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Biomedical subjects

P Berthezene

Publications and source records attributed to P Berthezene.

9 recordsLinked to original sources

Evidence that human kidney produces a protein similar to lithostathine, the pancreatic inhibitor of CaCO3 crystal growth.

Pancreatic juice is supersaturated in calcium carbonate. CaCO3 crystal growth is controlled by lithostathine, a secretory protein synthesized by pancreatic acinar cells, first described as a constituent of pancreatic stones. It was recently reported that, in the thin descending limb of the Henle's loop, urine was supersaturated in CaCO3 (Coe FL, Parks JH: Defenses of an unstable compromise: crystallization inhibitors and the kidney's role in mineral regulation. Kidney Int. 1990: 38, 625-631. This observation suggested the presence in kidney of a similar inhibitor. In this study, we show that a protein immunologically related to lithostathine is actually present in urine of healthy subjects and in renal stones. Immunocytochemistry of kidney sections localized the protein to cells of the proximal tubules and thick ascending limbs of the Henle's loops. Protein extracts of renal stones inhibited CaCO3 crystal growth in vitro and this inhibition was significantly lifted by incubating the extracts with antibodies to lithostathine. The protein is not immunologically related to nephrocalcin. Because of its structural and functional similarities with pancreatic lithostathine, it was called renal lithostathine.

Calcium Carbonate

Is tobacco a risk factor for chronic pancreatitis and alcoholic cirrhosis?

In a case control study alcohol intake and tobacco use were assessed between 1975 and 1987 in 103 male patients suffering from alcoholic cirrhosis of the liver, in 145 patients with chronic pancreatitis, and in 264 control subjects. The patients with chronic pancreatitis were significantly younger than the patients with cirrhosis (mean (SD) age 41.92 (2.4) v 60.9 (11.6) years). Among the patients with chronic pancreatitis, 94% were both smokers and drinkers compared with 83% of patients with cirrhosis of the liver. The relative risks for each disease were calculated by conditional multiple logistic regression. Whereas daily intake of alcohol was a major risk factor for both cirrhosis of the liver and chronic pancreatitis, smoking was significantly related only to the risk of having chronic pancreatitis. Moreover, the mean age at onset of pancreatitis was lower among smokers.

Adult

Liver cirrhosis and chronic calcifying pancreatitis are associated with different morphotypes.

The different morphotypes of patients have been determined by sonography of the upper abdomen and statistical calculation according to a previously published method. Patients have been classified into the following 3 groups: 'longilignes', 'normotypes' and 'brèvilignes' which fit with ancient anatomical descriptions. In 74 normal controls, there were 21.6% brévilignes and 44.5% longilignes, in alcoholic cirrhosis (n = 31) 77.4 and 6.4%, respectively, in postnecrotic viral cirrhosis (n = 28). 25.0 and 17.8% and in alcoholic chronic calcifying pancreatitis (n = 25) 12.0 and 76.0%. These differences which are significant between all groups show that the morphotype of the human body is different in cirrhotic and pancreatitis patients. As morphotypes preexist to cirrhosis and chronic pancreatitis, this is an argument for the assumed predisposition (possibly hereditary) to cirrhosis and chronic pancreatitis.

Chronic Disease

Changes in pancreatic exocrine secretion with age: pancreatic exocrine secretion does decrease in the elderly.

Pancreatic exocrine secretion was estimated in 180 normal control patients, free of abdominal and pancreatic disease, aged from 16 to 83 years. Duodenal juice was collected in two 15-min fractions after a single intravenous injection of 1 U/kg secretin + 3 U/kg CCK. Volume, maximal concentration and output of bicarbonate, lipase, phospholipase and chymotrypsin were estimated as well as minimal concentration and output of chloride and calcium. Each parameter was plotted against age, either individually or after separation into two age groups. Volume linearly increased up to the 3rd decade, and thereafter linearly decreased. Bicarbonate secretion paralleled fluid secretion and also decreased after the 3rd decade. The changes in chloride and calcium concentrations were different: concentrations linearly increased after the 3rd decade. Calcium concentration linearly increased with age (p less than 0.02) while chloride output was unchanged. The three enzymes that were studied linearly decreased in concentration as well as in output with age from the 3rd decade (p less than 0.02). Protein secretion decreased before water and bicarbonate secretion. One can conclude that pancreatic secretion changes in humans with age. Aging alters pancreatic secretion, through a decrease in flow rate, bicarbonate and enzyme secretion while calcium concentration is enhanced. Although not requiring substitutive therapy in the whole population, individual cases of pancreatic exocrine insufficiency might be explained by aging, without malnutrition.

Adult

[Vitamins A and E in digestive cancers].

Vitamins A and E, transthyretin (TT) and retinol binding protein (RBP) plasma levels were assayed in 70 patients having a recently diagnosed digestive cancer and in 116 controls. After adjustment for sex and age, vitamin A or RBP and TT were found lowered in digestive cancer but vitamin E was lowered only in esophagus cancer. The relationship of vitamin levels to the relative risk of digestive cancer was calculated by multiple logistic conditional regression. TT level remained the only significant parameter. Since TT levels are strongly influenced by the nutritional status of patients, our results suggest that the decreased blood levels of vitamin A and its carriers observed in digestive cancer are the consequence of nutritional alterations evoked by the disease.

Adult

Hepatic morphotypes. Their statistical individualization using ultrasonography.

The shape, topography, and vascular disposition of the liver depend on a subject's morphotype. The definition and classification of morphotypes was previously based on cadaver observation. In this study, 74 healthy adults (42 women, 32 males) were assessed using ultrasonographic parameters (hepatic diameters, xiphoid angle, orientation of the inferior face of the liver). The results were analyzed by discriminant analysis to differentiate the morphotypes. The three groups known by anatomists as breviligne (endomorphic), longiligne (ectomorphic), and normotype were again demonstrated and individualized in a significant manner. However, with the exception of the normotype group, fundamental differences were observed between our results and those of the anatomists. Ultrasonographic assessment shows that in the breviligne, the liver occupies the right hypochondrium and extends only slightly to the left of the midline; in the longiligne it extends into the left hypochondrium.

Female

[Estimation of the costs of radiographic and endoscopic examinations in gastroenterology using monographic studies].

This study is devoted to the study of rate-setting and cost price of fifteen radiological and endoscopic examinations in gastroenterology as based on monographic studies. In rate-setting the costs are the examinations actually performed in the department. In contrast, the cost price allocated to include only the expenses incurred by each examination and not those related to the time running between them. Both estimations converge when rooms and equipment are used maximally. Our results show that the amounts reimbursed by the Social Security system were always lower than those obtained from monographic studies, except for two radiological examinations for which expenses were adequate. However when cost prices are considered, all reimbursements would have to be increased for endoscopic examinations, but for Radiography, only those of cholangiography, cholecystography and small bowel barium series should be adjusted.

Costs and Cost Analysis