable. An acute abdominal disease (acute gastroenteritis or colitis, or a pseudoappendicitis due to acute terminal ileitis) and, less commonly, erythema nodosum and arthritis are the most important manifestations of the disease. On radiologic examination mucosal lesions of the terminal ileum are found in most patients with gastrointestinal symptoms. The colon is less frequently involved. The most typical lesions consist of shallow, small, round ulcers characteristic of the disease. Microscopic examination may suggest yersiniosis but does not show pathogenic signs. Y. enterocolitica can be detected by stool cultures or by serologic examinations. The disease is usually mild. If specific therapy is indicated the disease usually responds well to antibiotic therapy.

Anti-Bacterial Agents↗