PubMed Health⌕ Search

Biomedical subjects

M Lemann

Publications and source records attributed to M Lemann.

31 records · Page 2Linked to original sources
PubMed1992

Clinical relevance of scintigraphic measurement of gastric emptying of a solid-liquid meal in the dumping syndrome.

Gastric emptying of the solid and liquid components of an ordinary meal was evaluated by a dual isotopic technique in 36 patients referred to our hospital for early postprandial symptoms induced by various esophageal and/or gastric operations. Patients were classified as typical (n = 11), equivocal (n = 9) or improbable (n = 16) dumpers, in accordance with their presenting symptoms, as assessed before gastric emptying measurement. Patients with typical dumping symptoms displayed, as expected, significant acceleration of gastric emptying of liquids (t1/2: 18 +/- 6 min. vs. 48 +/- 7 min. in healthy controls; p less than 0.02), and also exhibited a dramatic enhancement of gastric emptying of solids (t1/2: 11 +/- 1 min. vs. 126 +/- 12 min. in healthy controls; p less than 0.001) and a complete loss of solid-liquid discrimination (7 +/- 6 min. vs. 78 +/- 7 min. in healthy controls; p less than 0.01). Mean gastric emptying rates for equivocal and improbable dumpers were not significantly different from those of healthy controls, but individual results were very heterogeneous; they included stasis, acceleration, or both disorders, and were not predictable by analysis of symptoms alone. Thus gastric emptying of solids as well as liquids is accelerated in symptomatic dumping patients, and objective evaluation of the emptying of both solid and liquid gastric emptying is essential in atypical dumpers, in order to characterize their disorders and prescribe the most rational treatment.

Adult↗
PubMed1991

[Physiopathological approach to non-ulcerative dyspepsia: clinical consequences].

Non-ulcer like dyspepsia comprises different symptoms of the upper intestinal tract with no macroscopic lesion and no identifiable etiology. Motility disturbances are the best known alterations and resemble a delay in the emptying of the stomach. Gastroesophageal reflux may produce atypical symptoms. Mucosal lesions are sometimes found which may explain the transmucosal electric potential differences. However, chronic active Helicobacter associated gastritis is usually asymptomatic. There has been no proof of psychological factors up to now. In 50% of the patients the minimum pain threshold in response to distention of the stomach is lowered. No generally accepted therapy has been found. The therapeutic principles depend on the pathogenesis of the syndrome in every individual. Medication which may enhance as well as inhibit motility may be of help.

Dyspepsia↗
PubMed1991

[Intestinal motility in patients with small bowel diverticulosis].

It has been demonstrated that motility disorders may be responsible for esophageal and colon diverticulosis. Recently anatomic alterations of both small bowel muscular layers and myenteric plexus have been described in patients with small bowel diverticulosis. Such pathological features could be responsible for motility disorders and small bowel diverticulosis formation. The aim of this work was to study the small bowel motility in patients with small bowel diverticulosis. Ten patients (mean age: 69.2 +/- 6 years mean +/- SEM) with more than 3 diverticula in the jejunum or the ileum (excepting duodenal diverticulum) were studied. After an overnight fast, a 4 lumen probe (side holes 10 cm apart) was used to record duodeno-jejunal motility for 4 hours. Esophageal manometry was also performed in 8 patients. The mean number of phase 3 of the migrating motor complex (mean +/- SEM) during 4 hours was significantly lower in patients with small bowel diverticulosis (0.15 +/- 0.05/hours; mean +/- SEM) than in 10 normal volunteers (0.52 +/- 0.07/hours; mean +/- SEM) (P less than 0.01); 5 patients had zero phase 3 during the 4 hours of recording; one patient displayed intestinal hypomotility associated with aberrant phase 3 like activity; 4 patients showed simultaneous minute-rhythm during more than 80 percent of the phase 2 of the migrating motor complex. Esophageal manometry was also disturbed in 6 patients (low amplitude contractions less than 30 cm H2O in the distal esophagus). Bacterial overgrowth was investigated in 8 patients by means of a glucose breath-test and was found in 6 cases. In conclusion, duodeno jejunal motility is altered in patients with small bowel diverticulosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[What to expect from expert systems for the diagnosis of functional bowel disorders].

