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Biomedical subjects

B Messing

Publications and source records attributed to B Messing.

At least 19 recordsLinked to original sources
PubMed1992

Peritoneal sarcoidosis. An unrecognized cause of sclerosing peritonitis.

In a Caucasian woman with a history of ocular and pulmonary sarcoidosis, the occurrence of sclerosing peritonitis with exudative ascites but without any of the well-known causes of this syndrome prompts us to consider that sclerosing peritonitis is a manifestation of sarcoidosis. The dramatic improvement that occurred on corticosteroid therapy adds credibility to this previously unreported association.

Chronic Disease↗
PubMed1991

Extrapyramidal disturbances after cyanide poisoning (first MRT-investigation of the brain).

A 29 year old student of chemistry took 50 ml of a 1% potassium cyanide solution (500 mg) in attempted suicide. He became comatose, mydriatic and was admitted to hospital in an apneic state. He woke up after seven hours and developed Parkinsonism in the following weeks. This regressed slowly in the second month after the poisoning apart from dysarthria, bradykinesia of the upper limbs and very brisk monosynaptic reflexes. Three weeks after the intoxication, CCT was largely normal, and there was CSF-dense hypodensity in both putamina after five months. Sharply delimited signal elevation in T2 corresponding to the two putamina was detected in the MRI eight weeks and five months after ingestion of the poison.

Adult↗
PubMed1991

Intestinal absorption of free oral hyperalimentation in the very short bowel syndrome.

Ten adult ambulatory patients with the nonactive digestive disease short bowel syndrome were prospectively studied to quantitatively assess their free oral intake and their net digestive absorption of total calories, fat, protein, and carbohydrate during a 3-day period at least 6 months after a resection. The remaining portions of small bowel had a mean length of 75 cm (range, 0-200 cm); the remaining colon lengths had a mean of 67% of normal (range, 0%-100%). The experimental diets were formulated according to a home dietary inquiry. During the study period, pooled intakes and digestive losses were measured for total calories, fat, and protein using the bomb calorimetry, Van de Kamer, and Kjeldahl techniques, respectively. The ingested diet provided 58 +/- 14 kcal.kg-1.day-1 (mean +/- SD) and consisted of 46% carbohydrate, 31% fat, and 23% protein. Net digestive absorption was 67% +/- 12% for total calories, 79% +/- 15% for carbohydrate, 52% +/- 16% for fat, and 61% +/- 19% for protein. The larger net digestive absorption of carbohydrate (P less than or equal to 0.004) compared with fat and protein suggests salvage of colonic cholesterol in short bowel syndrome patients. It is concluded that these patients with the short bowel syndrome adapted to a hypercaloric, hyperprotein diet to compensate for increased fecal losses and that this hyperphagia does not seem to have impaired their net digestive absorption.

Diet Records↗
PubMed1991

Glutamine metabolism after small intestinal resection in humans.

Glutamine and leucine kinetics were measured using stable isotopes in five enterectomized patients (residual small bowel, 80 +/- 25 cm [mean +/- SE]) who were in a near normal nutritional status at distance from surgery. While parameters of leucine metabolism were normal, rates of whole body glutamine utilization were reduced by 20% in the patients. The data suggest that the small intestine plays a prominent role in glutamine utilization in vivo in humans.

Adult↗
PubMed1991

Digestion of bovine milk proteins in patients with a high jejunostomy.

Digestion of milk proteins was studied in short-bowel patients. After ingestion of water, purified beta-lactoglobulin (beta-Ig), or skim milk, effluents were collected at the stoma. The flow rate of the effluent peaked in the first 30-min period after ingestion and returned to the basal value within the first 60 min. After milk ingestion 1) the nitrogen concentration of effluents peaked in the first 30 min, 2) SDS-polyacrylamide gel electrophoresis and Western blot indicated the presence of beta-Ig and alpha-lactalbumin (alpha-lac) in jejunal effluents but only during the first 30 min whereas caseins were detected during the initial 1-2 h effluents, and 3) immunoenzymo metric assay indicated that 64% and 44% of the beta-Ig and alpha-lac, respectively, were recovered in an intact antigenic form. Results indicate that the digestion of milk proteins in humans differs quantitatively. Digestion appeared partially incomplete in the upper jejunum, suggesting the importance of the ileum for completion of digestion.

