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Biomedical subjects

M Mignon

Publications and source records attributed to M Mignon.

At least 37 records · Page 2Linked to original sources
PubMed1991

[Intravenous chemotherapy with streptozotocin and 5 fluorouracil for hepatic metastases of Zollinger-Ellison syndrome. A prospective multicenter study in 21 patients].

Twenty-one patients with liver metastasis of gastrinoma received intravenous streptozotocin (STZ: 500 mg/sqm.day) and 5 fluorouracil (5 FU: 400 mg/sqm.day) during 5 consecutive days every 6 weeks. Variations in tumor mass (TM) on CT scan and in serum gastrin levels were assessed every two courses. Treatment was continued if TM decreased or remained unchanged, and if severe renal toxicity of STZ was not observed. Three patients had a minor (25-50 percent decrease in TM) and transient response. Only one patient (5 percent) presented an objective response (greater than 50 percent) which lasted 55 months. TM remained unchanged in 28 percent and increased in 65 percent of cases. Changes in serum gastrin levels did not parallel those of TM. Nausea and/or vomiting (66 percent) was easily controlled by symptomatic treatment. Renal toxicity (24 percent), including one case of acute and transient renal failure due to accidental overdosing, was observed in 24 percent of cases. This prospective study does not confirm the efficacy of combined STZ-5 FU as previously suggested by retrospective data.

Actuarial Analysis↗
PubMed1991

[Idiopathic ulcerative proctitis. Clinical presentation and endoscopic outcome].

Endoscopic information was obtained for 52 patients with ulcerative proctitis (23 F, 29 H) seen during a ten-year period. The median follow-up was 68 +/- 8 months. During the first referral period (38 patients experienced a first attack), endoscopic particularities were available: inflammation involved the anal mucosa above the dental line (n = 16), the whole circumference of rectal mucosa (n = 19) or the anterior wall exclusively (n = 33). The upper limit was 12.2 +/- 0.6 cm from the anal verge. Inflammatory lesions were higher in circumferencial conditions, when patients were older (late onset disease) but sex and ethnic state did not influence results of endoscopic presentation. Exulcerations or superficial ulcers were visualized in 16 and spontaneous bleeding in 43. Forty-five patients achieved clinical accuracy after 9.4 +/- 1 ms, but 32 only a complete endoscopic remission. Mean number of relapses was 3.6 +/- 0.4; 13 patients experienced a single attack. During relapses, inflammation was stable in 11 of 38 patients. Extension to the rectum in rectosigmoid junction, and sigmoid and above by 6, 14, and 7 patients respectively. After 5 years follow-up, the cumulative risk of further extension was 37 percent and 13 percent, respectively. Low abdominal pain, an family history of ulcerative colitis, and high inflammatory lesions at referral were significantly associated with a higher risk of extension. Cancer did not occur and not surgery was necessary during the follow-up. Idiopathic proctitis is perhaps at the "benign end" of the spectrum of ulcerative colitis. Nevertheless, its endoscopic particularities should be noticed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[pH gradient support and antacid action of gastroesophageal coating agents. In vitro pharmacologic study using a model of "the artificial stomach"].

The effects of gastroesophageal mucosal coating agents could be related to a) the decrease of aggressive contents of gastric juice and/or b) the presence of a pH gradient between intraluminal (IL) contents and mucosa. Antacid capacities of Gaviscon and Topaal, containing sodium alginate or alginic acid, respectively, were measured using the "artificial stomach" model. This model, reproducing two major gastric dynamic functions, secretion and gastric emptying, allows to evaluate the pH variations in the IL contents and at its surface, by a double pH metric recording. Experiments were performed when drugs to be tested were added either to 100 ml of human gastric juice (100 mmol/l or 88 mmol/l with biliary reflux) or to 100 ml of 0.1 N HCl, without and with 1 percent meat extract. Simulated secretion was represented by a 3 ml/min flux of either 0.1 N HCl or gastric juice and "gastric emptying" fluxes varied from 1.5, 3.0 to 4.5 ml/min. When 0.1 N HCl solution was used, the pH levels at the surface of IL contents were close to pH 3.0 when intragastric pH reached pH 1.0 independently of "gastric" emptying flux variations. In the presence of proteins or biliary reflux material, these pH levels were higher, close to pH 4.5 and persisted for a longer time. Antacid activity was calculated as the resistance to acidification of the IL contents, as the amount of H+ ions consumed after addition of antacid to recover initial pH, i.e. 37 and 22 mmol in human gastric juice, between 37 and 17.5 mmol in 0.1 N HCl for Gaviscon and Topaal, according to emptying fluxes.(ABSTRACT TRUNCATED AT 250 WORDS)

Alginates↗
PubMed1990

New approach for the in vitro evaluation of antacids.

