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Biomedical subjects

G Delpre

Publications and source records attributed to G Delpre.

At least 19 recordsLinked to original sources
PubMed1989

Barrett's mucosa of distal esophagus with concomitant isolated Crohn's disease and intramucosal adenocarcinoma. Report of a case and analysis of the literature.

The presence in the esophagus of three distinct entities--Barrett's mucosa, Crohn's disease, and adenocarcinoma--is a very rare finding. In a 60-year-old man with a long history of heartburn and recently developed dysphagia, narrowing of the distal esophagus was found to be related to the presence of Barrett's mucosa. A short time later repeated endoscopy revealed adenocarcinoma in this area. The patient underwent esophagogastrectomy and died a few days after surgery. Findings in the surgical specimen and upon autopsy were consistent with isolated Crohn's disease of the distal esophagus as well as with intramucosal adenocarcinoma. Analysis of the data available in the literature reveals that Crohn's disease of the esophagus, although rare, clearly possesses some definite characteristics of its own. It is suggested that the presence of these three features in a single patient constitutes no more than a chance coexistence.

Adenocarcinoma↗
PubMed1989

Induction of esophageal injuries by doxycycline and other pills. A frequent but preventable occurrence.

Many specialists and general physicians remain unaware of the potential for and pathogenesis of drug-induced esophageal ulcerations. To promote a greater awareness of the importance of this problem, we have reviewed the literature, particularly in regard to the mechanisms of action and the clinical and therapeutic implications of these chemical injuries to the esophagus. There can be no doubt that the frequency of occurrence of drug-induced esophageal ulceration far exceeds that reflected in the reported cases appearing in the medical literature. Nor can we deny that much of the responsibility for this situation lies in the failure of the prescribing physician to educate his patients (and himself!) in the art of taking potentially harmful pills and capsules, particularly tetracycline, doxycycline, potassium chloride, and quinidine preparations. Although most such drug injuries are self-limited events, there have been a number of fatalities reported and at the very least they involve acute discomfort.

Capsules↗
PubMed1989

A comparison of metronidazole and sulfasalazine in the maintenance of remission in patients with ulcerative colitis.

In a double-blind, randomized trial, we tested the effectiveness of metronidazole (0.6 g/day) against sulfasalazine (2 g/day) in the maintenance of remission in patients with ulcerative colitis. The patients were in remission for 1-11 months at entry to trial, which lasted for 12 months. Forty patients entered the trial and 33 completed it. Metronidazole was found to be slightly more effective than sulfasalazine, a difference statistically significant only at 12 months. Six patients also completed a crossover trial. Remission was maintained for 12 months in 3 patients by metronidazole and in none of the 6 by sulfasalazine. No significant side effects were noted, and in particular, no paresthesias were reported. This trial, as well as our previous one, suggests that metronidazole may be useful in the maintenance of remission in patients with ulcerative colitis, but that it is ineffective in the therapy of the acute attack.

Clinical Trials as Topic↗
PubMed1989

Ultrastructural abnormalities in endoscopically and histologically normal and involved colon in ulcerative colitis.

Twenty colonoscopies (eight complete or almost complete; 12 short) were carried out on 15 patients with ulcerative colitis with the aim of comparing the endoscopic aspects with the light and electron microscopic features in biopsies taken from multiple sites. Patients with severe attacks were examined without prior preparation (two examinations). When the attack was mild to moderate (11 examinations), or the patient was in remission (seven examinations), two saline enemas were given up to 1 h before examination. There was a favorable correlation between the endoscopic and light microscopic features in 94.7% of the biopsies (total number of biopsies, 76). The electron microscope findings greatly exceeded those observed by light microscope and indicated that the major abnormality resides within the colonic epithelial cells. Distinctive ultrastructural changes were present both in apparently uninvolved (endoscopically and histologically) parts of colon and in inactive stages of ulcerative colitis. These findings suggest that colonic mucosal involvement may be universal, persist during clinical remission, and precede the light microscopic findings. They also support the importance of maintenance therapy.

Adult↗
PubMed1987

A comparative study of metronidazole and sulfasalazine in active, not severe, ulcerative colitis. An Israeli multicenter trial.

Since metronidazole (M) was found to be effective in Crohn's disease, we evaluated its efficacy in the treatment of active ulcerative colitis (UC). Forty-six outpatients with acute, nonsevere UC were studied. Forty-two concluded the trial. Twenty-three received M 1.35 g/day and 19 received sulfasalazine (S) 4.5 g/day for 28 days in a randomized double-blind study. Six of 23 receiving M improved (26%) as against 13 of 19 patients receiving S (68%) (p less than 0.01). No significant side effects were noted. We conclude that M is ineffective in the therapy of an acute attack of UC.

Acute Disease↗
PubMed1986

Cellular immunity in patients with acquired immunodeficiency syndrome (AIDS) in Israel: effects of THF, a thymic hormone in vitro.

Markers and functions of T cell subsets were studied in 3 Israeli males suffering from AIDS, two of whom were homosexuals and one heterosexual developing AIDS after a coronary bypass operation followed by multiple blood transfusions. Two healthy homosexual partners of one of the AIDS patients were also studied. Sera from these individuals were also tested for suppressive activity on control normal donor lymphocytes. Monitoring of T-cell subsets during a period of 3-12 months demonstrated a reversed T helper: T suppressor ratio in the 3 AIDS patients and in one of the healthy homosexuals. Addition of AIDS sera to normal T helper cells abolished the helper activity whereas its addition to normal isolated T suppressor cells enhanced the suppressor activity. Incubation of the patients lymphocytes with THF, a calf thymus hormone, restored the impaired helper cell activity. A suppressor factor unrelated to acid labile interferon was demonstrated in the sera of the AIDS patients but was not found in the sera of the healthy homosexuals. THF neutralized the suppressor effect of this serum factor when tested on normal lymphocytes.

Acquired Immunodeficiency Syndrome↗