Blotting, Western↗
PubMed1991

Oral nutrition in patients receiving home cyclic parenteral nutrition: pattern of substrate utilization.

Patients receiving cyclic home parenteral nutrition (PN) often have a significant oral caloric intake. This study describes the metabolic use of fuels, as assessed by indirect calorimetry, in eight stable, ambulatory, noncancerous, adult patients receiving glucose-based PN with (PN + oral) or without (PN only) a self-selected oral intake. Patients' weight was 91 +/- 2% (mean +/- SE) of ideal body weight, and fat mass was 22 +/- 5 and 31 +/- 2% of actual body weight in males and females, respectively. Under the PN-only regimen, providing 104 +/- 5% of predicted basal energy expenditure (BEE), patients were in equilibrium for energy and nitrogen balances. Oral supplementation (absorbed oral intake 80 +/- 5% of BEE) was associated with positive energy and nitrogen balances but also with nearly continuous net fat synthesis. We conclude that the glucose-based PN + mixed oral regimen enables the patients to face the increased energy requirements of everyday ambulatory life but is not associated with an optimal body composition in long-term PN patients.

Administration, Oral↗
PubMed1991

Calcemic response to magnesium or 1-alpha-hydroxycholecalciferol treatment in intestinal hypomagnesemia.

The mechanism of hypocalcemia was assessed prospectively in 10 gastroenterological hypomagnesemic patients. Baseline serum magnesium was 0.9 +/- 0.1 mg/dl and calcium, 7.2 +/- 0.4 md/dl. Plasma 25-hydroxyvitamin D (25 (OH)D) was low in 5 patients and normal in the others. Plasma parathormone (PTH) and urinary cyclic AMP (ur. cAMP), although twofold above normal values, were inappropriately low and increased sharply after a magnesium bolus injection. There was no renal resistance to PTH as ur. cAMP increased after i.v. bovine PTH bolus injection. Subsequently, patients were randomly divided into 2 groups, each including patients with low or normal levels of 25 (OH)D, receiving either MgCl2 (group I) or 1 microgram/d of 1-alpha (OH)D (group II) for one week. Although magnesium status remained low in group II patients, increase in plasma calcium was identical in both groups. Serum calcium levels in patients receiving combined 1-alpha (OH)D and MgCl2 during a second week of treatment returned to normal. In the 4 tested patients, plasma 1,25 (OH)2D levels were low before, but also after correction of hypomagnesemia, suggesting that low level of 1,25 (OH)2D might not be due to hypomagnesemia. Therefore, treatment with low dosage of 1-alpha (OH)2D associated with magnesium chloride repletion can be recommended to restore normal calcium homeostasis in patients with intestinal hypomagnesemia.

Adult↗
PubMed1979

[The venous route in total parenteral nutrition of the adult patient (author's transl)].

Total parenteral nutrition (T.P.N.) takes presently an important place in the therapeutic methods. Nevertheless multiple complications, directly related to the venous route can constitute a limiting factor in the application of such procedures. Therefore complications such as sepsis and venous thrombosis must be prevented during T.P.N. Some conditions issued from our experiences and from the results in the literature can be now well defined: 1) Surgical catheterization of the vein in cases of long term T.P.N. and transcutaneously in cases of short term T.P.N. with in all cases a long subcutaneous way of the catheter. 2) Silastic catheter must be systematically used. 3) The intravenous way of the catheter must be as short as possible. 4) Nutrients must be strictly infused in the superior vena cava. 5) The utilisation of nutritive mixtures must be prefered if possible. 6) Handling of the infusion line must be avoided. Finally the management of T.P.N. in the best conditions requires a specialized staff.

Adult↗
PubMed1979

Chronic non-specific ulcerative duodenojejunoileitis: report of four cases.