Evidence is given that the in vitro evaluation of antacids has been incomplete, not regarding physiopathological conditions. As a consequence arbitrary antacid potency classifications were introduced and in clinical practice high dosages of antacid drugs were prescribed. The main reason is that the in vitro evaluation procedures used did not take into account the actual conditions of gastric acid secretion. The proposed methods allow to assess antacid activity under conditions similar to those during gastric secretion. "Pharmacologically", the capacity of binding H+ ions in acid milieu can be quantified and the antacid mechanism can be characterized. "Therapeutical efficacy" might be analysed under acid conditions taking into account gastric intraluminal flux variations by using the "artificial stomach" model. This procedure also allows to evaluate the influence of gastric protein content on antacid activity and to simulate the actual gastric conditions by using human gastric juice as gastric content and as simulated "secretion". The antacid-induced resistance to acidification largely corresponds to the therapeutical antacid activity. Data obtained with aluminum containing antacids are presented.

Antacids↗
PubMed1990

[Intermittent treatment or preventive treatment of recurrence in duodenal ulcer disease? A controlled, double-blind study with 150 mg ranitidine daily for one year].

This 1-year study compared two pragmatic strategies in long-term management of duodenal ulcer: continuous treatment with ranitidine 150 mg after dinner and treatment of duodenal ulcer attacks with ranitidine 300 mg and placebo in the interval. A multicentric, randomized double-blind study was conducted in 399 patients, 197 in the ranitidine group and 202 in the placebo group. Efficacy was judged by the prevalence of ulcer-pain recurrences; secondary criteria were the prevalence of endoscopic recurrences, complications and the number of facultative visits, hospitalizations and days off work related to duodenal ulcer disease. Both groups were similar with regard to main epidemiologic features and number of drop-outs (10.5 percent). Fifty-two patients were withdrawn for symptomatic or endoscopic relapses: 6 in the ranitidine group, 46 in the placebo group (p less than 0.05). Sixty-six percent of the patients remained asymptomatic at one year in the ranitidine group versus 33 percent in the placebo group (p less than 0.001). Seventeen patients with ranitidine (8.6 percent) and 59 with placebo (29.2 percent) experienced at least one endoscopic recurrence (p less than 0.05). In the placebo group, 8 complications were observed (bleeding = 5, duodenal stenosis = 3), and none in the ranitidine group (p less than 0.005). Patients with ranitidine had significantly less facultative visits and endoscopies, number of days off work, and hospitalizations (p less than 0.05). Tolerance was good (5 percent side-effects, all minor) and identical in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Assessment of antacid characteristics of drugs containing a combination of aluminium and magnesium salts using the "artificial stomach" model.

Antacid characteristics of three drugs containing aluminium and magnesium salts (combination of clay with aluminium and magnesium hydroxides, aluminium and magnesium hydroxide mixture and hydrotalcite) have been studied in a dynamic situation simulated by the "artificial stomach" model, simultaneously taking into account both gastric fluxes, a constant secretory flux and variable emptying fluxes. Therapeutic doses of the drugs were added 1. to 100 ml of 0.1 N HCl, without or with 1% or 5% meat extract, and 2. 100 ml of pooled human gastric juice (96 mmol/l, pH 1.1). In addition, antacid activity of 0.5 g aluminium and magnesium hydroxides, taken alone or in combination, were evaluated when added to 100 ml of 0.1 N HCl. In aqueous HCl solution or in human gastric juice, the three antacid drugs exhibited 1. a neutralising activity characterised by pH-rise and 2. a buffering capacity close to pH 3.8. In addition, hydrotalcite exhibited also buffering capacity at pH 1.2. The antacid-induced capacity, expressed as H+ mmol, to recover initial pH were very similar, indicating that antacid physiochemical properties are similar in HCl solution or in gastric juice. H+ consumption depended upon emptying fluxes. The same antacid characteristics were observed when antacids were mixed with 1% meat extract while 5% meat extract resulted in a modification of antacid characteristics. Therefore the antacid capacities of respective mixtures were of smaller magnitude (50-60%) than the sum of the activities of antacids plus meat extracts.(ABSTRACT TRUNCATED AT 250 WORDS)

Aluminum Hydroxide↗