"Tryptic-like" activity in sera of patients with pancreatitis.

Serum trypsin esterolytic activity was measured in 106 sera from 61 controls and 45 patients with pancreatitis. A trypsin specific synthetic substrate, N-alpha-benzoyl-L-arginine-paranitroanilide, was used. High levels of enzymatically active trypsin were shown to be present in serum of patients with pancreatitis. No difference between the two samples was noticed for the serum concentrations of alpha-1-antitrypsin and alpha-2-macroglobulin (the two main serum trypsin inhibitors). Active trypsin was contained in the high molecular weight fraction of plasma proteins, corresponding to a complex with alpha-2-macroglobulin. The determination of serum typsin activity as a sensitive test for detection of pancreatitis was demonstrated to be statistically significant.

[Health education about alcohol; need to abandon a purely quantitative message]. / Education de la santé sur l'alcool; nécessaire abandon d'un message purement quantitatif.

In health education, the foundations of the classic message of moderate alcohol consumption, based on the notion that there exist safe thresholds below which one can drink without danger, have become outdated. This is due to various factors: the discovery of additional routes for the oxidation of alcohol into acetaldehyde; epidemiological studies on the relationship between dose and effect that have challenged classic thresholds; and, finally, the rising emphasis on the role played by background, now better understood because of the opening of new physiological perspectives and evidence of the involvement of genetic factors. This role has led to an underling of the notions of vulnerability and inequality in relation to alcohol. The message of health education must therefore be one of "alcohol risk", a message combining both the factor of quantity ingested and the factor of background. Without giving rise to prohibitionist attitudes, it should lead to responsible individual behavior where alcohol is concerned.

[Nutrition hygiene centers and prevention of alcoholization and alcoholism: growth or decline]. / Centres d'hygiène alimentaire et prévention de l'alcoolisation et de l'alcoolisme: essor ou déclin.

Initially conceived for detection and early treatment (secondary prevention) of alcoholization and alcoholism by means of a clinical method Le Go's scale of biological markers of dangerous alcoholization and of an intervention method "The Alimentary Hygiene Centers" have deviated to a purpose assembling in theory prevention and care resulting in a new denomination "Alimentary Hygiene and Alcohology Center". In fact, this double purpose leads to a decrease in secondary prevention. This is unfortunate since the results are better when detection and treatment are done before alcohol dependence or visceral lesion appear. There is here a true problem of public health.

[Congenital cyst of the common hepatic duct. Adenocarcinoma of the gall bladder and of the stomach (author's transl)]. / Kyste congénital du canal hépatique commun. Adénocarcinome vésiculaire et adénocarcinome gastrique.

The authors report an unusual case of coexistence in the same patient of a congenital cyst of the common bile duct, a mucous adenocarcinoma of the stomach and a gall bladder adenocarcinoma. There was a favourable short term course after gastrectomy, cholecystectomy and resection of the cyst followed by bilio-digestive anastomosis on a long jejunal Y-shaped loop. The authors review recent literature.

[Health education on alcohol. The necessity to abandon a purely quantitative message]. / Education de la santé sur l'alcool. Nécessaire abandon d'un message purement quantitatif.

In health education, the foundations of the classic message of moderate alcohol consumption, based on the notion that there exist safe thresholds below which one can drink without danger, have become outdated. This is due to various factors: the discovery of additional routes for the oxidation of alcohol into acetaldehyde; epidemiological studies on the relationship between dose and effect that have challenged classic thresholds; and, finally, the rising emphasis on the role played by background, now better understood because of the opening of new physiological perspectives and evidence of the involvement of genetic factors. This role has led to an underlining of the notions of vulnerability and inequality in relation to alcohol. The message for health education must therefore be one of "alcohol risk", a message combining both the factor of quantity ingested and the factor of background. Without giving rise to prohibitionist attitudes, it should lead to responsible individual behavior where alcohol is concerned.

[Mixed idiopathic cryoglobulinemia and glomerulonephritis (author's transl)]. / Cryoglobulinémie mixte essentielle et néphropathie glomérulaire.

Mixed idiopathic cryoglobulinemia may be associated with renal failure. When this occurrence appears some characteristic lesions may be observed on renal biopsies. The authors describe a case of mixed idiopathic cryoglobulinemia with nephrotic syndrome and hypertension. Histologic data and immunofluorescence study of renal biopsies are similar to those described in the published literature. If antigen-antibody complex seems to be for all authors the etiological feature of renal disease, the treatment to apply is not well known. The related case had been treated by plasmapheresis and the authors give their results to short and mean term.

[Cure of chronic hepatitis B after treatment with basic aluminum hydroxide. One case report (author's transl)]. / Guérison d'ue hépatite chronique après traitement par l'hydroxyde d'aluminium injectable. Relation d'un cas.

The authors describe a case of cure of chronic hepatitis B. This therapy chronic hepatitis B was corticotherapy dependent and the cure appeared during a treatment with basic aluminum hydroxide. This drug is an adjuvant of immunity. Clinical and biological disturbances disappeared. An improvement of the histological liver disturbances during hepatitis cure had been noticed. Three years later no recurrence was observed. After a short review of published literature, the authors discuss the mode of action of basic aluminum hydroxide.

Serum trypsin-like activity in chronic alcoholized men: possible relationship with lipids, apoA-1 and apoB lipoproteins.

