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P Perney

Publications and source records attributed to P Perney.

42 records · Page 3Linked to original sources
PubMedDate not supplied

Doppler study of fasting and postprandial resistance indices in the superior mesenteric artery in healthy subjects and patients with cirrhosis.

PURPOSE: We assessed the resistance index (RI) in the superior mesenteric artery under fasting and postprandial conditions in healthy subjects and in patients with cirrhosis to determine whether the amount of change in the RI reflects the presence or severity of liver dysfunction. METHODS: Fifteen subjects with normal livers and 27 patients with cirrhosis underwent Doppler sonography of the superior mesenteric artery before and after ingesting a standard meal. The RI at baseline (fasting state) and the postprandial RI were compared between the 2 groups. The fasting RIs and post postprandial RIs changes in cirrhotic patients were correlated with the severity of disease. RESULTS: No difference was found between the baseline RIs in healthy (RI = 0.85) and cirrhotic subjects (RI = 0.84), nor was there a difference in baseline RIs between subgroups of cirrhotic patients according to the severity of liver disease. The RI decreased significantly (p < 0.05) after the meal in both the healthy (13%) and cirrhotic (8%) subjects, but the postprandial decrease was significantly less pronounced (p < 0.05) in cirrhotic patients than in healthy subjects. Among cirrhotic patients, there was no correlation between the postprandial decrease of the RI and severity of liver disease. CONCLUSIONS: The marked decrease in the postprandial RI in the SMA in healthy subjects is generally not seen in patients with cirrhosis, and changes in the postprandial RI do not reliably predict the severity of liver dysfunction.

Adult↗
PubMedDate not supplied

Changes in renal artery resistance after meal-induced splanchnic vasodilatation in cirrhotic patients.

PURPOSE: A relationship between vasomotor tone changes in mesenteric and renal vessels in cirrhotic patients has been suspected but remains controversial. The aim of this study was to assess by duplex Doppler sonography the changes in the circulatory resistance of the renal arteries and superior mesenteric artery (SMA) following meal-induced splanchnic vasodilatation. METHODS: Twenty-seven cirrhotic patients and 15 healthy volunteers with no hepatic or renal dysfunction were prospectively included in the study. The resistance index (RI) of the SMA and of the right and left renal arteries was measured by duplex Doppler sonography before and 30 minutes after ingestion of a standard 400-kcal balanced liquid meal. Values in controls and patients and values before and after the meal were compared, and correlations between RIs, Child-Pugh class (liver function), and creatinine clearance were assessed in cirrhotic patients. RESULTS: The fasting renal artery RI was greater in cirrhotic patients than in controls (p < 0.0001), but there was no difference in fasting SMA RIs. After the meal, there was a significant decrease in the SMA RI in controls (0.85 +/- 0.04 before versus 0.74 +/- 0.03 after meal, p = 0.0001) and in cirrhotic patients (0.85 +/- 0.04 before versus 0.77 +/- 0.04 after, p = 0.0001) and a significant increase in the renal artery RI (0.57 +/- 0.06 before versus 0.62 +/- 0.05 after in controls, p = 0.001; 0.68 +/- 0.07 before versus 0.70 +/- 0.07 after in cirrhotic patients, p = 0.001). No correlation was found in cirrhotic patients between the changes in renal artery RI and the postprandial SMA RI decrease, the Child-Pugh class, or the creatinine clearance. CONCLUSIONS: Meal-induced SMA vasodilatation (RI decrease) is associated with a marked increase in the renal artery RI, worsening the renal vasoconstriction in cirrhotic patients.

Adult↗
PubMedDate not supplied

[Collagen gastroenterocolitis].

INTRODUCTION: Collagenous gastroenterocolitis is a recently known rare cause of chronic diarrhoea, that raises numerous nosological and diagnostic problems. OBSERVATION: A 41 year-old woman was hospitalised for severe diarrhoea, diagnosed as collagenous gastroenterocolitis. Gastroscopy and ileocolonoscopy were macroscopically normal, but a 20 to 40 microns thick sub-epithelial collagenous band was revealed in the gastric, duodenal and colic biopsies. Parenteral nutrition and treatment with salazopyrine and prednisolone progressively normalised the transit. Three months later, only a 30 microns colic mucosa collagenous band persisted. All the biopsies taken during control gastro-colonoscopy 2 years later were histologically normal. After 5 years follow-up and absence of treatment, the patient no longer presented diarrhoea or biological abnormality. COMMENTS: This exceptional observation is a reminder that sub-epithelial collagen deposits are not always limited to the colon and therefore justify, in patients with collagenous colitis, systematic gastro-duodenal and ileum biopsies.

Adult↗
PubMedDate not supplied

[Detection of liver metastases from digestive cancer. Value of alkaline phosphatases, their macromolecular isoenzyme and of ceruloplasmin].

In order to improve the non aggressive diagnosis of hepatic metastasis from digestive neoplasm, the authors analyzed the following biological parameters: aminotransferases, alkaline phosphatase and lacticodehydrogenase isoenzymes, gammaglutamyl-transpeptidase, conjugated and total bilirubin, C-reactive protein, type A, G, M immunoglobulins, C3 complement factor, alpha-1 acidic glycoprotein (orosomucoid), haptoglobin, ceruloplasmin, transferrin, albumin, prealbumin, ferritin. This work included 54 patients with digestive tract cancer (esophageal, gastric, colic, rectal, anal localizations), divided in two groups: M- (n = 27), without hepatic metastasis), and M+ (n = 27, with histological confirmed hepatic metastasis). The Mann-Whitney test showed significant differences for 12 parameters between the 2 groups. With more than 60% sensitivity (Se) and specificity (Sp), according to the ROC curves, the following parameters can be selected: Total alkaline phosphatase (Se 89%, Sp 70%) and their macromolecular H2 fraction, lacticodehydrogenase fraction 4 (Se 63%, Sp 63%), gammaglutamyl-transpeptidase (Se 85%, Sp 82%), ceruloplasmin (Se 64%, Sp 65%), aspartate-aminotransferase determination (Se 63%, Sp 65%).

Adult↗