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Biomedical subjects

M Dapoigny

Publications and source records attributed to M Dapoigny.

At least 37 records · Page 2Linked to original sources
PubMed1996

Mesalamine in Crohn's disease with steroid-induced remission: effect on steroid withdrawal and remission maintenance, Groupe d'Etudes Thérapeutiques des Affections Inflammatoires Digestives.

BACKGROUND & AIMS: Steroid dependence and early relapse are frequent after a prednisolone-induces remission in Crohn's disease. The aim of this trial was to test whether mesalamine started at the onset of steroid tapering increases the rate of weaning from prednisolone and reduces the relapse rate after prednisolone cessation. METHODS: One hundred fifty patients with active Crohn's disease were administered oral prednisolone (1 mg.kg(-1). day(-1)) x 3-7 weeks; 129 patients went into clinical remission and were randomized to Pentasa (4 g . day(-1)) or placebo, administered until weaning and for 1 year thereafter. RESULTS: Groups were similar for clinical and biological items collected initially. Weaning failure rate was 30% and 12% in the placebo and mesalamine arms, respectively. At the end of the trial, 9 of 36 patients administered placebo and 14 of 48 administered mesalamine were in remission. Both groups had similar time to relapse curves in the postweaning year; after adjusting for risk factors (high Crohn's Disease Activity Index, white blood cell count of >9 x 10(9) /l-1 at weaning, and use of a medical treatment in the month before inclusion), Pentasa was found to be superior to placebo. CONCLUSIONS: After a prednisolone-induces remission in Crohn's disease, mesalamine facilitates steroid withdrawal and, during the postweaning year, may reduce the relapse rate in certain patient subgroups.

Adolescent↗
PubMed1996

[Hepatic hamartoma in adults. Apropos of a case documented by MRI].

A mixed hamartoma of the liver in a 39 year old man is reported. Abdominal ultrasound revealed a 4 cm inhomogeneous echogenic mass with acoustic shadowing. MRI T1 weighted images showed a inhomogeneous low intensity mass with lower gadolinium enhancement than normal liver, a moderate low signal intensity on proton density weighted images, and heterogeneous isosignal intensity on T2 weighted images. Peripheric calcifications were found on pathologic examination.

Adult↗
PubMed1995

Efficacy of peripheral kappa agonist fedotozine versus placebo in treatment of irritable bowel syndrome. A multicenter dose-response study.

The efficacy and safety of the peripheral kappa agonist fedotozine was evaluated in a double-blind, multicenter study involving 238 patients with the irritable bowel syndrome. After a two-week washout, patients were assigned to one of four groups to receive either placebo or fedotozine three times a day at doses of 3.5, 15, or 30 mg for six weeks. Patient assessment of mean symptom intensity indicated that the 30-mg dose of fedotozine was superior to placebo in relieving maximal daily abdominal pain (P = 0.01), mean daily pain (P = 0.007), and abdominal bloating (P = 0.02). Changes in bowel function and defecation disorders could not be evaluated reliably. According to the investigators, the highest dose of fedotozine markedly reduced overall disease severity (P = 0.003) and the pain component of the symptomatic profile (P = 0.009). Clinical and laboratory safety was very good. Fedotozine 30 mg three times a day therefore appears to be effective and safe in the treatment of the abdominal pain and bloating associated with IBS.

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↗
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

A technique of laparoscopic gastrectomy and Billroth II gastrojejunostomy.

This report describes a technique of total intraabdominal laparoscopic gastrectomy using laparoscopic stapling and suturing. The reestablishment of continuity of the upper gastrointestinal tract was performed by gastrojejunostomy (Billroth II) using the Endo GIA stapler. This procedure merits inclusion in the armamentarium of approaches toward surgical treatment of recurrent gastric ulcer.

Anastomosis, Surgical↗
PubMed1993

Laparoscopically assisted subtotal colectomy.

A technique for laparoscopic total resection of the colon performed in six patients is reported. The diseased colon was separated from the mesocolon and the greater omentum by electrocoagulation and sharp dissection. The mesenteric vessels were divided using an Endo GIA stapling device (AutoSuture, France). The whole colon was removed after transection of the rectum and extraction through a right minilaparotomy. A primary stapled end-to-side ileorectal anastomosis was performed through the anus under laparoscopic guidance. This technique can be applied to cases involving a variety of benign lesions of the entire bowel or multifocal small malignant colonic neoplasms with a decrease in patient morbidity and shorter inpatient period.

Adult↗
PubMed1993

[Subtotal colectomy under celioscopy].

Indications for laparoscopic surgery of digestive disease are increasing in scope and now include colorectal affections. A technique for subtotal colectomy with ileorectal anastomosis under laparoscopic control is described.

Anastomosis, Surgical↗
PubMed1992

Vagal influence on colonic motor activity in conscious nonhuman primates.

We investigated the role of the vagi in modulation of colonic motor activity in the fasted and fed states and determined the extent of vagal influence on colon motility in conscious monkeys. Monkeys were implanted with force transducers on the colon. A vagal cooling chamber was implanted supradiaphragmatically, and a vagal stimulating electrode was implanted just distal to the chamber. One week was allowed for recovery. After an overnight fast, control recordings were made for 1 h, and then the monkeys were either fed or remained fasting, with or without adrenergic blockade (propranolol and phentolamine). Then while recordings continued the vagi were cooled to their predetermined denervation temperature for 1 h. In a second set of experiments, adrenergic blockers were injected, and the vagi were stimulated during vagal cooling with or without atropine administration. In both the fasted and fed states, the contractile frequency was decreased during vagal cooling, with or without adrenergic blockade. With adrenergic blockade, however, the frequency of colon contractions was greater during cooling than during cooling without such blockade. Inhibition of colonic contractions during cooling decreased in magnitude from the proximal to the distal colon. Vagal efferent stimulation increased contractile frequency at all sites, but after atropine it decreased contractile frequency. We conclude that the vagi have either a direct or indirect influence on fasting and fed colonic motor activity throughout the colon, and that a nonadrenergic, noncholinergic inhibitory pathway is under vagal control.

Animals↗
PubMed1991

Effects of physical exercise on colonic motor activity.

We investigated the effect of physical exercise on colonic motor activity in the fasted and fed states in six conscious dogs. Each dog was implanted with nine strain gauge transducers: three on the proximal, three on the middle, and three on the distal colon. The dogs ran for 1 h on a treadmill at 5 km/h (slope 5%). In the fasted state, the dogs exercised during the 5th h of recording after an overnight fast, and in the fed state during the 1st, 3rd, and 5th postprandial hour. In the fasted state, exercise significantly decreased the frequency of colonic migrating motor complexes (MMCs) but had no effect on the total or the mean duration of contractile states in the proximal, middle, and distal colon. Postprandially, exercise disrupted colonic MMCs and replaced them with nonmigrating motor complexes in all three periods of exercise (1st, 3rd, and 6th h). Exercise also increased the total duration per hour of contractile activity throughout the colon during the 1st and 3rd h and only in the distal colon during the 6th h after the meal. The dogs never defecated during rest in the fasted or the fed state. Shortly after the start of exercise in the fasted and fed states, giant migrating contractions (GMCs) occurred, and they were followed by defecation. In approximately 40% of the experiments, another GMC originated in the proximal colon, approximately 10 min after the first defecation, and migrated caudad up to the middle colon. These GMCs were not associated with defecation but caused mass movements.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
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↗