Chronic alcoholization is known to increase plasma trypsin levels. One-hundred and forty-six male chronic alcohol users were tested for serum trypsin-like activity (STA), total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-/cholesterol (HDL-C), triglycerides (TG), apoA-1 and apoB lipoproteins. STA was positively correlated to LDL-C, TG and apoB rates and the CT/HDL-C index and negatively correlated to HDL-C and apoA-1 rates and the apoA-1/apoB index. Eighty-four patients with high STA (group B) compared to 62 patients with normal STA (group A) showed significantly higher LDL-C, TG, apoB rates and TC/HDL-C index contrasting with significantly lower HDL-C and apoA-1 rates and the apoA-1/apoB index. The two groups were matched for age, overweight, cigarette smoking and glycemia. Hepatic dysfunction does not explain the differences in the lipoproteic parameters. Such results would suggest that there may be a tryptic alteration of apoproteins in vivo as already demonstrated in vitro and experimentally suspected in vivo in some other studies. Competition by the trypsin-activated alpha 2 macroglobulin for the chylomicron-remnant LDL receptor-related protein may be evoked.

[Association of Hirschsprung disease, Meckel's diverticulum and gallbladder calculi in a young Down's syndrome patient]. / Association d'une maladie de hirschsprung, d'un diverticule de Meckel et d'une lithiase vésiculaire chez une jeune mongolienne.

Report of a case of Hirschsprung's disease associated with Meckel's diverticulum, gall stones and trisomy 21, in an 18 year old woman, operated for a bowel obstruction due to a volvulus secondary to bowel distention. A brief review of the literature is presented on the association Hirschsprung's disease-trisomy 21.

[Intestinal malabsorption with a dissociated deficiency of immunoglobulins (author's transl)]. / Syndrome de malabsorption en rapport avec une carence dissociée en immunoglobulines. Relation d'un cas et revue de la littérature.

The case of a 42-year-old-man with dissociated deficiency of immunoglobulins and intestinal malabsorption is presented. The gastrointestinal symptoms included post-prandial pains and steatorrhea. Histologic and immunohistochemistry studies of small intestinal biopsies revealed subtotal villous atrophy and absence of IgA producing plasma cells. The deficiency of immunoglobulins was total for IgA and moderate for IgM. IgG was increased. HLA B8 haplotype was present Gluten-free diet gave dramatic improvement in few days on clinic symptoms. Recovery of the villi was observed within three months. The cases reported in the published literature are reviewed and the physiopathologic hypothesis and nosology limits of the syndrome are discussed.

Platelet affinity for serotonin is increased in alcoholics and former alcoholics: a biological marker for dependence?

The kinetics of 3H serotonin platelet uptake were studied in alcoholics and former alcoholics to see whether differences found between alcohol-preferring and non-preferring rats could be reproduced in man. Three groups of patients were studied: 10 dependent alcoholics on admission for treatment; 10 dependent alcoholics after 20 days of treatment; 8 former dependent alcoholics, abstinent for 1-11 years. Controls were non-alcoholics, matched for age and sex. The Km for 3H serotonin uptake in platelets was lower in patients from all three groups compared to 15 controls. This phenomenon could be congenital or induced by the previous excessive intake of alcohol. We believe that this increased platelet affinity for serotonin, in the absence of cirrhosis of the liver and/or depression could be a marker for alcohol dependence, enabling the therapeutic effort to be focussed on these patients.

[High-density lipoproteins, total cholesterol, triglycerides and serum trypsin activity. Study in chronic alcoholic and withdrawn subjects]. / Lipoprotéines de haute densité, cholestérol total, triglycérides et activité trypsique sérique. Etude chez l'homme alcoolisé chronique et sevré d'alcool.

Apolipoprotein is controlled by proteolytic processus and serum trypsin-like activity (STA) may be elevated in some chronic alcoholic subjects. STA, apoA lipoprotein, HDL-cholesterol, total cholesterol and triglycerides were tested in 44 men dealt in 4 groups (subjects with normal or elevated STA, alcoholic or withdrawn). Significantly lower apoA lipoprotein (p less than 0,02) and HDL-cholesterol (p less than 0,001) levels as well as significantly higher triglyceride levels (p less than 0,01) were evidenced in the group with elevated STA compared to the group with normal STA. In another way, a negative correlation between HDL-cholesterol and STA (p less than 0,01) and a positive correlation between triglycerides and STA (p less than 0,001) were noted. The different factors known to modify these lipidic parameters cannot account for such disturbances. The role of elevated STA is evoked.

Ability of calcium bis acetyl homotaurine, a GABA agonist, to prevent relapse in weaned alcoholics.

After they had been weaned off alcohol in hospital 85 severe alcoholics (above 200 g alcohol/day) were included in a double-blind study of calcium bis acetyl homotaurine (Ca AOTA, 25 mg/kg/day), a new gamma-aminobutyric acid agonist, versus placebo. Patients were treated as outpatients during the 3-month study. The only other treatment that patients received was meprobamate, 800 to 1200 mg/day, in the first month. The criterion for success was abstinence at 3 months (with normal gamma-glutamyl transpeptidase being one of the criteria). Of the 70 patients who completed the study, 33 received Ca AOTA and 37 placebo. 20 patients on Ca AOTA did not relapse, compared with 12 on placebo (p less than 0.02 by X2 test). Side-effects were noted by 7 patients on Ca AOTA and 2 on placebo. The results suggest that Ca AOTA may be useful in helping severe alcoholics who have been weaned off alcohol not to relapse.

[Alcoholism, colic diverticular disease and metabolic disorders (author's transl)]. / Ethylisme, diverticulose colique et troubles métaboliques. Etude comparative contrôlée.

70 patients with colic diverticular disease and 50 control subjects were compared. Sexes and ages were matched in the two groups. Significant higher frequencies of alcoholism (P < 0,00001), hyperlipidemia (P < 0,0001), impaired oral glucose tolerance test (P < 0,001), hyperuricemia (P < 0,01) and atherosclerosis (P < 0,000001) were noted in the diverticular group. Hypothesis about pathogenesis of diverticular disease are suggested.