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Biomedical subjects

R Colin

Publications and source records attributed to R Colin.

At least 127 records · Page 7Linked to original sources
PubMed1984

Cavitation of mesenteric lymph nodes, splenic atrophy, and a flat small intestinal mucosa. Report of six cases.

This study describes, in 6 patients with a flat small intestinal mucosa and splenic atrophy, a particular lesion of the mesenteric lymph nodes termed "cavitation." In 4 women and 2 men with abdominal mass, intestinal obstruction, or suspected celiac disease-associated lymphoma, unusual pseudocystic lymph node lesions were found in the jejunal or jejunoileal mesentery. These lesions consisted histologically of a large central cavity occupied by hyaline-type material and surrounded by fibrous tissue and remnants of lymph node structures. There was no histologic evidence of malignant lymphoma or mesenteric panniculitis. Diffuse subtotal villous atrophy involving at least the jejunum was found in each case, together with unequivocal biological and morphological evidence of splenic atrophy, severe malabsorption, and a history of chronic or childhood diarrhea. HLA B8 or DR3, or both, was present in 4 of 4 cases; dermatitis herpetiformis was present in 1 case. An unequivocal mucosal response to a gluten-free diet was observed in 2 cases. Four patients died of cachexia or hyposplenism-related infections. We conclude that cavitation of mesenteric lymph nodes is an original feature which may be associated with splenic atrophy and a flat small intestinal mucosa; some of these patients may have celiac disease. Pathogenesis is unknown.

Adult↗
PubMed1983

[Effects of the administration of somatostatin 14 in the carcinoid syndrome. Clinical and biological study of 2 cases].

The effects of synthetic cyclic somatostatin 14 were studied in two patients with the carcinoid syndrome. The 3-hour intravenous administration of somatostatin (250 micrograms X h-1), a) resulted in the disappearance of flushing in the first patient but was without any clinical effect in the second subject who remained chronically colored; b) lowered plasma levels of motilin, prostaglandins (E1, E2 and F2 alpha) and to a lesser extent of catecholamines in both patients whereas the serotonin level was not altered; c) was followed by a rebound effect with recurrence of severe flushing in the first patient and was associated with a dramatic increase of prostaglandin, substance P and catecholamine levels in both patients. The inhibitory effect of somatostatin and the occurrence of a rebound effect at the end of infusion were confirmed by infusing somatostatin (6 mg per day) during 48 h in the first patients. These results: a) show that somatostatin is an effective drug in carcinoid syndrome with severe flushing; b) confirm that several mediators are affected in carcinoid syndrome. However it could not be excluded that increased circulating levels of prostaglandins, substance P and catecholamines may represent unrelated secondary events; c) suggest that somatostatin primarily inhibits the release rather than the synthesis of tumor products. Owing to the severity of the rebound effect, treatment of the carcinoid syndrome with somatostatin must be undertaken with precaution until specific long-acting analogs are available.

Aged↗
PubMed1983

Somatostatin in peptic ulcer bleeding--results of a double-blind controlled trial.

The aim of this work was to assess the usefulness of somatostatin in acute peptic ulcer bleeding. Sixty-four patients with endoscopic evidence of duodenal ulcer bleeding completed a double-blind trial to compare the effectiveness of somatostain (6 mg i.v. per day) with that of placebo; incidence of treatment failure (i.e., rebleeding or persistent haemorrhage) was not different in the somatostatin and in the placebo groups (respectively 24% and 23%). Because the efficacy of cimetidine had previously been demonstrated in gastric ulcer bleeding, somatostatin was tested against cimetidine (1.6 g per day) in 50 patients with gastric ulcer haemorrhage. The treatment failed to control bleeding in 15% of somatostatin and in 17% of cimetidine treated subjects (n.s.). Both treatments were well tolerated and blood requirements were not different in the trial groups. These results show that the efficacy of somatostain in peptic ulcer bleeding is not different from placebo in duodenal ulcers and not different from cimetidine in gastric ulcers.

Age Factors↗
PubMed1983

[Treatment of fecal incontinence in adults. Results as a function of clinical and manometric data and the importance of rehabilitation by biofeedback].

Twenty-five females and 8 males, 20 to 83 year old, with fecal incontinence, normal rectal capacity and without evidence of active anorectal disease were studied in order to evaluate: a) the incidence of associated constipation; b) the anorectal motility pattern; c) the efficiency of treatment based on clinical data and anorectal motility disorders. Fifteen patients had constipation associated with fecal incontinence and 23 patients presented with at least one anorectal motility abnormality indicating biofeedback therapy. Compliance to therapy was poor since 9 patients did not accept the treatment; among the 24 subjects who accepted the treatment, 18 became continent and 5 were improved. These results were observed after treatment of constipation alone (6 cases) or associated with biofeedback therapy (5 cases), after biofeedback therapy (7 cases), and after surgery alone (3 cases) or followed by biofeedback therapy (2 cases). These results show that: a) constipation is frequently associated with incontinence in the adult; b) treatment of constipation, biofeedback therapy and surgery, used alone or combined according to clinical and anorectal motility data lead to good results in 75 p. 100 of patients.

Adult↗
PubMed1983

Effects of oral methoxy-psoralen photochemotherapy (PUVA) on liver function and antipyrin kinetics.