Four patients with chronic non-specific ulcerative duodenojejunoileitis (CNSUDJI) are reported. The clinical picture included abdominal pain, fever, and a malabsorption syndrome. Main rediological findings were diffuse narrowing of the jejunal loops with total effacement of the mucosal folds. Multiple peroral biopsies of the small intestine showed various degrees of mucosal abnormalities from total villous atrophy to normal villi, but ulcerations were diagnosed only by operative full thickness biopsies or resection of the small bowel. The ulcerative process was associated with well-documented coeliac disease in two patients: in one of them it occurred as a fatal complication involving also the colon, three years after the start of a gluten free diet, while the disease was in full clinical and histological remission. In the other case, coeliac disease was revealed by obstructive symptoms due to stenosing ulcerations; five months after surgical resection of the stenosis, institution of a gluten free diet induced a dramatic improvement. In the two other patients ulcerations were not associated with coeliac disease: one of them had a patchy villous atrophy and resisted a gluten free diet and total parenteral nutrition; she was improved by and dependent upon steroids but finally died. The last patient had normal villous height; ulcerations were located exclusively along the mesenteric border of the small bowel; he had a low-grade protracted evolution resisting any form of therapy and developed a peripheral neuropathy of unknown aetiology. On the basis of our cases and of a review of the literature the discussion focuses on the difficulty in diagnosing CNSUDJI, its relationship with coeliac disease, and its management and prognosis.

Adult↗
PubMed1977

[Total parenteral nutrition in the adult. Theoretical aspects (author's transl)].

When oral or enteral feeding becomes impossible or inadequate, total parenteral nutrition makes it possible to reduce the occurrence of malnutrition states as complications of medicosurgical disorders. From a practical point of view it should provide a minimum fluid intake of 30 ml/kg with a nitrogen intake of the order of 150 to 300 mg/kg/day with sufficient quantities of all essential amino acids in a balanced ration. In most instances the calorie intake should be 40 to 60 Kcal/kg/day. Non-protein calories are obtained from carbohydrates or fats but the ideal percentage of each of these two nutrients is not known. In order to be effective and well tolerated, intravenous nutrition of this sort must be adapted to each patient and should be administered by a qualified medical and nursing team in order to minimise the metabolic and septic risks secondary to the techniques used.

Amino Acids↗
PubMed1977

Ulcerative colitis in a patient with anti-B lymphocytotoxin and hypogammaglobulinemia.

Lymphocytotoxins (LCT) have been recently reported in the serum of patients with inflammatory disease of the bowel, but up to now these antibodies have shown no specificity for B or T lymphocyte subpopulations. A 32-year-old patient with chronic ulcerative colitis, primary hypogammaglobulinemia and a very low number (0.5 to 1.5%) of B lymphocytes in peripheral blood is described. The presence in the serum of a LCT reacting specifically with B cells was demonstrated by cytotoxicity and direct immunofluorescence experiments. Intestinal immunofluorescence studies indicated a dichotomy between blood and gut immunoglobulins, and showed a heterogeneous distribution of plasma cells of the three major classes from the jejunum to the rectum. The significance of the association of hypogammaglobulinemia, chronic ulcerative colitis, and anti-B LCT is discussed. To explain the dissociation between blood and gut immunoglobulins, it is suggested that the intestine was, in this patient, a privileged site for differentiation of B cells.

Adult↗
PubMed1976

Salivary immunoglobulin determinations: their diagnostic value in Sjögren's syndrome.

Salivary immunoglobulins (IgA, IgG, IgM) determinations are performed on 74 patients with and without Sjögren's syndrome (SS). In normal subjects IgA is the only immunoglobulin detected in saliva by classical immunodiffusion methods. Correlations between the presence of IgG and/or IgM in saliva and other functional and objective clinical parameters and hsitological aspects of minor salivary glands are studied. In SS the prescence of IgG and/or IgM is in close relationship with "sialography index" which is the most reliable clinical investigation. These results point out that salivary immunoglobulins determinations constitute a simple and specific complementary test for SS diagnosis; they may allow the clinicians to observe the progress of the disease or to evaluate effectiveness of drugs.

Humans↗