Search PubMed⌕ Search

Biomedical subjects

J J Bernier

Publications and source records attributed to J J Bernier.

At least 55 records · Page 3Linked to original sources
PubMed1984

[Effects of a shielding antacid on changes in the gastric potential difference induced by aspirin in man].

Acetyl salicylic acid (AAS) disrupts the gastric mucosal barrier, causing a drop in the transmural potential difference (PD) and mucosal injuries. The decrease of PD correlates with endoscopic assessment and mucosal damage. The gastric PD may be used as a sensitive model for the assessement of drug-induced damage to the gastric mucosa. We have studied the effects of a shielding antacid ( Gelox ) on PD modifications induced by 500 mg of AAS in 12 healthy volunteers. Measures were performed after administration of one unit of Gelox and after a 3 day treatment period (1 unit, three times daily). Gelox induced a significant decrease of maximal PD drop (10.7 +/- 3.1 mV and 7.5 +/- 2.8 mV respectively; p less than 0.001) and of PD recovery time (p less than 0.05). After the 3 day treatment period and 14 h after the last intake, there was an increase of basal PD values and a very significant decrease (p less than 0.001) of maximal PD drop induced by AAS alone and AAS + Gelox (5.33 +/- 2.42 mV and 3.66 +/- 2.18 mV, respectively). Since the antacid effect had disappeared 14 h after the last intake of Gelox ; these results suggest an increase of the gastric mucosal barrier and a real "shielding effect".

Adult↗
PubMed1983

[Innovations in the treatment of gastroduodenal ulcers].

It has long been known that gastroduodenal ulcers may heal spontaneously; this is the placebo effect in which the healing rate ranges from 20% at 2 weeks to 80% at 8 weeks. Two or three weeks can be gained by using cimetidine or ranitidine, with healing rates of 42% at 2 weeks and 85% at 6 weeks. Ranitidine probably has less side-effects than cimetidine. A new drug, omeprozole, appears to be much more potent but is not yet available. A vagolytic drug with specific affinity to the stomach (pirenzepine), as well as low-dosage bismuth bi-citrate and gastric mucosa protectors (sucralfate) are now returning in force.

Aluminum↗
PubMed1983

Does total parenteral nutrition induce gallbladder sludge formation and lithiasis?

To assess the prevalence of sludge formation and lithiasis during total parenteral nutrition, serial biliary ultrasonographic studies were performed during and after i.v. nutrition periods in 23 selected adult gastroenterological patients. All patients were free of hepatobiliary disease before i.v. nutrition. Initial sonograms of 19 patients taken at the 12th day +/- 2 days (mean +/- SEM) of i.v. nutrition were normal. Initial studies for the 4 remaining patients, which were performed on the 39th day +/- 10 days of i.v. therapy (p less than 0.001), showed gallbladder sludge but did not demonstrate lithiasis. Serial ultrasonographic studies indicated that the percentage of sludge-positive patients during parenteral nutrition increased from 6% during the first 3 wk to 50% between the fourth and the sixth weeks and reached 100% in patients receiving i.v. nutritional therapy for greater than 6 wk. Gallstone formation was demonstrated in 6 of 14 sludge-forming patients but was not observed in patients who were sludge-negative. Three of the 6 stone-forming patients underwent cholecystectomy because of complications secondary to cholelithiasis after a mean 43-day course of parenteral nutrition. Analysis of bile from these patients revealed thick bile-containing cholesterol crystals and small stones of mixed bilirubin-cholesterol type. Ultrasonographic studies were obtained for sludge-positive patients after the parenteral nutrition period. Sludge positivity decreased from 88% during the first 3 wk of oral refeeding to 0% by the end of the fourth week. This study, therefore, strongly suggests that bowel rest and bile stasis during parenteral nutrition lead to production of sludge, which can result in eventual gallstone formation. Consequently, during parenteral nutrition exceeding 1 mo, gallbladder stasis should be palliated to prevent cholelithiasis formation.

Adolescent↗
PubMed1983

[Endogenous steatorrhea during total parenteral nutrition. Study of 22 patients with gastrointestinal diseases].

Endogenous steatorrhea has only been evaluated in patients with non-pathological digestive tract. We decided, therefore, to study this parameter in 22 consecutive patients submitted to total parenteral nutrition for severe gastrointestinal diseases. The determination of steatorrhea, creatorrhea, and fecal clearance of alpha 1-antitrypsin was performed by three days stool collections. After 10 days of parenteral nutrition, 13 of the 22 patients still had measurable stool losses and 106 fecal collections were done. In these 13 patients, fecal weight was 610 +/- 130 g.d-1, (mean +/- SEM), steatorrhea was: 3.1 +/- 0.4 g.d-1, creatorrhea was: 1.7 +/- 0.6 g.d-1, alpha 1-antitrypsin clearance was: 58 +/- 13 ml.d-1 (N less than 10 ml.d-1). The mean endogenous steatorrhea was therefore 5 fold larger than normal and creatorrhea 1.8 fold larger than normal. This discrepancy could be due to metabolism of nutrients by colonic bacterial flora. The comparison of patients with and without increased endogenous losses showed significant differences in the mean number of intestinal lesions (1.4 +/- 0.3 versus 0.5 +/- 0.2) and in the presence or absence of ileal involvement (p less than 0.05). A positive correlation was found between steatorrhea and stool weight but not between steatorrhea and creatorrhea or fecal clearance of alpha 1-antitrypsin. This first study of pathological endogenous steatorrhea does not suggest a relationship of this parameter with protein losing enteropathy. The main contribution to increased endogenous losses may be related to increased epithelial cell renewal of the intestine associated with malabsorption. The role of bacterial overgrowth in the gut cannot be ruled out by the present data.