Standard liver function tests and antipyrin kinetics were studied in 19 non-alcoholic patients before and after a four-week PUVA treatment with oral methoxy-psoralen. Whereas liver function remained normal in all subjects, antipyrin clearance was significantly reduced at the end of PUVA therapy. Although the mechanism of this pharmacological effect remains unclarified, these results suggest that there is considerable potential for interactions to occur with other drugs metabolized by the same hepatic pathways (cytochrome P 450) in patients undergoing PUVA therapy.

Adolescent↗
PubMed1983

[Treatment of acid gastroesophageal reflux by posterior hemifundoplication. Clinical and pH-metric results].

The efficiency of posterior hemifundoplication (Toupet's procedure) in the treatment of gastroesophageal reflux was studied prospectively in 25 patients. Surgery was performed because of resistance to medical therapy and/or ulcerated esophagitis (12 cases). Clinical symptoms were evaluated three times: preoperatively, from 2 to 4 months after surgery and thirdly at a late post-operative interview (mean 21 months). Esophageal pH was recarded through a 3-h period after a standard meal and acid peptic reflux was expressed using a scoring index taking into account the duration and magnitude of pH fall. Esophageal pH was assessed in all the patients before and shortly after surgery and in 10 patients at the late postoperative control. Twenty-four of the 25 patients, had a dramatic improvement or were symptom-free, from 2 to 4 months after operation; the gastroesophageal reflux score decreased in all but 1 patient, but returned to physiological values in only 19 patients (group A), and remained above the normal range in 6 patients (group B). In the latter subjects, the preoperative score was significantly higher and the time elapsed below pH 3 significantly longer than those in group A. At the late postoperative control, clinical symptoms of gastroesophageal reflux were noted in 10 of the 23 patients interviewed. The incidence of late postoperative deterioration was more frequent in group B patients (4 among 6 subjects) than in group A (6 out of 17), and in patients presenting with severe esophagitis before surgery. In conclusion, while they confirm the immediate clinical efficiency of posterior hemifundoplication in gastroesophageal reflux, these results indicate that an abnormal esophageal pH test persists in 25 p. 100 of patients, and seems to carry an increased risk of further clinical deterioration.

Adult↗
PubMed1982

[Treatment of cholesterol gallstones with ursodesoxycholic acid (author's transl)].

A double-blind clinical trial comparing ursodesoxycholic acid and chenodesoxycholic acid in patients with cholesterol stones in the gall-bladder showed that ursodesoxycholic acid was superior to the older drug not so much in percentage of biliary calculi dissolved but in dosage reduction (50%) and improved clinical and biological tolerance.

Chenodeoxycholic Acid↗
PubMed1982

Hepatic alterations during total parenteral nutrition in patients with inflammatory bowel disease: a possible consequence of lithocholate toxicity.

In order to understand the mechanism of hepatic abnormalities appearing during total parenteral nutrition, biliary bile acid composition and liver function tests were examined serially in 15 patients undergoing total parenteral nutrition for inflammatory bowel disease. In all 12 patients who underwent duodenal intubation before initiation of total parenteral nutrition, lithocholic acid accounted for less than 1% of total biliary bile acids. After 11-22 days of total parenteral nutrition, lithocholic acid accounted for 7%-15% of biliary bile acids in 5 patients and less than 1% of biliary bile acids in 10 patients. In the 5 patients with elevated levels of biliary lithocholic acid, serum alkaline phosphatase and aminotransferase activities rose progressively at serial determinations, the increase being significant after 2 wk of total parenteral nutrition. These results suggest that lithocholic acid may be involved in the hepatic lesions observed in patients undergoing total parenteral nutrition.

Adult↗
PubMed1981

Diverticulitis in a patient with a 47-year defunctionalized colon.

A patient who had a cecostomy because of a complicated appendicitis at the age of 17 functioned with an excluded colon for 47 years. He was then hospitalized for diverticulitis and left pericolic abscess. After treatment of the abscess by left segmental colectomy and reanastomosis, the cecostomy was closed. Two years later, he presented a normal bowel habit and improvement of his diverticulosis. Rectal manometric study showed that the rectal was normal both before and two years after surgery. Occurrence of diverticular disease in a normally innervated and vascularized, but almost empty, colon presenting with normal mechanical properties is consistent with Burkitt's hypothesis concerning long-term effects of a low residue diet on the gastrointestinal tract.

Colectomy↗
PubMed1981

Effect of ranitidine on resting pressure and pentagastrin response of human lower esophageal sphincter.

The effect on the lower esophageal sphincter pressure (LESP) of a new H2-receptor antagonist, ranitidine, has been tested during manometry in normal man. Basal tone and LES pentagastrin response were not significantly different after oral ranitidine administration in 10 healthy subjects. No significant variation of LESP was observed in six additional patients during 1 mg/kg body wt ranitidine infusion as compared to placebo. These results show that despite the difference in chemical structure and a greater inhibitory effect on gastric secretion, ranitidine, like cimetidine, does not alter resting pressure or LES response to pentagastrin in man. Ranitidine may therefore benefit patients with gastroesophageal reflux.

Administration, Oral↗
PubMed1981

Transient pulmonary impairment during attacks of Crohn's disease.

Lung function was studied in 10 patients with Crohn's disease during and after an attack of the disease. Pulmonary volumes and lung transfer factor were not impaired but functional residual capacity was greater during the attack than during remission; it was also greater than in normal subjects. FRC values and disease activity decreased concomitantly during remission as well as finger clubbing. The etiology of this impairment was unknown.

Adult↗