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Biomedical subjects

J M Rouillon

Publications and source records attributed to J M Rouillon.

8 recordsLinked to original sources
PubMed1993

[The value of laparoscopy in the staging of digestive system cancers].

Sixty two patients with a gastrointestinal carcinoma were evaluated pre-operatively by ultrasonography, CT scan and laparoscopy to seek liver metastases and/or peritoneal carcinomatosis. Performance levels of laparoscopy, ultrasonography and CT scan were comparable regarding the diagnosis of liver metastases. Laparoscopy was markedly better than CT scan and ultrasonography in the diagnosis of peritoneal carcinomatosis. Thus the investigation of choice for the detection of liver metastases is a single imaging technique. In contrast, if excision surgery is envisaged, all gastrointestinal carcinomas should be assessed by ultrasonography and/or CT scan and laparoscopy to definitely eliminate peritoneal carcinomatosis or small superficial liver metastases, in such a way as to avoid unnecessary laparotomy.

Carcinoma↗
PubMed1992

Lactitol or lactulose in the treatment of chronic hepatic encephalopathy: results of a meta-analysis.

Lactitol (beta-galactosido-sorbitol) has been recently compared with lactulose for the treatment of chronic hepatic encephalopathy in a few studies, each comprising a small number of patients. The results are controversial. We studied the efficiency and tolerance of both compounds by using a meta-analysis on the basis of published controlled trials. Our study only included controlled or randomized trials comprising cirrhotic patients with chronic hepatic encephalopathy. Analyzed parameters were the portosystemic encephalopathy index of Conn after treatment, the percentage of improved patients and the percentage of patients who had ill effects related to the treatment (flatulence, diarrhea). Bibliographical screening revealed five studies comparing the effects of lactitol and lactulose in chronic hepatic encephalopathy. Four crossover studies were done that included 48 patients and one parallel study that included 29 patients. The duration of the treatment ranged from 3 to 6 mo. All studies found a similar efficiency with both drugs. However, they exhibited some discrepancies in the relative frequency of adverse reactions (flatulence). Meta-analysis showed no statistical differences in the portosystemic encephalopathy index after lactitol or lactulose treatment. The percentage of improved patients after lactitol or lactulose was similar. In contrast, the analysis revealed a higher frequency (p less than 0.01) of flatulence in patients treated with lactulose compared with those treated with lactitol. In conclusion, this meta-analysis shows no statistical difference between therapeutic effects of lactitol and lactulose, but it does show a higher frequency of flatulence with lactulose. This suggests that lactitol should be preferred to lactulose for the treatment of chronic hepatic encephalopathy.

Chronic Disease↗
PubMed1991

Sensorial and intestinointestinal reflex pathways in the human jejunum.

Using an intestinal barostat that maintains a constant pressure within an air-filled bag (12 cm long), the authors have previously shown reflex changes in intestinal tone induced by distention. The aim of this study was to investigate the sensitivity and the responsiveness to such reflexes along the jejunum. Eight healthy volunteers were studied using two barostats operating simultaneously in the proximal and the distal jejunum (located 10 cm and 52 cm caudad to the ligament of Treitz, respectively). With one barostat, standardized distentions (1 minute duration at 10-minute intervals in 4-mm Hg increments) were produced; with the other barostat, intestinal tone was measured as volumetric variations at constant pressure. Perception was scored (0-6) by a questionnaire. The proximal jejunum relaxed in response to distention of the distal jejunum (mean +/- SE, 40% + 7% delta vol; 5.1 + 0.1 perception score at the threshold for discomfort; P less than 0.05 for both). In contrast, the distal jejunum did not respond to distention of the proximal jejunum, whereas the perception scores were similar (10% +/- 5% delta vol; 5.1 +/- 0.1 perception score). Thus, the responsiveness of the proximal jejunum to intestinointestinal reflexes fades distally, whereas intestinal sensitivity to distention remains uniform.

Adult↗
PubMed1991

Reflex changes in intestinal tone: relationship to perception.

Using an original technique, we demonstrated a modulation of intestinal tonic muscular activity (intestinal tone) by intestino-intestinal reflexes. In 11 healthy volunteers we quantitated intestinal tone variations as changes in the air volume within a flaccid bag (12 cm long) located in the proximal jejunum and maintained at a constant pressure by an electronic barostat. Validation studies with glucagon showed significant intestinal relaxation (117 +/- 10% delta vol; P less than 0.05). In six healthy volunteers, graded balloon distensions (1 min duration at 10-min intervals in 8-ml stepwise increments) were randomly performed 8 cm orad, 8 cm caudad, and 20 cm caudad to the bag of the barostat. Perception was scored (0-6) by a questionnaire. Distensions at the three sites induced similar perception; at the threshold for discomfort (score greater than or equal to 5) distension also induced intestinal relaxatory responses (43 +/- 10%, 34 +/- 5%, and 32 +/- 4% delta vol from orad to caudad, respectively; P less than 0.05 for all). However, while unperceived orad distensions (13 +/- 2 ml) induced reflex relaxation (21 +/- 6% delta vol; P less than 0.05), 20-cm-caudad distensions at higher levels (16 +/- 2 ml, 2.7 +/- 0.5 perception score; P less than 0.05) did not (1 +/- 7% delta vol). This dissociation between perception and intestinal tone reflexes suggests that both responses to intestinal distension are mediated by specific mechanisms.

Adult↗
PubMed1989

The increase in urinary excretion of 6 beta-hydroxycortisol as a marker of human hepatic cytochrome P450IIIA induction.

1. Urinary excretion of 6 beta-hydroxycortisol, hepatic microsomal cortisol 6 beta-hydroxylase and the specific content of several forms of cytochrome P450 were measured in 8 to 14 patients before and after treatment with rifampicin (600 mg orally per day for 4 days). 2. Rifampicin treatment produced an average five fold increase in daily excretion of urinary 6 beta-hydroxycortisol. 3. Cortisol 6 beta-hydroxylase activity increased from 15 +/- 6 pmol min-1 mg-1 in organ donors (considered as 'control subjects') to 87 +/- 31 pmol min-1 mg-1 in rifampicin treated patients. 4. Among three forms of human P450 (P450IA, IIC and IIIA), (1), (2), measured by Western blots, only P450IIIA was significantly induced by the antibiotic. 5. Only antibodies against P450IIIA selectively inhibited cortisol 6 beta-hydroxylase in human liver microsomes. 6. Cortisol 6 beta-hydroxylase was correlated with P450IIIA specific content. 7. The urinary level of 6 beta-hydroxycortisol correlated with liver microsomal cortisol 6 beta-hydroxylase and P450IIIA specific content. 8. We conclude that P450IIIA is predominantly responsible for cortisol 6 beta-hydroxylase activity in human liver microsomes and that urinary 6 beta-hydroxycortisol is a marker of the induction of this cytochrome P450.

Adult↗