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Biomedical subjects

C Florent

Publications and source records attributed to C Florent.

At least 55 records · Page 3Linked to original sources

[Intestinal malabsorption of starch and gas production in the colon].

The amount of dietary starch released in the colon, its excretion in the stools, the hydrogen and methane resulting from its fermentation, were measured in six healthy volunteers, ingesting two diets, rich and low in starch (100 and 300 grams). Regardless of the diet, approximately 5% of the ingested starch was malabsorbed in the small bowel and completely metabolized in the colon. While the amount of malabsorbed starch was 2.5 times higher with 300 g than with 100 g, the volumes of hydrogen exhaled were not different. This suggests that the responsibility of alimentary substrates in the production of colic gas is overestimated.

Adult↗

Starch malabsorption and breath gas excretion in healthy humans consuming low- and high-starch diets.

Dietary starch delivery to the colon and excretion in stools and the ability of unabsorbed carbohydrates to promote hydrogen and methane release in breath were evaluated in 6 volunteers during two 8-day periods on starch diets of 100 and 300 g, respectively. Significantly less starch was recovered from the terminal ileum by aspiration per 24 h during the low-starch period (4.1 +/- 0.3 vs. 9.5 +/- 1.1 g, mean +/- SEM, p less than 0.01). Unabsorbed glucose tended to rise during the high-starch period (2.7 +/- 0.8 vs. 1.1 +/- 0.3 g). Fecal outputs of starch, glucose, volatile fatty acids, and lactic acid were not significantly different during the two periods. Daily breath hydrogen excretion was unchanged (181.2 +/- 22.7 vs. 193.7 +/- 19.8 ml for the low- and high-starch periods, respectively), whereas breath methane excretion increased markedly in the three methane producers during the high-starch period (217.2 +/- 80.9 vs. 32.4 +/- 7.3 ml). Starch malabsorption in the healthy small intestine was moderate even with a high-starch diet and less than that previously estimated by indirect methods. Unabsorbed starch catabolism by the colonic flora does not seem to explain most of the breath hydrogen excretion.

Adult↗

Anomalous left coronary artery arising from the pulmonary artery: a series of 27 infants undergoing operation in the first years of life.

Between 1977 and 1987, 27 infants (aged 3 to 54 months) underwent surgical treatment for correction of an anomalous left coronary artery arising from the pulmonary artery (ALCAPA). All had a direct aortic reimplantation. The overall operative mortality was 18.5% (five deaths). The follow-up period was from 2 months to 8 years (mean, 38 months). No late deaths occurred. During the 10 years, modifications of the surgical procedure and myocardial preservation were introduced (ie, complete resection of the pulmonary trunk made anastomosis easier; since 1982, cardioplegia in both coronary systems has been used, and left atrial-to-aortic assistance was introduced). The latter was carried out when surgical repair was associated with acute cardiac failure and a high left atrial filling pressure at the end of cardiopulmonary bypass. In view of the results during the latter part of this series, it is felt that surgery should not be restricted in younger patients (< 12 months). If medical treatment is unsuccessful, surgery aims to avoid irreversible left ventricular dysfunction and development of severe endocardial fibroelastosis.

Cardiac Surgical Procedures↗

Starch absorption by healthy man evaluated by lactulose hydrogen breath test.

The amounts of hydrogen produced from starch and lactulose were compared to assess the accuracy of the hydrogen breath test with lactulose as standard to quantify starch malabsorption. The mean amounts of hydrogen produced from starch and lactulose were not different in fecal homogenates and in breath excretion after carbohydrate infusions into the cecum. Known amounts of starch infused into the cecum of 18 subjects were compared with amounts calculated from the total excess excretion of hydrogen in breath computed in relation to hydrogen production after the ingestion of 10 g lactulose; calculated amounts were 3.6 +/- 1.0, 9.9 +/- 1.3, and 22.0 +/- 3.4 g for the infusion of 5, 10, and 25 g of starch, respectively. The lactulose hydrogen breath test based on total excess hydrogen volume provides a valid measurement of the mean amount of starch metabolized in the colon in a group of subjects. However, large individual variations preclude its use in a given subject.

Absorption↗

Pathophysiological study of diarrhoea in a patient with medullary thyroid carcinoma. Evidence against a secretory mechanism and for the role of shortened colonic transit time.

Intubation techniques and scintigraphic studies were used to determine the origin and mechanism of diarrhoea in a patient with medullary thyroid carcinoma, high plasma immunoreactive calcitonin and normal circulating serotonin, substance P and prostaglandins E2 and F2 alpha. Normal function of the small intestine was found for the following: (a) absorption tests; (b) water and electrolyte absorption in the proximal jejunum; (c) 24 hour flow rate and composition of fluid entering the colon and (d) gastric emptying rate and small intestinal progression of a normal meal. By contrast, colonic function was markedly impaired in three ways: (a) water absorption was decreased by half; (b) as the main excreted solutes were organic acids, a large electrolyte gap was recorded in faecal water, and (c) colonic transit time of the meal marker was very short, and was in agreement with the rapid transit of ingested radioopaque markers. These data strongly suggest that decreased absorption in the colon secondary to a motor disturbance is the main mechanism of diarrhoea in this case of medullary thyroid carcinoma, while calcitonin induced small intestinal fluid secretion suggested earlier is either non-existent, or only of minor importance.