Celiac Disease↗
PubMed1983

[Comparative study of gastric emptying of digestible and nondigestible solids in normal man and duodenal ulcer patients].

Few studies have compared the gastric emptying of digestible and non-digestible solids in man. In 9 normal subjects and 16 duodenal ulcer patients, we measured simultaneously and during 3 h, the gastric emptying of: (a) radioopaque pellets (n = 100; volume = 30 mm3) ingested with an ordinary meal (450 kcal, 500 ml) and counted on X-ray series; and (b) digestible solids of the meal (99mtechnetium tagged egg white) detected by an isotopic method. Gastric emptying of liquids (labelled with 113mindium DTPA) was also determined. In normal subjects, emptying rates of the pellets was 5 +/- 2 p. 100 per hour while that of digestible solids was 29 +/- 1 p. 100 per hour (P less than 0.01). No correlation was evidenced between the emptying rates of either kind of solids. Emptying of liquids was faster than that of both digestible solids and pellets. Similar results were obtained in duodenal ulcer patients; no significant difference was found between patients and normal subjects for the three meal phases tested. These results are consistent with the hypothesis that digestible solids are retained in stomach until they are ground, and show that inert particles do not always reflect the gastric emptying of natural solids of the meal.

Adult↗
PubMed1982

Gastric emptying and intragastric distribution of lipids in man. A new scintigraphic method of study.

We measured gastric emptying of fat and water from a solid-liquid meal in healthy volunteers using a tubeless scintigraphic method. Selenium-75 glycerol triether, incorporated in butter, was the lipid-phase marker, and technetium-99m, ingested with 250 ml water, the non-lipid phase marker. In seven of these subjects we also measured the gastric emptying of solids and liquids with technetium-99m bound to cooked egg whites as the solid-phase marker and indium-111 ingested with 250 ml water as the marker of the solid and aqueous phases. Emptying and intragastric repartition of each marker were measured by detection of radioactivity changes over the abdominal area using a gamma-camera. The stability and the specificity of the labeling was checked for each marker. Mean gastric emptying rate (expressed as percentage ingested marker emptied per hr) of lipids (17.4 +/- 2.4) was much lower than that of the rest of the meal (34.2 +/- 1.8) and slightly, but significantly, lower than that of solids (22.8 +/- 1.8). An intragastric layering of fat above nonlipids was observed only after the first postprandial hour and remained moderate. Thus, lipids are emptied more slowly than any other component of an ordinary meal, and this is not due only to layering of fat above water.

Adult↗
PubMed1982

Diffuse follicular lymphoid hyperplasia of the small intestine without primary immunoglobulin deficiency.

Three cases of follicular lymphoid hyperplasia extending to the whole length of small intestine are reported in three young adult patients of low economic status. The disease was revealed by chronic diarrhea with malabsorption and/or protein-losing enteropathy. In one patient, all transitional patterns were found between the hyperplastic follicles and a small intestinal multicentric centrocytic-centroblastic lymphoma. No abnormalities in humoral or cellular immunity were found in the three patients. In particular, serum immunoglobulins (except IgG in one case) and plasma cell populations of small intestinal lamina propria were normal. Diffuse follicular lymphoid hyperplasia of the small intestine in the absence of primary immunoglobulin deficiency appears to be a rare condition associated with (or leading to) intestinal malignant lymphoma in most cases. Patients usually belong to the same populations as those suffering from alpha-chain disease.

Adolescent↗
PubMed1982

Technical hazards of using nutritive mixtures in bags for cyclical intravenous nutrition: comparison with standard intravenous nutrition in 48 gastroenterological patients.

Three methods for dispensing nutritional solutions are compared in 48 patients with gastrointestinal diseases on intravenous nutrition during 3582 days. The protocol for intravenous nutrition applied by the nursing team and the solutions used were the same in the three groups. In group A standard bottles were used, while in group B, 31PVC-disposable bags were used--with fat emulsion included (group B1) or with fat excluded (group B2). When fat was excluded from the bags it was infused separately from a bottle. The mixtures were made under laminar flow by the nursing team who applied a strict protocol which included bacteriological testing. The infection rate observed in the bags was 0.046%. The rate of septic complications was not significantly reduced in group B2 or B1 compared with group A; the type of container used was therefore unimportant and the key was the aseptic handling of the intravenous solutions. The rate of mechanical complications, mainly due to catheter obstruction, was higher (p less than 0.001) when fat was included in the bags--that is, in group B1--than in groups B2 and A. For 26 patients a cyclical regime of intermittent feeding was easier to manage when bags were used. In group B, this system replaced the continuous method n 75% of all therapeutic days without adverse effect; it improved compliance and allowed ambulatory treatment. The use of cyclical feeding with separate fat infusions has further reduced the hazards of intravenous nutrition and allowed the development of a programme that can be implemented at home.

