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Biomedical subjects

R Jian

Publications and source records attributed to R Jian.

13 recordsLinked to original sources
PubMed1992

[Disorders of gastric emptying].

Disorders of gastric emptying are observed in many clinical situations. Their symptoms are diverse and correlate poorly with the objective abnormalities of gastric emptying. The underlying mechanism consists of abnormalities of basal electrical rhythm, fundic compliance, post-prandial antral motricity and, above all, antro-pyloro-duodenal co-ordination, associated to varying degrees. Among possible causes 3 clinical situations predominate: diabetes mellitus, functional gastrointestinal disorders (idiopathic dyspepsia) and sequelae of gastric surgery where retention of solids and accelerated evacuation of liquids may coexist in the same patient. Treatment of gastric incontinence rests, almost exclusively, on dietary measures, but several drugs, such as metoclopramide, domperidone and cisapride, are available to treat gastric stasis. Other compounds, notably motilin agonists (erythromycin and its derivatives) are currently being evaluated and will reinforce this therapeutic armentarium in a not too distant future.

Cisapride↗
PubMed1992

Right and left colonic transit after eating assessed by a dual isotopic technique in healthy humans.

Propulsion of colonic contents after eating in the whole colon was studied in 15 volunteers by scintigraphy with injection of 111In-diethylenetriamine-pentaacetic acid and 99mTc-sulfur colloid into the colon through a nasogastric tube. The radionuclide was injected into the cecoascending colon (n = 7), the hepatic flexure (n = 6), the splenic flexure (n = 9), and the descending colon (n = 4). Changes of activity in the regions distal from and proximal to the injection points were determined before and after a 1000-kcal meal. Isotopic movements were also analyzed when a simultaneous injection of the two markers in the right and left parts of the colon was achieved (n = 11). During fasting, no significant change of activity was seen. After eating, radioactivity injected into the cecoascending and the hepatic flexure was transferred distally (P less than 0.01 and P = 0.07); radioactivity injected into the splenic flexure was transferred both distally (P = 0.07) and proximally (P less than 0.02); and no significant change of activity was seen proximally from or distally to the descending colon. Both antegrade and retrograde isotopic movements increased after eating (P less than 0.01), but the number of antegrade movements was significantly greater (P less than 0.05). This study confirms the colonic propulsive effect of eating and shows that this response is different in the right and left parts of the colon.

Adult↗
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

Abnormal perception of visceral pain in response to gastric distension in chronic idiopathic dyspepsia. The irritable stomach syndrome.

Sensory and pressure responses to gastric distension were evaluated in 24 consecutive patients suffering from chronic idiopathic dyspepsia and 20 healthy subjects. A latex balloon was placed in the proximal stomach and inflated by increments of 100 ml of air up to a maximal volume of 800 ml. Symptom response and intragastric pressure-volume curve were recorded during the gradual balloon distension. Thirteen of the 24 patients experienced pain at a distension volume less than or equal to 400 ml of air, but only one of the 20 controls (P less than 0.001). Intragastric pressure-volume curves were similar in patients and controls, and in patients with and without abnormal pain threshold, suggesting that a compliance defect was not the cause of the sensory anomaly. Gastric emptying of solids and liquids was measured in 20 of the 24 patients using a dual isotopic technique; psychological status was also evaluated in 18 patients using the Mini-Mult test. The frequency of the sensory anomaly was not different in patients with (7/14) or without (4/6) gastric stasis, but was lower in patients with (5/13) than in those without psychological disturbances (5/5, P less than 0.01). Thus, a primary visceral sensory anomaly, either alone or in conjunction with motility disturbances, can play an important role in chronic idiopathic dyspepsia and must be taken in account for further therapeutic research.

Abdominal Pain↗
PubMed1990

Effect of chronic administration of ursodeoxycholic acid on the ileal absorption of endogenous bile acids in man.

The effect of long-term administration of ursodeoxycholic acid on the ileal absorption of endogenous bile acids was determined using the tauro 23 (75Se) selena-25 homotaurocholic acid test in a controlled double-blind study involving healthy subjects (n = 15). Subjects received placebo or 13 to 15 mg/kg/day ursodeoxycholic acid for 5 wk. In the placebo group (n = 7) there was no change in the composition of serum bile acids or in the mean percentage of retention of tauro 23(75Se) selena-25 homotaurocholic acid (36.1% +/- 6.0% vs. 38.7% +/- 6.7%). In contrast, in the ursodeoxycholic acid group, serum ursodeoxycholic acid conjugates increased and the percentage of retention of tauro 23 (75Se) selena-25 homotaurocholic acid fell from 45.8% +/- 6.8% to 20.5% +/- 5.7% (p less than 0.01). We conclude that ursodeoxycholic acid administration reduces ileal absorption of endogenous bile acids. These findings provide a rational explanation for the changes in the composition of the bile acid pool during ursodeoxycholic acid therapy and could have important therapeutic implications.

Absorption↗
PubMed1990

Severe short bowel syndrome with a surgically reversed small bowel segment.

We report a case of short bowel syndrome (60 cm of jejunum anastomosed to the left colon) with reversal of the distal 15 cm of jejunum in a 21-year-old man. The nutritional absorptive capacity and digestive motility was studied for 18 months postoperatively. His absorptive capacity reached subnormal values allowing him oral nutritive autonomy and normal social life. The results of the manometric study suggested that the reversed segment delayed intestinal transit time. The prolonged contact of the chyme with the intestinal absorptive mucosa possibly increased its absorptive capacity. Our data and the literature reports suggest that reversal of a bowel loop could help wean patients from their dependence on parenteral nutrition.

Adult↗
PubMed1979

[Gastric emptying of an ordinary meal in man. Study by a radio-isotopic method (author's transl)].

A radio-isotopic method was used to study the gastric emptying of an ordinary meal in 15 control subjects. The technique developed may be used for direct measurement of the early phase of gastric emptying and a simultaneous study of emptying of liquid and solid phases, respectively labelled with Tc99m and Cr51. Emptying of the liquid phase of the meal takes place in accordance with a mono-exponential curve in relation to time, the T 1/2 of which is 54 min +/- 6 (MSD). Emptying of the solid phase is significantly slower than that of the liquid phase. The reproductibility of the method was confirmed and the imprecision of each measurement does not exceed 5%.

Chromium Radioisotopes↗