Adult↗

[Effects of enprostil on changes in the gastric transepithelial potential differential induced by aspirin].

Enprostil (E), is a semisynthetic E2 prostaglandin with wide-range antisecretory properties. Administered orally E reduced mucosal injury in rats exposed to NSAID and gastric acid. The aim of the present study was to analyze the cytoprotective effect of 7 micrograms of E on the aspirin-induced (500 mg) decrease in gastric transepithelial difference of potential (DP) in a) five healthy volunteers and b) five patients with epigastric heartburn, normal endoscopy and a low gastric DP (mucosal barrier weakness). Aspirin-induced decrease of gastric DP was measured during two four hour periods separated by an interval of two days: a) during a one hour basal period and after three hours after 7 micrograms of E, and b) during a second basal period and one hour after aspirin, E, and then aspirin again. The following parameters were analyzed: maximal drop of DP DP Max (mV), area under the curve of DP drop, AUC (mV.min), and time to return to basal values, TRB (min). In the control group, when E was administered after aspirin, the decrease in DP Max (11.4 +/- 2.3 vs 6.6 +/- 2.1) and in AUC (68 +/- 22 vs 35 +/- 11) was significant (p less than 0.05) as compared with values obtained after aspirin alone. In the patient group, E produced a significant decrease in aspirin-induced DP Max (11.8 +/- 1.9 vs 6.8 +/- 2.4) (p less than 0.003) and in AUC (117 +/- vs 48 less than 22) (p less than 0.006) as well as in TRB (52 +/- 2 vs 37 +/- 10) (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗

Gastric clearance of alpha-1-antitrypsin under cimetidine perfusion. New test to detect protein-losing gastropathy?

Gastric losses of plasma are usually measured with radiolabeled macromolecules. This method is expensive and cumbersome. Direct measurement of exudated plasma proteins are ineffective since proteins are denaturated by acidic gastric juice and pepsin. It was recently shown that albumin measurement after immediate neutralization allowed detection of gastric protein losses, but this method is quite complex and time consuming. We studied alpha 1-antitrypsin and 51Cr-labeled protein clearance in gastric juice during normal saline and cimetidine (1.5 mg/kg/hr) infusion in six healthy volunteers and six patients with exudative gastropathy. alpha 1-Antitrypsin was measurable in all samples during cimetidine infusion: alpha 1-AT and 51Cr losses were significantly correlated (P less than 0.001). The upper limit of gastric alpha 1-AT clearance in controls was 0.86 ml/hr (mean + 2 SD). Using this value, there was no overlapping between patients and controls. The upper limit of 51Cr test was 1.87 ml/hr (mean + 2 SD) in controls but gastric clearance of 51Cr was below this value in one patient. This suggests that the measurement of alpha 1-AT gastric clearance during cimetidine perfusion is a good test to detect an exudative gastropathy. This test is inexpensive and lasts only 3 hr.

Adult↗

Colonic metabolism of wheat starch in healthy humans. Effects on fecal outputs and clinical symptoms.

To study the intracolonic digestion of starch, 5 healthy volunteers were maintained on a constant diet for 7 days. On the fourth day, the cecum was intubated and a suspension of raw wheat starch (50 g, in 500 ml of 154 mM NaCl and containing 10 g of polyethylene glycol 4000) was infused into the distal ileum at 2 ml/min. Hydrogen excretion in breath was measured, cecal contents were sampled, and symptoms were recorded. For the 2-3 days before and after starch infusions, fecal weight, pH, and percentage of dry matter were monitored; fecal outputs of starch, volatile fatty acids, lactic acid, ethanol, polyethylene glycol, alpha-amylase, nitrogen, and ammonia were also measured. A lactulose (10 g) hydrogen breath test was performed 5-7 days after the starch infusions. After the infusion of starch, concentrations of lactic and volatile fatty acids increased and pH decreased markedly in cecal contents. None of the fecal values changed significantly after starch, however, indicating that carbohydrate catabolism was nearly complete and that the colon absorbed the catabolic products efficiently. Abdominal symptoms, especially bloating, were noted by all subjects, and 2 subjects complained of cramping pain. No subject experienced diarrhea. The amounts of starch metabolized in the colon (47.3 +/- 2.9 g), as calculated from the excretion of H2 in breath compared to the hydrogen breath test after lactulose, were close to the actual load (50 g).

Adult↗

Idiopathic pancreatitis associated with inflammatory bowel disease.

The list of extraintestinal manifestations of inflammatory bowel diseases does not classically include pancreatitis and pancreatic insufficiency. We report here six cases of unexplained pancreatitis associated with inflammatory bowel disease (five patients with Crohn's disease, one with indeterminate colitis). None of the classical etiologies for pancreatitis was found in our patients; moreover none of them had duodenal localization of Crohn's disease or sclerosing cholangitis, two conditions in which pancreatitis associated with inflammatory bowel disease has been previously described. Pancreatitis was painless (or was associated with moderate and atypical abdominal pain) in four of our six cases; no pancreatic calcification was found in any case; in three patients a total or subtotal exocrine pancreatic insufficiency was evidenced. Endoscopic retrograde pancreatography performed in four subjects showed normal or minimally altered pancreatic ducts even in those with severe pancreatic insufficiency. These cases emphasize the existence of a probably nonfortuitous association of inflammatory bowel disease with pancreatitis. Its recognition could make a significant contribution in the management of inflammatory bowel disease.

Adolescent↗