Adolescent↗
PubMed1981

Maximal capacity for fluid absorption in human bowel.

The intestinal handling of fluid has been studied in ten healthy volunteers while an isotonic saline solution (NaCl 140 mM, KC1 5 mM) was perfused into the stomach at rates of 5, 10, 15, and 20 ml/min. Polyethylene glycol 4000 (PEG-4000), as a nonabsorbable marker, was infused into the second portion of duodenum, and the intestinal contents were sampled continuously at a steady rate at 25, 50, 155, and 180 cm distally. Radiological assessment showed that the proximal sampling point was located at the angle of Treitz when the distal site was usually in the terminal ileum. Stools were collected for the following 12 hr. Volumes sampled from each site were used as a correction for volumes calculated at each distal site. The absorption rates of water (0.035 ml), sodium (4.72 muEq), and potassium ((0.18 183 muEq) per minute and per centimeter of bowel were constant along the small intestine and were independent of the perfusion rate. Stools only appeared when terminal ileal input to the colon was above 6 ml/min. When this occurred, the net absorption of water by the colon was 2.7 +/- 0.3 ml/min whatever the rate fluid entered the colon. A significant positive correlation was observed between ileal outputs and volume of stools.

Adult↗
PubMed1981

Increased cell loss in the human jejunum induced by laxatives (ricinoleic acid, dioctyl sodium sulphosuccinate, magnesium sulphate, bile salts).

Two conjugated bile salts (10 mmol/l sodium glycocholate, 10 mmol/l sodium taurodeoxycholate) and three laxatives (30 mmol/l magnesium sulphate, 10 mmol/l ricinoleic acid, 2 mmol/l dioctyl sodium sulphosuccinate) were tested on seven subjects with no intestinal lesions in 14 experiments by intestinal perfusion of the jejunum. A 25 cm segment was studied. Each solution was perfused at the rate of 10 ml/min. Water and electrolyte fluxes, losses of deoxyribonucleic acid (DNA), and intestinal cell enzyme activity were measured in the fluids collected. All the laxatives and bile salts tested (except sodium glycocholate) induced water and electrolyte secretion, a rise in intraluminal DNA loss, and enzyme activity. It was possible to establish a significant correlation (p less than 0.001) between the amounts of water fluxes and DNA loss under the effect of dioctyl sodium sulphosuccinate and ricinoleic acid.

Bile Acids and Salts↗
PubMed1981

Assessment of the accuracy of segmental perfusion under an occluding balloon for measuring the intrajejunal secretion of albumin and immunoglobulin A.

The suitability was investigated of the segmental perfusion technique under an occluding balloon (which prevents the contamination of the test segment by upper digestive secretions and pancreatic proteolytic enzymes) for measuring immunoglobulin A (IgA) and serum albumin outputs into the jejunal lumen. The influence of the perfusion rate and of the transintestinal water movements in the 40 cm long test segment was studied in 11 healthy subjects. IgA and serum albumin outputs did not differ significantly when the same isotonic solution was perfused at rates of 5 or 10 ml/min, nor when water absorption was stimulated by the presence of glucose. A possible artefact linked to intestinal wall distension by the occluding balloon was evaluated in eight subjects with complete exocrine pancreas insufficiency. IgA and serum albumin outputs obtained under the occluding balloon were compared with those found with the triple non-occlusive method. Care was taken to achieve a similar flow rate and solute composition of the fluid entering the test segments with both techniques in each subject. Under these conditions, IgA and serum albumin outputs measured with both methods did not differ significantly. These findings validate the use of the segmental perfusion technique under an occluding balloon to measure IgA and serum albumin outputs into the human small intestine.

Adult↗
PubMed1981

[Cryptal origin of the intestinal secretion induced in rats by prostaglandin El. Evolution of secretion after a single injection of 5-fluorouracil].

The intestinal secretions induced by an intrajejunal perfusion of prostaglandin E1 (PGE1) at the rate of 24 gamma/min in anaesthetized male Wistar rats, weighing 200-200 g, were studied during 6 days after a single injection of an antimitotic agent, the 5-fluorouracil (5-FU, 40 mg/kg). 5-FU induced changes in the structure of the intestinal mucosa. The modifications observed in the intestinal secretions of water and sodium induced by PGE1 suggest that these secretions might (a) originate from crypts; (b) be partly reabsorbed by villi. Concerning the endogenous secretions, the intestinal mucosa might act as a secretion-reabsorption system.

Alprostadil↗