The goal of this study was to evaluate the computer-aided diagnosis systems used for functional intestinal disorders published between 1970 and 1989. The methodology of all prospective studies published was evaluated using a score system of 12 items, filled in by two independent observers. A total of 10 studies were identified. None of the systems studied could truly be considered as an expert system. Most systems were not methodologically sound and the median score was 11 of a possible total of 24. The two principal characteristics of functional intestinal disorders are their high prevalence and the absence of objective diagnostic criteria. Taking these two facts into consideration when elaborating a diagnostic method, expert systems should be useful for teaching purposes and for conducting prospective epidemiologic or therapeutic studies. It seems too early, however, to consider the use of veritable expert systems as an aid to the practitioner in daily practice.

Algorithms↗
PubMed1988

[Home parenteral nutrition for adults. Results of a multicenter survey in France].

Home parenteral nutrition (HPN) is a growing therapy in North America and Europe. This first multicenter retrospective study of HPN in France has collected data on 81 patients sent home before December 31st, 1985. Intestinal failure, secondary to short bowel syndrome, small bowel stenosis or fistula, was the main indication for HPN. In 95 p. 100 of the cases, the clinical nutritional status during HPN was either normal or subnormal. The annual incidence of catheter change for technical complication was 0.78 and the mortality rate was 1.2 p. 100. Social rehabilitation was recovered during HPN in 60 p. 100 of patients. Thirty percent of the patients died of their primary disease during HPN but 43 p. 100 were off treatment, and 27 p. 100 were on HPN at the end of the study. The cost of HPN was reduced by 64 p. 100 in comparison with the cost of parenteral nutrition carried out in hospital.

Adult↗
PubMed1987

Crohn's disease with respiratory tract involvement.

Symptomatic respiratory tract involvement with granulomatous bronchial lesions has not yet been described in Crohn's disease. We report two patients with colonic Crohn's disease and severe respiratory symptoms (dyspnoea associated in one of the patients with voicelessness); erythema, aphthoid and superficial ulcerations were found in the colon and whitish granulations in the bronchi at endoscopy. Non-caseating tuberculoid granulomas were found in the colonic mucosa of both patients, as well as in the bronchial mucosa of one of them; in the second a diffuse inflammatory infiltrate including epithelioid cells was found underneath an erosion of bronchial epithelium. Both patients improved on oral prednisone. These two patients probably had bronchial involvement by Crohn's disease.

Adolescent↗
PubMed1987

Glomerulonephritis, B monoclonal small lymphocytic lymphoma and mixed cryoglobulinemia.

A novel association in the same patient with small lymphocytic lymphoma, type II cryoglobulinemia and glomerulonephritis is reported. This case is also characterized by a quite unusual sequence of glomerular alterations. A first renal biopsy showed severe endocapillary proliferative glomerulonephritis due to monocytic infiltration without any evidence of deposition of immune reactants. The immune deposits associated with type II cryoglobulinemia were only observed at a second renal biopsy performed five months later. This case shows that mononuclear cells can be responsible in and of themselves for severe glomerular damage, without deposition of immune material, and suggests that monocytic infiltration might be the first stage of type II cryoglobulinemia associated glomerulonephritis.

B-Lymphocytes↗
PubMed1987

[Subacute cutaneous lupus: critical study].

Subacute cutaneous lupus erythematosus has been identified as a bioclinical entity associating particular clinical signs (diffuse superficial cutaneous lesions evolving without atrophy or scarring), biological markers (anti-Ro/SSA, HLA A1 B8 DR3) and a good prognosis. We assessed the reality of this entity: 1) all the anti-Ro/SSA sera at H.-Mondor Hospital was examined over a 2 year period; 58 of the 963 sera tested were positive. Thirty one of the 58 positive patients had lupus (53 p. 100), but only 12 (21 p. 100) had subacute cutaneous lupus; 2) a photographic dossier was examined by three dermatologists who classified the photos of 74 patients independently. All three observers agreed on the diagnosis of subacute cutaneous lupus erythematosus in only 32 p. 100 of cases. The 17 patients in whom the diagnosis was retained did not differ clinically from the 23 cases of systemic lupus. Anti-Ro/SSA antibodies were found in 42 p. 100 of cases of subacute cutaneous lupus and in 23 p. 100 of cases of systemic lupus erythematosus (not significant). The results of this double blind study indicate that the reality of subacute cutaneous lupus erythematosus as a separate entity is debatable.

Diagnosis, Differential↗
PubMed1981

[Bilateral recurrent paralysis and his treatment (author's transl)].

The authors give here their conception of physiology of nerves of larynx. They think that among the bilaterals paralysies of vocal cords, the paralysie of dilators is the most frequent one. They offer a technical surgery which consist of linking the muscle thyro-hyoïdien to the vocal cord on both sides. Two cases operated have given a normal functioning of vocal cords and, in consequence, a very good phonetic and a satisfactory breathing.

Humans↗